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HIV incidence and factors contributed to retention in a 12-month follow-up study of injection drug users in Sichuan Province, China.

HIV-1 seroconversion and subtype were evaluated, and factors associated with cohort retention were analyzed for subjects' baseline sociodemographic and behavioral characteristics in a 12-month follow-up study of injection drug users (IDUs). In November 2002, a community-based baseline survey was conducted to recruit 333 HIV-seronegative IDUs for a prospective cohort study in Xichang County of Sichuan Province, China. During the 12-month follow-up period, HIV incidence was 3.17 per 100 person-years (95% confidence interval [CI]: 0.98, 5.37), and all subtypes of 8 HIV-1 seroconversions were CRF_07BC. The retention rate at the 12-month follow-up visit was 70.3% (234 of 333 subjects). In a multiple logistic regression model, ethnicity (OR = 0.60, 95% CI: 0.34, 1.04) and appearing at the 6-month follow-up visit (OR = 9.03, 95% CI: 5.14, 15.89) were independently associated with retention. No drug-using or sexual behaviors were found to be associated with retention. This study confirmed one of drug-trafficking routes in mainland China, from Yunnan to Sichuan and then to Xinjiang. This study also suggested that HIV is spreading rapidly to more geographic areas along drug-trafficking routes in China, and a short-term follow-up rate may predict a long-term retention rate in this IDU cohort.

Adult↗

Staff nurse retention: strategies for success.

At the same time the demand for nurses is on the rise, the supply is dwindling. Recruitment and retention are the two main factors which can be adjusted to affect supply. Recruitment has become increasingly difficult in the past two or three years due to decreasing enrollment in nursing education programs and increased demand for nurses in alternative delivery systems. Therefore staff nurse retention has become an issue of major importance. This article will begin by briefly delineating need and expectancy theories which in part explain job satisfaction and, hence, retention. Secondly, findings from the Magnet Hospital Study are summarized. Creative retention strategies will then be explored, concluding with a framework for developing a strategic plan for successful staff nurse retention.

Humans↗

Endothelial PDGF-B retention is required for proper investment of pericytes in the microvessel wall.

Several platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) family members display C-terminal protein motifs that confer retention of the secreted factors within the pericellular space. To address the role of PDGF-B retention in vivo, we deleted the retention motif by gene targeting in mice. This resulted in defective investment of pericytes in the microvessel wall and delayed formation of the renal glomerulus mesangium. Long-term effects of lack of PDGF-B retention included severe retinal deterioration, glomerulosclerosis, and proteinuria. We conclude that retention of PDGF-B in microvessels is essential for proper recruitment and organization of pericytes and for renal and retinal function in adult mice.

Alleles↗

Two Structural Domains Mediate Two Sequential Events in [gamma]-Zein Targeting: Protein Endoplasmic Reticulum Retention and Protein Body Formation.

[gamma]-Zein is a maize storage protein synthesized by endosperm cells and stored together with [alpha]- and [beta]-zeins in specialized organelles called protein bodies. Previous studies have shown that in maize there is only one type of protein body and it is derived directly from the endoplasmic reticulum (ER). In this article, we describe the domains of [gamma]-zein involved in ER retention and the domains involved in protein body formation. To identify the signal responsible for [gamma]-zein retention in ER-derived protein bodies, DNAs encoding various deletion mutants of [gamma]-zein were constructed and introduced into Arabidopsis as a heterologous system. By using pulse-chase experiments and immunoelectron microscopy, we demonstrated that the deletion of a proline-rich domain at the N terminus of [gamma]-zein puts an end to its retention in the ER; this resulted in the secretion of the mutated protein. The amino acid sequence of [gamma]-zein necessary for ER retention is the repeat domain composed of eight units of the hexapeptide PPPVHL. In addition, we observed that only those [gamma]-zein mutants that contained both the proline-rich repeat domain and the C-terminal cysteine-rich domain were able to form ER-derived protein bodies. We suggest that the retention of [gamma]-zein in the ER could be a result of a protein-protein association or a transient interaction of the repeat domain with ER membranes.

