Human papillomavirus prevalence, viral load and pre-cancerous lesions of the cervix in women initiating highly active antiretroviral therapy in South Africa : a cross-sectional study

Background Cervical cancer and infection with human immunodeficiency virus (HIV) are both important public health problems in South Africa (SA). The aim of this study was to determine the prevalence of cervical squamous intraepithelial lesions (SILs), high-risk human papillomavirus (HR-HPV), HPV viral load and HPV genotypes in HIV positive women initiating anti-retroviral (ARV) therapy. Methods A cross-sectional survey was conducted at an anti-retroviral (ARV) treatment clinic in Cape Town, SA in 2007. Cervical specimens were taken for cytological analysis and HPV testing. The Digene Hybrid Capture 2 (HC2) test was used to detect HR-HPV. Relative light units (RLU) were used as a measure of HPV viral load. HPV types were determined using the Roche Linear Array HPV Genotyping test. Crude associations with abnormal cytology were tested and multiple logistic regression was used to determine independent risk factors for abnormal cytology. Results The median age of the 109 participants was 31 years, the median CD4 count was 125/mm3, 66.3% had an abnormal Pap smear, the HR-HPV prevalence was 78.9% (Digene), the median HPV viral load was 181.1 RLU (HC2 positive samples only) and 78.4% had multiple genotypes. Among women with abnormal smears the most prevalent HR-HPV types were HPV types 16, 58 and 51, all with a prevalence of 28.5%. On univariate analysis HR-HPV, multiple HPV types and HPV viral load were significantly associated with the presence of low and high-grade SILs (LSIL/HSIL). The multivariate logistic regression showed that HPV viral load was associated with an increased odds of LSIL/HSIL, odds ratio of 10.7 (95% CI 2.0 – 57.7) for those that were HC2 positive and had a viral load of ≤ 181.1 RLU (the median HPV viral load), and 33.8 (95% CI 6.4 – 178.9) for those that were HC2 positive with a HPV viral load > 181.1 RLU. Conclusion Women initiating ARVs have a high prevalence of abnormal Pap smears and HR-HPV. Our results underscore the need for locally relevant, rigorous screening protocols for the increasing numbers of women accessing ARV therapy so that the benefits of ARVs are not partially offset by an excess risk in cervical cancer.

Polarized fluid movement and not cell death, creates luminal spaces in adult prostate epithelium

There are two predominant theories for lumen formation in tissue morphogenesis: cavitation driven by cell death, and membrane separation driven by epithelial polarity. To define the mechanism of lumen formation in prostate acini, we examined both theories in several cell lines grown in three-dimensional (3D) Matrigel culture. Lumen formation occurred early in culture and preceded the expression of cell death markers for apoptosis (active caspase 3) and autophagy (LC-3). Active caspase 3 was expressed by very few cells and inhibition of apoptosis did not suppress lumen formation. Despite LC-3 expression in all cells within a spheroid, this was not associated with cell death. However, expression of a prostate-secretory protein coincided with lumen formation and subsequent disruption of polarized fluid movement led to significant inhibition of lumen formation. This work indicates that lumen formation is driven by the polarized movement of fluids and proteins in 3D prostate epithelial models and not by cavitation.

Application of the self-efficacy model in nursing practice [自我效能模式於護理臨床應用之剖析]

Self-efficacy has two cognitive components, efficacy expectations and outcome expectations, and their influence on behavior change is synergistic. Efficacy expectation is effected by four main sources of information provided by direct and indirect experiences. The four sources of information are performance accomplishments, vicarious experience, verbal persuasion and self-appraisal. How to measure and develop interventions is an important issue at present. This article clearly analyzes the relationship between variables of the self-efficacy model and explains the implementation of self-efficacy enhancing interventions and instruments in order to test the model. Through the process of the use of theory and feasibility in clinical practice, it is expected that professional medical care personnel should firstly familiarize themselves with the self-efficiency model and concept, and then flexibly promote it in professional fields clinical practice, chronic disease care and health promotion.

