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Knowledge and perception of risk for HIV and condom use among male injecting drug users in Cebu City, Philippines.

Injecting drug users (IDU) represent a small fraction of the HIV and AIDS cases in the Philippines. To determine if these people are engaging in behaviors that put them at risk for HIV, interviews were conducted with 360 male IDUs in Cebu City, Philippines, from 1997 to 1999, as part of a national surveillance system. The interviews assessed knowledge about HIV transmission, sources of information about HIV/AIDS, perceived risks of contracting HIV, needle-sharing practices, condom use, self-reported signs and symptoms of STDs and number of sex partners. Although most of the men were able to recognize behaviors accurately that put them at risk for HIV, more than two-thirds claimed that they shared needles and almost two-thirds of those who were sexually active claimed that they never used condoms. Intervention strategies must be developed for this population if the nation is to avoid the dramatic increase in HIV infection among IDUs that has been witnessed in neighboring Southeast Asian nations such as Malaysia and Vietnam.

Adolescent↗

A review of the special tests associated with shoulder examination. Part I: the rotator cuff tests.

Careful examination of the shoulder is an essential component in forming a diagnosis of problems in this area. A number of tests have been described that are claimed to improve diagnostic accuracy by specifically examining one component of the shoulder complex. Many of these tests are eponymous, and there is confusion about not only how to perform them but also what conclusion to draw from the results. This article attempts to clarify the tests used to examine the rotator cuff by presenting them as described by the original authors with the additional aim of providing a source for those wishing to refresh their knowledge without the need to refer to the original source material.

Humans↗

A review of the special tests associated with shoulder examination. Part II: laxity, instability, and superior labral anterior and posterior (SLAP) lesions.

This is the second of a two-part article describing the various tests that have been used to examine the shoulder to find and treat problems in that area. Part I of this article (January/February 2003, pages 154-160) focused on tests used to examine rotator cuff abnormalities. This article attempts to clarify the tests of laxity, instability, and the superior labral anterior and posterior (SLAP) lesions by presenting them as described by the original authors, with the additional aim of providing a source for those wishing to refresh their knowledge without the need to refer to the original source material.

Humans↗

Using databases.

Through a relatively simple computer technique known as online searching, practitioners can use computers to "reach out" beyond their practice walls to expand their knowledge base. By bringing information sources closer to veterinarians, feelings of isolation, frustration, and ineptitude can be replaced with feelings of certainty, confidence, and knowledge. This article explores the equipment and the software needed, and by giving examples of a few of the veterinary databases, illustrates some techniques employed in signing up and signing on to the power of online searching.

Animals↗

Knowledge of breast cancer and its risk and protective factors among women in Riyadh.

BACKGROUND: We conducted this study to assess knowledge of breast cancer and sources of information about breast cancer among women in Riyadh. We also analyzed whether associations existed between demographic variables, knowledge of breast cancer, and the practice of breast self-examination and use of mammography screening. METHODS: Women interested in participating in this community-based descriptive study provided data by completing a pre-tested structured RESULTS: Of 864 participating women, 84% were Saudi, 45% were married and 67.8% had a university level education. Eighty percent were between the ages of 20 to 50 years. Knowledge of breast self examination (BSE) was high; 82% (95% confidence intervals [CI], 79.2%-84.4%) knew about BSE, while 61% (95% CI: 57.9%-64.5%) knew about mammography, but only 41.2% (95% CI, 37.9%-44.5%) had performed BSE and 18.2% (95%CI, 15.5%-20.8%) had had mammography screening. Knowledge of breast cancer, risk factors and protective factors for breast cancer was moderate. There was a statistically significant association between the demographic characteristics (marital status, educational status and family history of breast cancer) and knowledge and practice of BSE and CONCLUSION: Though it has limitations, this study revealed an imbalance between the knowledge and practice of BSE among women. It also showed that there is only moderate knowledge of risk and protective factors for breast cancer and that knowledge and practice of BSE and mammograms vary according to marital and educational status. Hence, frequent community-based awareness programs are needed so that all women can know and practice BSE, which in turn helps to prevent breast cancer.

Adult↗

Communication during the pre-operative visit.

