The life of Rev. Henry Martyn /

Principally compiled from the tenth English edition of the Memoirs of Mr. Martyn, by the Rev. John Sargent."-Pref.

Evaluación de la disfunción sexual en mujeres con incontinencia urinaria antes y después de la cinta suburetral

Objetivo: Evaluar prospectivamente el grado de disfunción sexual en pacientes con incontinencia urinaria de esfuerzo antes y después de la cinta suburetral libre de tensión mediante el cuestionario PISQ-12 validado en español. Materiales y Métodos: Estudio observacional longitudinal de antes y después. Se seleccionaron 60 mujeres sexualmente activas con algún grado de disfunción sexual, entre abril del 2014 hasta marzo del 2015, diagnosticadas con incontinencia urinaria, programadas para colocación de cinta suburetral transobturadora en el Hospital Universitario Mayor Méderi. La mayoría de las pacientes presentaron algún grado de prolapso genital y requirieron corrección quirúrgica asociada a la cinta. Todas las pacientes respondieron el cuestionario PISQ-12 antes y 6 meses después del procedimiento. Resultados: La edad promedio fue 48 ± 4.58 años. El grado de prolapso con mayor frecuencia fue el estadío II del POP-Q 55% (n=33). El 96.7% (n=50) de las pacientes requirieron además de la colocación de la cinta suburetral corrección quirúrgica del prolapso genital. En la evaluación preoperatoria la disfunción sexual se distribuyó así: Severa: 70%, Moderada 18.3% y Leve 11.7%, después de 6 meses postoperatorios se encontró una diferencia estadísticamente significativa del cambio en el grado de disfunción sexual así: Moderada 41.5% y Leve 58.2% donde ninguna paciente quedó clasificada con disfunción severa. Discusión y Conclusión: Las pacientes que presentaron disfunción sexual severa obtuvieron mayor cambio en el grado de disfunción, luego de la colocación de la cinta suburetral.

Hormonal Contraception and the Risk of HIV Acquisition: An Individual Participant Data Meta-analysis.

BACKGROUND Observational studies of a putative association between hormonal contraception (HC) and HIV acquisition have produced conflicting results. We conducted an individual participant data (IPD) meta-analysis of studies from sub-Saharan Africa to compare the incidence of HIV infection in women using combined oral contraceptives (COCs) or the injectable progestins depot-medroxyprogesterone acetate (DMPA) or norethisterone enanthate (NET-EN) with women not using HC. METHODS AND FINDINGS Eligible studies measured HC exposure and incident HIV infection prospectively using standardized measures, enrolled women aged 15-49 y, recorded ≥15 incident HIV infections, and measured prespecified covariates. Our primary analysis estimated the adjusted hazard ratio (aHR) using two-stage random effects meta-analysis, controlling for region, marital status, age, number of sex partners, and condom use. We included 18 studies, including 37,124 women (43,613 woman-years) and 1,830 incident HIV infections. Relative to no HC use, the aHR for HIV acquisition was 1.50 (95% CI 1.24-1.83) for DMPA use, 1.24 (95% CI 0.84-1.82) for NET-EN use, and 1.03 (95% CI 0.88-1.20) for COC use. Between-study heterogeneity was mild (I2 < 50%). DMPA use was associated with increased HIV acquisition compared with COC use (aHR 1.43, 95% CI 1.23-1.67) and NET-EN use (aHR 1.32, 95% CI 1.08-1.61). Effect estimates were attenuated for studies at lower risk of methodological bias (compared with no HC use, aHR for DMPA use 1.22, 95% CI 0.99-1.50; for NET-EN use 0.67, 95% CI 0.47-0.96; and for COC use 0.91, 95% CI 0.73-1.41) compared to those at higher risk of bias (pinteraction = 0.003). Neither age nor herpes simplex virus type 2 infection status modified the HC-HIV relationship. CONCLUSIONS This IPD meta-analysis found no evidence that COC or NET-EN use increases women's risk of HIV but adds to the evidence that DMPA may increase HIV risk, underscoring the need for additional safe and effective contraceptive options for women at high HIV risk. A randomized controlled trial would provide more definitive evidence about the effects of hormonal contraception, particularly DMPA, on HIV risk.

Gender-sensitive reporting in medical research

Sex and gender differences influence the health and wellbeing of men and women. Although studies have drawn attention to observed differences between women and men across diseases, remarkably little research has been pursued to systematically investigate these underlying sex differences. Women continue to be underrepresented in clinical trials, and even in studies in which both men and women participate, systematic analysis of data to identify potential sex-based differences is lacking. Standards for reporting of clinical trials have been established to ensure provision of complete, transparent and critical information. An important step in addressing the gender imbalance would be inclusion of a gender perspective in the next Consolidated Standards of Reporting Trials (CONSORT) guideline revision. Uniform Requirements for Manuscripts Submitted to Biomedical Journals, as a set of well-recognized and widely used guidelines for authors and biomedical journals, should similarly emphasize the ethical obligation of authors to present data analyzed by gender as a matter of routine. Journal editors are also promoters of ethical research and adequate standards of reporting, and requirements for inclusion of gender analyses should be integrated into editorial policies as a matter of urgency.

