bluuebunny/crossref_metadata_2025 huggingface dataset:
Resistance to Biodegradative Stress Cracking in Microporous Vascular Access Grafts
Authors: Carson Robert J. , Edwards Alan , Szycher Michael
Published: January 2017

Degradative cracking, more commonly known as "environmental stress cracking" (ESC) has been observed in many implanted polyetherurethane elastomers. This phenomenon has been attributed to biochemical and cellular interactions at the surface of the implanted material causing polymer chain cleavage. This may result in surface fissuring followed by the deep cracking associated with considerable biodegradation of the polymer, resulting in loss of mechanical strength and the formation of aneurysms in an in vivo situation.

These cracking effects are believed to be due to mechanical stress combined with the oxidising actions of macrophages and giant cells, as surface cracking has been observed to occur directly under adherent macrophages on a polyetherurethane implant. These cells form part of the body's immune response which uses enzymes and reactive oxygen species (02, 02, HO* and H2O2) to degrade foreign material.

We describe a modification of an in vitro test method developed by Zaho et al. [1] using glass wool and a Hydrogen Peroxide/Cobalt (II) Chloride (H2O2/CoCl2) mixture to replicate the oxidising effects of macrophages in vivo. The modifications were made to establish a routine testing system for resistance to biodegradation which could be used to screen a range of polymers designed for use in microporous vascular grafts. The grafts are pre-stressed by a method devised by Stokes et al. [2] where each graft is stretched to a predetermined elongation over a mandrel and the strain is fixed by tying PTFE tape around each end of the mandrel.

Initial comparative testing used two materials fabricated into vascular grafts with identical dimensions and an interior diameter of 5 mm. The first, a polyetherurethane-Estane 5714 F1 (BF Goodrich Specialty Plastics UK Ltd.), showed the in vitro test method to have an acceleration factor of approximately nine times over in vivo trials resulting in catastrophic failure during the sixth week. The second material, a new generation polycarbonate-based polyurethane, Chrono Flex (Cardio Tech International Ltd.), displayed outstanding resistance against environmental stress cracking, maintaining its structure throughout the entire test period of thirty-five weeks. These results will be followed up with long-term in vivo implantation studies to corroborate these findings.
Health Services Management Manpower and Educational Needs with American Health Reform
Authors: Weil T. P.
Published: January 2017

This paper argues that our previous health services management (HSM) manpower projections may be overly optimistic as the health networks, managed care, capitated payment, and eventually global budgetary targets become the dominant themes to implement cost restraints, universal access, and social equity. HSM programs should, therefore, focus more on their educational pursuits to produce leaders for clinical management teams, who are able to allocate scarce clinical resources. A sensible strategy for HSM programs is to develop closer ties with the schools of medicine, public health, nursing, or allied health. These cooperative efforts would be particularly beneficial in teaching ‘clinical-fiscal performance methodologies’ to familiarize students with such concepts as clinical benchmarking, managing quality, resource management, and continuous quality improvement (CQI).
Targeting the Mature Consumer Market
Authors: Moschis G. P. , Bellenger D. N. , Kennett P. A. , Aab L. E.
Published: January 2017

The aging population in the USA makes skill in marketing to the mature consumer increasingly important. The biophysical and psychosocial aging process create a need for specific strategies to address the changes brought on by age. This study attempts to ascertain the degree to which the health service providers recognize some of the needs of the elderly market and the degree to which marketing programs are addressing these needs. A comparison with other industries is also provided. The results indicate that 4 out of 16 strategies directed at the mature market have been used by more than 80% of health care respondents. In addition, there are significant differences between the health care industry and other industries for five of the strategies. All but two of the strategies are thought to be important by more than half of the survey respondents.
The Corporatization of Health Care: An Evaluation and An Alternative
Authors: Jacobs K. , Nilakant V.
Published: January 2017

The corporatization of health care organizations has become a significant international trend. This paper examines that trend, comparing the development of corporate health care in the USA with the impact of the New Zealand health reforms. The paper traces the evolution of the organizations of health care systems and explains the emergence of the corporate form. We argue that the corporate model of work organization is unsuited to the complex and ambiguous nature of the medical task as it ignores inherent interdependencies. An alternative is needed which addresses work practices rather than just participation in decision making and is based on a concept of mutual interdependence and support in the execution of work.
Streptococci and the Genital Tract
Authors: Rowen D
Published: January 2017

Streptococci of Lancefield Group B (GBS) are known to cause maternal sepsis and neonatal infection, whereas streptococci Lancefield Group A (GAS) cause vulvo-vaginitis in both children and adults. Prevalence of SGB colonization of the lower genital tract of normal women is between 4–18%, with higher rates found in hospital personnel and delivery rooms. Such high carriage rates may be a significant factor in nosocomial transmission of GBS to neonates. Symptomatic infection is uncommon and usually secondary to other pathological states. Amnionitis is a complication of vaginal carriage of GBS and there is now evidence that chorioamnionitis is associated with pre-term labour and its attendant problems. GBS infection of the male genitalia has also been described. Intrapartum chemoprophylaxis has been shown to prevent early onset GBS disease of the neonate. Prevalence of GAS in the genital tract is lower than that for GBS, but is more likely to be symptomatic. The response to penicillin is usually prompt. Optimal drug regimens need to be determined, particularly for use in pregnancy.
The Role of Aerosol Pentamidine Prophylaxis
Authors: Ong E L C
Published: January 2017

