Hepatitis C coinfection is independently associated with decreased adherence to antiretroviral therapy in a population-based HIV cohort

OBJECTIVE: To characterize the impact of hepatitis C (HCV) serostatus on adherence to antiretroviral treatment (ART) among HIV-infected adults initiating ART. METHODS: The British Columbia HIV/AIDS Drug Treatment Program distributes, at no cost, all ART in this Canadian province. Eligible individuals used triple combination ART as their first HIV therapy and had documented HCV serology. Statistical analyses used parametric and non-parametric methods, including multivariate logistic regression. The primary outcome was > or = 95% adherence, defined as receiving > or = 95% of prescription refills during the first year of antiretroviral therapy. RESULTS: There were 1186 patients eligible for analysis, including 606 (51%) positive for HCV antibody and 580 (49%) who were negative. In adjusted analyses, adherence was independently associated with HCV seropositivity [adjusted odds ratio (AOR), 0.48; 95% confidence interval (CI), 0.23-0.97; P = 0.003], higher plasma albumin levels (AOR, 1.07; 95% CI, 1.01-1.12; P = 0.002) and male gender (AOR, 2.53; 95% CI, 1.04-6.15; P = 0.017), but not with injection drug use (IDU), age or other markers of liver injury. There was no evidence of an interaction between HCV and liver injury in adjusted analyses; comparing different strata of HCV and IDU confirmed that HCV was associated with poor adherence independent of IDU. CONCLUSIONS: HCV-coinfected individuals and those with lower albumin are less likely to be adherent to their ART.

Efectos de una intervención educativa en la promoción de la actividad física, otros comportamientos saludables y los conocimientos para la prevención del cáncer de pulmón en jóvenes del colegio La Merced en Bogotá D.C., Colombia

Introducción: El cáncer de pulmón es el tipo de cáncer más mortal a nivel mundial, al cual se atribuyen una de cada cinco muertes anualmente. El objetivo de este estudio fue determinar los efectos de una intervención educativa en la promoción de la actividad física, otros comportamientos saludables y los conocimientos para la prevención del cáncer de pulmón en jóvenes estudiantes de una institución educativa pública en Bogotá, Colombia. Métodos: Estudio experimental no controlado en 243 estudiantes de sexo femenino (Edad 14±1,5 años). La intervención educativa se desarrolló en tres momentos: una sesión educativa con una duración de 60 minutos acorde a la Guía para la Comunicación Educativa en el Marco del Control del Cáncer, en Colombia. Segundo, se enviaron tres correos electrónicos con información acerca del cáncer pulmonar; finalmente se desarrollaron actividades grupales. Para la toma de datos se utilizaron el cuestionario Cáncer Awareness Measure (CAM) y el Sistema de Vigilancia de Factores de Riesgo del Comportamiento (BRFSS). La evaluación se realizó en un período de seguimiento a 1, 3 y 6 meses post-intervención. Resultados: La intervención educativa incrementó significativamente los conocimientos de las jóvenes sobre los signos de alarma del cáncer pulmonar y los principales factores de riesgo modificables, tales como el consumo de cigarrillo, la exposición al humo del mismo y el sedentarismo, al sexto mes post-intervención. Las mejoras en el cambio comportamental no lograron significancia estadística. Conclusiones: Una intervención educativa mejora los conocimientos acerca de la detección temprana y la prevención del cáncer de pulmón, así como los comportamientos saludables en jóvenes estudiantes en Bogotá, Colombia. Se requiere de estudios controlados aleatorizados.

Índice bibliográfico de la revista de educación de los números 321-323 y número extraordinario año 2000.

Incluye cuatro tipos de índices que facilitan la búsqueda de los artículos publicados en los números 321 a 323 y en el número extraordinario del año 2000. En el primer índice, los artículos se agrupan por notaciones de la Clasificación Decimal Universal (CDU) y en los siguientes por orden alfabético de autores, títulos y materias.

Diatom oxygen and silicon isotopes data from IODP Hole 323-U1341B in the Bering Sea through the late Pliocene and over the onset of major Northern Hemisphere Glaciation