Eighty-six patients completed a questionnaire about what they expected from a pre-operative visit by an anaesthesiologist. Ninety-one per cent of the patients wanted a detailed and informative conversation. The patient's previous knowledge stemmed primarily from lay sources, such as other patients and visitors. Age and marital status influenced the extent of the patient's previous knowledge.

Adult↗

Sources of HIV information among injecting drug users: association with gender, ethnicity, and risk behaviour. AIDS Community Demonstration Projects.

Sources of HIV information were examined for 774 male and female injecting drug users (IDUs). The majority (80.7%) had received HIV information from one or more sources in the prior 3 months. The most frequently mentioned sources were television (39.9%) and friends or family (22.2%). There were few differences in source of HIV information with regard to gender, ethnicity, or age. Differences were more frequently observed between cities. The relationship of information source and subject characteristics with HIV knowledge, perceived risk, drug-related and sexual practices was examined using logistic regression. For men, exposure to mass media sources (OR = 1.48) and small media materials (OR = 2.03) were related to HIV knowledge. Small media and interpersonal information were related to HIV testing for men (OR = 1.95 and 1.85, respectively) and women (OR = 2.25 and 2.54). Interpersonal sources of information were also associated with increased sharing of injection equipment (OR = 2.04) and bleach use (OR = 2.23) among female IDUs. Significant differences in HIV knowledge and risk-related practices were also observed for ethnicity, city, men who have sex with men, and women who had traded sex for money or drugs. Implications for targeting HIV prevention efforts for IDUs are discussed.

Adolescent↗

Ontologies for data and knowledge sharing in biology: plant ROS signaling as a case study.

Modern technologies have rapidly transformed biology into a data-intensive discipline. In addition to the enormous amounts of existing experimental data in the literature, every new study can produce a large amount of new data, resulting in novel ideas and more publications. In order to understand a biological process as completely as possible, scientists should be able to combine and analyze all such information. Not only molecular biology and bioinformatics, but all the other domains of biology including plant biology, require tools and technologies that enable experts to capture knowledge within distributed and heterogeneous sources of information. Ontologies have proven to be one of the most-useful means of constructing and formalizing expert knowledge. The key feature of an ontology is that it represents a computer-interpretable model of a particular subject area. This article outlines the importance of ontologies for systems biology, data integration and information analyses, as illustrated through the example of reactive oxygen species (ROS) signaling networks in plants.

Computational Biology↗

Network analytic methods for epidemiological risk assessment.

The authors measure the efficacy of three methods for predicting the time to infection for susceptible individuals in a population undergoing an HIV epidemic. The methods differ in whether they require detailed information of the contact network and whether they require knowledge of the initial source of infection. Efficacy is evaluated using simulations for 20 different contact patterns. Only the risk score that uses both kinds of information accounts for more than 15 per cent of individual variability. The efficacy of this score ranges from 10 per cent in very unstructured populations to 60 per cent for spatially localized contact networks. This improved performance may be explained by the larger fraction of the total variability not due to the disease dynamics. When all variables are dichotomized, the two poorer methods produce odds ratios between 1.4 and 2.3. The odds ratio for the risk score with full information ranges from 2.5 to 17. Risk assessment protocols and intervention programmes are encouraged to assess contact patterns and detect sources of infection.

Analysis of Variance↗

Sourcing sediment using multiple tracers in the catchment of Lake Argyle, Northwestern Australia.

Control of sedimentation in large reservoirs requires soil conservation at the catchment scale. In large, heterogeneous catchments, soil conservation planning needs to be based on sound information, and set within the framework of a sediment budget to ensure that all of the potentially significant sources and sinks are considered. The major sources of sediment reaching the reservoir, Lake Argyle, in tropical northwestern Australia, have been determined by combining measured sediment fluxes in rivers with spatial tracer-based estimates of proportional contributions from tributaries of the main stream entering the lake, the Ord River. The spatial tracers used are mineral particle magnetics, the strontium isotopic ratio, and the neodymium isotopic ratio. Fallout of 137Cs has been used to estimate the proportion of the sediment in Lake Argyle eroded from surface soils by sheet and rill erosion, and, by difference, the proportion eroded from subsurface soils by gully and channel erosion. About 96% of the sediment in the reservoir has come from less than 10% of the catchment, in the area of highly erodible soils formed on Cambrian-age sedimentary rocks. About 80% of the sediment in the reservoir has come from gully and channel erosion. A major catchment revegetation program, designed to slow sedimentation in the reservoir, appears to have had little effect because it did not target gullies, the major source of sediment. Had knowledge of the sediment budget been available before the revegetation program was designed, an entirely different approach would have been taken.