Pneumocystis carinii pneumonia (PCP) is the most frequent opportunistic infection in patients with AIDS, occurring in 80% and recurring in 50% of patients within 12 months of the first episode. Prophylaxis for PCP is recommended if the CD4+ cell count is <200×106/l or 20% of the total lymphocyte count, or after an episode of PCP. The most effective prophylactic agent currently is trimethoprim-sulphamethoxazole and should be the drug of choice but alternatives such as aerosol pentamidine are being increasingly used for patients who cannot tolerate this combination or other oral preparations. If aerosol pentamidine is used and administered via a Respigard II Marquest nebulizer, the dosage should be higher than the currently recommended monthly dosage of 300 mg.
Case Definitions for Paediatric AIDS: The Zambian Experience
Authors: Chintu C , Malek A , Nyumbu M , Luo C , Masona J , DuPont H L , Zumla A
Published: January 2017

For the purpose of surveillance of the acquired immunodeficiency syndrome (AIDS) in developing countries, the World Health Organization (WHO) has recommended criteria for the clinical case definition of AIDS in adults and children. In a preliminary examination of children in Zambia a number of patients with obvious AIDS did not fit the published WHO case definition for paediatric AIDS. Based on this the Zambia National AIDS Surveillance Committee designed local criteria for the clinical case definition of paediatric AIDS. We compared the Zambian criteria with the WHO criteria for the diagnosis of paediatric AIDS by studying 134 consecutively admitted children to one of the paediatric wards at the University Teaching Hospital in Lusaka. Twenty-nine of the patients were HIV-1 seropositive and 105 were HIV-1 seronegative. Among the 29 HIV-seropositive patients, the Zambian criteria identified 23, and the WHO criteria identified 20 children as having AIDS. The 105 HIV-seronegative children were classified as having AIDS in 9 cases by the Zambian criteria and in 38 cases by the WHO criteria. These results give the Zambian criteria for the diagnosis of AIDS a sensitivity of 79.3%, a specificity of 91.4% and a positive predictive value of 86.8% compared to a sensitivity of 69%, specificity of 64% and a positive predictive value of 38% for the WHO criteria. The current WHO criteria are inadequate for the diagnosis of paediatric AIDS. The need to refine the WHO criteria for the diagnosis of paediatric AIDS is discussed.
How Often Do Condoms Break or Slip off in Use?
Authors: Richters Juliet , Donovan Basil , Gerofi John
Published: January 2017

Men attending 3 sexually transmissible disease clinics and a university health service in Sydney were given a questionnaire asking how many condoms they had used in the past year and how many broke during application or use or slipped off. Respondents were 544 men aged 18 to 54 years. Of these, 402 men reported using 13,691 condoms for vaginal or anal intercourse; 7.3% reportedly broke during application or use and 4.4% slipped off. Men having sex with men reported slightly higher slippage rates than those having sex with women. Breakage and slippage were unevenly distributed among the sample: a few men experienced very high failure rates. A volunteer subsample reported 3 months later on condoms supplied to them: 36 men used 529 condoms, of which 2.8% broke during application or use and 3.4% slipped off. Many of these failures pose no risk to the user, especially those occurring during application, as long as they are noticed at the time, but failure may discourage future use. Research is needed to identify user behaviours related to breakage.
Determining the Prevalence of Neurosyphilis in a Cohort Co-Infected with HIV
Authors: Brandon W R , Boulos L M , Morse A
Published: January 2017

A retrospective study of 767 HIV positive patients from a large urban public hospital, 238 of whom were co-infected with syphilis, was performed to determine the prevalence of neurosyphilis.

A prevalence of 3% of neurosyphilis in the co-infected cohort was demonstrated. The 7 cases of neurosyphilis ascertained were of the early stage variety, with cranial nerve involvement the predominant focal deficit. Of the 5 cases presenting after initial diagnosis and treatment of syphilis, 4 were felt to be inadequately treated. An overall prevalence of 1% (7/767) was determined for the entire HIV(+) cohort. The majority of the cases of syphilis (90%) were characterized as latent syphilis.

Based on these findings, the authors recommend routine CSF examination in all patients who are HIV positive and who present with latent syphilis. Treatment regimens should be maximized in an effort to reduce the prevalence of neurosyphilis in such a co-infected cohort.
Contraceptive Practices in HIV Seropositive Females in Ireland
Authors: Murphy D , Lynch M , Desmond N , Mulcahy F M
Published: January 2017

A questionnaire was administered to a cohort of 130 HIV seropositive women attending the Department of Genitourinary Medicine, St James's Hospital, Dublin, in order to establish their current contraceptive practices. Forty (42%) of the sexually active women did not use reliable contraception; 55 (57%) used a method reliable in fertility control only, and 21 (22%) used a method reliable in terms of both partner and congenital transmission. The intravenous drug users were less likely to use reliable contraception, 9 (39%), in comparison to the heterosexual group 14 (70%), P < 0.05. The heterosexual group were more likely to use condoms consistently, 7 (35%) in comparison to one (4%) of intravenous drug users, P < 0.02. Nineteen children, 3 borne to heterosexual mothers and 16 borne to intravenous drug-using mothers were HIV seropositive after 18 months.
Roxithromycin Compared to Doxycycline in the Treatment of Genital Chlamydial Infection and Non-Specific Urethritis
Authors: Lidbrink P , Bygdeman S , Emtestam L , Gajecki M , Lapins J , Weden U
Published: January 2017