Journal Article↗

The impact of a social network intervention on retention in Belgian therapeutic communities: a quasi-experimental study.

BACKGROUND: Although numerous studies recognize the importance of social network support in engaging substance abusers into treatment, there is only limited knowledge of the impact of network involvement and support during treatment. The primary objective of this research was to enhance retention in Therapeutic Community treatment utilizing a social network intervention. AIMS: The specific goals of this study were (1) to determine whether different pre-treatment factors predicted treatment retention in a Therapeutic Community; and (2) to determine whether participation of significant others in a social network intervention predicted treatment retention. DESIGN, SETTING AND PARTICIPANTS: Consecutive admissions to four long-term residential Therapeutic Communities were assessed at intake (n = 207); the study comprised a mainly male (84.9%) sample of polydrug (41.1%) and opiate (20.8%) abusers, of whom 64.4% had ever injected drugs. Assessment involved the European version of the Addiction Severity Index (EuropASI), the Circumstances, Motivation, Readiness scales (CMR), the Dutch version of the family environment scale (GKS/FES) and an in-depth interview on social network structure and perceived social support. Network members of different cohorts were assigned to a social network intervention, which consisted of three elements (a video, participation at an induction day and participation in a discussion session). FINDINGS: Hierarchical regression analyses showed that client-perceived social support (F1,198 = 10.9, P = 0.001) and treatment motivation and readiness (F1,198 = 8.8; P = 0.003) explained a significant proportion of the variance in treatment retention (model fit: F7,197 = 4.4; P = 0.000). By including the variable 'significant others' participation in network intervention' (network involvement) in the model, the fit clearly improved (F1,197 = 6.2; P = 0.013). At the same time, the impact of perceived social support decreased (F1,197 = 2.9; P = 0.091). CONCLUSIONS: Participation in the social network intervention was associated with improved treatment retention controlling for other client characteristics. This suggests that the intervention may be of benefit in the treatment of addicted individuals.

Adult↗

Nasal retention of budesonide and fluticasone in man: formation of airway mucosal budesonide-esters in vivo.

AIMS: The efficacy of topical glucocorticosteroids in rhinitis and asthma is likely to depend on drug retention in the airway mucosa. With fluticasone propionate, retention may be achieved exclusively by lipophilicity, whereas for budesonide an additional possibility may be provided by its ability to form fatty acid esters in the airway mucosa that release the active drug. The aim of the present study was to determine the nasal mucosal retention of budesonide and fluticasone propionate, and the occurrence of budesonide-esters (budesonide-oleate, budesonide-palmitate) in the nasal mucosa. METHODS: In the present study, involving 24 healthy subjects, we have examined nasal mucosal drug retention of single doses of topical budesonide (256 microg) and fluticasone propionate (200 microg). Treatments were given consecutively and the administration sequence was randomised. Subjects were randomised into four parallel groups and two nasal biopsies were taken from each subject, i.e. before and at 2 h, at 2 and 6 h, at 6 and 24 h, or before and at 24 h after drug administration, resulting in 12 biopsies/time point. The measurement of unesterified budesonide, budesonide-oleate, budesonide-palmitate, and fluticasone propionate was based on microwave extraction procedures combined with liquid-chromatography/tandem mass-spectrometry. RESULTS: Neither of the analytes was detected in samples taken before glucocorticosteroid administration. After administration, unesterified budesonide, budesonide-esters, and fluticasone propionate were detected in the tissue from 23, 20, and 19 subjects, respectively. The mean tissue levels of budesonide at 2 and 6 h were 1051 and 176 pmol g(-1); the mean levels of fluticasone propionate at these time points were 237 and 10 pmol g(-1). The dose-corrected budesonide/fluticasone propionate tissue concentration ratios were 3.5 (P = 0.07) and 13.7 (P < 0.0002), respectively. At 24 h, budesonide and fluticasone propionate were detected in 8/12 and 3/12 of the biopsies, respectively. CONCLUSIONS: The present study demonstrates the formation of budesonide-esters in the human nasal mucosa in vivo, and that budesonide is retained in the nasal mucosa to a greater extent than fluticasone propionate. It is suggested that the formation of budesonide-esters and their subsequent release of budesonide contributes to an extended retention of budesonide in the airway mucosa.