Australia↗

Adaptive comanagement for building resilience in social-ecological systems.

Ecosystems are complex adaptive systems that require flexible governance with the ability to respond to environmental feedback. We present, through examples from Sweden and Canada, the development of adaptive comanagement systems, showing how local groups self-organize, learn, and actively adapt to and shape change with social networks that connect institutions and organizations across levels and scales and that facilitate information flows. The development took place through a sequence of responses to environmental events that widened the scope of local management from a particular issue or resource to a broad set of issues related to ecosystem processes across scales and from individual actors, to group of actors to multiple-actor processes. The results suggest that the institutional and organizational landscapes should be approached as carefully as the ecological in order to clarify features that contribute to the resilience of social-ecological systems. These include the following: vision, leadership, and trust; enabling legislation that creates social space for ecosystem management; funds for responding to environmental change and for remedial action; capacity for monitoring and responding to environmental feedback; information flow through social networks; the combination of various sources of information and knowledge; and sense-making and arenas of collaborative learning for ecosystem management. We propose that the self-organizing process of adaptive comanagement development, facilitated by rules and incentives of higher levels, has the potential to expand desirable stability domains of a region and make social-ecological systems more robust to change.

Canada↗

What makes a food protein an allergen?

Food allergens are almost always proteins, but not all food proteins are allergens. This one statement sums up the purpose of this article, defining the difference between an innocuous food protein and a food allergen. The simplest answer is that a food allergen has the ability to first elicit an IgE response, and then, on subsequent exposures, to elicit a clinical response to the same or similar protein. However, this simplistic answer avoids the more complex issues of defining the biochemical characteristics that allow a food protein to survive the extremes of food processing, escape the digestive enzymes of the human gastrointestinal tract, and interact with the immune system. More than 700 allergen sequences have been identified from food and nonfood sources. However, despite increasing knowledge of the structure and amino acid sequences of the identified allergens, only a few biochemical characteristics can be associated with food allergens. Food allergen characteristics, including abundance of the protein in the food; multiple, linear IgE binding epitopes; resistance of the protein to digestion and processing; and allergen structure are discussed, and the possible reasons they predispose some food proteins to become allergens are suggested.

Allergens↗

The tuberomammillary nucleus region as a reinforcement inhibiting substrate: facilitation of ipsihypothalamic self-stimulation by unilateral ibotenic acid lesions.

The tuberomammillary nucleus (TM), located in the posterior hypothalamic region, consists of five subgroups and is the only known source of brain histamine. Knowledge about the function of this nucleus is still scarce. In a previous study we found an increase in the rate of ipsihemispheric hypothalamic self-stimulation following a dc lesion in the rostroventral part of this nucleus, suggesting that this region has an inhibitory action on a neuronal reward system or on the brain's reinforcement mechanism. In the present study we examined whether this facilitating effect on reinforcement was due to the destruction of fibers passing through the lesion area or of intrinsic cells, by lesioning subgroups of the TM with ibotenic acid, an excitatory amino acid, that selectively destroys neural cell bodies, leaving fibers largely intact. Following such lesions in the rostroventral part of the TM the operant response rates increased over the six days of testing when the animals stimulated themselves in the lateral hypothalamus in the hemisphere located ipsilateral but not contralateral to the lesion. No significant changes in response rate occurred following the lesion in the caudal part of the ventral TM. The results indicate that the region influenced by the lesion exerts inhibitory control over lateral hypothalamic self-stimulation, and that it is possible that histamine-containing neurons are involved in this effect.

Animals↗

Dispersion and transport paths of toxic persistent organochlorines to the Arctic--levels and consequences.