The Bering Sea is one of the most biologically productive regions in the marine system and plays a key role in regulating the flow of waters to the Arctic Ocean and into the subarctic North Pacific Ocean. Cores from Integrated Ocean Drilling Program (IODP) Expedition 323 to the Bering Sea provide the first opportunity to obtain reconstructions from the region that extend back to the Pliocene. Previous research at Bowers Ridge, south Bering Sea, has revealed stable levels of siliceous productivity over the onset of major Northern Hemisphere Glaciation (NHG) (circa 2.85-2.73 Ma). However, diatom silica isotope records of oxygen (d18Odiatom) and silicon (d30Sidiatom) presented here demonstrate that this interval was associated with a progressive increase in the supply of silicic acid to the region, superimposed on shift to a more dynamic environment characterized by colder temperatures and increased sea ice. This concluded at 2.58 Ma with a sharp increase in diatom productivity, further increases in photic zone nutrient availability and a permanent shift to colder sea surface conditions. These transitions are suggested to reflect a gradually more intense nutrient leakage from the subarctic northwest Pacific Ocean, with increases in productivity further aided by increased sea ice- and wind-driven mixing in the Bering Sea. In suggesting a linkage in biogeochemical cycling between the south Bering Sea and subarctic Northwest Pacific Ocean, mainly via the Kamchatka Strait, this work highlights the need to consider the interconnectivity of these two systems when future reconstructions are carried out in the region.

A auto-interpretação de Husserl em 1930-31: o Nachwort às Ideen como escrito polémico

This essay seeks to expose Husserl’s defensive attitude towards what he calls “the mistaken views” found in the new ways of conducting phenomenology, in the Epilogue to his Ideas. While the polemic side of Husserl’s project, basically but tacitly against Heidegger, is underlined, it is also sustained that this auto-interpretive piece is a fundamental key within Husserl’s corpus in that it defines the direction of the phenomenological project. At the centre of the controversy are the answer to the objections of intellectualism and solipsism, and the disavowal of all forms of anthropologism in the conception of subjectivity.

Formal complaints of workplace sexual harassment lodged with Australian Human Rights and Equal Opportunity Commissions - 1 July 2009 - 31 December 2009

This report presents an analysis of quantitative data collected from the Australian Human Rights Commission, the Anti-Discrimination Commission of Queensland, the Victorian Equal Opportunity and Human Rights Commission, the Anti-Discrimination Board of New South Wales, the Equal Opportunity Commission of South Australia, the Australian Capital Territory Human Rights Commission, the Equal Opportunity Commission Western Australia, the Northern Territory Anti-Discrimination Commission, and the Office of the Anti-Discrimination Commissioner (Tasmania) (hereafter referred to as the Commissions). The data comprise formal complaints lodged under the various federal, state and territory anti-discrimination laws in the period 1 July 2009 to 31 December 2009 where a complainant had alleged sexual harassment in the area of employment.

Infertility resolved with or without fertility treatment in Australian women aged 31-36 years: A prospective, population-based study [abstract]

Birth outcomes during a three year period were compared for women with a history of infertility who did or did not use fertility treatment with hormones and/or in vitro fertilisation. Participants in the Australian Longitudinal Study on Women’s Health born in 1973-78 were randomly selected from the universal public health insurance database and completed up to five mailed surveys (1996-2009). Participants reported on their infertility and use of treatment at age 28-33 years (survey 4 (S4) in 2006) and 31-36 years (survey 5 (S5) in 2009). The odds of resolved infertility at S5 were estimated using logistic regression with adjustment for age, area of residence, private health insurance and male infertility. Among 7280 women who responded to both S4 and S5, 18.6% (n=1378) reported infertility. More than half (n=804, 56.8%) of these women did not use treatment and 43.9% (n=347) gave birth between S4 and S5. Compared to infertile women who did not use treatment, women who used treatment were more likely at S5 to have recently given birth (odds ratio (OR) = 1.59, 95% CI 1.26-2.00) or be pregnant (OR = 1.77, 1.27-2.46). Further, women who used treatment were more likely to have twins (3.37, 1.18-9.62), premature births (1.52, 0.95-2.43), or low birthweight babies (1.83, 0.70-2.53) compared to women who gave birth without using treatment. Many women aged up to 36 years with a history of infertility can conceive naturally over a three year period without the use of treatment.Women who have never had a prior birth may need to use treatment to resolve their infertility but they are at higher risk of poorer perinatal outcomes, such as premature or low birthweight babies.

Temporal boundary objects in megaprojects : mapping the system with the integrated master schedule

Recently, a stream of project management research has recognized the critical role of boundary objects in the organization of projects. In this paper, we investigate how one advanced scheduling tool, the Integrated Master Schedule (IMS), is used as a temporal boundary object at various stages of complex projects. The IMS is critical to megaprojects which typically span long periods of time and face a high degree of complexity and uncertainty. In this paper, we conceptualize projects of this type as complex adaptive systems (CAS). We report the findings of four case projects on how the IMS mapped interactions, interdependencies, constraints, and fractal patterns of these emerging projects, and how the process of IMS visualization enabled communication and negotiation of project realities. This paper highlights that this advanced timeline tool acts as a boundary object and elicits shared understanding of complex projects from their stakeholders.