bluuebunny/crossref_metadata_2025 huggingface dataset:
Père alcoolique, consommation de psychotropes à l'adolescence et facteurs de protection
Authors: Vitaro Frank , Tremblay Richard E , Zoccolillo Mark
Published: January 2017

Objectifs:

La présente études 'intéresse aux caractéristiques personnelles et familiales des enfants de pères alcooliques qui ne développent pas de problème d'alcool et/ou de drogue à l'adolescence (c 'est à dire, les enfants résilients) en comparaison avec ceux qui en développent. Divers traits comportementaux sont examinés comme facteurs de résilience ainsi que certaines pratiques éducatives des parents.

Méthode:

Les facteurs de résilience sont évalués tout au cours de l'enfance, soit entre l'âge de 6 et 12 ans. La présence ou l'absence de problème d'alcool et/ou de drogue chez le jeune est établie à l'âge de 15 ou 16 ans.

Résultats:

Près de 1000jeunes des 2 sexes ont participé à l'étude. Comme prévu, l'alcoolisme du père constitue un facteur de risque important en regard des problèmes de consommation des substances psychotropes à l'adolescence. Des traits de personnalité comme une faible recherche de sensations ainsi qu'une propension à l'inhibition constituent, au contraire, des facteurs qui diminuent le risque d'éprouver des problèmes de consommation. Ces facteurs ne peuvent cependant être considérés comme des facteurs de resilience car leur effet s'exerce autant chez les enfants de pères non alcooliques que chez ceux de pères alcooliques. Par contre, la supervision parentale s'est avérée protectrice car elle a diminué le risque de problème de consommation seulement chez les enfants de pères alcooliques.

Conclusion:

Ces résultats indiquent qu 'au-delà des variables de personnalité, l'alcoolisme du père constitue un facteur de risque élevé en regard d'un problème de toxicomanie chez les jeunes. Toutefois, la supervision parentale permet d'atténuer ce risque, ce qui constitue un élément d'intervention important à considérer.
Using a Positive Psychology and Family Framework to Understand Mexican American Adolescents’ College-Going Beliefs
Authors: Vela Javier C. , Lenz A. Stephen , Sparrow Gregory Scott , Gonzalez Stacey Lee
Published: January 2017

Positive psychology is a useful framework to understand Mexican American adolescents’ academic experiences. We used a quantitative, predictive design to explore how presence of meaning in life, search for meaning in life, subjective happiness, hope, and family importance influenced 131 Mexican American adolescents’ college-going beliefs. We used the Meaning in Life Questionnaire, Subjective Happiness Scale, Hope Scale, Pan-Hispanic Familism Scale, and College-Going Self-Efficacy Scale to measure the aforementioned factors. Using multiple regression analysis, findings indicated that hope and familism were significant predictors of college-going beliefs. Higher levels of hope and familism positively predicted college-going beliefs. We provide a discussion regarding the importance of these findings as well as recommendations for future research.
Functional Adult Literacy
Authors: Akello Judith Abal , Lutwama-Rukundo Evelyn , Musiimenta Peace
Published: January 2017

This article presents findings of study on women’s experiences of Functional Adult Literacy (FAL) as a gateway to their financial progress and welfare in Lango region, Northern Uganda. The qualitative study of 45 participants aimed at examining women’s live changes resulting from using their acquired FAL knowledge and skills to participate in Income Generating Activities. The study demonstrates that FAL brings out women’s individual and collective agency through “conscientization” concept and dialogue as tools for marginalized people in the act of social and economic change agents. This argument is grounded within agency concept that portray the power of the oppressed individual as well as collective agency. Findings revealed that FAL training improves women’s livelihood. The article concludes that Government, international development partners, NGOs, and civil society should ensure strong support and implementation of FAL program because it can help women succeed in the contemporary world.
Initial Experience with Tissue Plasminogen Activator in Two Pediatric Oncology Patients
Authors: Johnson Tiffanie R. , Tobias Joseph D.
Published: January 2017

With the more frequent use of central venous catheters in children for therapeutic interventions such as the administration of chemotherapy and total parenteral nutrition, there has been an increased recognition of thrombotic complications including thrombotic occlusion, deep venous thrombosis, and superior vena cava syndrome. In the symptomatic child, treatment may be warranted to prevent the sequelae of venous thrombosis including embolic phenomena, secondary bacterial infection, as well as post-thrombotic changes in an extremity. One option for treatment is the use of a thrombolytic agent such as tissue plasminogen activator (TPA). The authors present two children who developed thrombotic complications of central venous devices. TPA successfully resolved the clot and reversed the clinical signs and symptoms of venous obstruction. The literature concerning the use of TPA in pediatric patients, its application in such situations, adverse affects, and dosing regimens are presented.
Examinations of a new long-term degradable electrospun polycaprolactone scaffold in three rat abdominal wall models
Authors: Jangö Hanna , Gräs Søren , Christensen Lise , Lose Gunnar
Published: January 2017

