Search

Background Many adolescents and young people with HIV require the transfer of care from paediatric/ adolescent clinics to adult ART clinics. Transition is beset with factors that hinder or facilitate the process, thereby raising the transition process’s ethical challenges. Decisions made regarding therapy, such as when and how to transition to adult HIV care, should consider ethical benefits and risks. Understanding and addressing ethical challenges in the healthcare transition could ensure a successful transition. The purpose of this study was to analyse the ethical challenges of transitioning HIV care for adolescents into adult HIV clinics. Method We conducted 18 focus group discussions among 191 adolescents attending nine different health facilities in Uganda. We explored facilitators and barriers regarding adolescents transitioning to adult HIV clinics. Thematic data analysis was used to analyze the data. The Silences Framework guided data analysis and interpretation. The principles of Bioethics and the four-boxes ethics framework for clinical care (Patient autonomy, Medical indications, Context of Care and Quality of life) were used to analyze the ethical issues surrounding the transition to adult HIV care. Results The key emerging ethical issues were: reduced patient autonomy; increased risk of harm from stigma and loss of privacy and confidentiality; unfriendly adult clinics induce disengagement and disruption of the care continuum; patient preference to transition as a cohort and contextual factors are critical to a successful transition. Conclusion The priority outcomes of the healthcare transition for adolescents should address ethical challenges of the healthcare transition to ensure retention in HIV care, facilitate long-term self-care, provide ongoing holistic healthcare and support to promote health and wellbeing and build trust in the healthcare system. Identifying what facilitates successful transitions and the gaps that interventions can target may ensure adolescents and young people with HIV infectionremain healthy across the healthcare transition.

From October 2020 to June 2021 KDK Archaeology Ltd undertook a programme of Archaeological Observation, Investigation & Recording at the Church of St Mary the Virgin, Great Brickhill, Buckinghamshire, for the construction of a single storey WC extension attached to the west end of the nave, and trenches for the emplacement of services/drainage

Between January and March 2019 a Historic Building Watching brief was carried out at St Mary's Church, Northchurch to fulfil a planning condition for repair works to the nave and north aisle roofs. The north aisle was constructed in 1882 and the leadwork displayed two methods of joining the lead sheets above the north-south aligned softwood boards; by way of a timber batten and by a hollow roll. The nave roof was of a different construction, having diagonally placed sarking boards beneath very thin lead sheets that were all joined using timber battens. Graffiti discovered on the boards gave the date of this roof as September 1903 and the names of the men working on it for Matthews Builders and Undertakers of Castle Street, Berkhamsted. Modern repairs were evident in the screeding to the valley gutters and the use of blockwork in the north wall of the north aisle. No other features of note were observed.

Background: Rwanda has a high unmet need for family planning which could be reduced by improving access to postpartum intrauterine contraceptives device (PPIUCD) insertion. The objective of the study was to assess the prevalence and factors associated with the uptake of PPIUCD among postpartum women in Muhima Hospital.Methods: A concurrent mixed-method study was used. Three hundred eight three (383) immediate postpartum mothers, and 10 health services providers were interviewed using a structured questionnaire and in-depth interviews respectively. Logistics regression was done to assess for factors associated with PPIUCD uptake and thematic analysis was used for qualitative data.Results: The prevalence for PPIUCD use was 28.1% , women who had spontaneous vaginal delivery were more likely to take up PPIUCD (Adjusted Odds Ratio (AOR) 2.623, 95%CI=2.017-6.507 compared to those who had cesarean section; women who received PPIUCD counselling during the antenatal period were more likely to use PPIUCD ((AOR 2.072, 95%CI=1.018-4.218) as compared to those who didn’t receive any form of counselling; mothers who received spouse approval were more likely to use PPIUCD (AOR 2.591,95%CI= 1.485-4.492); as compared to those who didn’t receive any spousal approval; women who had more than one child were more likely to use PPIUCD (AOR =2.265, 95%CI=1.472-3.163) as compared to prime gravida; Mothers with birth to pregnancy interval less than two years were more likely to use PPIUCD (AOR =2.123, CI =1.477-2.706) as compared to those who had birth to pregnancy interval more than 2 years. From the qualitative findings, health education of mothers and partners on PPIUCD, training of health care providers, and availability of supplies to provide PPIUCD influenced the use of PPIUCD. Conclusion: The acceptability to use for PPIUCD was high in this population. PPIUCD uptake was associated with normal birth, PPIUCD counselling, spousal approval, parity, birth interval, level of education. Health education of mothers and partners on PPIUCD, training of health providers, and availability of supplies to provide PPIUCD influenced uptake of PPIUCD.

International audience

Between January and November 2019 KDK Archaeology Ltd undertook a programme of Observation and Recording of St Nicholas, Rectory Lane, Stevenage, Hertfordshire as part of the reconfiguration of the church interior. In total 22 individual burials were observed during the ground reduction, and 10 groups of disarticulated remains were revealed, predominantly in the south transept, which was added in 1841 and the north and south aisles. External works were limited to a single test pit against the east wall of the south transept, which revealed only the foundations of the wall and the associated ground disturbance.

Between October 2014 and January 2019, KDK Archaeology Ltd undertook a programme of Historic Building Recording, Strip Map and Sample Excavation (Areas 1 and 2) and Archaeological Observation and Recording of De Havilland Aircraft Museum. This was done as a condition of the planning permission for the development of the site. Sub-surface investigations revealed no archaeological finds, features or deposits that predated the Second World War. The remnant foundations of a potential WWII Mosquito hangar were exposed in Area 2 and service pipes and cables were commonly encountered during the archaeological investigations. However, the entire area investigated was predominantly covered in made-ground (including tarmac and concrete). Consequently, the local stratigraphy had been comprehensively truncated and re-worked from the mid-20th century onwards.

Introduction: Auricular displacement and earlobe distortion such as the „pixie ear“ after surgical rhytidectomy are frequent and can significantly diminish the aesthetic outcome. Particularly, occurrence of such complications are more present in in secondary or tertiary rhytidectomy cases.[for full text, please go to the a.m. URL], 50. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 24. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)