Administration, Topical↗

Factors related to grade retention in children with short stature.

A recent study by Holmes et al. (1982) revealed a high degree (23%) of grade retention in a group of children with significant short stature secondary to growth hormone deficiency (GHD), constitutional delay (CD); or Turner's Syndrome (TS). Parents indicated in a free response format that 'immaturity' and 'small size' were the reasons for retention. The present follow-up study obtained academic achievement data on 47 of the 56 short children from the Holmes et al. (1982) study to assess what role academic factors, not spontaneously mentioned by parents, may have had in the retention decision. Results indicated that despite repeating a year in the primary grades, the group of retained children were still functioning 6 months below grade expectation, compared to grade appropriate achievement in the never-retained group. Parents and teachers were both accurate in their perceptions of children's academic achievement. Behavioural ratings by teachers indicated more adjustment difficulties for retained children, while parent ratings of behaviour showed a similar high level of problems for short children regardless of retention status. Although both groups of children possessed average intellectual abilities, the retained children obtained lower IQ scores than the never retained children. In summary, a majority of short children were achieving appropriate grade levels, but a substantial minority were experiencing under-achievement, behaviour problems, and grade retention, despite average intelligence.

Achievement↗

The effect of different etching times on the retention of fissure sealants in second primary and first permanent molars.

This study investigated the effect of different etching times on the retention of fissure sealants in second primary and first permanent molars. Eighty-four children with a total of 144 second primary molars and 264 first molars were included in the study. Etching times of 15, 30, 45 and 60 seconds were used. The fissure sealants were evaluated at 6 and 12 months. The results showed that the overall retention rate of fissure sealants in second primary molars was 73.0% at 6 months and 64.7% at 12 months, whereas in first permanent molars the retention rates were 60.7% at 6 months and 44.1% at 12 months respectively. There was no significant difference in the retention of fissure sealants either on second primary molars or on first permanent molars at a 6- and 12-month follow-up with the different etching times. It was concluded that the different etching times did not appear to affect the retention of fissure sealants on the first permanent molars or second primary molars. It might therefore be prudent to etch the teeth for a much shorter period than conventionally recommended.

Acid Etching, Dental↗

Randomized, controlled trial comparing the retention of a flowable restorative system with a conventional resin sealant: one-year follow up.

UNLABELLED: This clinical trial evaluated the retention rate of a flowable restorative system (Bond 1 + Flow-It!) used as a pit-and-fissure sealant compared with a conventional filled resin sealant (Fluroshield) over a 1-year period. METHOD: Using a half-mouth design, 160 sealants (80 in primary and 80 in permanent teeth) were placed on sound first/second primary molars and first permanent molars of 40 children aged between 4 and 7 years. For both primary and permanent dentitions, half the teeth (n = 40) were sealed with Fluroshield and half (n = 40) with Bond 1 + Flow-It! Teeth were evaluated at baseline, 6- and 12-month intervals. RESULTS: For both materials, there was no total loss of sealants placed on either the primary or permanent molars over 1 year. From Fluroshield sealants placed on primary teeth, 33 were completely intact after 6 months and 31 after 1 year. From those placed on permanent molars, no loss of material was observed after 6 months, while partial loss was noticed on 5% of teeth at 1-year recall. For Flow-It! resin applied on primary molars, partial loss of material was observed in only 1 sealant after 6 months and in 2 sealants after 1 year. On permanent teeth, 100% retention rate was observed over a 1-year follow up. There was a statistically significant difference (P < 0.01) between the sealing materials on primary but not permanent teeth, and, overall, Flow-It! sealants presented a higher retention rate at both 6-month and 1-year evaluations. Significant differences (P < 0.01) between baseline and the other evaluation periods were also observed. CONCLUSION: It may be concluded that the flowable restorative system yielded optimal retention on both primary and permanent molars. Its retention rate was significantly higher than that of the conventional pit-and-fissure sealant on primary teeth.