Alternative approaches to reinforce native tissue in reconstructive surgery for pelvic organ prolapse are warranted. Tissue engineering combines the use of a scaffold with the regenerative potential of stem cells and is a promising new concept in urogynecology. Our objective was to evaluate whether a newly developed long-term degradable polycaprolactone scaffold could provide biomechanical reinforcement and function as a scaffold for autologous muscle fiber fragments. We performed a study with three different rat abdominal wall models where the scaffold with or without muscle fiber fragments was placed (1) subcutaneously (minimal load), (2) in a partial defect (partial load), and (3) in a full-thickness defect (heavy load). After 8 weeks, no animals had developed hernia, and the scaffold provided biomechanical reinforcement, even in the models where it was subjected to heavy load. The scaffold was not yet degraded but showed increased thickness in all groups. Histologically, we found a massive foreign body response with numerous large giant cells intermingled with the fibers of the scaffold. Cells from added muscle fiber fragments could not be traced by PKH26 fluorescence or desmin staining. Taken together, the long-term degradable polycaprolactone scaffold provided biomechanical reinforcement by inducing a marked foreign-body response and attracting numerous inflammatory cells to form a strong neo-tissue construct. However, cells from the muscle fiber fragments did not survive in this milieu. Properties of the new neo-tissue construct must be evaluated at the time of full degradation of the scaffold before its possible clinical value in pelvic organ prolapse surgery can be evaluated.
Evaluation on biological compatibility of carboxymethyl chitosan as biomaterials for antitumor drug delivery
Authors: Jiang Zhiwen , Han Baoqin , Liu Wanshun , Peng Yanfei
Published: January 2017

Carboxymethyl-chitosan, a water-soluble derivative of chitosan, has emerged as a promising candidate for biomedical applications due to its excellent water solubility, biodegradation, biocompatibility, hydrating, antimicrobial, and nontoxicity. In this paper, the antitumor proliferation and metastasis was studied in vitro and in vivo to evaluate biocompatibility of carboxymethyl-chitosan as biomaterials for antitumor drug delivery. The results showed that carboxymethyl-chitosan could significantly reduce the clone formation and tumor migration of human cancer cells including kidney cancer cell line OS-RC-2, gastric cancer cell line SGC-7901, colon cancer cell line HT-29, and nonsmall cell lung cancer cell line NCI-H1650 in vitro. Through Lewis tumor-bearing C57BL/6 mouse model, carboxymethyl-chitosan was proved to be able to inhibit solid tumor growth and tumor metastasis to the liver and lung, meanwhile increase the level of tissue inhibitor of metalloproteinase 1 and E-cadherin, and decrease the level of mice blood serum matrix metalloproteinase 9. This study suggested that carboxymethyl-chitosan had certain antimetastasis effect and good biocompatibility and may have a potential application as a synergic antitumor reagent.
Drug Interactions with Antiulcer Agents: Considerations in the Treatment of Acid-Peptic Disease
Authors: Welage Lynda S. , Berardi Rosemary R.
Published: January 2017

All of the antiulcer agents have been implicated in drug interactions. These agents generally influence the absorption, metabolism, or elimination of other medications. However, these interactions can lead to alterations in pharmacodynamic response. The mechanisms by which antiulcer agents produce drug interactions differ among the agents. It is beyond the scope of this article to review all of the drug interactions that have been reported with antiulcer agents. However, it is the intent to provide the reader with a detailed understanding of the mechanisms by which antiulcer agents may interact with other medications and to provide insight into factors that may influence the potential magnitude or clinical consequences of these interactions. An understanding of antiulcer drug interactions will aid pharmacists in assisting clinicians with drug selection and/or monitoring of drug interactions. Specifically, pharmacists can assist with the identification of potential antiulcer drug interactions and develop strategies designed to minimize adverse consequences of these interactions.
Alcohol: Gastrointestinal and other Toxicities
Authors: O'Donnell James T.
Published: January 2017

This article will focus on the two areas of alcohol injury: first, the gastrointestinal system, primarily liver toxicity and cirrhosis, and second, the human toll in injury, examining injury epidemiology information that estimates alcohol's involvement in trauma. Any pharmacist consulting in any capacity, especially related to gastrointestinal disorders, will need to understand the significant sociological, pathological, pharmacological, and psychological impact of alcohol. Pharmacists providing care, including dispensing many different drugs to patients, should be cognizant of the interacting effects of alcohol and the need to warn patients. Finally, the reader will learn of a case in which a pharmacist was sued for not warning about the use of alcohol with a central nervous system depressant, and the resultant litigation after that lawsuit.
Lyme Disease: A Comprehensive Look
Authors: Ondeck Deborah Anne
Published: January 2017

