Parents living with HIV in a high-income country: do patients need specific support?

The number of HIV-infected persons with children and caregiving duties is likely to increase. From this statement, the present study was designed to establish how HIV infected caregivers organise their parenting routines and to determine their support needs. A further aim was to ascertain caregivers' perception of conspicuous behaviours displayed by their children. Finally, it sought to determine the extent to which the caregivers' assessment of their parenting activity is influenced by the required support and their children's perceived conspicuous behaviours. The study design was observational and cross-sectional. Sampling was based on the 7 HIV Outpatient Clinics associated with the national population-based Swiss HIV Cohort Study. It focused on persons living with HIV who are responsible for raising children below the age of 18. A total of 520 caregivers were approached and 261 participated. An anonymous, standardised, self-administered questionnaire was used for data collection. The data were analysed using descriptive statistical procedures and backward elimination multiple regression analysis. The 261 respondents cared for 406 children and adolescents under 18 years of age; the median age was 10 years. The caregivers' material resources were low. 70% had a net family income in a range below the median of Swiss net family income and 30% were dependent on welfare assistance. 73% were undergoing treatment with 86% reporting no physical impairments. The proportion of single caregivers was 34%. 92% of the children were living with their HIV infected caregivers. 80% of the children attended an institution such as a school or kindergarten during the day. 89% of the caregivers had access to social networks providing support. Nevertheless, caregivers required additional support in performing their parenting duties and indicated a need for assistance on the material level, in connection with legal problems and with participation in the labour market. 46% of the caregivers had observed one or more conspicuous behaviours displayed by their children, which indicates a challenging situation. However, most of these caregivers assessed their parenting activity very favourably. Backward elimination multiple regression analysis indicated that a smaller number of support needs, younger age of the eldest child and fewer physical impairments on the part of the caregiver enhance the caregivers' assessment of their parenting activity. Physicians should speak to caregivers living with HIV about their parenting responsibilities and provide the necessary scope for this subject in their consultation sessions. Physicians are in a position to draw their patients' attention to the services available to them.

Daniel D. Tompkins letter to General Dearborn, June 28, 1812.

Transcript [original spelling and grammar retained]: Albany June 28 1812 Sir Your letter of the 23d has been received. I had anticipated your request by ordering the detachment from Washington, Essex, Clinton and Franklin Counties into service and have fixed the days and places of their Rendezvous. Upon application to the quarter master General I find there are but 139 tents & 60 camp kettles at this place & even those I take by a kind of stealth. The Deputy Quarter Master General declines giving an order for their delivery until he shall have a written order from the Quarter Master General, and the latter is willing I Shall take them but will not give the Deputy a written order for that purpose. Under Such circumstances I shall avail myself of the rule of Possession and by virtue of the Eleven Points of Law Send them tomorrow morning without a written order from anyone. You may remember that when you were Secretary of the war department I invited you to forward and deposit in our Frontier Arsenals, arms ammunition and camp equipage free of expense to be ready in case of war and the same invitation to the war department has been repeated some time, Since The United States have now from 5 to 600 regular troops at Plattsburgh, Rome, Canandaigua & c, where those arsenals are, and yet those recruits are now and must be for weeks to come unarmed and unequipped in every respect although within musket Shot of arsenals. The recruits at Plattsburgh are within 50 miles of two tribes of Canadian Indians. In case of an attack upon the Frontiers that portion of the United States army would be as inefficient and unable to defend the inhabitants or themselves even. The Militia Detachments on the Western Frontiers received the news of war with [cherafulness] and determined courage, and I am happy to find they are united late brothers, highly improved in Discipline & ready to devote themselves to any Service or danger which the good of the Country may require. But they are in barracks from which they cannot move a days march for the want of tents and other equipage, and they are in Separate and Independent Detachments without a General Officer to command them or combine their exertions for the accomplishment of any desirable and important object. The only officer of the United States here who can do anything is the Quarter Master General and he has not a tent Camp Kettle or Knapsack in this arsenal except what I have concluded to send off tomorrow morning as above mentioned to furnish men As to Cannon Muskets and Ammunition. I can find now one here who will exercise any authority over them or deliver a Single article upon my requisition. Neither can I find any Officer of the army who feel himself authorized to exercise any authority or do any act which will aid me in the all important object of protecting the Inhabitants of an extended Frontier exposed to the Cruelties of Savages and the depredations of the enemy. If I must rely upon the Militia Solely for Such protection I entreat you to give orders to your Officers to furnish upon my orders, for the use of the Militia Detachments , all needful weapons and articles with which the United States are Supplied and of which we are destitute . You may rely upon all the assistance which my talents, influence or authority can furnish in the active prosecution of the first & necessary way which has been declared by the Constituted Authorities of our beloved Country. I am, Sir, respectfully Your ob. Servt. Daniel D. Tompkins

