bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Validation of an Instrument to Assess Imminent Risk of Homelessness among Veterans
Authors: Montgomery Ann Elizabeth , Fargo Jamison D. , Kane Vincent , Culhane Dennis P. 
Published: January 2017

Objectives. Veterans are overrepresented within the homeless population compared with their non-veteran counterparts, particularly when controlling for poverty. The U.S. Department of Veterans Affairs (VA) aims to prevent new episodes of homelessness by targeting households at greatest risk; however, there are no instruments that systematically assess veterans' risk of homelessness. We developed and tested a brief screening instrument to identify imminent risk of homelessness among veterans accessing VA health care. Methods. The study team developed initial assessment items, conducted cognitive interviews with veterans experiencing homelessness, refined pilot items based on veterans' and experts' feedback and results of psychometric analyses, and assigned weights to items in the final instrument to indicate a measure of homelessness risk. Results. One-third of veterans who responded to the field instrument reported imminent risk of homelessness (i.e., housing instability in the previous 90 days or expected in the next 90 days). The reliability coefficient for the instrument was 0.85, indicating good internal consistency. Veterans who had a recent change in income, had unpaid housing expenses, were living temporarily with family and friends, needed help to get or keep housing, and had poor rental and credit histories were more likely to report a risk of homelessness than those who did not. Conclusion. This study provides the field with an instrument to identify individuals and households at risk of or experiencing homelessness, which is necessary to prevent and end homelessness. In addition, it supports VA's investment in homelessness prevention and rapid rehousing services for veterans who are experiencing or are at risk for homelessness.
Effectiveness of the U.S. National HIV Testing Day Campaigns in Promoting HIV Testing: Evidence from CDC-Funded HIV Testing Sites, 2010
Authors: Van Handel Michelle , Mulatu Mesfin S. 
Published: January 2017

Objectives. We assessed if HIV testing and diagnoses increased during the week of National HIV Testing Day (NHTD) and if characteristics of people who were tested varied compared with control weeks. Methods. We analyzed HIV testing data from the 2010 National HIV Prevention Program Monitoring and Evaluation system to compare NHTD week (June 24–30, 2010) with two control weeks (January 7–13, 2010, and August 12–18, 2010) for the number of HIV testing events and new HIV-positive diagnoses, by demographics and other HIV-related variables. Characteristics associated with testing during NHTD week compared with control weeks were identified using Chi-square analyses. Results. In 2010, an average of 15,000 more testing events were conducted and 100 more new HIV-positive diagnoses were identified during NHTD week than during the control weeks ( p<0.001). Compared with control weeks, people tested during NHTD week were significantly less likely to be aged 20–29 years and non-Hispanic white and significantly more likely to be ( 1) aged ≥50 years, ( 2) non-Hispanic black or African American, ( 3) men who have sex with men, ( 4) low-risk heterosexuals, ( 5) tested with a rapid HIV test, or ( 6) tested in a non-health-care setting. Conclusion. In 2010, CDC-funded HIV testing events and new HIV-positive diagnoses increased during NHTD week compared with control weeks. HIV testing programs increased the use of rapid tests and returned a high percentage of test results. NHTD campaigns reached populations disproportionately affected by HIV and further expanded testing to people traditionally less likely to be tested. Incorporating strategies used during NHTD in programs conducted throughout the year may assist in increasing HIV testing and the number of HIV-positive diagnoses.
Change in Cotton, Linen, Rayon, and Cellulose Secondary Acetate with Temperature of Steaming
Authors: Ester Virginia C. , Gerber Ruth , Edgar Rachel 
Published: January 2017

Reaction of woven cotton, linen, rayon, and cellulose secondary acetate with steam at three temperatures from 115.2° to 153.0° is measured, after rinsing of cloth in water, as amount of change in brightness, reducing action, weight, and wet strength of each polar polymer and change in acetyl of the cellulose secondary acetate. The trends of interdependence among these changes and the linearity of the relationship between logarithm of change and reciprocal of absolute temperature are compared as slopes. Apparent energies of interaction are evaluated as parameters of the Arrhenius and Eyring equations for temperature dependence of rate of reaction under the assumption that increment in copper(II) reduced to copper (I) by residual fiber and decrement in acetyl of the cellulose secondary acetate were each directly proportionate to rate of reversible reaction. The logarithm of the pre-exponential parameter is shown to increase linearly with Arrhenius energy of activation as change in entropy increases linearly with change in enthalpy accompanying depolymerization of the bleached linen, bleached cotton, rayon, and desized unbleached cotton.
Spinning of Fibers from Graft Copolymers of Polyacrylonitrile and Poly(Methyl Acrylate)
Authors: El-Garf Samy Abdel Monem 
Published: January 2017