Lyme disease is one of the Centers for Disease Control and Prevention's (CDC's) reportable diseases. This article describes the discovery, cause, treatment, and prevention of this illness, an illness that can render an individual incapable of independent activities of daily living (ADLs). It is written to provide an overview of the agent, the transmission, the host, and the effects through the stories of individuals who have suffered. It is hoped that the outcome of reading this article will be a better understanding of Lyme, an enhanced knowledgebase to share with individuals for prevention, and, in general, a more aware society. Lyme is real! It is also very easily treatable in its earlier stages.
Women Directors in English District Health Authorities: Position, Performance and Prospects
Authors: Harrison J. J. H.
Published: January 2017

This paper reports new research on corporate governance in the NHS, in particular some of the findings concerning the changing position of women directors, together with a consideration of their impact in the boardroom and their prospects for the future. The implications of the findings are considered in terms of policy and its implementation and in terms of boardroom practice and director development. As such, the paper is a further contribution to the debate about the changing role of women in society and their contribution to important institutions of the state.
Mapping as a Method for Analysing Policy Response in the Management of Health Services
Authors: Luger Lisa , Carrier Jane , Power Robert
Published: January 2017

Health services are susceptible to changes in health need, resource allocation, public-health debates and health policies. Service mapping is considered a useful tool for analysing complex issues, monitoring changes over time and facilitating change. It also enables one to describe pathways of care and the relationships between services. This article centres on two projects — a London-wide project ‘Service networks for HIV Care’ and a local survey ‘Mapping of HIV-related services for illicit drug users’ — and demonstrates the usefulness of mapping for both studies. Mapping of service networks allowed exploration of a variety of connections between treatment centres, and led to recommendations for a model of HIV service networks across London. The mapping of HIV-related services for illicit drug users confirmed that the service provision was balanced in time, space and target groups, but also identified gaps showing that services were not very successful in attracting women and members of ethnic minority groups. It is clear from both studies that mapping provides an overview of existing services, describing details of services, their target groups or links. It can assist to monitor changes over time, to reconfigure services according to need, and to target resources where need becomes apparent. Mapping exercises also can be useful in identifying new areas for collaboration and interagency work.
The Impact of Market-Like Arrangements on Specialist Services: A Case Study
Authors: Tilley Ian , Tilley Helen
Published: January 2017

This article considers how specialist hospital services in the UK fared under Conservative health policy, with its emphasis on market-like arrangements, and what looks likely under the New Labour era, where new shibboleths (cooperation, quality, etc.) supposedly are in place. There appeared inherent in the Conservative health policy threats to specialist services from local competition, and purchaser agendas for local health needs of equity and prioritization. Moreover, small providers grappled with costs and the bureaucracy engendered by market-like arrangements and with their inability to make economies of scale. From the policy rhetoric since the New Labour election victory of May 1997, one might expect such specialist services to be ‘coming in from the cold’, but the reality seems quite different. In particular, this paper will outline the policy context for specialist providers for the period in the 1990s when the Conservative government undertook to reform the NHS. We also, through the Unit that is the subject of the case study, examine the actual effects of those reforms on this specialist service. Finally, we reflect further upon the resonances for specialist services in the New Labour era that can be gleaned from the case study.
On the Efficiency of Public, Welfare and Private Hospitals in Germany over Time: A Sectoral Data Envelopment Analysis Study
Authors: Helmig Bernd , Lapsley Irvine
Published: January 2017

This paper examines the efficiency of the German hospital sector over time and the relative efficiency of public, welfare (both nonprofit) and private (for-profit) hospital sectors using data from the Federal Statistics Office of German hospitals. Efficiency scores were computed using data envelopment analysis. The absolute efficiency of the hospital sector as a whole was found to have improved between 1991 and 1996. In this comparison, the empirical results showed that the hospitals in the public and welfare sector are relatively more efficient than private hospitals. Our results suggest that public, welfare and private hospital sectors have different best-practice frontiers; and that public and welfare hospital sectors appear to use relatively fewer resources than private hospitals. These results suggest differences in quality of care arising from ownership.
Perspectives on General Management in the National Health Service
Authors: Hunter David J. , Williamson Peter
Published: January 2017

If general managers experience problems in establishing a dialogue with their various constituencies both inside and outside the NHS, they are not alone. Researchers of health policy and management experience similar difficulties in trying to engage in a mutually useful exchange of views with health service managers. Attempts to bring the two groups together in order to interweave their respective experience and knowledge have rarely been successful. The reasons are manifold but the chief problem is the existence of suspicion on each side: researchers suspect managers of being intellectual philistines or of being unduly defensive about perceived criticism of their activities; for their part, managers accuse academics of indulging in ‘intellectual mystification’ and peddling useless models or of making unwarranted generalisations on the basis of small and unrepresentative samples. The upshot of this divide is that each group tolerates the other but, with few exceptions, warily and without any real or shared comprehension.
Notions of ‘Success’ in General Management
Authors: Barbour James
Published: January 2017