Bisphenol A-Glycidyl Methacrylate↗

A quasi-experimental research to investigate the retention of basic cardiopulmonary resuscitation skills and knowledge by qualified nurses following a course in professional development.

The research was undertaken with the intention of testing six null hypotheses regarding the retention of basic cardiopulmonary resuscitation (CPR) skills and knowledge of registered nurses. The hypotheses were formulated from the broad aims of the research, which were to investigate conclusions reached by other researchers highlighting the speed with which retention of CPR skills and knowledge deteriorates, and to investigate the need for regular updating in CPR. The research was quasi-experimental in nature. The 19 nurses participating in the research were qualified staff undertaking the English National Board (ENB) 923 course in Professional Development, which included a refresher on basic CPR skills and included some discussion regarding advanced techniques. The latest guidelines issued by the Resuscitation Council (1993) were used, which also aided in the design and use of the two research tools, namely an eight-point skills-testing observation tool and a 26-point knowledge-testing questionnaire. While a 3-hour update in CPR skills revealed an initial improvement, the decrease in retention of skills 10 weeks later was significant (P = 0.0000). The update in CPR knowledge also revealed an initial improvement but the decrease in retention of knowledge 10 weeks later was significant (P = 0.0000). The findings of the research reflect similar results to previous research undertaken and discussed in the literature review, suggesting that retention of skills and knowledge quickly deteriorates if not used or updated regularly. Therefore this research supports the importance of CPR refresher courses on a regular basis.

Adult↗

Nurse job satisfaction and retention: comparing public to private hospitals in Jordan.

AIMS: To identify variables of Jordanian nurses' job satisfaction and retention. Comparisons were performed between three public and two private hospitals. BACKGROUND: There has been little research on nurse job satisfaction and retention in Jordan. Interest in nurse retention is renewed with each cycle of nursing shortage. METHODS: A descriptive design using surveys guided this study through convenience sample of 438 nurses. Data were analysed using descriptive and inferential statistics. RESULTS: Nurses reported that they were "moderately satisfied" in their jobs with "neutral" opinion about their retention. Nurses who work in private hospitals were more satisfied and intended to retain their jobs more than nurses in public hospitals. CONCLUSION: Nurse job satisfaction and retention are related concepts; nurses who are satisfied in their jobs are likely to retain these jobs.

Adult↗

Reduced liver function is the trigger for renal sodium retention following portal vein ligation in the rat.

Sodium retention along with peripheral vasodilation are features of prehepatic portal hypertension. In several models of experimental liver damage, sodium retention occurs only when hepatic function, measured by the aminopyrine breath test (ABT-k), falls below a critical threshold. The relationship between renal sodium handling, ABT-k and systemic and renal haemodynamics in partial portal vein ligated (PVL) rats was examined to test hypothesis that peripheral vasodilation was responsible for initiating sodium retention. Haemodynamic measurements were conducted early after surgery in portal hypertensive rats with and without sodium retention and in sham-operated controls. Compared with control, both PVL groups of rats had elevated portal pressure and lower peripheral vascular resistance (P < 0.05). Sodium retaining-PVL rats had both lower ABT-k (0.95 +/- 0.05 vs 1.38 +/- 0.06 x 10(-2)/min; P < 0.05) and higher sodium balance (1.38 +/- 0.09 vs 0.43 +/- 0.09 mmol/day; P < 0.05) than non-sodium retaining PVL rats. No differences in plasma renin activity or noradrenaline concentrations were observed. In a separate group of rats, hydralazine-induced pheripheral vasodilation did not induce sodium retention. These results suggest that the presence of peripheral vasodilation alone is not sufficient to trigger a sodium-retaining status. A factor, probably liver function-dependent, acting directly on renal tubules may be necessary for changes in renal sodium handling in this model.

