Access to Social Protection by People Living with,at Risk of,or Affected by HIV in Eswatini,Malawi, Tanzania,and Zambia: Results from Population-Based HIV Impact Assessments

AIDS and Behavior - We aimed to measure social protection coverage among the general population, women and men living with HIV (WLHIV, MLHV), female and male sex workers (FSW, MSW), men who have...     

On the potential of a short‐term intensive intervention to interrupt HCV transmission in HIV‐positive men who have sex with men: A mathematical modelling study

Increasing access to direct‐acting antiviral (DAA) treatment for hepatitis C virus (HCV) infection and decelerating the rise in high‐risk behaviour over the next decade could curb the HCV epidemic among HIV‐positive men who have sex with men (MSM). We investigated if similar outcomes would be achieved by short‐term intensive interventions like the Swiss‐HCVree‐trial. We used a HCV transmission model emulating two 12‐months intensive interventions combining risk counselling with (i) universal DAA treatment (pangenotypic intervention) and (ii) DAA treatment for HCV genotypes 1 and 4 (replicating the Swiss‐HCVree‐trial). To capture potential changes outside intensive interventions, we varied time from HCV infection to treatment in clinical routine and overall high‐risk behaviour among HIV‐positive MSM. Simulated prevalence dropped from 5.5% in 2016 to ≤2.0% over the intervention period (June/2016‐May/2017) with the pangenotypic intervention, and to ≤3.6% with the Swiss‐HCVree‐trial. Assuming time to treatment in clinical routine reflected reimbursement restrictions (METAVIR ≥F2, 16.9 years) and stable high‐risk behaviour in the overall MSM population, prevalence in 2025 reached 13.1% without intensive intervention, 11.1% with the pangenotypic intervention and 11.8% with the Swiss‐HCVree‐trial. If time to treatment in clinical routine was 2 years, prevalence in 2025 declined to 4.8% without intensive intervention, to 2.8% with the pangenotypic intervention, and to 3.5% with the Swiss‐HCVree‐trial. In this scenario, the pangenotypic intervention and the Swiss‐HCVree‐trial reduced cumulative (2016‐2025) treatment episodes by 36% and 24%, respectively. Therefore, intensive interventions could reduce future HCV treatment costs and boost the benefits of long‐term efforts to prevent high‐risk behaviour and to reduce treatment delay. But if after intensive interventions treatment is deferred until F2, short‐term benefits of intensive interventions would dissipate in the long term.     

Elimination of rumination by controlled eating and differential reinforcement

The purpose of the present study was to examine the effectiveness of a controlled eating technique and a procedure which combined controlled eating with differential reinforcement of other behavior (DRO) for the reduction of rumination in an obese, 23-year-old, severely retarded and autistic male. The controlled eating technique resulted in a 75 per cent reduction in the rate of rumination while controlled eating with DRO resulted in an overall 95 per cent reduction. A six month follow-up showed that the participant's ruminative behavior had declined to zero.     

Engineering controls for furniture strippers to meet the OSHA methylene chloride PEL

This case study demonstrates how methylene chloride exposures during furniture stripping can be reduced to below the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) of 25 ppm (as an 8-hour time-weighted average). Five surveys were conducted at one facility; the first four resulted in employee exposure geometric means from 39 to 332 ppm. For the fifth survey local exhaust ventilation was used at the stripping tank and the rinsing area, which together exhausted 138 m3/min (4860 ft3/min). Additional controls included providing adequate make-up air, adding paraffin wax to the stripping solution, raising the level of the stripping solution in the tank, and discussing good work practices with the employee. The employees' methylene chloride exposures during the fifth survey resulted in a geometric mean of 5.6 ppm with a 95% upper confidence limit of 8.3 ppm, which was found to be significantly lower than the OSHA PEL and the OSHA action level of 12.5 ppm. The cost of the ventilation system was $8900.     

The impact of maintenance and design for ventilation systems

Ventilation systems need to be designed to include access for cleaning and preventive maintenance. Without such access, the exhaust volume will deteriorate. Because of access difficulties and the many demands on their time, plant managers are sometimes errant in performing proper preventive maintenance. Three surveys measuring workers' exposures to methylene chloride were conducted at the same furniture stripping facility. A new ventilation system was installed for the first survey, resulting in an exhaust volume of 2900 cfm and worker exposure to methylene chloride of 59 ppm (geometric mean). Immediately after the first survey, the gasoline-powered fan was replaced by a smaller capacity electrically powered fan. Deterioration in the ventilation system was seen after seven years. Problems included clogged slots, paint chips and sawdust deposits in plenums, and a loose and frayed fan belt. The second survey indicated a reduction in exhaust volume to 1060 cfm and increased worker exposure to 330 ppm. With the smaller capacity fan still in place, the system was otherwise upgraded to allow for easier access and maintenance was performed. The third survey showed that the ventilation system performance was better (exhaust volume improved to 2080 cfm) and the worker exposures were reduced to 73 ppm. This study shows the benefits of designing for preventive maintenance and the necessity of keeping the ventilation systems clean.     

Research and dissemination needs for ergonomics in agriculture

In 1998, the National Institute for Occupational Safety and Health convened a conference of researchers interested in the ergonomics of agricultural workers. Participants included 20 representatives from universities, state governments, private agricultural and insurance companies, migrant worker organizations, agricultural industry organizations, and the Agricultural Extension Service. The attendees divided into three groups and brainstormed about research ideas and dissemination methods related to ergonomics for farm workers. The groups separately reported that interventions, cost-benefit analyses, and cultural belief systems were the main topics that needed to be researched to reduce physical risk factors for musculoskeletal disorders. The participants also presented ideas for disseminating information to farm owners and workers.     

Analyzing Exposure, Use, and Policies Related to Tobacco Use on Campus for the Development of Comprehensive Tobacco Policies at Canadian Post-secondary Institutions

Canadians in their early twenties represent the highest prevalence of reported tobacco use among all age groups. With the majority of Canadian young adults accessing post-secondary education, post-secondary institutions can facilitate targeting of health promotion efforts to curb tobacco use among young adults. Effective targeting requires clear comprehensive campus tobacco policies. However, the development and implementation of comprehensive campus tobacco policies has been lacking among Canadian post-secondary institutions. As the first step towards the development of a comprehensive campus tobacco policy at the University of Guelph, an on-line survey of students, faculty and staff was conducted in November 2012. The objectives of this survey were two-fold: (1) Determine the current level of exposure to second-hand smoke on campus, the type and frequency of tobacco use, opinions on seven different tobacco policy options, and the level of awareness of current tobacco policies and programs and; (2) Determine if any associations between opinions on tobacco policy options and exposure to second-hand smoke and tobacco use existed. The results of this survey demonstrate that tobacco use is associated with opinions on tobacco policy options and that the level of awareness of tobacco policies and programs is relatively low and is not associated with tobacco use. This study represents one of the first studies to examine the association between tobacco use and support of policy options and awareness of tobacco policies and programs. As other post-secondary institutions develop comprehensive tobacco policies, these findings will serve as a comparison for other similar institutions.