It is surely significant that the title of this paper deals in vague terms such as notions, and that in line with true Health Service caution, the idea of success is hedged with appropriate punctuation. It is almost inconceivable that a similar evaluation of general management in the private sector would be so constrained and tentative. No doubt this largely reflects the imperatives of the balance sheet and the ‘cash nexus’ which provide a ready means of assessing managerial competence by reference to objective and absolute criteria. A separate analysis of general management in the private sector might nevertheless conclude that ‘success’ is achieved as much by political intervention and the manipulation of exchange rates, as it is by managerial performance. Certainly, it has always struck me that the epitomes of good management, so persuasively presented in ‘In Search of Excellence’ and so eagerly consumed by the new generation of Health Service Managers, might not stand up to the kind of microscopic scrutiny so commonplace in the Health Service. It would be interesting, for example, to ask the Scottish workforce of the Caterpillar Corporation whether that company's place in the ‘Excellence’ Hall of Fame accorded with their perceptions!
Analysis of Hospitalization Rates by Electoral Ward: Relationship to Accessibility and Deprivation Data
Authors: Slack R. , Ferguson B. , Ryder S.
Published: January 2017

The objective of this paper is to investigate the relevance of access to hospital services in explaining utilization rates at a District Health Authority level in the UK. In order to test the hypothesis that access is important, it is necessary to develop a means of scoring access factors and then combining these scores with other more recognized influences on hospitalization rates e.g. deprivation measures.

Acknowledging that hospitalization rates are not merely products of a population's socio-economic characteristics, the effect of accessibility to hospital services for the resident population is investigated through the derivation of an access score using both private and public transport from electoral ward of residence.

Deprivation and accessibility to services were both found to be significant factors in determining hospitalization rates at electoral ward level. The chosen supply variable — number of GPs — was not found to be significant in any of the models developed using linear regression techniques.

To conclude, it appears that access plays an important role in determining hospitalization rates within a given population. If high hospitalization rates are accepted as an indicator of effectively met demand then policy makers may have to consider increasing the accessibility of hospital services.
Developing Purchasing Strategy: A Case Study of a District Health Authority Using Soft Systems Methodology
Authors: Brown A. D.
Published: January 2017

This paper examines the attempt by a District Health Authority (DHA) to create structures (called Purchasing Strategy Groups or PSGs) to facilitate the effective development of its purchasing strategy. The paper is based on a case study design conducted using Soft Systems Methodology (SSM). The research contribution the paper makes is twofold. First, it analyses some of the fundamental management-related difficulties that a DHA can experience when attempting to come to terms with its role and responsibilities in the 1990s. Second, it provides a discussion and evaluation of the utility of SSM for qualitative research in the National Health Service (NHS) in the UK.
Programme Budgeting Revisited: Special Reference to People with Learning Disabilities
Authors: Jones C. , Wright K.
Published: January 2017

The recent reorganization of community care in the UK removed many of the perverse incentives identified in the previous system. However, the organization of care for many people is still divided across several agencies in the public and independent sectors. As purchasing and providing agencies in both the National Health Service and local authority personal social services attempt to coordinate policy objectives and the means to achieve them, the total resources available and their allocation across different care groups and among people in the same care groups form a consistent focus of attention. The principles and practice of programme budgeting provide important lessons for planning and monitoring expenditure. This paper rehearses such principles in the specialized area of policies for people with learning disabilities and draws on the experience of mapping expenditure on relevant services in a survey over 10 local authorities in England.
Investigation of all-speed schemes for turbulent simulations with low-speed features
Authors: Du Ruofan , Yan Chao , Qu Feng , Zhou Ling
Published: January 2017

Turbulence plays a key role in the aerospace design process. It is common that incompressible and compressible flows coexist in turbulent flows around aerospace vehicles. However, most upwind schemes in compressible solvers were designed to capture shock waves and have been proved to have difficulties in predicting low-speed flow regions. In order to overcome this defect, many all-speed schemes have been proposed. This paper investigates the properties of the all-speed schemes when applying to Reynolds averaged Navier–Stokes simulations with important low-speed features. First, the correctness of our code is validated. Then four test cases are adopted to evaluate the scheme performance, including a Mach 2.85 compression ramp, the NACA 4412 airfoil, a Mach 2.92 ramped cavity and a three-dimensional surface-mounted cube. Grid-converged results from the all-speed schemes show good agreement with the experimental data and remarkable improvement when compared to standard upwind schemes. Moreover, different from the traditional preconditioning methods, the all-speed schemes are simple to realize and free from the cut-off strategy or any problem-dependent parameter. Therefore, they are expected to be widely implemented into compressible solvers and applied to all-speed turbulent flow simulations.
Integrated aerodynamics/structure/stability optimization of large aircraft in conceptual design
Authors: Wan Zhi-Qiang , Wang Xiao-Zhe , Yang Chao
Published: January 2017

