bluuebunny/crossref_metadata_2025 huggingface dataset:
The Importance of Lesion Location in Poststroke Depression: A Critical Review
Authors: Singh Anu , Herrmann Nathan , Black Sandra E
Published: January 2017

Background:

Mood disorder may be a specific complication of stroke. An earlier finding of an association between left anterior lesions and poststroke depression stimulated interest in the significance of stroke lesion characteristics. Subsequent research efforts, however, often failed to replicate this finding.

Objective:

This paper represents a critical appraisal of hemispheric lesion localization studies by computed tomography (CT) scanning in poststroke depression.

Method:

Systematic selection of original studies involved a Medline search and a review of the bibliographies of retrieved articles for additional references. Two sets of inclusion criteria were independently applied to the studies by 2 observers blind to authorship, affiliation, and journal name. Studies that satisfied minimum inclusion criteria, as determined by consensus, were included in the review.

Results:

Twenty-six original articles were retrieved by the search. Thirteen studies satisfied all or nearly all of the minimum criteria for inclusion. Six of those studies found no difference between right- and left-hemisphere lesions leading to depression. Two studies found right-sided lesions more likely to be associated with depression, while 4 studies found depression to be associated more often with left-sided lesions. One study matched subjects with and without depression for lesion location and size to identify nonlesion risk factors. All studies suffered from methodological limitations, and no studies were completely comparable with respect to sample, timing and analysis of CT scan, and psychiatric evaluation.

Conclusion:

Based on a systematic review of the present literature, any definitive statements regarding stroke lesion location and risk for depression are not yet substantiated. The authors suggest methodologies for future localization studies of poststroke depression.
Aspect multidimensionnel des hypothèses proposées pour rendre compte de la prévalence des troubles mentaux en milieu carcéral
Authors: Dessureault Danny , Côté Gilles , Ohayon Maurice M
Published: January 2017

Objectif:

Cet article fait le point sur les hypothèses formulées pour rendre compte de la prévalence des troubles mentaux en milieu carcéral. Tour à tour, sont présentées et discutées les hypothéses du déplacement de la clientèle, de la criminalisation des personnes manifestant un trouble mental et de la spécificité clinique des sujets atteints de troubles mentaux. Par la suite, une nouvelle hypothèse est suggérée pour rendre compte de la prèvalence des troubles mentaux en milieu carcéral. Elle postule que les premières prises en charge, soit judiciaire ou médicale, exercent une influence sur les prises en charge ultérieures.

Discussion:

Les 4 facteurs (politique, administratif, individuel et cognitif) inférés des hypothèses permettent de concevoir une approche multidimensionnelle pour rendre compte de la prévalence des troubles mentaux en milieu carcéral.
Exploring the Longitudinal Course of Psychotic Illness: A Case-Study Approach
Authors: Cortese Leonardo , Malla Ashok K , McLean Terry , Diaz J Fernando
Published: January 2017

Objective:

Thirty-three patients with a diagnosis of a psychotic disorder (schizophrenia, bipolar disorder, atypical psychosis) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) were studied to qualitatively assess the longitudinal course of the disorder using a case-study approach.

Methods:

Weekly fluctuations in patient symptomatology and overall social and personal functioning using the Global Assessment Scale were assessed following index hospitalization. Patients were followed for 1 year.

Results:

The emergent courses showed no relationship to diagnosis but followed 3 general trends: 1) positive incline; 2) fluctuating; and 3) stable. Individual representations of each course were examined closely, and biological and psychosocial factors associated with each were evaluated.

Conclusions:

The results supported the longitudinal patterns and individual interactions of Strauss's Interactive Developmental Model. The clinical course of psychotic disorders may be represented by 3 patterns. Key factors in the interaction between patient and environment that generate important changes in the evolution of each illness were illustrated.
The Effects of Hypnosis on Dissociative Identity Disorder: A Reexamination of the Evidence
Authors: Powell Russell A , Gee Travis L
Published: January 2017

Objective:

To examine the possibility that hypnosis has significant iatrogenic effects on dissociative identity disorder (DID).

Method:

This paper reexamines previously published data that have been interpreted as indicating that hypnosis does not exert significant iatrogenic effects on DID.

Results:

The use of hypnosis is associated with differences in DID phenomenology and number of DID patients in treatment.