A single-blind randomized follow-up study was conducted to evaluate the efficacy and tolerance of roxithromycin 300 mg once a day compared to doxycycline 200 mg day 1 and 100 mg day 2–10 in the treatment of genital chlamydial infection in men and women and non-specific urethritis (NSU) in men. A total of 211 patients (200 men and 11 women) between 18 and 46 years were enrolled. The women were excluded from the efficacy analysis because of the low number, but were included in the tolerance analysis. The clinical (clearance of polymorphonuclear leucocytes in urethral smears) and bacteriological response was evaluated one and 11 days after the treatment. Of 113 included men with chlamydial infection, 105 (93%) and 96 (85%) were evaluable on respective follow-up visits and of 87 included men with NSU, 74 (85%) and 64 (74%) were evaluable one and 11 days after treatment, respectively. The bacteriological eradication rate immediately after the treatment in chlamydia positive patients was 92.7% and 100% for roxithromycin and doxycycline, respectively, and 91.8% and 100% at follow-up. The clinical cure rate of all evaluable patients was 83.1% and 80.7% for roxithromycin and doxycycline, respectively, one day after the treatment and 80.5% and 85.3% for the two drugs, respectively, 11 days after treatment. None of these observed differences was statistically significant. The diagnosis did not influence the clinical response rate with either drug. Probable and possible drug-related side-effects were more common after doxycycline than after roxithromycin, 35% and 19% respectively ( P = 0.0032). The side effects were mainly mild gastro-intestinal symptoms with short duration and none of the patients receiving roxithromycin stopped the treatment. Roxithromycin, belonging to a new generation of macrolides related to erythromycin, can be given as an effective single daily dose of 300 mg for 10 days to cure genital chlamydial infection and NSU in men, and its efficacy is comparable with that of doxycycline in standard recommended dose. Roxithromycin was shown to be safe and it had fewer and milder side-effects than doxycycline.
Restricting Personal Behaviour: Case Studies on Legal Measures to Prevent the Spread of HIV
Authors: Woodhouse D E , Muth J B , Potterat J J , Riffe L D
Published: January 2017

People infected with HIV who persist in exposing others to infection through negligent, reckless, or criminal activity create a legal and ethical dilemma for public officials. Protection of the public health requires balancing the rights of infected people with the expectations of society. When reasonable efforts fail to obtain the voluntary cooperation of infected individuals, Colorado law permits health officers to restrict their behaviour. Since 1986, at least 20 people who were aware of their infection are known to have exposed others to HIV in Colorado Springs, Colorado. Restrictive measures have been initiated in 14 cases to date. Presented here is an overview of Colorado law, selected case studies, and a summary of its strengths and shortcomings.
An Open, Comparative, Study of the Efficacy of 0.5% Podophyllotoxin Lotion and 25% Podophyllotoxin Solution in the Treatment of Condylomata Acuminata in Males and Females
Authors: Kinghorn G R , McMillan A , Mulcahy F , Drake S , Lacey C , Bingham J S
Published: January 2017

The efficacy and safety of topical treatment for external condylomata acuminata with either self-applied 0.5% podophyllotoxin (PT) or hospital-applied 25% podophyllin (PODO) solution was compared in 138 males and 67 females in an open multicentre study. After one week of treatment, wart clearance was observed in 53% of males and 37% of females in the PT group as compared with 19% of males and 19% of females in the PODO group ( P < 0.001 in males; P = 0.13 in females). At 5 weeks after commencing treatment, clearance of warts had been achieved in 86% males and 72% females in the PT group as compared with 78% of males and 62% females in the PODO group ( P = 0.08 in males; P = 0.14 in females). Treatment had cleared 81% of 180 treated sites in all PT recipients as compared with 61% of 95 treated sites in all PODO recipients ( P < 0.001). The increased speed of action of PT was associated with an increased incidence of symptoms and signs of inflammation at treatment sites in both males and females ( P < 0.001). These were generally mild, did not interfere with continuing treatment, and were more frequent in those patients whose warts were eradicated most rapidly.