Muṛbadhno ek āćhoḍo (?) : manuscript, 1900 ?

Foreign paper, manufactured in Bombay by Abdoola Saheb Abdool Rehman Hurufullah, watermark : "River Jumna".

Treatment of maternal syphilis in rural South Africa: effect of multiple doses of benzathine penicillin on pregnancy loss

OBJECTIVES Despite few data, the treatment of syphilis in pregnant women using a single dose of benzathine penicillin is the standard of care in many resource-poor settings. We examined the effect of various doses of benzathine penicillin on pregnancy loss among women with a positive Rapid Plasma Reagin (RPR) test result in a rural South African district. METHODS All pregnant women making their first antenatal care visit during pregnancy were screened for syphilis using the RPR test. Those testing positive were counselled to receive three weekly doses of benzathine penicillin, and received a partner notification card. Pregnancy outcomes were determined from facility records or home visits where necessary. RESULTS Of 8917 women screened, 1043 (12%) had reactive syphilis serology; of those with titre data available, 30% had titres of 1:8 or greater. While 41% (n = 430) of women received all three doses as counselled, 30% (n = 312) received only one dose, and 20% (n = 207) did not return to the clinic to receive treatment. Among the 947 women with pregnancy outcome data available, there were 17 miscarriages and 48 perinatal deaths observed. There was a strong trend towards reduced risk of pregnancy loss among women receiving multiple doses of penicillin (adjusted OR for perinatal mortality for each additional dose received, 0.63; 95% CI, 0.48-0.84). CONCLUSIONS While this association requires further investigation, these results suggest that there may be substantial benefit to providing multiple doses of benzathine penicillin to treat maternal syphilis in this setting.

The use of curriculum modifications and instructional accommodations to provide access for middle school students with autism to the general curriculum

The number of students identified as having autism increased by 500% in the past 10 years (United States Government Accountability Office, 2005). All students with disabilities are required to be placed in least restrictive environments and to be given access to the general curriculum in the major subjects of math, reading, writing, and science as mandated by federal legislation such as the Individuals with Disabilities Education Act (IDEA, 2004) and No Child Left Behind (NCLB, 2001). As a result of this legislation, an increasing number of students with autism are being educated in inclusive classrooms. Most studies on general education access and curriculum modifications and/or instructional accommodations center on students with intellectual disabilities (e.g. Soukup, Wehmeyer, Bashinski, & Boviard, 2007; Wehmeyer, Lattin, Lapp-Rincker, & Agran, 2003). Wehmeyer et al. (2003) and Soukup et al. (2007) found included students with intellectual disabilities had more access to the general curriculum than mostly self-contained students. This meant included students were more likely to be working on the general curriculum as mandated by NCLB than those in only self-contained classrooms. This study builds and expands the research of Wehmeyer et al., as well as Soukup et al., by examining how students with autism are given access to the general curriculum through curriculum modifications and instructional accommodations used by general education teachers in three schools. This investigation focused on nine inclusive classrooms for students with autism using a parallel mixed methods design (Newman, Newman, & Newman, 2011). Classroom observations using both an IEP related checklist and field notes, teacher interviews, an archival document review of the Individual Education Plan (IEP) for the selected students with autism were performed. Findings of this study were organized by interview questions and subsequent coding categories. Quantitative data were organized in a nominal scale. Participants asserted that their middle school students with autism functioned well in their classrooms, occasionally exhibiting behavioral differences. Most instructional accommodations on IEPs were being implemented by participants, and participants often provided additional instructional accommodations not mandated by the IEP. The majority of participants credited county workshops for their knowledge of instructional accommodations.

Professors’ Perspectives on Educational Cohorts

Cohort educational models (CEM) are used to support students in graduate degree completion. Studies around CEMs focus mainly on student benefits. Voices of professors who organize and ultimately teach educational cohorts have been missing from this dialog. This study seeks to uncover professors’ perspectives on CEMs.

Special Education Teachers: What Keeps Them in the Field?

The dilemma of securing a special education teacher supply is a critical issue. Understanding causes of attrition is vital to addressing the problem. This review analyzes literature and identifies factors for teacher retention/attrition while overlaying the concept of Maslow’s hierarchy of needs to understand this phenomenon from a psychological perspective.

General Curriculum Access: What Does it Mean for Students with Disabilities?

This paper examines the status of empirical research on the use of curriculum modifications and instructional accommodations for students with all types of disabilities. Conclusions and implications are provided for improving the quality of education and access to the general curriculum for students with autism.