Conclusion:

Hypnosis may have significant iatrogenic effects on DID.
A novel human-like collagen hemostatic sponge with uniform morphology, good biodegradability and biocompatibility
Authors: Jiang Xijuan , Wang Ya , Fan Daidi , Zhu Chenhui , Liu Lin , Duan Zhiguang
Published: January 2017

Biodegradable sponges, as a promising hemostatic biomaterial, has been clinically required over the past decades. Current hemostatic sponges are generally prepared by crosslinking and freeze-drying, but the quality control or biocompatibility is often unsatisfactory due to the freezing-caused morphological non-uniformity and the toxicity of raw materials or cross-linkers. The crosslinking often greatly retards the degradation of the sponges and thus affects the healing of the wound. In this work, we prepared a novel hemostatic sponge using human-like collagen and glutamine transaminase (non-toxic cross-linker) and optimized its morphology via “two-step” freezing instead of conventional “one-step” freezing. The resulting sponge showed a good biocompatibility in cytotoxicity and implantation tests and had a significant hemostatic effect in ear artery and liver injury models. Moreover, the sponge could be degraded high efficiently by several common enzymes in organisms (e.g. I collagenase, trypsase, and lysozyme), which means that the sponge can be easily digested by metabolism and can facilitate seamless healing. Finally, both the front and back of the sponge prepared via two-step freezing was more uniform in morphology than that prepared via one-step freezing. More importantly, two-step freezing can be used as a universal approach for preparation of diverse uniform biomaterials.
Facile preparation of antibacterial, highly elastic silvered polyurethane nanofiber fabrics using silver carbamate and their dermal wound healing properties
Authors: Hong Suk-Min , Kim Jong-Wan , Knowles Jonathan C , Gong Myoung-Seon
Published: January 2017

In this study, polycarbonate diol/isosorbide-based antibacterial polyurethane nanofiber fabrics containing Ag nanoparticles were prepared by electrospinning process. Bio-based highly elastic polyurethane was prepared from hexamethylene diisocyanate and isosorbide/polycarbonate diol (8/2) by a simple one-shot bulk polymerization. Ag nanoparticles were formed using simple thermal reduction of silver 2-ethylhexylcarbamate at 120℃. The structural and morphological properties of polyurethane/Ag nanofibers were characterized by X-ray diffraction and scanning electron microscopy. The polyurethane nanofiber fabrics were flexible, with breaking strains from 355% to 950% under 7.28 to 23.1 MPa tensile stress. The antibacterial effects of the treated polyurethane/Ag fabrics against Staphylococcus aureus and methicillin resistant Staphylococcus aureus were examined and found to be excellent. Cell proliferation using the immortalized human keratinocyte HaCaT cell line was performed in order to determine cell viability in the presence of polyurethane and polyurethane/Ag fabrics, showing cytocompatiblility and a lack of toxicity.
Positive Aspects of Caregiving Questionnaire
Authors: Abdollahpour Ibrahim , Nedjat Saharnaz , Noroozian Maryam , Salimi Yahya , Majdzadeh Reza
Published: January 2017

Objective:

The potential role of positive aspects of caregiving in enhancing caregivers’ health is an important issue. The aim of this study was to develop and validate Positive Aspects of Caregiving Questionnaire (PACQ) in caregivers of patients with dementia in Iran.

Methods:

Content validation process was used to content valid development. Cronbach α and intraclass correlation coefficient (ICC) were calculated as reliability indices. We used exploratory factor analysis to extract potential latent factors and evaluate the factor structure of PACQ. We assess correlation between PACQ and caregiver burden for divergent validity. For convergent validity, correlation between PACQ and self-rated health was specified.

Results:

Content validity indices (CVIs), internal consistency, and test–retest reliability were CVI > 0.80, α = 0.785, and ICC = 0.905, respectively. Moreover, item–total correlations confirmed good reliability of PACQ. Two factors were identified by factor analysis in this 10-item measure: patient and caregiver relationship and caregiver’s psychological well-being. Divergent validity and convergent validity were established by high negative correlation between positive aspect of caregiving (PAC) and caregiver burden along with significant positive correlation between PAC and self-rated health, respectively. While Cronbach α for the entire scale was 0.785, Cronbach αs for both of the scale components were 0.71.

Conclusion:

The PACQ demonstrated acceptable psychometric properties of reliability and performs well in preliminary tests of validity as a measure of positive aspects of caregiving. This measure can be used to determine the outcome of interventional programs on positive, not only negative, aspect of caregiving.
Synthesis, characterization, application and band gap study of calcium mercaptosuccinate
Authors: Kannammal L , Palanikumar S , Meenarathi B , Anbarasan R
Published: January 2017

In the present investigation, a new material was used for the ring-opening polymerization (ROP) of ∊-caprolactone (∊-CL) as a chemical initiator. Generally, the metal salt initiated ROP of ∊-CL yielded a polymer with high melting temperature ( Tm). By keeping this idea in mind, the present research work was carried out. The PCL was synthesized under two different experimental conditions like Monomer to Initiator Ratio ([M/I]) and temperature variation. The optical band gap ( Eg) value for a hybrid was found to be reduced whereas after making composites the same was increased due to the encapsulation effect. The Tm of Poly Caprolactone (PCL) was varied between 68.5°C and 71.4°C. The PCL composites synthesized above were characterized by various analytical tools like Fourier transform infrared spectroscopy, ultraviolet–visible spectroscopy, gel permeation chromatography, differential scanning calorimetry, thermogravimetric analysis, nuclear magnetic resonance spectroscopy (proton and carbon-13), particle size analysis and scanning electron microscopy. The Eg value was increased with the increase in [M/I] ratio due to the decrease in calcium content.
Life Design Counseling Group Intervention With Portuguese Adolescents
Authors: Cardoso Paulo , Janeiro Isabel Nunes , Duarte Maria Eduarda
Published: January 2017