Animals↗

Foetal and neonatal autopsy rates and use of tissue for research: the influence of 'organ retention' controversy and new consent process.

AIM: To examine whether the 'organ retention' controversy and new autopsy consent process had any effect on foetal and neonatal autopsy rates and on permitting the use of tissue for scientific research and education. METHODS: An audit of perinatal autopsy rates in a tertiary hospital prior to (1999-2001) and subsequent to the 'organ retention' controversy (2001-2002), and the introduction of a new consenting process (2002-2004). Rates were compared also with those a decade earlier (1990-1993). RESULTS: Overall autopsy rates have been falling significantly between the three study periods (1999-2001 71.7%; 2001-2002 61.5%; 2003-2004 50.5%). Autopsy rates have fallen significantly between 1990-1993 and 1999-2001 (P<0.00005) and between 1990-1993 and 1999-2004 (P<0.0000001). The autopsy rates for stillbirths and neonatal deaths have fallen significantly further since the 'organ retention' controversy but not significantly so following the new consenting process. Significantly fewer autopsies are performed on foetuses less than 20 weeks gestation in recent years than a decade ago (P<0.0000001). There were more external or limited autopsies in later years (P=0.015). Permission for the use of tissue for education and research is less frequent following the 'organ retention' controversy and particularly following the introduction of the new consenting process. CONCLUSION: Perinatal autopsy rates have fallen over the past 10 years. Fewer autopsies are being performed following the 'organ retention' controversy and use of tissue for research and education is permitted even less frequently following the introduction of the new consenting process.

Autopsy↗

Correlates of retention on the South Australian Methadone Program 1981-91.

OBJECTIVES: To investigate correlates of retention on the South Australian Methadone Program during 1981-91. DESIGN: Retrospective study of a nonstratified random sample of 229 HIV-negative clients who received methadone between January 1981 and June 1991. Data were collected from clinical records of the 229 HIV-negative clients and also from the 40 clients known to be infected with HIV during the decade. RESULTS: Being HIV positive, receiving larger maximum doses of methadone, receiving methadone from a private pharmacy and enrolling later in the decade were all associated with longer retention times on the program. CONCLUSIONS: This study supports the findings of previous studies, that maximum dose of methadone is crucial to retention in methadone programs, But even allowing for maximum dose, obtaining methadone from a private pharmacy was also strongly associated with retention on the program. The more 'humane' clinic policy later in the decade is likely to have increased retention and reduced illicit drug use also.

HIV Seropositivity↗

Fire and green-tree retention in conservation of red-listed and rare deadwood-dependent beetles in Finnish boreal forests.

Habitat loss, fragmentation, and declining habitat quality have created an extinction debt in boreal forests, which could be partly reversed by deliberately improving the habitat quality in managed areas outside reserves. We studied the effects of green-tree retention and controlled burning on red-listed and rare, deadwood-dependent (saproxylic) beetles in a large-scale field experiment in eastern Finland. Our factorial study design included 24 sites dominated by Scots pine (Pinus sylvestris L.) and with three levels of green-tree retention (0, 10, and 50 m3/ha) and uncut controls. Twelve of the 24 sites were burned in 2001. We sampled beetles with 10 flight-intercept traps on each site during the years 2000-2002 (i.e., 1 pretreatment and 2 post-treatment years). A total sample of 153,449 individuals representing 1,160 beetle species yielded 2,107 specimens of 84 red-listed or rare saproxylic species. The richness of these species was higher on the burned than on the unburned sites, and higher levels of green-tree retention promoted species richness, but there were clear differences between the years. The richness of red-listed and rare saproxylic species increased in the first post-treatment year, evidently due to the treatments, continued to increase on the burned sites in the second post-treatment year, but decreased on the unburned sites. Our results showed that the living conditions of many red-listed and rare saproxylic species could be improved significantly with rather simple alterations to forest management methods. Controlled burning with high levels of green-tree retention creates resources for many saproxylic species, but increasing the levels of green-tree retention in unburned areas can also be beneficial.