Fibers were spun from graft copolymers of polyacrylonitrile and poly(methyl acrylate). Increasing poly(methyl acrylate) side chains from 5 to 8% decreased the viscosity of the spinning solution in dimethylformamide. The spinning solutions were unstable. When the graft copolymer contained 5% side chains, the viscosity of these solutions returned to almost its initial value by heating. Fibers were obtained from graft copolymers containing from 5–13% poly(methyl acrylate) side chains. These were formed at the temperature of the coagulation bath (50°C), while at temperatures less than 50°C the fibers were not obtained. Weak fibers were produced from a graft copolymer containing 13% side chains at the temperatures of the coagulation bath (20 and 50°C). No fibers were obtained from graft copolymer containing 25% side chains. The method of dissolution of the graft copolymers does affect the drawing of fibers produced from them. It was observed that the heating of the spinning solution decreases the amount of drawing of the produced fibers. The presence of the flexible side chains of poly(methyl acrylate) in the graft copolymer improves the maximum possible degree of drawing of the fibers relative to that of fibers from the initial linear copolymer and homopolyacrylonitrile.
Development of Resilience and Retention of Strength and Abrasion Resistance in Durable-Press-Treated Flame-Retardant Cotton Fabrics
Authors: Rowland Stanley P. , Mason John S. 
Published: January 2017

Durable-press (DP) treatments were applied to cotton sheeting that was flame-retarded (FR) with 7 different types of commercial candidate finishes. The finishes, based on tetrakis(hydroxymethyl)phosphonium chloride (THPC), neutralized THPC (THPOH), Fyrol 76, and Pyrovatex CP were: THPOH-NH2, THPOH-urea-trimethylolmelamine, Proban-NH3, THPC-urea-Na2HPO4, Fyrol 76, Fyrol 76-N-methylolacrylamide, and Pyrovatex CP-methylolmelamine. Dimethyloldihydroxyethyleneurea in conjunction with glycolic acid was employed for the DP treatment of each type of FR cotton at each of three levels of add-on. Textile performance properties of DP-FR cotton fabrics are reported as a function of add-on of each of the FR finishes. The relationships of retained strength and abrasion resistance to developed resilience are discussed. Actual responses of the various types of FR cottons to DP treatments were quite different, but they were generally similar in that they showed decreased increments in DP appearance rating as the amount of FR agent on the fabric increased. Although some of the samples of DP-FR fabrics had DP appearance ratings that fell in an acceptable range (3.5-4.0), none exhibited a particularly attractive combination of resilience with retention of strength and abrasion resistance on this lightweight fabric. It is expected that overall performance would be better on heavier weight fabrics.
Tuberculosis in Swaziland: A Health Needs Assessment in Preparation for a Community-Based Programme
Authors: Pushpananthan S , Walley J D , Wright J 
Published: January 2017

This study was undertaken to assess the healthcare needs of people with tuberculosis (TB) in the rural district of Lubombo in Swaziland, with a view to improving the delivery of healthcare services. Qualitative and quantitative methodologies were used to describe the knowledge, attitudes and behaviour of TB patients, the epidemiology of TB, and the strengths and weaknesses of the current TB control programme. The incidence of TB is rising rapidly in this rural region of Swaziland. Poor treatment completion rates indicate low levels of knowledge about the importance of compliance with TB treatment among many other factors. If local health services are to cope with future rising demands, then efforts must be made to implement a community-based TB treatment strategy. Key practical steps in establishing such a programme are discussed, and the experience from Lubombo is used to demonstrate the steps in performing a health needs assessment in a developing country.
Clinico-Histopathological Concordance in Leprosy
Authors: Singh Premala Anthony , Agarwal Ranjan , Misra Vatsala , Gupta Suresh Chand , Bajaj Ashok Kumar 
Published: January 2017