This article examines the process and outcome of a life design counseling group intervention with students in Grades 9 and 12. First, we applied a quasi-experimental methodology to analyze the intervention’s effectiveness in promoting career certainty, career decision-making, self-efficacy, and career adaptability in a sample of 236 students. Second, focus groups comprising 33 participants were conducted, examining participants’ perceptions of the intervention process and outcome. Our findings showed that the intervention had a significant effect on both career certainty and career self-efficacy, but it had no effect on career adaptability. Our results also showed that My Career Story (MCS) had a stronger effect on Grade 12 students. Focus group participants reported on the usefulness of MCS, as well as on its benefits, which include increased information as well as a sense of direction, self-discovery, connection, and increased self-awareness. Grade 9 participants expressed more difficulties in narrating self-experience than Grade 12 participants did. Implications for future research and practice are discussed.
Current Status of Gastric Proton Pump Inhibitors in the Treatment of Acid-Peptic Disease
Authors: Berardi Rosemary R. , Welage Lynda S.
Published: January 2017

Proton pump inhibitors represent an important advance in the treatment of acid-peptic disease. Omeprazole, the prototype of the drug class, produces a profound and sustained degree of gastric acid suppression. Recent studies confirm earlier reports that omeprazole 20 mg/d is generally more effective than standard histamine2 receptor antagonist (H2RA) dosage regimens in treating duodenal ulcer (DU), gastric ulcer (GU), and erosive esophagitis. Omeprazole tends to accelerate DU and GU healing, especially during the first 2 weeks of treatment, and also accelerates mucosal healing in patients with all grades of esophagitis. Omeprazole is the drug of choice for treating patients with large or refractory ulcers, severe or refractory erosive esophagitis, Barrett's esophagus, and Zollinger-Ellison syndrome. Maintenance therapy with omeprazole seems to reduce ulcer recurrence and esophagitis, but optimal treatment regimens must be established. Dual therapy with omeprazole and amoxicillin shows encouraging results in eradicating Helicobacter pylori, reducing duodenal ulcer recurrence rates, and altering the natural history of peptic ulcer disease. Further studies are required to determine the efficacy of omeprazole in preventing nonsteroidal anti-inflammatory drug-induced ulcers and stress-related mucosal bleeding, and in treating upper gastrointestinal bleeding. Omeprazole is well-tolerated in the majority of patients receiving either short-term or long-term treatment. The type and frequency of adverse effects are similar to those reported with the H2RAs. There is no evidence to support genotoxicity or hypergastrinemia-induced enterochromaffin-like cell carcinoid of the stomach in patients receiving omeprazole treatment for more than 5 years. Omeprazole interacts selectively with hepatic P-450 and may potentially interact with phenytoin, warfarin, or diazepam. Pharmacoeconomic studies suggest that treatment with omeprazole provides a significant cost-savings over the H2RAs in patients with moderate to severe erosive esophagitis and possibly in patients with DU. Lansoprazole, a newly developed proton pump inhibitor, seems to offer no clear advantage over omeprazole.
The Continuum of Health Care: Highlights of Orthopaedic and General Medical Pathways
Authors: Leininger Susan M. , Laux Lori H.
Published: January 2017

Clinical pathways have been developed and utilized to manage patients in the acute care setting. However, it is important to recognize and integrate the home setting whether it is a postoperative surgical patient or a patient with a chronic medical illness. This article will share two examples, one surgical and one medical, to demonstrate how home care agencies play an important role in the continuum of care.
General Management in the NHS: Three Views from the Trenches: Griffiths Five Years On
Authors: Wall Andrew
Published: January 2017

Views from three general managers focus respectively on the impact of the Griffiths changes after five years; how ‘success’ in general management may be evaluated; and the changing nature of central-local relationships.

At district level, the job of DGM has changed much more than was expected and the demands have greatly increased. These developments have resulted in increased satisfaction for the general manager and a desire to achieve results. ‘Success’ in general management is an elusive concept. There are many perceptions of success. For general managers, success may be reduced to a struggle for survival. Ultimately, success needs to be extended beyond short-term goals and to be concerned with shaping the longer term future. Central-local relationships have, in many ways, changed little. The major criticism of the centre by the service remains much the same as before the Griffiths reforms — the lack of central leadership and direction. Regions are perceived as part of the centre by districts and units. There is much to be done to make central-local relationships more creative and supportive.
Utilization of Hospital Services by the Elderly: Geriatric Crisis in one Canadian Single Payer System
Authors: Bay K. S. , Long M. J. , Kerr J. C. Ross
Published: January 2017