Home-based treatment with 0.5% podophyllotoxin lotion in appropriately instructed patients of either sex is superior in efficacy to outpatient applied 25% podophyllin and has the potential to reduce the number of hospital attendances required in genital wart eradication.
HIV Infection among STD Patients—Kigali, Rwanda, 1988 to 1991
Authors: Karita Etienne , Martinez Waldina , Van de Perre Philippe , Nziyumvira Alphonse , Nyiraminani Josepha , Butera Jean Baptiste , Fox Emile
Published: January 2017

To follow the progression of HIV seropositivity among heterosexual adults at risk for HIV infection in the country of Rwanda prospectively, up to 100 patients with sexually transmitted diseases (STD) were tested each month from 1988 to 1991 at the health centre of Biryogo, which is located in a very crowded sector of the capital city, Kigali. Each patient had a blood sample tested anonymously for the presence of HIV antibodies. HIV seropositivity was defined as a reactive ELISA test combined to a reactive Western blot test. The overall HIV seropositivity among the 2058 subjects tested was 61%. It was higher (73%) among the 688 women tested as compared to the 1362 men tested (55%; P < 0.001). The per cent HIV seropositivity did not increase between 1988 and 1991, neither among the male nor among the female clinic attenders. However, the per cent seropositivity was higher in the older age groups, especially among the males. This exceedingly high proportion of HIV-infected STD patients in Kigali re-emphasizes the urgent need to include STD treatment, prevention and control among the priority actions for decreasing HIV transmission in African towns. Also, as the per cent seropositivities did not show any trend to increase over the 4-year period considered, we propose that our intensive HIV serosurveillance strategy among STD patients in Kigali be modified, since the plateau of HIV infection appears to have been attained in this particular high-risk population.
Intracavernosal Papaverine and Phentolamine for the Medical Management of Erectile Dysfunction in a Genitourinary Clinic
Authors: Armstrong D K B , Convery A , Dinsmore W W
Published: January 2017

A total of 160 men with erectile failure received treatment with 13030 intracavernosal papaverine and phentolamine injections as outpatients. One-hundred-and-fifteen (72%) achieved an erection sufficient for sexual intercourse and after a mean follow-up period of 14.1 months, 55 (48%) are still attending and successfully using intracavernous therapy. Sixteen patients had a total of 22 episodes of priapism and one patient developed corporeal fibrosis. We conclude that intracavernous papaverine and phentolamine is an effective therapy for erectile failure in a genitourinary clinic.
Use of a Dublin Inner City A & E Department by Patients with Known HIV-1 Infection
Authors: Desmond N , Murphy M , Plunkett P , Mulcahy F
Published: January 2017

During the period January 1990 to January 1992 260 patients known to be infected with human immunodeficiency virus type 1 (HIV-1) attended the Accident & Emergency (A & E) Department of St James's Hospital, Dublin. There was a total of 709 visits with a mean annual attendance rate of 2.7, twice that for the general A & E population. Eighty-nine per cent of patients were intravenous drug users (IVDUs), 9% homosexual/bisexual and 2% heterosexual. Known HIV-1 seropositive patients accounted for 0.7% and 0.8% of the total number of patients who attended A & E in 1990 and 1991 respectively. The majority of patients disclosed their HIV status. Bacterial respiratory tract infection was the single most common reason for attending A & E and for admission to hospital. Seventy-two per cent of IVDUs fulfilled Centers of Disease Control (CDC) criteria for stage II and III disease; the majority of these used A & E for primary medical care, although listed with a general practitioner (GP) and attending during the daytime. Sixty-eight per cent of homosexuals/bisexuals were CDC stage IV with AIDS defining illnesses accounting for 52.6% of clinical presentations. Of this risk category, 79% required medical admission. Homosexuals/bisexuals represent more advanced disease, thus the full impact of HIV-1 infection in IVDUs in this A & E setting has yet to be realized.
Why Virgins Attend Sexually Transmitted Disease Clinics
Authors: Bodsworth N J , Knight V , Rohrsheim R
Published: January 2017

We sought to ascertain the reasons why virgins might attend sexually transmitted disease (STD) clinics. The medical records of 31 patients (18 males and 13 females) attending a major public STD clinic and who declared no lifetime sexual partners were examined. Nine subjects were concerned about genital anatomical variation while 3 had non-STD genital pathology (urinary tract infection, non-specific genital dermatosis, vaginismus). Six attended for human immunodeficiency virus antibody testing and 3 for hepatitis-related reasons. Of 6 children, 5 were screened for congenital syphilis and the other had genital warts. Three older patients (aged 34–38) presented with genital symptoms as part of a previously diagnosed psychosis. One prostitute who attended for a ‘certificate’ had never had penetrative sex. Most attendances in this study were appropriate and reflect the increasing recognition of STD clinics as appropriate centres for a wide range of non-STD genital and sexual problems.
Psychiatric Morbidity in Women Attending a Clinic for Vulval Problems—Is There a Higher Rate in Vulvodynia?
Authors: Jadresic Danitza , Barton Simon , Neill Sally , Staughton Richard , Marwood Roger
Published: January 2017

A General Health Questionnaire (GHQ) was completed by 55 women attending a clinic for vulval problems in central London. The GHQ-caseness rate was 40% from which the psychiatric morbidity in the sample was estimated to be 32%. The level of psychiatric morbidity in 10 women with a diagnosis of vulvodynia was similar to that of 41 women with other vulval diagnoses.
The National STD Surveillance System in Italy: Results of the First Year of Activity
Authors: Suligoi B , Giuliani M , Binkin N ,   The STD Surveillance Working Group
Published: January 2017