The multidisciplinary design optimization is suitable for modern large aircraft, and it has the potential in conceptual phase of aircraft design especially. An integrated optimization method considering the disciplines of aerodynamics, structure and stability for large aircraft design in conceptual phase is presented. The objective is the minimum stiffness of a beam-frame wing structure subject to aeroelasticity, aerodynamics, and stability constraints. The aeroelastic responses are computed by commercial software MSC. Nastran, and the cruise stability is evaluated by the linear small-disturbance equations. A viscous-inviscid iteration method, which is composed of a computational fluid dynamics tool solving the Euler equations and a viscous correction method, is used for computing the flow over the model. The method ensures effective and rapid computation. In this paper, a complete aircraft model is optimized, and all the responses are computed in the trim condition with a fixed maximum takeoff weight. Genetic algorithm is utilized for global optimizations, and the optimal jig shape, the elastic axis positions and the stiffness distribution can be attained adequately. The results show that the method has a value of application in engineering optimizations. For the satisfaction of the total drag and stability constraints, the structure weight usually needs a price to pay. The integrated optimization captures the tradeoff between aerodynamics, structure and stability, and the repeated design can be avoided.
Optimal attitude trajectory planning method for CMG actuated spacecraft
Authors: Zhang Lijun , Yu Chunmei , Zhang Shifeng , Cai Hong
Published: January 2017

This paper presents an optimal attitude trajectory planning method for the spacecraft equipped with control moment gyros as the actuators. Both the fixed-time energy-optimal and synthesis performance optimal cases are taken into account. The corresponding nonsingular attitude maneuvering trajectories (i.e. open-loop control trajectories) with the consideration of a series of constraints are generated via Radau pseudospectral method. Compared with the traditional steering laws, the optimal steering law designed by this method can explicitly avoid the singularity from the global perspective. A linear quadratic regulator closed-loop controller is designed to guarantee the trajectory tracking performance in the presence of initial errors, inertia uncertainties and external disturbances. Simulation results verify the validity and feasibility of the proposed open-loop and closed-loop control methods.
Comparative Study of Cefuroxime Axetil and Procaine Penicillin in the Treatment of Uncomplicated Gonorrhoea
Authors: Kinghorn G R , Spencer R C , Smith T K , Woolley P D , Patel R , Robinson A J
Published: January 2017

A total of 311 patients presenting with uncomplicated gonorrhoea were entered into a comparative randomized open-label study and given single-dose treatment with either oral cefuroxime axetil (CAE) or intramuscular procaine penicillin (PP). Neisseria gonorrhoeae was eliminated from 129 (98%) of 131 evaluable patients treated with CAE and 127 (98%) of 129 evaluable patients treated with PP. None of the 4 treatment failures (3 male and 1 female) were caused by β-lactamase-producing isolates.

Both treatments were well tolerated with minor adverse events reported in 3 (2%) of CAE treated patients.

We conclude that CAE is an effective, well tolerated treatment for uncomplicated gonorrhoea which has the convenience and acceptability of single-dose oral therapy.
Reasons for Non-Use of Condoms by Homosexually Active Men during Anal Intercourse
Authors: Ross Michael W
Published: January 2017

Sixty-eight homosexually active men attending an STD clinic were questioned to ascertain the percentage of the time they did not use condoms during anal intercourse, and the reasons for this. Data indicated that the reasons most commonly given were being in a steady relationship (32.8%), being unprepared (19.4%), couldn't be bothered (19.4%), use of alcohol or drugs (7.5%), being bisexual (4.5%), attractiveness of partner or partner attitude toward sex, and knowing the partner (3% each). These data suggest that both trust and situational variables are barriers to consistent condom use in homosexually active men.
Clinical and Virological Associations between External Anogenital Warts and Cervical HPV Infection in an STD Clinic Population
Authors: Law C L , Merianos A , Grace J , Rose B R , Thompson C H , Cossart Y E
Published: January 2017

To determine the significance of overt anogenital warts as indicators of human papillomavirus (HPV) infection of the cervix, 177 women attending a Sydney STD clinic were screened for evidence of cervical HPV infection using clinical criteria together with cytology and HPV DNA dot hybridization. HPV DNA probing was also performed on biopsies of 50 exophytic warts. A very high prevalence of both anogenital warts (40%), and of cervical HPV infection (58%) was indicated in this group of women. In the exophytic warts, HPV types 6/11 were most commonly detected, whereas the rates of detection of types 6/11 and 16/18 in the cervix were similar. Of the 87 women with evidence of cervical HPV infection, 57 (66%) had a history of either past or current overt exophytic anogenital warts; while the corresponding figure for the 90 women with no evidence of cervical infection was 45 (50%). Cytological evidence of dysplasia (CIN I–III) was detected in 13 (7%) of the cervical smears: of these, 4 were positive for HPV 16/18 only, 2 for 6/11 only and 4 for both 6/11 and 16/18.
T4+ Cell Depletion as a Major Risk Factor for AIDS-Related Complex and AIDS. Longitudinal Study of 253 HIV-Antibody Positive Heroin Addicts from Northern Italy
Authors: Conte D , Mandelli C , Cesana B M , Barbera R , Aimo G P , Piubello W , Bianchi P A
Published: January 2017