As the number and proportion of elderly persons in the Canadian population increase, utilization of health services by the elderly becomes a growing concern for health service insurers, financial managers and policy makers, as well as for care providers. The purpose of this paper is to present the results of a study to analyse the use of hospital services by the elderly in Alberta since the introduction of a universal single payer health care insurance system in 1970. The study period coincides with the implementation of publicly-financed comprehensive medical and hospital insurance programmes for all Alberta residents, making it possible to perform historical and population-based utilization analyses. Thus the data used for the study included all hospital discharge abstracts generated by all Alberta hospitals from 1971 to 1991. Trends in hospital service utilization by the elderly in terms of total number of separations, patient-days, and per case measures such as average length of stay as well as per capita utilization rates were reviewed to identify utilization patterns over the study period. Further, relative per capita utilization measures, in comparison with the base year (1971), age group 15–44, male, metropolitan residents, were derived and historical trends identified. A series of regression analyses were carried out to estimate the effects of age, sex and origin on utilization rates. In addition, for the period of 1984–1991, Diagnosis Related Groups (DRG) case weights were used to measure per capita and per case rates and to analyse historical relative utilization rates over the 8-year period. In general, there has been a significant decline in hospital utilization by Albertans under the publicly-financed single payer system, but utilization rates for the elderly have remained high, resulting in high relative utilization rates in comparison with other age groups. It was also noted that per capita utilization rates for rural residents were substantially higher than urban residents. It appears that these higher utilization rates by the elderly and rural residents in combination with tight bed and financial control by the government have been causing significant bed shortage problems for non-elderly elective patients in urban areas.
Promoting a Quality of Service Culture in Health Care: Review of a Scottish Initiative
Authors: Curry A. C. , Keogh W. , Hogg G. M.
Published: January 2017

This paper is a review of a quality of service initiative which was carried out as a PICKUP Quality Project within the Scottish Health Service. This Quality Initiative took place between 1989 and 1990: before the emergence of The Patient's Charter. The aim of the review was to provide answers to a number of important questions which examined the perceptions of staff who took part in the Quality of Service initiative, identified parts of the process which were in need of substantial revision, and reported on the reactions of participants to the overall process. The methodology employed involved questionnaires and interview techniques. A number of problems were identified and, after examination, these were taken to indicate learning pointers for the future. It was evident that good quality of service training can be delivered, but only if it is clearly and appropriately tailored to the audience. It is also of fundamental importance to be familiar with the environment in which the organization is operating. In this instance, as is often the case for health care, there were considerable financial limitations in force at the time. These limitations heightened the general business sensitivity and showed that carrying through quality of service improvements involved the demonstration of commitment and the provision of resources.
Being a Clinical Director: First among Equals or Just a Go-Between?
Authors: Thorne M. L.
Published: January 2017

This article explores doctors' experience of the role of clinical director in a large National Health Service (NHS) teaching Trust. The advent of doctors in management, as a relatively new phenomenon in the NHS, is reviewed to provide a contextual setting for the case study. The empirical findings are presented as a ‘clinical diamond’ which emerged as a form that captured the multifaceted nature of the role. The research demonstrates that, for a doctor, being a clinical director potentially threatens the professional identity, collegiality and autonomy of both the individual and the professional group the directorate represents. Moreover, stress that emanates from the structural tension inherent in the role is displaced into personal and professional stress. Clinical directors embody the tensions and conflicts of different managerial and professional cultures, whilst attempting to reconcile the demands of purchasers with the views of disparate and difficult professional colleagues. The argument concludes that there is an urgent need to recognize the demands being placed upon doctors who take on this role, and identifies the benefits and challenges that the role creates in leading health care. The final section identifies the issues that need to be considered to sustain this role in future and the recognition that it has substantially increased the power base of the medical profession, but often at a high price for the individuals involved.
Primary Care: Past and Future
Authors: McKinnon M. , Townsend J. , Walker Z.
Published: January 2017

There is anecdotal evidence of a crisis in the recruitment and retention of general practitioners nationwide and particularly in inner cities. The relationship between quality of service and single-handed or group practice is uncertain and confounded by other aspects of practice structure and populations. The review examines the factors that influence doctors to enter and remain in general practice. It explores whether initiatives designed to address problems of recruitment and retention have been evaluated in the past and suggests how could they inform current initiatives.
Adoption of a Managerial Innovation: A Study of Physician Impact Analysis
Authors: Cockerill R. , Charles C. , Roberts J.
Published: January 2017

This article examines the adoption of physician impact analysis (PIA) among active treatment hospitals in Ontario, Canada. The influence of variables from three different levels of analysis (individual, organizational and contextual) were included as well as measures of key stakeholders' (Chief Executive Officer (CEO) and Medical Chief of Staff) assessments of the attributes of the innovation. A number of conclusions were drawn. First, by adding information about the perceived attributes of the innovation the model was able to account for a larger percentage of explained variance than has been seen in related work. Secondly, the adoption of PIA within a context of written guidelines agreed to by senior management, specifying process and structure concerns, is most likely in organizations which are large and where the CEO positively evaluates the innovation.
Reception of the Greek Story of Melchizedek in Syriac Christian Tradition
Authors: Minov Sergey
Published: January 2017