A prospective STD surveillance system was developed in Italy in 1990. Newly diagnosed cases of sexually transmitted disease (STD) are reported by a network of 45 sentinel STD clinics throughout the country. A total of 10 253 patients were reported between September 1990 and December 1991. The most frequent diagnoses were genital warts (30.8%), non-specific genital infection (male) (12.8%), and non-specific genital infection (female) (11.5%). All patients were asked to undergo an HIV test; 68.4% accepted, of whom 9.3% were seropositive. During the 16–month study period HIV prevalence decreased among IDUs and homo-bisexuals, but increased among non-IDU heterosexuals. These data suggest that STD patients may represent a useful early warning system to detect changes in the epidemic and in the spread of the virus among low-risk heterosexuals. A better counselling programme is needed to improve the acceptance rate of HIV testing among STD patients, and to draw more attention to at-risk sexual behaviours.
Relationships of Cervical Cytologies to Selected Variables among Women Attending a Sexually Transmitted Disease Clinic
Authors: Campbell P J , Hewitt S H , Kowalchuk P A , Joffres M , Romanowski B
Published: January 2017

A retrospective chart review was conducted for one year to determine cervical cytological abnormalities and their distribution among women attending a STD clinic, and to analyse cervical cytologies by STD diagnosis and history or presence of genital warts. Analysis was performed on 790 Pap smears. Most (60%) cytologies were benign. Prevalence of STD among CIN-1 cytologies (78%) was significantly higher ( P = 0.02) than among benign cytologies (46%). Commonest cytologies presenting among youngest age groups were CIN-1/condyloma, CIN-1, CIN-2. Women with preceding or concurrent clinical HPV infection had significantly more HPV associated changes on cytology ( P < 0.001) than women with no such history. The presentation of cytological abnormalities considered to be precursors to cervical cancer among sexually active young women demonstrates the importance of Pap smear testing of STD clinic populations.
Prevalence of Antibodies to Herpes Simplex Virus in Pregnant Women in Stockholm in 1969, 1983 and 1989: Implications for STD Epidemiology
Authors: Forsgren Marianne , Skoog Eva , Jeansson Stig , Olofsson Sigvard , Giesecke Johan
Published: January 2017

Prevalence of antibody to herpes simplex virus types 1 and 2 was assessed in consecutive serum samples from a total of 3700 women pregnant in 1969, 1983, or 1989 from the same catchment area in Stockholm. There was little change in seroprevalence of antibody to herpes simplex type 1 in the 3 groups, but age-adjusted herpes simplex virus type 2 antibody prevalence was 19, 33, and 33% respectively. Increase in type 2 seropositivity with age was slight and similar in 1969 and 1989, but steep in 1983, indicating a shift in sexual behaviour. However, rising prevalence in women will be mirrored by rising prevalence in their male partners. The increase from 1969 to 1989 will thus partly be due to higher risk of infection per partner, and cannot be taken as direct evidence of increased rate of partner change during this 20-year period.
Syphilis and HIV Infection among Displaced Pregnant Women in Rural Mozambique
Authors: Cossa H A , Gloyd S , Vaz R G , Folgosa E , Simbine E , Diniz M , Kreiss J K
Published: January 2017

A cross-sectional study was conducted among displaced pregnant women in Mozambique to determine the prevalence and correlates of HIV infection and syphilis. Between September 1992 and February 1993, 1728 consecutive antenatal attendees of 14 rural clinics in Zambézia were interviewed, examined, and tested for HIV and syphilis antibodies. The seroprevalence of syphilis and HIV were 12.2% and 2.9%, respectively. Reported sexual abuse was frequent (8.4%) but sex for money was uncommon. A positive MHA-TP result was significantly associated with unmarried status, history of past STD, HIV infection, and current genital ulcers, vaginal discharge, or genital warts. Significant correlates of HIV seropositivity included anal intercourse, history of past STD, and syphilis. In summary, displaced pregnant women had a high prevalence of syphilis but a relatively low HIV seroprevalence suggesting recent introduction of HIV infection in this area or slow spread of the epidemic. A syphilils screening and treatment programme is warranted to prevent perinatal transmission and to reduce the incidence of chancres as a cofactor for HIV transmission.
Patterns of Risk Behaviour for Patients with Sexually Transmitted Diseases and Surveillance for Human Immunodeficiency Virus in Kuala Lumpur, Malaysia
Authors: Lye Munn Sann , Archibald Chris , Ghazali Azizan Aiyub , Low Bin Tik , Teoh Boon Hooi , Sinniah Mangalam , Rus Sulaiman Che , Singh Jit , Nair Rama C
Published: January 2017

A study was conducted to determine the feasibility of establishing a sentinel human immunodeficiency virus (HIV) surveillance system involving patients with sexually transmitted diseases attending private clinics and a government sexually transmitted disease clinic in Kuala Lumpur, Malaysia. Information on risk behaviours for HIV infection were also collected.

A total of 84 female and 91 male patients were interviewed and tested for HIV infection; 41.7% of the women reported working as prostitutes, other occupations included masseuses, hairdressers, waitresses, salesgirls, receptionists, factory workers, and others. The most common diagnosis was gonorrhoea. Other diagnoses included non-specific genital infection, pelvic inflammatory disease, genital herpes and syphilis. 58.3% of the women had a hundred or more sex partners during the previous month; 99% had 6 or more sex partners.

Only 4.8% of female patients had their male partners using condoms most of the time, 11.9% hardly used condoms at all.