We enrolled 253 HIV-antibody positive heroin addicts without HIV-related disease ( n = 81) or with persistent generalized lymphadenopathy ( n = 172) in a prospective study to evaluate clinical progression to AIDS related complex (ARC) or AIDS and to identify factors of possible prognostic relevance. Follow-up lasted between 6 and 40 months (median 12 months). According to the non-parametric Cox's model the only significant ( P<0.001) prognostic variable was T4+ cell count considered in three classes: >800/μl (no depletion), 400–800/μl (moderate depletion) and <400/μl (absolute depletion). Subjects with T4+ cell count of <400/μl had a risk of developing ARC or AIDS that was 6.46 and 1.98 higher than those with values of >800/μl or between 400 and 800/μl respectively. The estimated probability of progression to ARC or AIDS was 0.029, 0.056 and 0.172 at one year in subjects with T4+ cell count of >800/μl, 400–800/μl and <400/μl, respectively, and 0.2%, 0.501, and 0.896 at two years.
Tuberculosis in HIV Seropositive Individuals—A Retrospective Analysis
Authors: Tomlinson D R , Moss F , McCarty M , Mitchell D , Main J , Harris J R W , Karim Q N
Published: January 2017

A retrospective analysis of all culture-positive cases of Mycobacterium tuberculosis infection in HIV positive individuals, over a 5 year period, revealed 18 cases, drawn from a population of approximately 1500. The prevalence of culture proven M. tuberculosis over the 5 year period was therefore 1.2% and was strongly associated with either a concomitant, or a subsequent, AIDS diagnosis. Sixty-one per cent had pulmonary tuberculosis, 17% had both extra-pulmonary and pulmonary infection and 22% had extra-pulmonary infection alone. Although a wide range of radiological abnormalities was seen, segmental consolidation was the commonest, occurring in 57% of cases. Only 55% of the specimens were positive on initial stains for M. tuberculosis, with a mean duration of 4 weeks to become culture positive, emphasizing that early diagnosis rests on clinical suspicion.
Abnormalities of Liver Function during HIV Seroconversion Illness
Authors: Boag Fiona C , Dean Richard , Hawkins David A , Lawrence Adam G , Gazzard Brian G
Published: January 2017

In 6 patients with a severe human immunodeficiency virus (HIV) seroconversion illness distinct abnormalities of liver transaminases were observed; in addition there was marked hepatomegaly in 5 patients.
Induction by arsenate of cell-type-specific cytotoxic effects in nerve and hepatoma cells
Authors: Kharroubi Wafa , Nury Thomas , Ahmed Samia Haj , Andreoletti Pierre , Sakly Rachid , Hammami Mohamed , Lizard Gérard
Published: January 2017

The aim of the study was to compare the effect of sodium arsenate (AsV) on two different cell types: 158N murine oligodendrocytes and HepG2 human hepatoma cells. Exposure of 158N cells to AsV (0.1–400 µM; 48 h) induced a biphasic cytoxic effect defined as hormesis. Thus, low concentrations of AsV stimulate cell proliferation, as shown by phase-contrast microscopy, cell counting with trypan blue, and crystal violet assay, whereas high concentrations induce cell death associated with a loss of cell adhesion. These side effects were confirmed by staining with propidium iodide and cell cycle analysis, characterized by the presence of a subG1 peak, a criterion of apoptosis. The effects of AsV on mitochondrial function, as determined by the 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium (MTT) assay, the measurement of mitochondrial transmembrane potential with 3,3′-dihexyloxacarbocyanine iodide, and the rate of mitochondrial adenosine triphosphate confirm the impact of AsV on the mitochondria. In contrast to 158N cells, HepG2 cells were susceptible to all AsV concentrations as shown by microscopic observations, by counting with trypan blue. However, no alteration is noted in the cell membrane integrity, which indicated an apoptotic mode of cell death, and this side effect is confirmed by the cycle analysis, which revealed a subG1 peak. Of note, there was a loss of MTT, suggesting that AsV induces mitochondrial complex II dysfunction. Altogether, our data show that the cytotoxic characteristics of AsV depend on the cell type considered.
How Rape Myths Are Used and Challenged in Rape and Sexual Assault Trials
Authors: Smith Olivia , Skinner Tina
Published: January 2017

Court responses to rape and sexual assault have been repeatedly criticized in England and Wales (Brown et al., 2010). In particular, research has identified prevalent stereotypes about rape in both the criminal justice system and wider society, with these rape myths often being used as the predominant explanation for inadequate victim/survivor treatment (see Temkin and Krahé, 2008). The existing literature, though, tends to rely on interviews or is outdated by policy, so the present research uses court observations to explore what is actually happening in adult rape and sexual assault trials. The findings show that rape myths are still routinely used at trial, but that they are sometimes resisted using judicial directions or prosecution comments. In addition, the research highlights how rape myths are kept ‘relevant’ to trial through a focus on inconsistencies, a dichotomy of wholly truthful/untruthful witnesses, and conceptualisations of ‘rational’ behaviour as being the ‘normal’ way to act. These findings provide a new understanding of rape myths and have implications for policy; in particular, that while training legal professionals is helpful, it cannot be expected to fully address the use of rape myths.
A Case-Control Study to Evaluate Efficacy-Of Screening for Faecal Occult Blood
Authors: Lazovich DeAnn , Weiss Noel S , Stevens Nancy G , White Emily , McKnight Barbara , Wagner Edward H
Published: January 2017