Identification of copper species present in Cu-ZSM-5 catalysts for NOx reduction

The structure of Cu-ZSM-5 catalysts that show activity for direct NO decomposition and selective catalytic reduction of NOx by hydrocarbons has been investigated by a multitude of modern surface analysis and spectroscopy techniques including X-ray photoelectron spectroscopy, thermogravimetric analysis, and in situ Fourier transform infrared spectroscopy. A series of four catalysts were prepared by exchange of Na-ZSM-5 with dilute copper acetate, and the copper loading was controlled by variation of the solution pH. Underexchanged catalysts contained isolated Cu2+OH-(H2O) species and as the copper loading was increased Cu2+ ions incorporated into the zeolite lattice appeared. The sites at which the latter two copper species were located were fundamentally different. The Cu2+OH-(H2O) moieties were bound to two lattice oxygen ions and associated with one aluminum framework species. In contrast, the Cu2+ ions were probably bound to four lattice oxygen ions and associated with two framework aluminum ions. Once the Cu-ZSM-5 samples attained high levels of exchange, the development of [Cu(μ-OH)2Cu]n2+OH-(H2O) species along with a small concentration of Cu(OH)2 was observed. On activation in helium to 500°C the Cu2+OH-(H2O) species transformed into Cu2+O- and Cu+ moieties, whereas the Cu2+ ions were apparently unaffected by this treatment (apart from the loss of ligated water molecules). Calcination of the precursors resulted in the formation of Cu2+O2- and a one-dimensional CuO species. Temperature-programmed desorption studies revealed that oxygen was removed from the latter two species at 407 and 575°C, respectively. © 1999 Academic Press.

Manufacture of fine-grained Y2BaCuO5 powder by coprecipitation

Quantities of Y2BaCuO5 powder greater than 500g have been manufactured by a co-precipitation process. By suitable heat treatments, the particle size of these powders can be varied from 5µm to less than 500nm. Sub-micrometer size powders may, under some conditions, have a duller green colour which is attributed to <2% unreacted material. However, after re-grinding and re-firing of this powder, high-purity powders can be achieved without significant grain growth. Inductively coupled plasma (ICP) spectroscopy is used to measure the stoichiometry of the powders and X-ray diffraction is used to determine phase purity. In both cases, the bulk composition is consistent with Y2BaCuO5 and phase purity is considered better than 95%.

Advanced battery storage control for an autonomous microgrid

A new control method for battery storage to maintain acceptable voltage profile in autonomous microgrids is proposed in this article. The proposed battery control ensures that the bus voltages in the microgrid are maintained during disturbances such as load change, loss of micro-sources, or distributed generations hitting power limit. Unlike the conventional storage control based on local measurements, the proposed method is based on an advanced control technique, where the reference power is determined based on the voltage drop profile at the battery bus. An artificial neural network based controller is used to determine the reference power needed for the battery to hold the microgrid voltage within regulation limits. The pattern of drop in the local bus voltage during power imbalance is used to train the controller off-line. During normal operation, the battery floats with the local bus voltage without any power injection. The battery is charged or discharged during the transients with a high gain feedback loop. Depending on the rate of voltage fall, it is switched to power control mode to inject the reference power determined by the proposed controller. After a defined time period, the battery power injection is reduced to zero using slow reverse-droop characteristics, ensuring a slow rate of increase in power demand from the other distributed generations. The proposed control method is simulated for various operating conditions in a microgrid with both inertial and converter interfaced sources. The proposed battery control provides a quick load pick up and smooth load sharing with the other micro-sources in a disturbance. With various disturbances, maximum voltage drop over 8% with conventional energy storage is reduced within 2.5% with the proposed control method.

Hazard based models for freeway traffic incident duration

Assessing and prioritising cost-effective strategies to mitigate the impacts of traffic incidents and accidents on non-recurrent congestion on major roads represents a significant challenge for road network managers. This research examines the influence of numerous factors associated with incidents of various types on their duration. It presents a comprehensive traffic incident data mining and analysis by developing an incident duration model based on twelve months of incident data obtained from the Australian freeway network. Parametric accelerated failure time (AFT) survival models of incident duration were developed, including log-logistic, lognormal, and Weibul-considering both fixed and random parameters, as well as a Weibull model with gamma heterogeneity. The Weibull AFT models with random parameters were appropriate for modelling incident duration arising from crashes and hazards. A Weibull model with gamma heterogeneity was most suitable for modelling incident duration of stationary vehicles. Significant variables affecting incident duration include characteristics of the incidents (severity, type, towing requirements, etc.), and location, time of day, and traffic characteristics of the incident. Moreover, the findings reveal no significant effects of infrastructure and weather on incident duration. A significant and unique contribution of this paper is that the durations of each type of incident are uniquely different and respond to different factors. The results of this study are useful for traffic incident management agencies to implement strategies to reduce incident duration, leading to reduced congestion, secondary incidents, and the associated human and economic losses.