Of the males, 93.3% were heterosexual, while 6.7% were bisexuals, 41.1% had between 6–20 different partners in the previous year. 78.0% of them had prostitutes as their sex partners most of the time. 41.8% had experiences in Thailand and the Philippines. 73.6% never used condoms, while 19.8% only used condoms rarely.

Although all patients were tested negative for HIV antibodies, lot quality assurance sampling methods indicate that the upper limits of prevalences for females and males were 3.5% and 3.3% respectively, at a 5% type I error. The study has shown that it is feasible to carry out a sentinel surveillance programme among STD patients and provided useful baseline data for future comparisons. The high prevalence of risk behaviours among STD patients is alarming and underscores the urgency of multiagency cooperation and aggressive health education and behaviour change programmes to combat the growing problem of HIV infection in the country.
Gender Identity Disorder and HIV Disease
Authors: Pang H , Pugh K , Catalan J
Published: January 2017

Four cases of male-to-female transsexuals with HIV infection are described, showing that individuals with gender identity disorder are vulnerable to HIV infection through unsafe sexual behaviour and intravenous drug use. The various practical problems associated with carrying out major surgery on this group of individuals are discussed, as well as some of the ethical issues raised by their treatment needs.
Heterosexual Vaginal and Anal Intercourse Amongst London Heroin and Cocaine Users
Authors: Strang John , Powis Beverly , Griffiths Paul , Gossop Michael
Published: January 2017

A community-derived sample of 392 heroin users and 145 cocaine users were interviewed about their drug use and sexual behaviour, with (optional) collection of saliva specimen for linked anonymous HIV/HBV testing. The heroin sample was stratified (50/50) across current treatment and non-treatment status. For cocaine users 80% were not in current contact with any treatment. Overall levels of sexual activity were several times higher than reported in recent national surveys. Last-year prevalence of heterosexual anal intercourse was 23% and 20% for heroin-using males and females respectively (last-month figures—12% and 10%); and 23% and 15% for cocaine-using males and females respectively (last-month figures—7% and 9%). Two-thirds of subjects rarely or never used condoms during heterosexual anal intercourse. For females, receptive anal intercourse was positively related to a history of sex-for-money activity, high scores of severity of dependence, and injecting as a current route of use.
Long Distance Truck Drivers in India: HIV Infection and Their Possible Role in Disseminating HIV into Rural Areas
Authors: Singh Yadu Nath , Malaviya Anand Narayan
Published: January 2017

In this study, a large number of truck drivers were found to be having sex with the prostitutes in rural areas along the highways of India. Some were having sex with men also. HIV/AIDS awareness and condom use was poor among them. Three out of 302 truck drivers were found to be infected with HIV. The truck drivers could play an important role in the spread of the infection in rural India.
Double-Blind, Randomized Clinical Trial on the Effect of Interferon-Beta in the Treatment of Condylomata Acuminata
Authors: Olmos L , Vilata J , Pichardo A Rodríguez , Lloret A , Ojeda A , Calderón M D
Published: January 2017

A randomized, double-blind, placebo-controlled trial was conducted to assess interferon-beta efficacy and safety in the treatment of anogenital condylomatous lesions.

One hundred patients received a daily intramuscular injection of either interferon-beta (IFN-β) (2 MIU/day) or placebo for 10 days.

Of 94 evaluable patients, the complete response rate observed 8 weeks after treatment was significantly higher in the group receiving IFN-β, as compared to the placebo-treated group (51% vs 28.9%, P<0.05).

After one year, 24 patients (100%) out of 24 complete responders to IFN-β who attended for follow-up remained free of lesions. Twelve of 13 patients with complete response to placebo (92.3%) remained free of lesions after one year.

Side effects were mild and no significant analytical changes were observed.

In conclusion, interferon-beta is an effective and safe treatment for long-term eradication of anogenital condylomatous lesions.
Screening for Lower Genital Tract Infections in Women Presenting for Termination of Pregnancy
Authors: Smith N , Nelson M R , Hammond J , Purkayastha S , Barton S E
Published: January 2017

Over a four-month study period, 87 patients requesting termination of pregnancy at a gynaecology clinic were offered screening for sexually transmitted diseases, of whom 63 accepted. A total of 41 infections were found in 34 women, the commonest being vaginal candidiasis and bacterial vaginosis. Chlamydia was found in six patients. Although HIV antibody testing was offered to every patient, all declined this test.
Incidence of Sexually Transmitted Diseases Among Massage Parlour Employees in Bangkok, Thailand
Authors: Bonhomme Michèle G , Rojanapithayakorn Wiwat , Feldblum Paul J , Rosenberg Michael J
Published: January 2017

The results of a study of sexually transmitted disease (STD) incidence and related risk factors for STDs among uninfected women at high risk of contracting STD infection in Bangkok are reported. Comprising the control arm of a randomized controlled trial of a vaginal contraceptive sponge and STD incidence, 163 women aged 18 or older were recruited from 4 massage parlours and followed for evidence of new infections over a 6–week period or until cervical infection occurred. Gynaecological examinations were performed and endocervical specimens were obtained at weekly intervals, at which time women returned coital logs recording their number of sexual partners. There were 76.5 new STD infections per 100 woman-months, including 31.7 with gonorrhoea, 43.1 with chlamydia, 1.8 of trichomoniasis and 3.5 of candidiasis. None of the risk factors examined were good predictors of STD infection in this population, which may be related to the restricted admission criteria in the study.
Condom Use among Female Commercial Sex Workers and Male Clients in Hong Kong
Authors: Wong K H , Lee S S , Lo Y C , Lo K K
Published: January 2017

