Late presentation for HIV care across Europe: update from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study, 2010 to 2013.

Late presentation (LP) for HIV care across Europe remains a significant issue. We provide a cross-European update from 34 countries on the prevalence and risk factors of LP for 2010-2013. People aged ≥ 16 presenting for HIV care (earliest of HIV-diagnosis, first clinic visit or cohort enrollment) after 1 January 2010 with available CD4 count within six months of presentation were included. LP was defined as presentation with a CD4 count < 350/mm(3) or an AIDS defining event (at any CD4), in the six months following HIV diagnosis. Logistic regression investigated changes in LP over time. A total of 30,454 people were included. The median CD4 count at presentation was 368/mm(3) (interquartile range (IQR) 193-555/mm(3)), with no change over time (p = 0.70). In 2010, 4,775/10,766 (47.5%) were LP whereas in 2013, 1,642/3,375 (48.7%) were LP (p = 0.63). LP was most common in central Europe (4,791/9,625, 49.8%), followed by northern (5,704/11,692; 48.8%), southern (3,550/7,760; 45.8%) and eastern Europe (541/1,377; 38.3%; p < 0.0001). There was a significant increase in LP in male and female people who inject drugs (PWID) (adjusted odds ratio (aOR)/year later 1.16; 95% confidence interval (CI): 1.02-1.32), and a significant decline in LP in northern Europe (aOR/year later 0.89; 95% CI: 0.85-0.94). Further improvements in effective HIV testing strategies, with a focus on vulnerable groups, are required across the European continent.

Patient Safety Net Update

It’s been three months since we’ve gone live with Patient Safety Net, and it has been a great success! Managers and front line staff have been trained on how to input, review, and submit event reports that formerly were detailed on the hard copy “RIR” forms. Utilization of the webbased PSN system has been better than expected. PSN has enabled us to greatly improve the way we document and react to patient safety related events.

International Transfer Pricing for Goods and Intangible Asset Licenses in a Decentralized Multinational Corporation: Review and Extensions

We review and extend the core literature on international transfer price manipulation to avoid or evade taxes. Under negotiated transfer pricing with a viable bargaining structure, including performance evaluation disconnected from the transfer price, divisions voluntarily exchange accurate information to obtain firm-wide optimality, a result not dependent on restraint from exercising internal market power. For intangible licenses, a larger optimal profit shift for a given tax rate change strengthens incentives for transfer pricing abuse. In practice, an intangible's arm's length range is viewed as a guideline, a context where incentives for abuse materialize. Transfer pricing for intangibles obliges greater tax authority scrutiny.

Epidemiologic and methodological issues in serial measurements of blood pressure: The blood pressure study in Mexican children

The Blood Pressure Study in Mexican Children (BPSMC) is a short term longitudinal study of serial blood pressure collected in three observation periods by standardized examinations of 233 female children, 10 to 12 years of age, enrolled in public and private primary schools in Tlalpan, Mexico. Study objectives were: (1) to describe from baseline information the distribution and relationship of blood pressure to age and selected anthropometric factors, as well as to compare the BPSMC results with other blood pressure studies, (2) to examine the sources and amount of variation present in serial blood pressure of 123 children, and (3) to evaluate observer performance by means of intra- and inter-observer variability.^ Stepwise regression results from baseline revealed that of all anthropometric factors and age, weight was the best predictor for blood pressure.^ The results of serial blood pressure measurements show that, besides the known sources of blood pressure variability (subject, day, reading), the physiologic event of menarche has an important bearing upon the variability and characterization of blood pressure in young girls. The assessment of the effects of blood pressure variability and reliability upon the design and analysis of epidemiologic studies, became apparent among post-menarcheal girls; where blood pressure measurements taken from them have low reliability. Research is needed to propose alternatives for assessing blood pressure during puberty.^ Finally, observer performance of blood pressure and anthropometry were evaluated. Anthropometric measurements had reliabilities in excess of R = 0.96. Acceptable reliabilities (R = 0.88 to 0.95) were obtained for systolic and diastolic (phase 4 and 5) blood pressures. The BPSMC showed a 50 percent decrease in measurement error from the first to the third observation periods. ^

Estimates of life expectancy gains from reducing/eliminating major causes of death in the USA: An update analysis for population in 2001--2008