Animals↗

Interstitial inflammation, sodium retention, and the pathogenesis of nephrotic edema: a unifying hypothesis.

BACKGROUND: The pathophysiology of edema in the nephrotic syndrome is controversial. Some investigators believe that sodium retention may result from a primary renal defect that causes an "overfilled" blood volume. In contrast, other authors believe that fluid escapes the vascular compartment due a low oncotic pressure, and sodium retention is a compensatory physiological response to an "underfilled" blood volume. The patients that best fit the "underfilled" hypothesis are children with minimal-change nephrotic syndrome (MCNS). METHODS: We analyzed critically the available evidence for and against each proposed pathogenic mechanism in the light of recent evidence indicating that the inflammatory infiltrate may play a role in primary renal sodium retention. RESULTS: Inflammatory infiltrate in the kidney is a constant characteristic in nephrotic syndrome associated with primary sodium retention and it is absent in most cases of MCNS in children CONCLUSIONS: We propose that primary sodium retention in the nephrotic syndrome depends on the existence and the intensity of renal inflammatory infiltrate, conspicuously absent in most cases of MCNS in children and present in other conditions associated with massive proteinuria. The tubulointerstitial inflammatory infiltrate is associated with increased vasoconstrictive mediators that result in increased tubular sodium reabsorption and with glomerular hemodynamic changes that reduce filtered sodium load.

Edema↗

Buprenorphine retention in primary care.

BACKGROUND: This study assesses the rate and predictors of treatment retention for primary care patients with opioid dependence-prescribed buprenorphine, a long-acting partial opioid agonist. METHODS: Observational cohort study of patients prescribed buprenorphine/naloxone and followed for 6 months in the period after the adoption of buprenophine/naloxone by a primary care practice in Rhode Island. Practice policy precluded patient discharges due to continuing drug use. RESULTS: Patients (n=41) had a mean duration of opioid use of 15.7 years and most had a history of heroin use (63.4%). Thirty-nine percent of patients transferred from methadone maintenance. At 24 weeks, 59% remained in treatment. Nearly half of dropouts occurred in the first 30 days. Participants with opiate-positive toxicologies at week 1 were more likely to drop out of the program (P<.01) and had a significantly shorter retention time (P<.01) on average. Among other drug use and drug treatment variables, employment and addiction counseling during treatment were significantly associated with treatment retention (P=.03). CONCLUSION: Retention rates in a real world, primary care-based buprenorphine maintenance practice reflect those reported in clinical trials. Abstinence during the first week of treatment and receipt of counseling were critical to patient retention.

Adult↗

Atrial "J" pacing lead retention wire fracture: radiographic assessment, incidence of fracture, and clinical management.

UNLABELLED: In November 1994, Telectronics Pacing Systems issued a voluntary recall of their Accufix 330-801 and 329-701 "J"-shaped atrial pacemaker leads. To assess the integrity of the lead, 156 consecutive patients with the Accufix 330-801 atrial lead implanted underwent fluoroscopic screening. Leads were visualized in at least two orthogonal views. When identified, fractured retention wires were classified into one of four groups, depending on the degree of wire extrusion outside of the lead insulation. RESULTS: Of the 156 patients, 35 patients (22.4%) had a definite retention wire fracture, and an additional 13 patients (8.3%) had indeterminate leads. Neither the age of the patients, the time since lead implant, nor the site of fracture correlated with the incidence of wire fracture. When analyzed to include indeterminate leads that were re-evaluated and found to be fractured, as well as two leads that were identified as being radiographically normal but found to be fractured after extraction, the incidence of retention wire fracture is 25.6% (40 of 156 leads evaluated). CONCLUSIONS: The incidence of retention wire fracture in the Accufix 330-801 lead is significantly higher than originally reported. Patients should be notified of the potential dangers associated with this lead. Cardiac digital fluoroscopy is an effective method of screening for wire fracture. Leads with fractured retention wires should be extracted and those with normal fluoroscopic appearance should undergo regular fluoroscopic screening.

Aged↗