Conjoncture et historicité de l'accession de la norme à sa juridicité : les droits linguistiques au Canada

"Thèse présentée à la Faculté des études supérieures En vue de l'obtention du grade de Docteur en droit"

Entre Hippocrate et De Coubertin: les obligations professionnelles des médecins face au dopage sportif

Le contexte particulier du dopage suscite de nombreuses questions à l'égard des obligations et de la responsabilité des médecins. Suivant le Code médical du Mouvement olympique (2005), les médecins doivent respecter les principes de l'éthique médicale et ceux de l'éthique sportive, comme le fairplay. Il arrive parfois que l'éthique sportive entre en conflit avec l'éthique médicale. Les médecins sont alors confrontés à d'importants dilemmes qui peuvent engager leur responsabilité professionnelle et civile. Ces dilemmes se situent notamment au niveau de l'obligation de soins et du secret professionnel. Par exemple, les médecins peuvent-ils prescrire des médicaments pour contrer les effets néfastes du dopage afin de préserver la santé des athlètes ? La question de la recherche sur l'amélioration de la performance est également préoccupante. En raison du caractère clandestin de cette recherche, il y a lieu de se demander si les médecins qui y participent respectent leurs obligations professionnelles. L'analyse des principaux instruments normatifs applicables en l'espèce démontre que les médecins ne doivent pas être placés dans une situation telle qu'ils doivent refuser de suivre des athlètes de crainte d'être accusés de dopage. De plus, le secret professionnel devrait être maintenu lorsqu'un médecin suit un athlète dopé afin de préserver la relation de confiance. Finalement, l'analyse du contexte de la recherche portant sur l'amélioration de la performance révèle que les médecins ne respectent pas toujours leurs obligations. Les médecins fautifs risquent donc d'engager leur responsabilité professionnelle et civile et de faire face à des sanctions sévères.

Pratiques et usages de l'Europe dans le maintien de la paix : la coopération franco-irlandaise au Tchad

Thèse réalisé en cotutelle avec l'Université libre de Bruxelles (Belgique)

Examen des contributions d’une approche relationnelle de la socialisation organisationnelle

Tant auprès des chercheurs que des praticiens, la socialisation organisationnelle semble représenter un sujet d’intérêt à l’heure actuelle (Fang, Duffy, & Shaw, 2011). Dans cette lignée, la présente thèse cherche à approfondir notre compréhension de la socialisation organisationnelle, afin d’en dresser un portrait plus complet et étayé, mais aussi d’y arrimer des pratiques porteuses pour les organisations et leurs employés. Plus précisément, les aspects relationnels inhérents au vécu des nouveaux employés, largement ignorés à ce jour dans la documentation (Ashforth, Sluss, & Harrison, 2007), sont examinés à partir de données recueillies à trois temps de mesure distincts auprès d’un échantillon de 224 nouveaux employés. Avec comme point de départ la théorie de l’échange social (Blau, 1964) et le concept de confiance affective (McAllister, 1995), le premier des deux articles qui composent la thèse démontre que, par rapport aux approches dites classiques (i.e., exprimant une vision cognitive de la socialisation organisationnelle), une approche relationnelle de la socialisation organisationnelle permet de mieux rendre compte du lien psychologique qui s’établit entre les nouveaux employés et l’organisation, alors que les approches cognitives classiques sont davantage explicatives de la performance des employés. Les deux approches semblent donc complémentaires pour expliquer l’adaptation des nouveaux employés. Le second article s’appuie sur la démonstration effectuée dans le premier article et cherche à approfondir davantage les aspects relationnels inhérents au vécu des nouveaux employés, de même que leur influence sur l’adaptation de ces derniers. À cette fin, la théorie de la conservation des ressources (Hobfoll, 1989) est considérée et l’engagement affectif (Meyer & Herscovitch, 2001) est mis de l’avant comme concept focal. Les résultats suggèrent que l’engagement affectif envers le supérieur compense pour un déclin de l’engagement affectif envers l’organisation, tel qu’il résulte d’un bris de la relation avec l’organisation. Les relations semblent donc, dans certaines circonstances, avoir une portée qui dépasse leurs protagonistes directs. La présente thèse démontre donc que les aspects relationnels inhérents au vécu des nouveaux employés ont une influence distincte, prépondérante et complexe sur leur adaptation en emploi. Ce faisant, elle s’insère dans un courant de recherche visant à remettre à l’avant-plan et mieux comprendre la sphère relationnelle dans les organisations (Ragins & Dutton, 2007). Les implications théoriques et pratiques qui en découlent seront discutées.