Evaluation of the impact of a disease on life expectancy is an important part of public health. Potential gains in life expectancy (PGLE) that can properly take into account the competing risks are an effective indicator for measuring the impact of the multiple causes of death. This study aimed to measure the PGLEs from reducing/eliminating the major causes of death in the USA from 2001 to 2008. To calculate the PGLEs due to the elimination of specific causes of death, the age-specific mortality rates for heart disease, malignant neoplasms, Alzheimer disease, kidney diseases and HIV/AIDS and life table constructing data were obtained from the National Center for Health Statistics, and the multiple decremental life tables were constructed. The PGLEs by elimination of heart disease, malignant neoplasms or HIV/AIDS continued decreasing from 2001 to 2008, but the PGLE by elimination of Alzheimer's disease or kidney diseases revealed increased trends. The PGLEs (by years) for all race, male, female, white, white male, white female, black, black male and black female at birth by complete elimination of heart disease 2001–2008 were 0.336–0.299, 0.327–0.301, 0.344–0.295, 0.360–0.315, 0.349–0.317, 0.371–0.316,0.278–0.251, 0.272–0.255, and 0.282–0.246 respectively. Similarly, the PGLEs (by years) for all race, male, female, white, white male, white female, black, black male and black female at birth by complete elimination of malignant neoplasms, Alzheimer's disease, kidney disease or HIV/AIDS 2001–2008 were also uncovered, respectively. Most diseases affect specific population, such as, HIV/AIDS tends to have a greater impact on people of working age, heart disease and malignant neoplasms have a greater impact on people over 65 years of age, but Alzheimer's disease and kidney diseases have a greater impact on people over 75 years of age. To measure the impact of these diseases on life expectancy in people of working age, partial multiple decremental life tables were constructed and the PGLEs were computed by partial or complete elimination of various causes of death during the working years. Thus, the results of the study outlined a picture of how each single disease could affect the life expectancy in age-, race-, or sex-specific population in USA. Therefore, the findings would not only assist to evaluate current public health improvements, but also provide useful information for future research and disease control programs.^

The epidemiology of left ventricular outflow tract obstruction defects in Texas, 2002-2008: An update and assessment of effect heterogeneity

Left ventricular outflow tract (LVOT) defects are an important group of congenital heart defects (CHDs) because of their associated mortality and long-term complications. LVOT defects include aortic valve stenosis (AVS), coarctation of aorta (CoA), and hypoplastic left heart syndrome (HLHS). Despite their clinical significance, their etiology is not completely understood. Even though the individual component phenotypes (AVS, CoA, and HLHS) may have different etiologies, they are often "lumped" together in epidemiological studies. Though "lumping" of component phenotypes may improve the power to detect associations, it may also lead to ambiguous findings if these defects are etiologically distinct. This is due to potential for effect heterogeneity across component phenotypes. ^ This study had two aims: (1) to identify the association between various risk factors and both the component (i.e., split) and composite (i.e., lumped) LVOT phenotypes, and (2) to assess the effect heterogeneity of risk factors across component phenotypes of LVOT defects. ^ This study was a secondary data analysis. Primary data were obtained from the Texas Birth Defect Registry (TBDR). TBDR uses an active surveillance method to ascertain birth defects in Texas. All cases of non complex LVOT defects which met our inclusion criteria during the period of 2002–2008 were included in the study. The comparison groups included all unaffected live births for the same period (2002–2008). Data from vital statistics were used to evaluate associations. Statistical associations between selected risk factors and LVOT defects was determined by calculating crude and adjusted prevalence ratio using Poisson regression analysis. Effect heterogeneity was evaluated using polytomous logistic regression. ^ There were a total of 2,353 cases of LVOT defects among 2,730,035 live births during the study period. There were a total of 1,311 definite cases of non-complex LVOT defects for analysis after excluding "complex" cardiac cases and cases associated with syndromes (n=168). Among infant characteristics, males were at a significantly higher risk of developing LVOT defects compared to females. Among maternal characteristics, significant associations were seen with maternal age > 40 years (compared to maternal age 20–24 years) and maternal residence in Texas-Mexico border (compared to non-border residence). Among birth characteristics, significant associations were seen with preterm birth and small for gestation age LVOT defects. ^ When evaluating effect heterogeneity, the following variables had significantly different effects among the component LVOT defect phenotypes: infant sex, plurality, maternal age, maternal race/ethnicity, and Texas-Mexico border residence. ^ This study found significant associations between various demographic factors and LVOT defects. While many findings from this study were consistent with results from previous studies, we also identified new factors associated with LVOT defects. Additionally, this study was the first to assess effect heterogeneity across LVOT defect component phenotypes. These findings contribute to a growing body of literature on characteristics associated with LVOT defects. ^

BioCentury Research Farm Update

The BioCentury Research Farm (BCRF) had a diversity of users in 2011. Iowa State faculty and staff from agricultural and biosystems engineering (ABE), agricultural systems technology (AST), agronomy, chemical and biological engineering (CBE), civil, construction, and environmental engineering (CCEE), food science and human nutrition (FSHN), horticulture, mechanical engineering (ME), and natural resource ecology and management (NREM) conducted research, teaching, and outreach at the BCRF. Private industry users included Avello Bioenergy, DCE, Frontline BioEnergy, and Virent, Inc.