Histopathological examination of biopsies from 111 patients with clinically diagnosed leprosy was carried out in order to observe the clinico-histopathological correlation. Clinical diagnosis was based on Ridley and Jopling (R-J) classification and World Health Organization (WHO) classification. The concordance rate between the two clinical classifications was 73.8%. Sections were stained with haematoxylin and eosin (H&E) and Ziehl-Neelsen's (Z-N) stains. The histological classification was as per the R-J criteria. Skin biopsy showed evidence of leprosy in 104 cases (93.69%). Overall concordance was observed in 58.6% (R-J) and 85.6% (WHO classification). The kappa test, when applied, showed significant agreement between clinical and histopathological diagnosis ( z=11.775; P<0.001). Individual subtypes showed variable concordance rates — which were again higher using WHO classification. When some of the subtypes were combined, the concordance rate was 83.02% for TT+BT; 72.58% for BT+BB+BL; 73.91% for BL+LL; 80.77% for BL+HL and 100% for LL+HL. (See Introduction for definitions of abbreviations. The present study highlights the importance of histopathological examination for exact subtyping of leprosy, so as to facilitate the institution of accurate mode of therapy and regular follow-up of patients to prevent undesirable complications.
Where There is No Ultrasound: Delay and Failure of Antenatal Diagnosis of Twin Pregnancy
Authors: Groot M C , Buchmann E J 
Published: January 2017

We investigate the problem of late diagnosis of twin pregnancy in Soweto, South Africa, where routine antenatal ultrasound is not available. One hundred consecutive pairs of twins were studied, using the notes of mothers who delivered twins at Chris Hani Baragwanath Hospital and the referring Soweto clinics. A positive history was found in 31 mothers (22 family history, nine previous history of twins). Six mothers did not attend for antenatal care. Twenty-five twin pregnancies were discovered at delivery, 15 of them in the second stage of labour, and 27 were diagnosed accidentally in the third trimester. Only 15 pregnancies were referred specifically for suspicion of twin pregnancy. Most twin pregnancies are detected only in the third trimester or at delivery. Until routine ultrasound is available to all pregnant women, the teaching of antenatal care in South Africa must give emphasis to clinical suspicion of twin pregnancy.
Telemedicine — The Way Ahead for Medicine in the Developing World
Authors: Graham L E , Zimmerman M , Vassallo D J , Patterson V , Swinfen P , Swinfen R , Wootton R 
Published: January 2017

An e-mail link with the facility to send high-resolution digital images is a cheap and uncomplicated telemedicine method. The Swinfen Charitable Trust helped establish such a link in Patan Hospital Kathmandu, Nepal in March 2000. Over 12 months using this link 42 telemedicine referrals were sent to specialists throughout the world. Referrals were: 36% respiratory medicine; 21% neurology, 21% dermatology; 14% cardiology; 5% nephrology; and 3% radiology — 28 had digital pictures attached, of which 96% were of high enough quality on which specialists were able to comment. Thirty-nine replies were received. The average time for a specialist reply was 2 days, and 45% were answered within 24 hours. All replies were judged by independent assessors to be helpful or very helpful for diagnosis, management and education. The assessors decided that in 50% of cases the advice if acted upon would have shortened hospital stay. This pilot study has shown that a low-cost telemedicine link is technically feasible and can be of significant benefit for diagnosis, management and education in a developing world setting.
Correlation between Serum-Ascites Albumin Concentration Gradient with Gastrointestinal Bleeding in Patients of Portal Hypertension
Authors: Mene Anirudh , Sharma Dhananjaya , Raina V K 
Published: January 2017