Regulating journalists? The Finkelstein Review, the Convergence Review, and News Media Regulation in Australia

This paper identifies two major forces driving change in media policy worldwide: media convergence, and renewed concerns about media ethics, with the latter seen in the U.K. Leveson Inquiry. It focuses on two major public inquiries in Australia during 2011-2012 – the Independent Media Inquiry (Finkelstein Review) and the Convergence Review – and the issues raised about future regulation of journalism and news standards. Drawing upon perspectives from media theory, it observes the strong influence of social responsibility theories of the media in the Finkelstein Review, and the adverse reaction these received from those arguing from Fourth Estate/free press perspectives, which were also consistent with the longstanding opposition of Australian newspaper proprietors to government regulation. It also discusses the approaches taken in the Convergence Review to regulating for news standards, in light of the complexities arising from media convergence. The paper concludes with consideration of the fast-changing environment in which such proposals to transform media regulation are being considered, including the crisis of news media organisation business models, as seen in Australia with major layoffs of journalists from the leading print media publications.

Assessment of the molecular structure of the borate mineral boracite Mg3B7O13Cl using vibrational spectroscopy

Boracite is a magnesium borate mineral with formula: Mg3B7O13Cl and occurs as blue green, colorless, gray, yellow to white crystals in the orthorhombic – pyramidal crystal system. An intense Raman band at 1009 cm−1 was assigned to the BO stretching vibration of the B7O13 units. Raman bands at 1121, 1136, 1143 cm−1 are attributed to the in-plane bending vibrations of trigonal boron. Four sharp Raman bands observed at 415, 494, 621 and 671 cm−1 are simply defined as trigonal and tetrahedral borate bending modes. The Raman spectrum clearly shows intense Raman bands at 3405 and 3494 cm−1, thus indicating that some Cl anions have been replaced with OH units. The molecular structure of a natural boracite has been assessed by using vibrational spectroscopy.

Speech interference and transmission on residential balconies with road traffic noise

Balcony acoustic treatments can mitigate the effects of community road traffic noise. To further investigate, a theoretical study into the effects of balcony acoustic treatment combinations on speech interference and transmission is conducted for various street geometries. Nine different balcony types are investigated using a combined specular and diffuse reflection computer model. Diffusion in the model is calculated using the radiosity technique. The balcony types include a standard balcony with or without a ceiling and with various combinations of parapet, ceiling absorption and ceiling shield. A total of 70 balcony and street geometrical configurations are analyzed with each balcony type, resulting in 630 scenarios. In each scenario the reverberation time, speech interference level (SIL) and speech transmission index (STI) are calculated. These indicators are compared to determine trends based on the effects of propagation path, inclusion of opposite buildings and difference with a reference position outside the balcony. The results demonstrate trends in SIL and STI with different balcony types. It is found that an acoustically treated balcony reduces speech interference. A parapet provides the largest improvement, followed by absorption on the ceiling. The largest reductions in speech interference arise when a combination of balcony acoustic treatments are applied.

An examination of the factorial invariance and refinement of the multidimensional school anger inventory for five Pacific Rim countries

The validity of the Multidimensional School Anger Inventory (MSAI) was examined with adolescents from 5 Pacific Rim countries (N ¼ 3,181 adolescents; age, M ¼ 14.8 years; 52% females). Confirmatory factor analyses examined configural invariance for the MSAI’s anger experience, hostility, destructive expression, and anger coping subscales. The model did not converge for Peruvian students. Using the top 4 loaded items for anger experience, hostility, and destructive expression configural invariance and partial metric and scalar invariances were found. Latent means analysis compared mean responses on each subscale to the U.S. sample. Students from other countries showed higher mean responses on the anger experience subscale (ds ¼ .37–.73). Australian (d ¼ .40) and Japanese students (d ¼ .21) had significantly higher mean hostility subscale scores. Australian students had higher mean scores on the destructive expression subscale (d ¼ .30), whereas Japanese students had lower mean scores (d ¼ 2.17). The largest latent mean gender differences (females lower than males) were for destructive expression among Australian (d ¼ 2.67), Guatemalan (d ¼ 2.42), and U.S. (d ¼ 2.66) students. This study supported an abbreviated, 12-item MSAI with partial invariance. Implications for the use of the MSAI in comparative research are discussed.