Objectives —

Faecal occult blood testing is routinely used for early detection of colorectal cancer, but evidence of its efficacy in preventing death from colorectal cancer is limited. A case-control study was carried out to evaluate whether screening for faecal occult blood is associated with a reduced risk of fatal colorectal cancer.

Setting —

A health maintenance organisation in western Washington State, which has offered its members faecal occult blood testing every two years since 1983.

Methods —

Cases (n = 248) were members of the health maintenance organisation who died from colorectal cancer between 1986 and 1991. For each case,. two control subjects, who did not die from colorectal cancer and who were similar to each case in age, gender, and year of enrolment at the health maintenance organisation, were randomly selected from the membership list of the year in which the case was diagnosed (n = 496). Information about episodes of faecal occult blood testing (including the location and reason for the test, and the evaluation of positive tests) and potential confounders was obtained from medical records.

Results —

Cases were less likely than controls to have ever been screened (odds ratio (OR) =0·7, 95% confidence interval (CI) 0·5 to 1·0), consistent with a beneficial impact of screening. There was little difference, however, for screening that had taken place within a three year period before diagnosis (OR = 0·9, 95% CI 0·6 to 1·2), the maximum interval during which most tumours ought to have been detectable by faecal occult blood testing. A reduction in risk was seen for home testing but not for office testing, and in individuals aged less than 75 but not in those aged 75 or older. Although most of the 21 controls with a positive faecal occult blood test underwent some additional testing, only five (24%) were evaluated with colonosocopy or air contrast barium enema.

Conclusions —

While there can be uncertainty as to whether specific faecal occult blood tests were performed as screening or diagnostic tests, those performed at home and in younger persons may be relatively less likely to be diagnostic tests that were misclassified as screening. Thus the modest reduced risk associated with faecal occult blood testing in these settings/persons may reflect genuine benefit. However, the presence of a reduced risk associated with a screening faecal occult blood test received in the past, well before a tumour or polyp might bleed enough to allow detection, is compatible with uncontrolled confounding. Interpretation is further complicated by the fact that a number of individuals in the study group who had positive test results underwent limited or no diagnostic testing. Thus our results should be interpreted with considerable caution.
Independent Double Reading of Screening Mammograms
Authors: Ciatto Stefano , Del Turco Marco Rosselli , Morrone Doralba , Catarzi Sandra , Ambrogetti Daniela , Cariddi Angelo , Zappa Marco
Published: January 2017

Objective —

To evaluate the cost effectiveness of independent double reading of screening mammograms.

Setting —

Prospective study of 18817 women undergoing first or repeat screening in a population based programme in the Florence district.

Methods —

Mammograms were independently double read by experienced radiologists. Subjects with mammographic abnormalities reported by at least one reader were recalled for diagnostic assessment. The mean increase in recall rate, cancer detection rate, and screening costs attributable to double reading was calculated.

Results —

Eleven of 125 cancers were detected by only one reader. The mean increase in cancer detection rate attributable to double reading compared with single reading was 4·6% (95% confidence interval (CI) 1·1 to 8·9). From a total of 748 cases referred for diagnostic assessment, 196 subjects were referred by one reader only. The mean increase in referral rate attributable to double reading compared with single reading was 15·1% (CI 12·3 to 17·8). Double reading caused a marked increase in the cost for each woman screened −8·5% at the first screening and 6·2% at repeat screening and a more limited increase in the cost for each cancer detected −3·5% at the first screening and 2·7% at repeat screening. Cancers detected by only one screener were at an earlier stage than those detected by both screeners (P = 0·6, not significant).

Conclusions —

Independent double reading results in only a modest increase in the detection of cancers and therefore may not be cost effective.
Cost Effectiveness of Screening for Primary Open Angle Glaucoma
Authors: Boivin J F , McGregor M , Archer C
Published: January 2017

Objectives and Setting

–To determine the cost effectiveness of screening for glaucoma.

Methods

–Information on treatment efficacy, diagnostic methods, epidemiological characteristics of glaucoma, and costs were determined from the literature, from administrative databases, and from experts. Scenarios with different screening frequency, age, participation in screening, compliance with treatment, treatment efficacy, and diagnostic tests were examined.