Non-availability of endoscopic screening to detect portal hypertensive patients at a high risk of index gastrointestinal (GI) haemorrhage led us to examine the relationship between serum-ascitic albumin concentration gradient (SAAG) measurements and the occurrence of GI haemorrhage in patients with portal hypertension and ascites. Fifty-six consecutive patients of portal hypertension with ascites attending the GI surgery outpatients clinic were divided into two groups on the basis of history: ( a) those who had no history of GI bleeding; and ( b) those who had an episode of GI bleeding within the past 21 days. Child—Pugh score was calculated for all patients. All the patients were assessed by ultrasonography and SAAG was estimated. Groups ( a) and ( b) were compared and sensitivity, specificity, positive and negative predictive value of using SAAG as a possible screening test for GI bleeding were calculated. SAAG values correlated significantly with bleeding and splenomegaly. For prediction of bleeding, SAAG had a sensitivity of 100% and specificity of 33.33%, positive predictive value of SAAG for GI bleeding was 71.4% and the negative predictive value was 100%. Estimation of SAAG is possible even in a small, modestly equipped laboratory, and could provide a new means for the identification of high-risk patients for GI bleeding and define patients more accurately for future clinical studies. The results of the present study are encouraging for clinicians working in developing countries and may help in optimizing prophylactic therapy and where available, improving the cost effectiveness of screening endoscopy.
Primary Healthcare Workers' Perceptions about Barriers to Health Services in Zambia
Authors: Birbeck Gretchen L , Kalichi Ellie M N 
Published: January 2017

In Zambia, health policy reforms have recently focused upon decentralization of care with an emphasis upon community-based services. The perspective of primary healthcare workers (PHCWs), who provide these services, may offer valuable insight into this changing health system. To explore the perspective of PHCWs in Zambia, we conducted a written survey of 80 PHCWs. Several barriers to care, many surrounding issues of access to care, were consistently and independently reported by the PHCWs surveyed. Shifting care into the community will only be beneficial if primary care clinics can offer a reasonable minimal standard of care. From the perspective of healthcare workers on the frontline of primary care delivery in Zambia, expanded training of providers and an increased number of providers is needed. Improving access to drugs and supplies is also necessary. User fees that might increase financial resources for the healthcare system may also deter needed care among vulnerable patient populations.
Pharmacokinetics of Artesunate following Oral and Rectal Administration in Healthy Sudanese Volunteers
Authors: Awad M I , Eltayeb I B , Baraka O Z , Behrens R H , Alkadru A M Y 
Published: January 2017

The aims of this study were to determine the pharmacokinetic parameters of a single dose of 200 mg oral and rectal artesunate in healthy volunteers, and to suggest a rational dosage regimen for rectal administration. The study design was a randomized open cross- over study of 12 healthy volunteers; the analytical method used was a reversed phase high performance liquid chromatography with post column derivatization and subsequent ultraviolet detection. Pharmacokinetic parameters were derived from the main metabolite α-dihydroartemisinin data due to the rapid disappearance of artesunate from the plasma. Dihydroartemisinin following oral administration of artesunate had a significantly higher AUC0-∞ ( P<0.05 95% confidence interval (Cl) −1168.73, −667.61 ng.h/mL−1) and Cmax( P<0.05;95%Cl −419.73, −171.44 ng/mL− 1, and had shorter tmax ( P<0.05; 95% Cl −0.97, −0.10 h) than that following rectal artesunate. There was no statistically significant difference in the elimination halflife between both routes of administration ( P> 0.05; 95% Cl −0.14, 0.53 h). The relative bioavailability of rectal artesunate was [mean (coefficient of variation%)54.9(24.8%)%]. On the basis of these data an 8 hourly dosing regimen per day with rectal artesunate is proposed.
Brain Hydatid Cyst in Basrah
Authors: Ameen Ameen Abbas 
Published: January 2017

Although infestation with Echinococcus granulosus is common in Iraq, brain hydatid cysts are rare. The first case since the establishment of the neurosurgical unit in Basrah (population 1.5 million) four years ago is reported. It was successfully treated by operation. The two points emphasized are the rarity of this problem, and the technical steps to maintain the integrity of the cyst during surgery. This seems to be the most important factor in preventing recurrence, which contributes largely to the outcome after surgery.
Feeding Patterns of Children with Protein-Energy Malnutrition in Nigeria
Authors: Jinadu M K , Ojofeitimi E O , Osifor E O 
Published: January 2017