The use of condoms is an aid to protection against human immunodeficiency virus (HIV) infection and other sexually transmitted diseases (STDs). In a one-and-a-half month period in mid-1993, 190 commercial female sex workers and 633 male clients of 8 Social Hygiene Clinics in Hong Kong were interviewed on their practice in condom usage. For both sex workers and clients, 18.5% and 22.8% never and 55.3% and 50.3% seldom used condoms during sexual contacts with paying partners and non-paying partners respectively. The majority (86%) of male clients claimed that they would use a condom if they knew it could reduce risk of contracting HIV and other STD. Condom promotion activities are necessary, particularly for those at higher risk of infection because of their sexual behaviour.
Energy and Telecommunications — An Environmental Impact Analysis
Authors: Tuppen C.G.
Published: January 2017

Whole life, annual energy consumption figures have been compiled for the main UK telephone service. The total primary energy expenditure related to the provision of the national telephone service has been divided into network operations, the associated company infrastructure, equipment manufacturing, raw material processing and equipment disposal.

A detailed analysis of telephone traffic statistics has been used to develop an empirical model of UK call volume as a function of call distance. The model is then used to provide a general expression for the operating energy required to power both intra-national and international telephone calls. The energy consumed by a number of typical telephone calls is compared with the energy requirements for equivalent journeys made by different modes of powered transport.
Sources and Sinks of Fossil Fuel Emissions
Authors: Klass Donald L.
Published: January 2017

Fossil fuel utilization worldwide has increased significantly over the last 100 years, especially since World War II, as illustrated by the curves in Figure 1. The resulting emissions to the atmosphere are believed by many to result in a variety of environmental problems such as the Greenhouse Effect and global warming (1). The purpose of this paper, therefore, is to assess in some detail specific atmospheric pollutants that have been either directly (CO2, CO, CH4, SOx, NOx hydrocarbons, particulates) or indirectly (O3) related to fossil fuel usage and to compare them with emissions from other anthropogenic and non-anthropogenic sources.
Vibration Spectra as a Feedback for Controlling Multicylinder Engine Performance
Authors: Abou-Arab T.W. , Othman M. , Najjar Y.S.H.
Published: January 2017

Increasing requirements for vehicle confort, economy and reliability lead some investigators to consider the relationships between the mechanical vibrations with the heat and fluid flow induced vibration and noise in a more accurate manner. This paper describes the variation of the vibration phenomena associated with the motion of some engine components under different operating conditions. The measured vibration spectra indicates its capability in predicting symptoms of early engine failures, hence, expediting their control using a suitable feedback system. Parametric studies involving the effect of air-fuel ratio, ignition timing and engine speed on the vibration pattern are also carried out. These studies indicate that the amplitude of vibration decreases as the speed increases then increases again after certain engine speed. The effect of ignition system characteristic on the induced vibration are obtained and the correlation between the developed power and the engine dynamics over a range of operating conditions are discussed.
Equity and Efficiencyin Policies to Reduce Carbon Emissions in The Domestic Sector
Authors: Barker Terry , Johnstone Nick
Published: January 2017

It is frequently asserted that the distribution effects of a carbon/energy tax - such as that proposed by the Commission of the European Communities - will be largely regressive: that the burden of the tax will fall disproportionately on lower income households. Such an assertion, although valid within the confines of the respective analyses, is based upon an unduly limited treatment of the fiscal implications of such a tax as well as a simplification of the demand for energy services in the domestic sector. It will be argued that such analyses, by implicitly assuming that efficiency objectives (reducing carbon emissions at lowest cost) and equity objectives (ensuring that lower-income households do not suffer welfare losses) are to be separately achieved, overstate the cost of reducing emissions in terms of both objectives. Stated differently, such studies fail to recognize that the adverse efficiency effects and equity effects are opposite sides of the same problem and that the revenue generated by the tax can be recycled in such a ways as to exploit the complementarity of the objectives. The relative importance of exploiting this complementarity with respect to domestic thermal energy service (space and water heating) is explored.
Scientific Consensus and Climate Change: The Codification of a Global Research Agenda
Authors: Boehmer-Christiansen Sonja
Published: January 2017