Results

–The initial scenario comprised three-yearly screening of subjects aged 40–79 by funduscopy and tonometry, followed by perimetry when abnormalities were discovered. The assumption of levels of participation in screening and of compliance with treatment of 75%, and treatment efficacy of 50% resulted in a cost of $C100 000 per year of blindness prevented. A scenario in which screening was restricted to subjects aged 65–79, with the same input variables, would prevent 81% of the cases of blindness prevented with scenario 1, at a cost of $C42 000 per year of blindness prevented. Screening with tonometry only as the initial diagnostic test in subjects aged 65–79 would result in a cost of $C36 000 per year of blindness prevented, but would only prevent 59% of the cases prevented with scenario 1.

Conclusions

–There is as yet no proof that treatment of glaucoma or of high intraocular pressure will arrest the progression of glaucoma to blindness. Even when treatment efficacy is assumed to be as high as 50%, however, the cost effectiveness of most glaucoma screening programmes considered would not be competitive.
Cervical Screening of Arabic-Speaking Women in Australian General Practice
Authors: Lesjak Margaret , Ward Jeanette , Rissel Chris
Published: January 2017

Abstract

Objective—

To determine recency and predictors of cervical screening among Arabic-speaking women in Sydney, Australia.

Method—

A consecutive sample of Arabic-speaking women, attending 20 Arabic-speaking general practitioners, was asked to complete a self administered health risk questionnaire available in Arabic or English which included three questions about cervical screening knowledge and behaviour.

Results—

Of 756 eligible women, 526 (70%) returned completed questionnaires. Of these, 69 (13%) did not know what a cervical smear was. Sixteen per cent of overseas-born compared with 2% of Australian-born women at risk had not heard of a cervical smear. Women were defined as being at risk of cervical cancer if they had both been married and not had a hysterectomy. Of 318 women at risk for cervical cancer who knew what a cervical smear was, 66% had had a smear in the last two years, a further 7% were attending for one that day while 11% had not had a smear for at least two years, 9% had never had one and 7% did not answer/could not remember. Religion, age, and residence in Australia for more than 10 years were significant and independent predictors of screening after adjustment for other variables in a simultaneous logistic regression model (P = 0.002, P = 0.002, and P = 0.040 respectively). Muslim women and older women were more likely to be under-screened, and women with more than 10 years' residence in Australia were more likely to have been screened in the last two years. Acculturation, smoking status, health status, duration of relationship with participating doctor, and chronic disease were not significant predictors of a recent smear.

Conclusion—

As only 73% of women at risk had been screened in the last two years, including women attending on the day, and 9% had never been screened, Arabic-speaking women should be a priority for public campaigns, particularly Muslim and older women. Studies to evaluate the effectiveness and acceptability of reminders by ethnic general pratitioners are recommended.
South African State Capture: A Symbiotic Affair between Business and State Going Bad(?)
Authors: Shai Kgothatso B.
Published: January 2017

Since March 2016, the subject of South African state capture has received much attention from the political, business and scholarly community in the country and beyond. The vibrancy of this public and scholarly discourse was reignited by the claims by some politicians from the ruling party, the African National Congress (ANC), that in the recent past, they were approached by the Gupta family (business moguls) for consideration in ministerial appointments. These revelations have since produced a dominant perception that the Gupta family wields an undue influence over the President of the Republic and by extension, the entire state machinery. This extends to the family and friends as well. While the Guptas ‘capture’ the state, ministers and premiers are not directly accountable to them by protocol, but only to the President as a constitutional prerogative to do so. The view on state capture is not uniformly accepted. One notes the discourse is dominated by Euro-American perspectives, purporting to create a misunderstanding of the current trajectory of business–state relations in South Africa. As a theoretical framework, Afrocentricity is adopted and used in this article to answer the following two central questions: (i) Is it a myth or reality that the Gupta family has captured the South African state? (ii) At which point should corporate influence in state affairs be considered as illegal? Methodologically, this is achieved through thematic content analysis on conversations and the prevailing discourses circulating within South Africa.
Soft Power: The Fourth ‘Tentacle’ of South Africa’s Foreign Policy
Authors: Ogunnubi Olusola
Published: January 2017

Studies on South African post-apartheid foreign policy have evolved through four distinctive strands: the estimative, the new dispensation, the ambiguity and strategic engagement. In this article, I attempt to illustrate that a burgeoning thread is noticeable in recent times within the fourth strand offering a marked perspective on the ideational and utilitarian substance of soft power for South Africa’s foreign policy and within the discursive context of its regional/middle power status. In considering the varied arguments submitted by scholars in this regard, the article uncovers three significant thematic positions. First, the cultivation and utilisation of soft power instruments present multiple platforms for expanding South Africa’s global reputation and regional influence. Second, soft power has been the fulcrum of South Africa’s post-apartheid foreign policy. Third and definitely no less important, this new body of analysis offer critical explanation into the international moral authority and global acceptance that South Africa ostensibly enjoys over and above other regional competitors. Drawing on Alden and Schoeman’s ‘symbolic representivity’ narrative, I argue that it is on the basis of these three interrelated assertions that South Africa’s putative hegemonic reference thrives.