Most people still consider the Arctic as one of the last non-polluted regions of the world. However, recent studies have shown that the levels of organochlorines such as chlorinated pesticides, dibenzofurans and dibenzo-p-dioxins are surprisingly high in biota such as seals and polar bears from the Norwegian and Canadian Arctic. A short review is given of our knowledge concerning levels and sources as well as consequences of the presence of persistent toxic organochlorines in the Arctic. Long-range air transport, in particular, as the main source of these compounds will be discussed in more detail.

Adipose Tissue↗

Dyslexia, dysnomia, and lexical retrieval: a longitudinal investigation.

Results from a 3-year longitudinal investigation of confrontation naming in 98 children (75 average readers, 14 severely impaired readers, 9 bilingual readers) indicate: kindergarten performance on confrontation naming predicts Grade 2 reading performance, particularly reading comprehension; confrontation naming differentiates average from severely impaired readers; and lexical retrieval, not vocabulary knowledge, is the major source of difference between reading groups. Findings on lexical retrieval are integrated with research on naming access speed. The implications of these results for specification of dyslexia subgroups are discussed.

Anomia↗

Limited impact of the breast self-examination movement: a Latin American illustration.

Analysis of data obtained through a survey of women in Monterrey, Mexico, indicates that the transfer of breast self-examination (BSE) technology from the medical community to the Monterrey public has been inefficacious. Only 1 in 200 women reported monthly breast self-examination performed correctly and at the optimal time of the month. Among women who reported examining their breasts monthly, transfer of BSE technology, whether by medical or non-medical sources, was unrelated to knowledge of correct time and method of BSE. Personal instruction of BSE technology by physician failed to produce the desired response since 80% of the respondents were taught BSE technique in 'one-shot', short sessions. The findings indicate that, ultimately, the success of BSE in improving disease outcomes rests with the medical community more than with the patient population. Success will only follow more intense initial instruction and persistent reinstruction of women in BSE. The implications of these findings for current research seeking to evaluate BSE influence on cancer outcomes are noted.

Adolescent↗

Stereotaxic localization of intracranial targets.

We report on a useful clinical method for precisely locating intracranial targets. Utilizing the BRW system, the technique is currently used in stereotaxic irradiation of arteriovenous malformations. An intracranial localizer box, with four radio-opaque markers on each face, surrounds the patient's head and is attached to the BRW Head Ring. Two localization films are required. One film includes the target and the eight anterior and posterior markers, whereas the other film includes the target and the eight right and left markers. There are no constraints that the films be orthogonal or parallel to the box faces, only that the target and radio-opaque markers appear on the films. In addition, knowledge of the source-image and source-target distances are not required. Analysis of the projected target and radio-opaque markers gives both the target location and magnification. Simulation with the BRW Phantom Base demonstrates that point targets can be located with respect to the BRW system to within 0.3 mm and magnification determined to within 0.5%.

Cerebral Angiography↗

Multiple viral infections in the immunocompromised host: recognition and interpretation.

BACKGROUND: During the past decade, diagnostic virology has become an integral part of patient management. Concurrent infection with multiple viruses occurs in both the healthy and immunocompromised host. Many common viruses result in latent infection with the potential for reactivation throughout the life of the host. Superimposed on this are transient infections with yet other viruses. OBJECTIVES: To review multiple viral infections in immunocompromised hosts, focusing on laboratory recognition and interpretation of results. STUDY DESIGN: A review of the literature, with case examples from the author's laboratory. RESULTS: Viral infections are more likely to cause morbidity and mortality in immunodeficient hosts, and early recognition and treatment may be lifesaving. To detect two or more viruses shed concurrently from the same body site requires the use of multiple test modalities, which are now available in many clinical laboratories. Establishing the significance of a virus isolate is a complex process. Knowledge of the specimen source, virus quantitation and characteristics of the patient are helpful. Careful evaluation of the patient's clinical findings together with other laboratory test results, including histopathology, X-rays and the detection of other microorganisms, is also essential. CONCLUSIONS: The recognition and interpretation of multiple virus infections requires heightened awareness as well as close cooperation and communication between the professionals in the laboratory and physicians at the bedside.

Journal Article↗