Alto Hospicio : el Estado y la violencia de género en Chile

El presente artículo busca explorar una nueva dimensión en el tema de la violencia de género: la discriminación por parte del Estado, de un grupo de niñas de los sectores bajos. El análisis focaliza en la desaparición de un número de niñas adolescentes en una población precaria y de pocos recursos, Alto Hospicio, en el Norte de Chile junto a la próspera ciudad de Iquique. Las autoridades culparon a las víctimas y sus familias. Mientras tanto, un asesino en serie continuaba con sus matanzas.

Actualización del relevamiento de suelos irrigados por el río Mendoza (Argentina)

Este trabajo actualiza un relevamiento de suelos del área regada por el río Mendoza (Argentina) cuyo muestreo edáfico -el de mayor intensidad en la zona- y sus análisis se efectuaron en 1974. Con un Sistema de Información Geográfica (SIG) se obtuvo un mapa digital operativo que fijó los límites -o unidades cartográficas- de los suelos, conociendo la precisión de las cartografías realizadas. La información básica sobre el recurso suelo servirá de base para posteriores investigaciones; por ej. su eventual degradación por el recurso hídrico utilizado. Método para establecer las unidades cartográficas del suelo: a) Recuperación digital de 2 475 datos puntuales tabulados. La tabla suministró el identificador de los mismos (id.) y la textura y salinidad de dos capas: 0-25 y 50-80 cm. b) Transferencia cartográfica de los atributos edáficos de la tabla para vincular la cartografía con la base asociada de datos. c) Definición de las unidades cartográficas y la extensión de cada atributo mediante el método de interpolación de los polígonos de Thiessen. d) Limitación de la extensión de la interpolación a una distancia máxima de 178 m, 10 ha. e) Diseño de mapas temáticos definitivos con tabulaciones cruzadas. Dichos mapas, a escala de semi-detalle, fueron previstos para planificaciones y recomendaciones de uso a nivel regional, no parcelario.

Caracterización ampelográfica de Torrontés riojano : : Mendoza, Argentina

Pese a la amplia difusión y destacada calidad enológica del Torrontés riojano -perteneciente al grupo de cepajes "criollos"- no se disponía de una caracterización completa del mismo. Su estudio, como parte del programa "Caracterización ampelográfica, fenológica y bioclimática de cepajes" pone al día su descripción según normas actualizadas y homologadas internacionalmente. El método utilizado se basa en los Códigos de Caracteres Ampelográficos de la O.I.V., que incluyen una detallada observación de los órganos de la planta, sinónimos, origen, antecedentes, situación actual, características ampelográficas y diferenciales, comportamientos agronómico y fenológico, y aptitud. Los resultados conformaron una ficha complementada con fotografías de brotes, hoja, racimo, flor, baya y semilla, confrontada con descripciones de cepajes vinculables de las islas Canarias y España continental.

Especies del género Frankliniella (Thysanoptera: Thripidae) registradas en la Argentina, una actualización

Este trabajo proporciona una clave ilustrada para 21 especies de Frankliniella registradas para la Argentina, incluyendo tres citas nuevas: Frankliniella graminis Cavalleri & Mound, colectado sobre Sorghum halepense; Frankliniella otites Berzosa & Maroto, sobre flores de Senecio spp. y Verbena seriphioides; y Frankliniella williamsi Hood sobre hojas de Zea maiz “maíz". También son proporcionados nuevos hospedadores para Frankliniella gracilis. Se incluyen notas sobre cada especie. Frankliniella cognata Hood es excluida de la fauna de tisanópteros de la Argentina.

Un dispositivo de acompañamiento y los sucesos críticos emergentes : una experiencia de intervención - formación

Este trabajo presenta la descripción y el análisis de un dispositivo de acompañamiento en situaciones de intervención-formación desde un abordaje clínico, basado en la reflexión en búsqueda de interpretaciones sobre los sucesos críticos en los sujetos participantes, en su propia singularidad. El dispositivo fue diseñado teniendo en cuenta por un lado, los resultados de dos investigaciones: Dispositivos de acompañamiento en la formación docente durante el ciclo de las prácticas (Alonso, M. C.; 2004-2008) y Los sucesos críticos en la trayectoria personal y profesional de formadores de docentes (Ormaechea, S., 2007-2009) y, por el otro, el análisis de una demanda de acompañamiento para animar procesos de cambio en un grupo de profesionales médicos en el marco de un curso de actualización en educación que se desarrollara entre los años 2007-2009.