This article focuses on the history of reception of the Story of Melchizedek, an original Greek composition from Late Antiquity, among Syriac-speaking Christians during the Middle Ages. For the first time the original Syriac text, English translation and discussion of three different witnesses to this apocryphal work in Syriac is provided, namely (1) the abbreviated translation of the Story incorporated into Catena Severi (ninth century), (2) the Pseudo-Athanasian excerpt found in ms. Vatican Syr. 159, and (3) the brief discourse entitled Melchizedek the Priest.
A novel proton conducting polymer electrolyte membrane for fuel cell applications
Authors: Paradesi Deivanayagam , Gandhimathi Sivasubramanian , Krishnan Hariharasubramanian , Jeyalakshmi Ramaswamy
Published: January 2017

A series of phenolphthalein-based sulfonated poly(ether ether sulfone) (SPEES) membranes were synthesized by aromatic nucleophilic polymerization reaction. The degree of sulfonation was controlled by direct synthesis of sulfonated polymer, which leads to high thermal stability. The physicochemical properties of the SPEES membranes were studied in order to evaluate the suitability of these membranes in fuel cell applications. The ion-exchange capacity of the synthesized SPEES membranes was found in the range between 2.19 mequiv. g−1 and 2.35 mequiv. g−1. The morphology of the membranes was investigated with high-resolution scanning electron microscopy and confirmed the presence of hydrophilic domains that impart good proton conductivity. The membrane electrode assembly of SPEES-30 and SPEES-50 membranes has been successfully fabricated, where SPEES-50 produced a maximum peak power density of 643 mW cm−2 while applying in hydrogen–oxygen fuel cell.
A new serial approach of the forward kinematic model of spherical parallel manipulators for real-time applications
Authors: Saafi Houssem , Vulliez Margot , Zeghloul Said , Laribi Med Amine
Published: January 2017

Parallel architectures are increasingly used as haptic devices to provide low inertia, high stiffness and compactness. Thus, spherical parallel manipulators have been developed to generate the three rotational movements in a sufficient workspace. However, these parallel structures have complex kinematic models and can suffer from critical singularity issues. This paper proposes a serial approach to solve the forward kinematic model of a spherical parallel manipulator, which is used as a haptic device in minimally invasive surgery. The new forward kinematic model is based on the serial positioning of the three sensors on one leg rather than placing the three sensors on the three actuated base joints. The forward kinematic model calculation is thus simplified to be suitable for real-time applications (computing time around 5 µs) without cost increase. Parallel singularity effects are removed using this approach and the accuracy of the forward kinematic model is highly enhanced. Simulations were carried out to show the benefits of this approach. The resulting errors of the forward kinematic model calculation due to measurement noises do not exceed 0.2° along the workspace. Experiments were carried out to demonstrate the control of a surgical robot.
Tracking of group targets using multiple models GGIW-PHD algorithm based on best-fitting Gaussian approximation and strong tracking filter
Authors: Wang Yun , Hu Guo-Ping , Li Zhen-Xing
Published: January 2017

Gamma Gaussian inverse Wishart probability hypothesis density (GGIW-PHD) filter algorithm is always used for tracking group targets with unknown number and variable measurement rates in the presence of cluttered measurements and missing detections. Aiming at the defect that the tracking error of GGIW-PHD filter algorithm will increase greatly in the maneuvering stage, a multiple model GGIW-PHD (MM-GGIW-PHD) algorithm is proposed in this paper based on the best-fitting Gaussian approximation and strong tracking filter. Firstly, on the basis of measurement set partition, the best-fitting Gaussian approximation method is proposed to implement the fusion of multiple models in the PHD predict stage. And a fading factor of strong tracking filter is proposed to correct the predicted covariance matrix of the GGIW component. Then, the estimation of kinematic state and extension state are deduced in the frame of multiple models. The probability of different tracking models is updated by the modified likelihood functions. The simulation results show that the MM-GGIW-PHD algorithm based on best-fitting Gaussian approximation and strong tracking filter can decrease the tracking error of group targets in the maneuvering stage and treated with the combination/spawning of group effectively.
Sexually Transmitted Diseases and Rape: The Experience of a Sexual Assault Centre
Authors: Lacey H B
Published: January 2017

Epidemiological data and rates of sexually transmitted diseases (STDs) are presented from a group of 90 women screened following rape. Forty-eight (53%) women knew their assailant. In 6 cases multiple assailants were involved. In 21 (23%) rapes weapons were used. Of 47 women examined within 48 hours of rape, 17 (36%) had evidence of genital trauma. Anal injury was common (8 of 11, 73%) in those reporting anal intercourse. Anal assault (17 of 90, 19%) and oral assault (16 of 90, 18%) commonly accompanied rape. STDs were diagnosed in 13 (14.4%) women, 3 having mixed infections. Neisseria gonorrhoeae was isolated in 2 women, Chlamydia trachomatis in 7, Trichomonas vaginalis in 6, genital warts in 2 and Pediculosis pubis in 2 women. Five of 16 cervical cytology results showed abnormalities, 2 were suggestive of CIN.