First-principle studies of electronic structure and C-doping effect in boron nitride nanoribbon

Structural and electronic properties have been studied for Boron Nitride nanoribbons (BNNR) with both zigzag and armchair shaped edge (Z-BNNR and A-BNNR) by first-principle spin-polarized total energy calculations. We found that the energy band gap of Z-BNNR is indirect and decreases monotonically with the increasing ribbon width, whereas direct energy band gap oscillation was observed for A-BNNRs. Additionally, C-substitution at either single boron or nitrogen atom site in BNNRs could induce spontaneous magnetization. Our results could be potentially useful to design magnetic nano-devices based on BNNRs.

Impact of recent coastal development and human activities on Nha Trang Bay, Vietnam : evidence from a Porites lutea geochemical record

Nha Trang Bay (NTB) is located on the Central Vietnam coast, western South China Sea. Recent coastal development of Nha Trang City has raised public concern over an increasing level of pollution within the bay and degradation of nearby coral reefs. In this study, multiple proxies (e.g., trace metals, rare earth elements (REEs), and Y/Ho) recorded in a massive Porites lutea coral colony were used to reconstruct changes in seawater conditions in the NTB from 1995 to 2009. A 14-year record of REEs and other trace metals revealed that the concentrations of terrestrial trace metals have increased dramatically in response to an increase in coastal development projects such as road, port, and resort constructions, port and river dredging, and dumping activities since 2000. The effects of such developmental processes are also evident in changes in REE patterns and Y/Ho ratios through time, suggesting that both parameters are critical proxies for marine pollution.

Design of a professional development programme for palliative care nurses (Part Two)

Yates et al (1996) provided a review of the literature on educational approaches to improving psychosocial care of terminally ill patients and their families and suggested that there was an urgent need for innovation in this area. A programme of professional development currently being offered to 181 palliative care nurses in Queensland, Australia, was also described. This paper presents research in progress evaluating this programme which involves use of a quasi-experimental pre-post test design. It also includes process and outcome measures to assess effectiveness in improving the participant's ability to provide psychosocial care to patients and families. Research examining the effectiveness of various educational programmes on care of the dying has offered equivocal results (Yates et al 1996). Degner and Gow (1988a) noted that the inconsistencies found in research into death education result from inadequate study designs, variations in the conceptualisation and measurement of the outcomes of the programmes and flaws in data analysis. Such studies have often lacked a theoretical basis, few have employed well-controlled experimental designs, and the programme outcomes have generally been limited to the participant's 'death anxiety', or other death attitudes which have been variously defined and measured. Whilst Degner and Gow (1988b) have reported that undergraduate nursing students who participated in a care of the dying educational programme demonstrated more 'approach caring' behaviours than a control group, the impact of education programmes on patient care has rarely been examined. Failure to link education to nursing practice and subsequent clinical outcomes has, however, been seen as a major limitation of nursing knowledge in this area (Degner et al 1991). This paper describes an approach to researching the effectiveness of professional development programmes for palliative care nurses.

Improving psychosocial care: a professional development programme

Despite the numerous reports of difficulties experienced by health care providers in providing psychosocial care to terminally ill patients and their families, few studies have yet been undertaken to examine the effectiveness of different educational approaches to addressing these issues. The aim of this paper is to describe a programme of professional development for palliative care nurses, which is currently being offered to 181 registered nurses in Queensland, Australia. The programme is based on an action learning model and is designed to facilitate processes of reflection and peer consultation. In Part One of this paper, a review of this literature is presented to provide the background and rationale for the programme design. Details of the research programme developed to evaluate the programme will be presented in Part Two of this paper, which is to be published in the next issue of this Journal. Surveys of health professionals suggest that the demands of working with terminally ill patients are associated with a great deal of stress (Beaton and Degner 1990, Seale 1992, Vachon 1995), and emotional burden, as they are confronted with their patients' physical and emotional suffering over extended periods of time (Ullrich and Fitzgerald 1990). Key areas of concern (Lyons 1988, Bramwell 1989, Seale 1992, Copp and Dunn 1993, Wilkinson 1995) include: * Handling questions and conversations with dying patients. * Dealing with ethical and moral issues. * Handling emotions. * Giving hope. * Providing spiritual care and bereavement support. * Confronting team communication problems.