Discours des plaignantes/victimes : distinction et caractérisation entre les fausses et les vraies allégations de crimes violents

Rapport de stage présenté à la Faculté des arts et des sciences en vue de l’obtention du grade de Maîtrise en criminologie option analyse

A pressure-jump time-resolved x-ray diffraction study of cubic-cubic transition kinetics in monoolein

In the past two decades, the geometric pathways involved in the transformations between inverse bicontinuous cubic phases in amphiphilic systems have been extensively theoretically modeled. However, little experimental data exists on the cubic-cubic transformation in pure lipid systems. We have used pressure-jump time-resolved X-ray diffraction to investigate the transition between the gyroid Q(II)(G) and double-diamond Q(II)(D) phases in mixtures of 1-monoolein in 30 wt% water. We find for this system that the cubic-cubic transition occurs without any detectable intermediate structures. In addition, we have determined the kinetics of the transition, in both the forward and reverse directions, as a function of pressure-jump amplitude, temperature, and water content. A recently developed model allows (at least in principle) the calculation of the activation energy for lipid phase transitions from such data. The analysis is applicable only if kinetic reproducibility is achieved, at least within one sample, and achievement of such kinetic reproducibility is shown here, by carrying out prolonged pressure-cycling. The rate of transformation shows clear and consistent trends with pressure-jump amplitude, temperature, and water content, all of which are shown to be in agreement with the effect of the shift in the position of the cubic-cubic phase boundary following a change in the thermodynamic parameters.

EnvironalPlanning: an analytical network process model for environmentally conscious construction planning

Although the construction pollution index has been put forward and proved to be an efficient approach to reducing or mitigating pollution level during the construction planning stage, the problem of how to select the best construction plan based on distinguishing the degree of its potential adverse environmental impacts is still a research task. This paper first reviews environmental issues and their characteristics in construction, which are critical factors in evaluating potential adverse impacts of a construction plan. These environmental characteristics are then used to structure two decision models for environmental-conscious construction planning by using an analytic network process (ANP), including a complicated model and a simplified model. The two ANP models are combined and called the EnvironalPlanning system, which is applied to evaluate potential adverse environmental impacts of alternative construction plans.

Offering 802.11 MAC frame transport over multiband OFDM for consumer devices

A method to map all the variants of the IEEE 802.11 MAC frames into the Multiband OFDM based ECMA-368 Physical standard is proposed, without contravening the standard. The transportation of IEEE 802.11 MAC frames over ECMA-368 allows for the migration current of Wireless LAN applications towards a Wireless Personal Area Network (WPAN) solution. This system benefits the Consumer Electronics Market as the high data-rate WPAN is capable of transporting broadcast-quality video while the same system can also transport existing applications available today, maintaining existing effort, products and backward-compatibility(1).

Features for detection of Parkinson's disease tremor from local field potentials of the subthalamic nucleus

Deep Brain Stimulation (DBS) is a treatment routinely used to alleviate the symptoms of Parkinson's disease (PD). In this type of treatment, electrical pulses are applied through electrodes implanted into the basal ganglia of the patient. As the symptoms are not permanent in most patients, it is desirable to develop an on-demand stimulator, applying pulses only when onset of the symptoms is detected. This study evaluates a feature set created for the detection of tremor - a cardinal symptom of PD. The designed feature set was based on standard signal features and researched properties of the electrical signals recorded from subthalamic nucleus (STN) within the basal ganglia, which together included temporal, spectral, statistical, autocorrelation and fractal properties. The most characterized tremor related features were selected using statistical testing and backward algorithms then used for classification on unseen patient signals. The spectral features were among the most efficient at detecting tremor, notably spectral bands 3.5-5.5 Hz and 0-1 Hz proved to be highly significant. The classification results for determination of tremor achieved 94% sensitivity with specificity equaling one.

An optimal inverse method using Doppler lidar measurements to estimate the surface sensible heat flux

Inverse methods are widely used in various fields of atmospheric science. However, such methods are not commonly used within the boundary-layer community, where robust observations of surface fluxes are a particular concern. We present a new technique for deriving surface sensible heat fluxes from boundary-layer turbulence observations using an inverse method. Doppler lidar observations of vertical velocity variance are combined with two well-known mixed-layer scaling forward models for a convective boundary layer (CBL). The inverse method is validated using large-eddy simulations of a CBL with increasing wind speed. The majority of the estimated heat fluxes agree within error with the proscribed heat flux, across all wind speeds tested. The method is then applied to Doppler lidar data from the Chilbolton Observatory, UK. Heat fluxes are compared with those from a mast-mounted sonic anemometer. Errors in estimated heat fluxes are on average 18 %, an improvement on previous techniques. However, a significant negative bias is observed (on average −63%) that is more pronounced in the morning. Results are improved for the fully-developed CBL later in the day, which suggests that the bias is largely related to the choice of forward model, which is kept deliberately simple for this study. Overall, the inverse method provided reasonable flux estimates for the simple case of a CBL. Results shown here demonstrate that this method has promise in utilizing ground-based remote sensing to derive surface fluxes. Extension of the method is relatively straight-forward, and could include more complex forward models, or other measurements.

