Impact of HIV-associated conditions on mortality in people commencing anti-retroviral therapy in resource limited settings

Objectives: To identify associations between specific WHO stage 3 and 4 conditions diagnosed after ART initiation and all cause mortality for patients in resource-limited settings (RLS).

Design, Setting: Analysis of routine program data collected prospectively from 25 programs in eight countries between 2002 and 2010.

Subjects, Participants: 36,664 study participants with median ART follow-up of 1.26 years (IQR 0.55–2.27).

Outcome Measures: Using a proportional hazards model we identified factors associated with mortality, including the occurrence of specific WHO clinical stage 3 and 4 conditions during the 6-months following ART initiation.

Results: There were 2922 deaths during follow-up (8.0%). The crude mortality rate was 5.41 deaths per 100 person-years (95% CI: 5.21–5.61). The diagnosis of any WHO stage 3 or 4 condition during the first 6 months of ART was associated with
increased mortality (HR: 2.21; 95% CI: 1.97–2.47). After adjustment for age, sex, region and pre-ART CD4 count, a diagnosis of extrapulmonary cryptococcosis (aHR: 3.54; 95% CI: 2.74–4.56), HIV wasting syndrome (aHR: 2.92; 95%CI: 2.21 -3.85), nontuberculous mycobacterial infection (aHR: 2.43; 95% CI: 1.80–3.28) and Pneumocystis pneumonia (aHR: 2.17; 95% CI 1.80–3.28) were associated with the greatest increased mortality. Cerebral toxoplasmosis, pulmonary and extra-pulmonary
tuberculosis, Kaposi’s sarcoma and oral and oesophageal candidiasis were associated with increased mortality, though at lower rates.

Conclusions: A diagnosis of certain WHO stage 3 and 4 conditions is associated with an increased risk of mortality in those initiating ART in RLS. This information will assist initiatives to reduce excess mortality, including prioritization of resources for
diagnostics, therapeutic interventions and research.

Farming the waters for people and food : proceedings of the global conference on aquaculture 2010

The Global Conference on Aquaculture 2010 brought together a wide range of experts and important stakeholders and reviewed the present status and trends in aquaculture development, evaluated the progress made in the implementation of the 2000 Bangkok Declaration and Strategy, addressed emerging issues relevant to aquaculture development, assessed opportunities and challenges for future aquaculture development and built consensus on advancing aquaculture as a global, sustainable and competitive food production sector. This volume, yet another joint effort of FAO and NACA, brings the outcome of the Global Conference on Aquaculture 2010, the much-needed clear and comprehensive technical information on how aquaculture could be mobilized to alleviate global poverty and improve food and nutrition security in the coming decades.

Legal issues: Disciplinary proceedings for inappropriate prescription of opioid medications by medical practitioners in Australia (2010-2014)

An analysis of 32 cases reported between July 2010 and September 2014 byprofessional disciplinary tribunals in New South Wales and Victoria againstmedical practitioners found guilty of inappropriately prescribing Sch 8 medications(mainly opioids) and Sch 4 drugs (mainly benzodiazepines) demonstrated, among others, a lengthy delay between the occurrence of the miscreant conduct and the conclusion of disciplinary proceedings. The study also raised questions about the appropriateness of utilising common criminal law theories of punishment and deterrence by non-judicial tribunals.

Theoretical issues in psychology : Proceedings of the International Society for Theoretical Psychology 1999 conference

As to the former, a glance at the contents list of this volume will demonstrate both the maturity and the vigour of theoretical debate within psychology. There is a level of sophistication here that should be the cause of quiet celebration.

Disciplinary proceedings against doctors who abuse controlled substances

Study examined 27 reports from disciplinary tribunals against medical practitioners who abused narcotic analgesics (often combined with other drugs of addiction) between 2010 and 2015. The study covered all States and Territories except Tasmania (no reports were accessible for this jurisdiction. The reports revealed that 12 medical practitioners were in their 40s; five in their 30s; and one person still in the 20s. Although majority were General Practitioners (15 out of 27), other medical specialties were also represented. Self-administered Pethidine was the most prevalent opioid (11 out of 27), and was the only drug used alone. Morphine was self-administered by six doctors; the same number used high doses of Panadeine Forte, Codeine and Codeine Phosphate, and Fentanyl was abused by five doctors. Surprisingly, fewer medical practitioners appear to use such opiates such as Propofol, Tramadol and Tramol, Oxycodone and Endone. The examination of cases suggests lack of consistency in the imposition of professional sanctions and penalties by the relevant tribunals. The study concludes that disciplinary tribunals should apply the test of proportionality in the form of ‘reasonable necessity’ when deciding whether to remove or suspend the addicted medical practitioner from the Register.

Future network systems and security : first international conference, FNSS 2015, Paris, France, June 11-13, 2015, Proceedings

This book constitutes the refereed proceedings of the International Conference on Future Network Systems and Security, FNSS 2015, held in Paris, France, in June 2015. The 13 full papers presented were carefully reviewed and selected from 34 submissions. The papers focus on the technology, communications, systems and security aspects of relevance to the network of the future.

Desporto e ciência 2010: actas/proceedings

Coordenadores: João Prudente e Helder Lopes