Eleven of 13 women with an STD (84.6%) had been sexually active within the 3 months prior to the rape. Previous sexual activity may be the most relevant factor determining those most at risk of harbouring an STD.
Prevalence of Genital Human Papillomavirus Infections in a Mass-Screened Finnish Female Population Aged 20–65 Years
Authors: Syrjänen Kari , Yliskoski Merja , Kataja Vesa , Hippeläinen Marita , Syrjänen Stina , Saarikoski Seppo , Ryhänen Arja
Published: January 2017

The results of the nationwide, population-based cervical cancer screening programme (organized by the Finnish Cancer Society since early 1960s) were analysed to establish the prevalence figures (and their changes) for genital human papillomavirus (HPV) infections in an unselected Finnish female population (aged between 20 and 65 years) screened in Kuopio Province between 1981 and 1989. During the study period 82,393 women were invited on a regular basis for the mass-screening, and also 4131 women in a risk group. Of these, a total of 63,115 and 3249 women attended, resulting in the attendance rates of 76.6% and 78.6%, respectively. As a result of the screening, a total of 509 (0.80%) of the 63,115 smears were diagnosed as having the cytological changes consistent with HPV infection in the mass screening. The corresponding figures in the risk group screening were 58/3249 (1.78%). There was a sharply increasing trend in the prevalence of genital HPV infections from 1981 through 1987, from 0.04% to 1.76% (ie a 44-fold increase in 7 years) which, surprisingly, then declined to 1.43% in 1988 and 1.04% in 1989. Based on a random sample of 2084 routine (non-mass-screening) Pap smears (out of 28,861) collected from the files of our laboratory, the prevalence of HPV infections was stratified by age groups. The highest prevalence (6.1%) was observed in women aged between 20 and 29 years, followed by 2.2% in those aged 30–39 years. Using the figures of the relative risk (RR) of HPV infections by age, an estimation was made to assess the prevalence of clinical HPV infections in the Finnish female population in general. With the annual number of female births (approximately 30,000), it was estimated that some 18,000 women aged between 20 and 29 years will harbour a clinically manifest genital HPV infection. It is noteworthy that the above established figures do not include any data of the subclinical and latent HPV infections, not detectable by the Pap smear. Beyond any doubt, genital HPV infections are the most frequent STD in Finland.
Discriminant Attitudes and Beliefs about Condoms in Young, Multi-Partner Heterosexuals
Authors: Chapman Simon , Stoker Lyn , Ward Michael , Porritt Don , Fahey Paul
Published: January 2017

Four hundred and eight people aged 15–35 years who reported having more than one sexual partner of the opposite sex in the past year or who thought it likely that they would do so in the next year were surveyed about their sexual behaviour, concern about acquired immunodeficiency syndrome and sexually transmitted diseases and attitudes to condom use. Differences in concerns and attitudes between regular and non- or irregular condom users and between men and women are reported. Three conceptually coherent factors (condom use as positive action; condom use as cue to embarrassment; and condom use as antithetical to good sex) discriminated between users and non-users. Implications for health promotion campaigns designed to promote condom use are discussed.
Adult Male Victims of Sexual Assault: An Underdiagnosed Condition
Authors: Hillman Richard , O'Mara Nigel , Tomlinson David , Harris J R William
Published: January 2017

The records of 28 male victims of sexual assault were analysed retrospectively. The mean age at time of assault was 21.7 years and the mean number of assailants was 2.8. Sixteen victims (57%) reported skin or mucosal damage and 25 (89%) sustained penetrative anal intercourse. The threat of transmission of HIV was used by the assailant in 16 cases and sexually transmitted diseases, presumed consequent upon the attack, were found in 5 (18%). These observations suggest that male victims of sexual assault may be at particular risk of sexually transmitted infections, including HIV, and that efforts should be made to encourage them to come forward for help.
HIV Seroprevalence among Healthy Blood Donors in Northeastern Zaire
Authors: Fischer Philip R , Horton Geoffrey L , Knight Peter , Lusi K M
Published: January 2017

Human immunodeficiency virus (HIV)-anribody screening of blood donors in northeastern Zaire was reviewed to determine overall seroprevalence in the population and to identify particular subgroups of the population who are at relatively high risk. Six hundred and seventy-five healthy blood donors were tested from March 1989 to May 1990 using either the HIV-CHEK or Karpas cell tests. A total of 25 donors (3.7%) were seropositive, and seropositivity was more common in female donors (5.4%) than in male donors (2.5%, P<0.05). Donors who came from major population centres had a higher rate of seropositivity than did individuals coming from rural villages (10.5% vs 2.0%, P<0.001). There was a tendency toward increasing seroprevalence during the 13 months of the study with 2.8% of donors positive in 1989 and 5.8% positive in 1990 ( P<0.1). It is concluded that in healthy blood donors in northeastern Zaire: (1) HIV seropositivity is more frequent in women and in individuals coming from major population centres, and, (2) HIV seropositivity seems to be increasing rapidly.
An Epidemic of Neisseria Gonorrhoeae in a Somali Orphanage
Authors: Ahmed H Jama , Ilardi I , Antognoli A , Leone F , Sebastiani A , Amiconi G
Published: January 2017