Towards conceptualizing reverse service supply chains

Purpose – Recognizing the heterogeneity of services, this paper aims to clarify the characteristics of forward and the corresponding reverse supply chains of different services. Design/methodology/approach – The paper develops a two-dimensional typology matrix, representing four main clusters of services according to the degree of input standardization and the degree of output tangibility. Based on this matrix, this paper develops a typology and parsimonious conceptual models illustrating the characteristics of forward and the corresponding reverse supply chains of each cluster of services. Findings – The four main clusters of service supply chains have different characteristics. This provides the basis for the identification, presentation and explanation of the different characteristics of their corresponding reverse service supply chains. Research limitations/implications – The findings of this research can help future researchers to analyse, map and model forward and reverse service supply chains, and to identify potential research gaps in the area. Practical/implications – The findings of the research can help managers of service firms to gain better visibility of their forward and reverse supply chains, and refine their business models to help extend their reverse/closed-loop activities. Furthermore, the findings can help managers to better optimize their service operations to reduce service gaps and potentially secure new value-adding opportunities. Originality/value – This paper is the first, to the authors ' knowledge, to conceptualize the basic structure of the forward and reverse service supply chains while dealing with the high level of heterogeneity of services.

Second-life retailing: a reverse supply chain perspective

Purpose – The authors examine the role of entrepreneurial business models in the reverse supply chain of apparel/fashion retailers. The purpose of this paper is to offer an alternative approach to the “return to the point of origin” prevalent in the reverse chain of manufacturers but less technically and economically feasible in the case of apparel/fashion retailers. This approach, second-life retailing, not only reduces waste but also democratises consumption. Design/methodology/approach – The paper is based on an extensive literature review, semi-structured interviews with managers of two second-life retailers in Malaysia and observations of a number of stores. Findings – Using the Business Model Canvas, the authors demonstrate the essential characteristics of second-life retailers. Retailers in this study, unlike retailers in the developed world, combine traditional business models with off-price retailing. There is no clear demarcation between the forward and reverse supply chain used to manage first- and second-hand retailing. Practical implications – The paper demonstrates the potential of innovative business models in the reverse supply chain. It encourages managers to look beyond the “return to the point of origin” and seek imaginative alternatives. Such alternatives potentially could result in additional revenue, enhanced sustainability and democratisation of consumption meeting triple bottom line objectives. Originality/value – This paper highlights the importance and relevance of entrepreneurial business models in addressing the reverse supply chain, demonstrating this with the aid of two Malaysian off-price retailers. It also contributes to our nascent knowledge by focusing on emerging markets.

DGGE with genomic DNA: Suitable for detection of numerically important organisms but not for identification of the most abundant organisms

Identification of all important community members as well as of the numerically dominant members of a community are key aspects of microbial community analysis of bioreactor samples. A systematic study was conducted with artificial consortia to test whether denaturing gradient gel electrophoresis (DGCE) is a reliable technique to obtain such community data under conditions where results would not be affected by differences in DNA extraction efficiency from cells. A total of 27 consortia were established by mixing DNA extracted from Escherichia coli K12, Burkholderia cepacia and Stenotrophomonas maltophilia in different proportions. Concentrations of DNA of single organisms in the consortia were either 0.04, 0.4 or 4 ng/mu l. DGGE-PCR of genomic DNA with primer sets targeted at the V3 and V6-V8 regions of the 16S rDNA failed to detect the three community members in only 7% of consortia, but provided incorrect information about dominance or co-dominance for 85% and 89% of consortia with the primer sets for the V6-V8 and V3 regions, respectively. The high failure rate in detection of dominant B. cepacia with the primers for the V6-V8 region was attributable to a single nucleoticle primer mismatch in the target sequences of both, the forward and reverse primer. Amplification bias in PCR of E. coli and S. maltophilia for the V6-V8 region and for all three organisms for the V3 region occurred due to interference of genomic DNA in PCR-DGGE, since a nested PCR approach, where PCR-DGGE was started from mixtures of 16S rRNA genes of the organisms, provided correct information about the relative abundance of original DNA in the sample. Multiple bands were not observed in pure culture amplicons produced with the V6-V8 primer pair, but pure culture V3 DGGE profiles of E. coli, S. maltophilia and B. cepacia contained 5, 3 and 3 bands, respectively. These results demonstrate DGGE was suitable for identification of all important community members in the three-membered artificial consortium, but not for identification of the dominant organisms in this small community. Multiple DGGE bands obtained for single organisms with the V3 primer pair could greatly confound interpretation of DGGE profiles. (C) 2008 Elsevier Ltd. All rights reserved.