The feeding patterns of 115 consecutive cases of children suffering from protein-energy malnutrition (PEM) seen at Ile-Ife University Teaching Hospital, were investigated. The majority of the children were from Ile-Ife township and nearly all their mothers were working outside their respective homes. The survey shows an earlier mean age (27 months) of onset of kwashiorkor compared with Naismith's (1973) study. About two-thirds of the mothers had stopped breastfeeding their children by the age of 17 months. Artificial milk was introduced briefly, in token quantity, and was replaced by “corn-pap” and other starchy foods such as “yam” and “hard-pap”. Over 80% of mothers would not feed their children on meat and fish because they believed these foods would cause worms which, in turn, would cause abdominal pain and loss of weight. Cow's milk, groundnut and cowpeas were said to cause diarrhoea by about two-thirds of the mothers. Our study shows that cessation of breastfeeding, inadequate feeding on artificial milk, and cultural beliefs about appropriate weaning diets for the infants were the major causes of PEM in this part of the world.
Immunogenicity of Measles Vaccine from a Hospital Based and Outreach Programme in Rural Kenya
Authors: Kaan J A , van Vlokhoven P C A , Schneeberger P M , Nijhof W 
Published: January 2017

Data on efficacy of rural immunization programmes are scarce. We investigated the seroconversion rate following measles vaccination in an outreach programme in Kakamega District, Kenya. Of 170 children, 120 (71%) showed seroconversion after vaccination. Haemagglutination inhibition test was performed on paired blood samples before and 30 days or more (mean 46, range 30–70 days) after vaccination. These results are comparable to results found by other studies in developing countries. Geometrical mean titres before vaccination of children in the age group above 14 months were significantly lower than in the younger age groups ( P < 0.001). This investigation indicates that seroconversion rate studies are feasible in remote rural areas.
The Reasons for Amputations in Children (0–18 Years) in a Developing Country
Authors: Loro Antonio , Franceschi Fulvio , Dal Lago Annamaria 
Published: January 2017

This study describes 49 young amputees who either have attended or have been operated at the Orthopaedic Department of Dodoma Regional Hospital from 1983 to 1991. Emphasis has been put on the aetiological factors of 56 amputations under review, underlying those that are typical of the Least Developed Countries in Africa and highlighting how they interrelate with the beliefs and traditions of the African society. Apart from 14 amputations performed for trauma of different type, important roles were played by home environment, tumours, wild animal bites and the health system itself. Nine amputations have been carried out for burns, while complications after medical care, particularly operative, have called for 12 amputations. Bone tumours have been responsible for eight and hyena assaults and snake bites have resulted in seven amputations. Special interest has been raised by four amputations performed for the so-called ‘idiopathic tropical lower limbs gangrene’ whose aetiology is still unknown.
Experience of Autologous Blood Transfusion at a District General Hospital in Zambia
Authors: Manda Winfred , Duffy Gillian 
Published: January 2017

SUMMARY An Autologous Blood Transfusion Programme has been in operation at Ndola Central Hospital (NCH) since April 1992. This paper describes a method of cell salvage and reviews the two types of autologous transfusion [acute isovolaemic haemodilution (AIH) and cell salvage] practised over the 6 month period November 1992 to April 1993. No complications or adverse effects were encountered and the benefits include reduction of immunological reactions and transmission of infection, which are risks associated with homologous transfusion. There is need to minimize homologous transfusions because of these risks and hospitals should develop reasonable, practical guidelines for safer transfusion, including the use of autologous blood whenever possible.
Endoscopic Injection Therapy for Bleeding Peptic Ulcer Using Absolute Alcohol
Authors: Misra S P , Dwivedi M 
Published: January 2017

The injection of sclerosants and adrenaline in a bleeding peptic ulcer is known to arrest bleeding in the majority of patients. However, there are very few studies from India on this subject. Injection therapy was carried out using absolute alcohol in 21 patients with bleeding gastric ulcer and 55 with bleeding duodenal ulcer. Injection therapy successfully controlled bleeding in all 76 patients. Bleeding recurred in two patients who were successfully managed with a second injection of absolute alcohol. Post-injection blood transfusion was required in 16 (76%) patients with gastric ulcer compared with only 12 (22%) of those with a duodenal ulcer. The difference was statistically significant ( P < 0.001). No complication of injection therapy was noted. It is concluded that injection therapy using absolute alcohol is a safe and effective therapy for managing patients with bleeding peptic ulcer.