Neisseria gonorrhoeae was isolated from 53 young females (6–14 years old) in a Somali orphanage. A male guardian was found to be the effective transmitter having sexually abused the children. All the bacterial isolates were of the same serogroup WI and the same serovar Aedih. This presents an unusual example of a tight geographic cluster of infected people which is often characteristic of gonorrhoea epidemics.
Small Intestinal Manifestations of HIV Infection
Authors: Ehrenpreis Eli D
Published: January 2017

The small intestine is a common site of involvement in patients infected with the human immunodeficiency virus (HIV). Although there are numerous mechanisms by which small intestinal disease may occur in HIV infected patients, the resulting clinical manifestations of these disorders are remarkably similar and include the development of diarrhoea, weight loss and nutrient deficiences1. In fact, the original designation of AIDS in African countries as the ‘slim disease’ underlines the importance of small intestinal involvement (most likely secondary to parasitic infections) which commonly occurs in Third World Countries2.

The current review will provide a clinically oriented overview of small intestinal disease in patients infected with HIV. Because specific data on treatment of small intestinal diseases in AIDS is often lacking, some presented information is based on the author's experience and opinions.
Injection Drug Use-Related HIV Healthcare—Problems and Management in Edinburgh
Authors: Brettle R P
Published: January 2017

The relatively high numbers of patients with IDU-related HIV in Scotland has resulted in considerable management difficulties not previously experienced by other medical units. Chronic physical ill health in drug users is becoming commoner with the advent of HIV and other centres are now experiencing the type of problems that the Regional Infectious Disease Unit (RIDU) in Edinburgh has faced over the last 10 years. Very little has been published concerning the difficulties of managing patients who use drugs and have a physical illness in medical units in the UK. This paper presents examples of common problems together with the RIDU's experience of management in the hope that it will help others to deliver effective and efficient physical and mental health care to patients with drug problems.
A real-time immune planning algorithm incorporating a specific immune mechanism for multi-robots in complex environments
Authors: Yuan Mingxin , Jiang Yafeng , Hua Xiaobin , Wang Binbin , Shen Yi
Published: January 2017

To solve the real-time path planning of multi-robots in complex environments, a new immune planning algorithm incorporating a specific immune mechanism is presented. In the immune planning algorithm incorporating a specific immune mechanism, a new coding format for an antibody is first defined according to the impact of the obstacle distribution on the obstacle avoidance behaviors of multi-robots. Then, a new robot immune dynamic model for antibody selection is designed in terms of different impacts of obstacles and targets on robot behaviors. Finally, aiming at the local minimum problem in complex environments and inspired by the specific immune mechanism, a series of appropriate avoidance behaviors are selected through the calculation of a specific immune mechanism to help robots walk out of local minima. In addition, to solve deadlock situations, a learning strategy for the antibody concentration is presented. Compared with four related immune planning algorithms—an improved artificial potential field, a rapidly exploring random tree algorithm, a D* algorithm and a A* algorithm—the simulation results in four static environments show that the paths planned by immune planning algorithm incorporating a specific immune mechanism are the shortest and the path smoothness is generally the highest, which shows its strong planning capability in multi-obstacle environments. The simulation result in a dynamic environment with local minima shows that the immune planning algorithm incorporating a specific immune mechanism has strong planning ability in dynamic obstacle avoidance and in escaping from local minima. Additionally, an experiment in a multi-robot environment shows that two robots can not only avoid static obstacles but also avoid dynamic obstacles, which further supports the validity of the proposed immune planning algorithm incorporating a specific immune mechanism for multi-robots in real environments.
High lifetime probability of screen-detected cervical abnormalities
Authors: Pankakoski Maiju , Heinävaara Sirpa , Sarkeala Tytti , Anttila Ahti
Published: January 2017

Objective

Regular screening and follow-up is an important key to cervical cancer prevention; however, screening inevitably detects mild or borderline abnormalities that would never progress to a more severe stage. We analysed the cumulative probability and recurrence of cervical abnormalities in the Finnish organized screening programme during a 22-year follow-up.

Methods

Screening histories were collected for 364,487 women born between 1950 and 1965. Data consisted of 1 207,017 routine screens and 88,143 follow-up screens between 1991 and 2012. Probabilities of cervical abnormalities by age were estimated using logistic regression and generalized estimating equations methodology.

Results

The probability of experiencing any abnormality at least once at ages 30–64 was 34.0% (95% confidence interval [CI]: 33.3–34.6%) . Probability was 5.4% (95% CI: 5.0–5.8%) for results warranting referral and 2.2% (95% CI: 2.0–2.4%) for results with histologically confirmed findings. Previous occurrences were associated with an increased risk of detecting new ones, specifically in older women.