The 'scientific consensus' which influenced the Framework Convention on Climate Change was carefully drafted by the Intergovernmental Panel on Climate Change (IPCC) between 1988 and 1992. In spite of it, there have been divergent national responses and policy controversy continues. The willingness of States to reduce the emission of greenhouse gases appears to be declining. An explanation for this is proposed which stresses the question of whether the nature of the scientific advice as sought and given bears some responsibility for the weak policy response. Institutional and personality factors in the formulation of IPCC advice are explored, as is the policy model upon which advice was given. It is concluded that this model is intrinsically unable to generate decisive environmental policy, but rather invites the institutions of the natural sciences and macro-economics to endow their research agendas with claims to policy relevance through the production of future 'findings'. As this model was accepted by governments, IPCC advice and its underlying 'consensus' cannot be assessed as an example of 'science' failing policy. The Convention was the outcome not of science advising policy-makers, but of a complex process of global and national bargaining in which the research institutions played an active but, in the end, minor role. In the much wider struggle over access to strategic resources, capital, income and power in both senses of the word, the global research lobby successfully protected its own interests. This involved 'government science' taking the lead and adopting an increasingly 'neutral' position so that scientific advice was sought by all the contending parties. Whether the global stabilisation of emissions will be achieved remains to be seen; it is unlikely to depend on more scientific certainty being found first.
Environment-Thermal Power Generation Nexus: The Indian Scenario
Authors: Bhattacharyya Subhes C.
Published: January 2017

Coal based thermal power has emerged as the major source of electric power in India over the years and this trend is expected to continue even in the future. The environmental effects of thermal power generation are becoming a major concern. Here we present a review of the status of environmental control at present in terms of regulation and their application in the power industry and study the environmental issues of and options for the thermal power generation.
Biomethanation of Agro-Waste in Combination with Cattle Dung
Authors: Patel Vikram , Madamwar Datta
Published: January 2017

The potential of different agro-wastes like green grass (Cynodon dactylon (L.)), bagasse, algae (Enteromorpha spp.), banana stem and water hyacinth (Eichhornia crassipes) in combination with cattle dung for methane production by anaerobic digestion have been evaluated. The results indicate that these wastes can be exploited for methane generation in combination with cattle dung. Best results were obtained with green grass when it was combined with cattle dung in the ratio of 1:4.
Review of Some Energy and Environmental Aspects of The Gas Turbine Engine
Authors: Najjar Y.S.H. , kyurt M. A. , AI-Rabghi O.M. , Alp T.
Published: January 2017

Due to its numerous relative merits, a bright future awaits the gas turbine engine. Hence the gas turbine engine technology has been developed continuously in diverse areas such as cycle analysis, including novel cycles and second-law analyses; design, development and economic maintenance; combustion and environment; in addition to modeling, simulation and performance of engine components. Therefore a brief review of these areas is presented to highlight future trends.
Regulation and Energy Policy, Hydropower Plant Upgrading, and Environment
Authors: Escudero Javier
Published: January 2017

Improvements in existing hydroelectric power plants can increase quantity of production, but very often they are also designed to improve its quality, that is, peak generation capacity and availability of reserve energy, which in turn leads to a reduction of emissions in the producer part. An adequate valuation and economic recognition of the energy quality in remuneration seems essential to encourage these improvements. Frequent size discrimination acts against this recognition, because quality of energy is more often present in conventional-sized installations.
International Cooperation for Environmental Coexistence and Technology Transfer of Hydropower Development in Developing Countries
Authors: Fujino Koichi
Published: January 2017

This paper examines the current situation and the future outlook for hydropower development in developing countries from the perspectives of the environment and technology transfer. Beginning from the current system of international co-operation, this paper recommends both smaller and larger scale paths for the future.
Capability Indices – A Simple “Look-See” Approach for Energy Recovery Systems
Authors: Griffiths A J
Published: January 2017

Energy intensive industries like that of steel making has a considerable potential for using waste heat recovery to improve process efficiency. Although the energy managment function in this sector is well structured, like most industries it is suffering from a lack of manpower to conduct activies not deemed necessary for its sole activity. As a result the analysis of a “good or speculative idea”, especially in terms of waste heat recovery is difficult to undertake. To support the management function in this speculative area, a software tool has been developed to aid the analysis of potential projects using waste heat recovery. These projects tend to have long lead times and many fall down when applying individual financial criteria. The software tool has been designed to speed up this process by assigning a Capability Index varying from 0 − 1. 0 indicates a low and 1 a high potential for waste heat recovery systems to be implemented.
Synthesizing Environmental Externality Costs – A Statistical and Multi-Attribute Analysis Approach
Authors: Huang J.P. , Ang B.W. , Poh K.L.
Published: January 2017

Due to the high degree of uncertainty and complexity of environmental effects, estimates of environmental damage costs tend to vary significantly from one study to another. It is often difficult for the policy maker or analyst to choose reasonable estimates of environmental externality adders in policy analysis. In this paper, we propose an approach to synthesizing estimates of environmental externality adders given in different sources using the Finite Mixture Distribution statistical technique and the Analytic Hierarchy Process multi-attribute analysis method. We present the results of the marginal social costs of C02 obtained using the proposed approach and the possible applications of these results in environmental studies.
Decomposition of Aggregate Energy Intensity of Industry with Application to China, Korea and Taiwan
Authors: Ang B.W.
Published: January 2017

There have been significant decreases in the aggregate energy intensity of industry in China, Korea and Taiwan since 1980. We decompose changes in this often-used energy performance indicator into contributions associated with industry product mix and sectoral energy intensity. In all cases, the results obtained show a large effect of changes in sectoral energy intensity and a relatively smaller effect of changes in product mix. We further decompose the sectoral energy intensity effect to identify the impact of fuel substitution. It is concluded that decreases in the aggregate energy intensity of industry in the three economies were due primarily to improvements in fuel use efficiency.