Conclusion

A considerable proportion of women experience at least one abnormal screening result during their lifetime, and yet very few eventually develop an actual precancerous lesion. Re-evaluation of diagnostic criteria concerning mild abnormalities might improve the balance of harms and benefits of screening. Special monitoring of women with recurrent abnormalities especially at older ages may also be needed.
Reliability of Underlying Incidence Rates for Estimating the Effect and Efficiency of Screening for Breast Cancer
Authors: Prior P , Woodman C B J , Wilson S , Threlfall A G
Published: January 2017

The process of setting screening performance targets requires an estimate of what the incidence of breast cancer would have been in the population invited for screening if there had not been a screening programme. Before the introduction of the National Health Service breast screening programme in 1988 the incidence of breast cancer was already increasing in the population targeted for screening. To establish the incidence before screening the most recent complete data from all the regional cancer registries were collated. An age-period model was constructed to predict what these incidence rates might now have been if the screening programme had not been introduced. The model predicted that if prescreening trends continued (between 1987 and 1995) underlying incidence over this period would increase by 2.3 per 10 000 in women aged 50–54, 2.6 per 10 000 in women aged 55–59, and 2.9 per 10 000 in women aged 60–64. If the prescreening trends have continued then the use of a universal rate, applied across all calendar years and age groups, would seem to be inappropriate when setting targets.
The Swedish Randomised Mammography Screening Trials: Analysis of Their Effect on the Breast Cancer Related Excess Mortality
Authors: Larsson Lars-Gunnar , Nyström Lennarth , Wall Stig , Rutqvist LarsErik , Andersson Ingvar , Bjurstam Nils , Fagerberg Gunnar , Frisell Jan , Tabár László
Published: January 2017

Objective

–To apply an indirect method for estimation of the breast cancer related excess mortality in the Swedish randomised mammography screening trials.

Setting

–Randomised trials on mammography screening have, in Sweden, been performed in the counties of Kopparberg (W) and Östergötland (E), the so called WE study, and in the three largest cities in Sweden, Stockholm (southern part), Gothenburg, and Malmö. An overview of the trials was presented in the Lancet in 1993 and included 156 911 women in the invited group and 125 866 in the control group.

Methods

–The excess mortality in the breast cancer subgroups was estimated by indirect standardisation using official national cause of death statistics according to Statistics Sweden as a reference. Results—The estimated reduction of the breast cancer related mortality was 24% for the whole group (40–74 years at randomisation). The corresponding figures for the age groups 40–49, 50–59, and 60–69 years were 6%, 28%, and 34% respectively.

Conclusion

–The results are very similar to those presented earlier based on the traditional comparison of the breast cancer mortality in the invited and in the control group. This analysis further strengthens previous reports on a beneficial effect of mammography screening, which is especially pronounced in the age group 50–69.
Randomised Trial of Prostate Cancer Screening in the Netherlands: Assessment of Acceptance and Motives for Attendance
Authors: Nijs H G T , Tordoir D M R , Schuurman J H , Kirkels W J , Schroder F H
Published: January 2017

Abstract

Objectives—

To assess motives for attending a randomised population based prostate cancer screening trial, and to assess acceptance of screening and invitation procedures.

Methods—

First pilot of the European Randomised Study of Screening for Prostate Cancer (ERSPC; 1992/1993). Men aged 55–75 years, randomly selected from the population register of four city districts of Rotterdam, were invited by a single invitation for screening. Screening consisted of prostate specific antigen prescreening followed by either (1) digital rectal examination, transrectal ultrasound, and, on indication, biopsy, or (2) no additional screening. After screening, or in the case of non-attendance, a questionnaire was sent to a random sample of 600 attenders and 400 non-attenders, with a reminder after three weeks.

Outcome measures—

In both attenders and non-attenders: Knowledge of prostate cancer, attitudes towards screening, motives for attending, procedural aspects and sociodemographic characteristics. In attenders, acceptance of screening procedures.

Results—

The response rate for the questionnaire was 76%: 94% in attenders and 42% in non-attenders. The main reasons for attending were expected personal benefit (76%) and scientific value (39%), and those for not attending were the absence of urological complaints (41%) and anticipated pain or discomfort (24%). Uptake of screening was 32%, which increased to a sustained 42% in following years. Attenders, compared with non-attenders, were significantly younger, more often married, better educated, and had higher perceived health status, more knowledge about prostate cancer, and a more positive attitude towards screening. Information materials and invitation procedure were adequate. Screening procedures were well accepted (high report marks and satisfaction, and 95% would attend for rescreening). A single prostate specific antigen determination was liked less than a combination of all three screening modalities.

Conclusions—

(1) The main reasons for attending are personal benefit and science, and those for not attending were absence of urological complaints and anticipated pain or discomfort; (2) knowledge, attitudes, and motives for attending are comparable with other screening programmes; hence, for population based prostate cancer screening, known health promotional aspects should be carefully considered; (3) prostate specific antigen, digital rectal examination and transrectal ultrasound are acceptable to attenders.