Partner notification among asymptomatic Chlamydia trachomatis cases, by means of mailed specimens.

The objective of the study was to evaluate the prevalence of Chlamydia trachomatis infection and the participation, among partners of asymptomatic cases in general practice. Index cases were requested to invite partners for testing by mailed urine samples. One or more partners of 62% of the index cases participated, and the prevalence of infection among partners was 48%. A steady relationship was a determinant of both participation and prevalence. In conclusion, the mailing strategy is an effective strategy for partner notification. A high prevalence wasfound among partners.     

Feasibility of identifying out of care HIV-positive patients in a hospital setting and enrolling them in a retention intervention

Background: The hospital setting provides an opportunity to re-engage people living with HIV (PLWH) in HIV care. We developed and implemented a protocol to identify PLWH in a hospital setting. The aim of the current study was to report on our strategy to recruit hospitalized HIV patients into an intervention study, and to report on lessons learned for future studies.

Methods: Our protocol was developed based on experience of our research staff in recruiting HIV patients as well as clinical input from providers and administrators on delivering care in hospitalized settings. We identified hospitalized PLWH between 2010 and 2013 who were potentially eligible for an intervention study. Patients were identified by review of electronic medical records and clinician referral, followed by in-person screening to confirm eligibility. We examined factors related to identifying and enrolling hospitalized patients, and documented lessons learned.

Results: Key strategies included systematic medical record review followed by in-person screening, collaboration with staff, and flexibility in recruitment logistics. We identified 1801 PLWH hospitalized during the 3-year study period. Eighty-four percent (n = 1514) met the met the inclusion criteria based on medical record review. Of these, 48% (n = 733) were ineligible. Among eligible patients, 59% (n = 460) were enrolled. Only 3% (n = 23) of eligible patients declined; 84% (n = 321) were not enrolled because they were discharged before enrollment. Lessons learned included (1) needing to identify patients and deliver the intervention before hospital discharge, (2) limiting the complexity of the intervention, and (3) having research staff available on weekends and after hours.

Conclusions: Targeted recruitment of hospitalized populations is a feasible and productive approach for finding and engaging PLWH who are newly diagnosed or out of routine care.     

Thin-layer chromatography of lipid antigens as a means of identifying nontuberculous mycobacteria.

The previously described thin-layer chromatography procedure (Brennan et al., J. Clin. Microbiol. 8:374-379, 1978) for identifying serovars of the Mycobacterium avium-M. intracellulare-M. scrofulaceum complex, based on their specific C-mycoside glycopeptidolipid antigens, has now been extended to all 31 known serovars. Photographs of the characteristic pattern of the glycopeptidolipids are presented. Although the procedure is fraught with the difficulties inherent to comparative thin-layer chromatography, it is particularly suitable for the screening of isolates which are not amenable to seroagglutination, such as those which autoagglutinate or for which antisera are not presently available. In this way it was possible to tell whether isolates were of the M. avium-M. intracellulare-M. scrofulaceum complex and whether or not they had previously been recognized. Knowledge of the chemical features of the typing antigens nontuberculous mycobacteria other than M. avium-M. intracellulare-M. scrofulaceum strains also enables us to develop thin-layer chromatography systems for the identification of M. kansasii, M. szulgai, members of the M. gordonae complex, M. terrae, M. xenopi, and M. gastri.     

Partner violence, partner notification, and women's decisions to have an HIV test

OBJECTIVES: Reports of partner violence against HIV-positive women after they have disclosed their serostatus have led some to reassess partner notification strategies and to speculate that fear of partner violence following partner notification may influence women's HIV testing decisions. We studied whether associations exist between women's declining to have an HIV test and history of partner violence, fear of partner violence, previous experience with partner notification, or beliefs about partner notification. METHODS: In this cross-sectional study, we interviewed women seen at Newark and Miami sexually transmitted disease clinics. The women were at least 18 years old, not known to be HIV positive, not tested for HIV in the previous 3 months, and offered HIV testing during the clinic visit. Women who declined testing were compared with women who accepted. RESULTS: Of 490 participants (89% of eligible women), 16% reported partner violence in the past year, and 28% declined HIV testing. Declining the test was not significantly (p >.05) associated with history or fear of partner violence, previous experience with partner notification, or beliefs about partner notification. When specifically asked, only 2 women responded that their declining the test was related to fear that their partner or partners might harm them if the women tested positive. CONCLUSIONS: Among women seen at these clinics, we did not find evidence that declining the HIV test was strongly influenced by partner violence, previous experience with partner notification, or beliefs about partner notification. However, many women reported partner violence. Therefore, providers should assess the potential for partner violence and be prepared to make appropriate referrals.     

Lymphocyte autoantibodies and alloantibodies in HIV-positive haemophilia patients.

In order to elucidate the fine specificity of anti-cardiolipin antibodies (ACA) in patients with SLE compared to patients with syphilis (SY) various inhibition experiments were performed. Seven SLE sera and eight SY sera positive for ACA were diluted and preincubated with either cardiolipin VDRL-antigen, mitochondial particles, dsDNA, ssDNA or dilution buffer. The sera were subsequently assayed for residual ACA activity of IgG or IgM class using a sensitive ELISA technique. Significant inhibition of IgM ACA activity in SLE sera was found with cardiolipin, VDRL-antigen and mitochondrial particles. Cardiolipin inhibited binding to a significantly higher extent than the other antigens. In SY sera significant inhibition of the IgM ACA activity was found with all antigens used. The strongest inhibition was seen using VDRL-antigen. Inhibition of IgG ACA activity could only be clearly estimated in SY sera where VDRL-antigen was found to be a much stronger inhibitor than the rest, purified cardiolipin being the weakest. Only two out of seven SLE sera were IgG ACA positive which made a clear conclusion impossible but a strong inhibitory capability of pure cardiolipin and a weaker inhibition with VDRL-antigen was found. This study disclosed a difference between SLE and SY sera showing strong reactivity of ACA in SLE sera with purified cardiolipin, contrasting to ACA in SY sera which predominantly reacted with cardiolipin in the liposome environment, as found in the VDRL-antigen and in mitochondrial particles.     

Investigating the therapeutic potential of a heritage-object focused intervention: a qualitative study

This study explores the therapeutic potential of heritage-object handling in nurse-patient encounters with women facing cancer. Ten women participated in an object-focused conversation with a nurse specialist. Sessions were audio-tape recorded and transcribed. Kleinian theory framed the analysis to reveal the individual ways women 'used' the object in the session. Professionally observed heritage-object handling provides an aid to discussion with patients and has potential as an assessment platform for therapeutic work or as an intervention approach in its own right. Further longitudinal controlled trials are needed to evaluate such benefits, particularly given the depth of the talk revealed in this study.     

Cognitive-behavioral stress management intervention buffers distress responses and immunologic changes following notification of HIV-1 seropositivity.

Forty-seven asymptomatic, healthy gay men were randomly assigned to a cognitive-behavioral stress management (CBSM) condition or an assessment-only control group 5 weeks before being notified of their HIV-1 antibody status. Seventy-two hours before and 1 week after serostatus notification, blood samples and psychometric data were collected. Control subjects showed significant increases in depression, but only slight decrements in mitogen responsivity and lymphocyte cell counts pre- to postnotification of seropositivity. Seropositive CBSM Ss did not show significant pre-post changes in depression, but did reveal significant increases in helper-inducer (CD4) and natural killer (CD56) cell counts as well as a slight increment in proliferative responses to phytohemagglutinin (PHA). Individual difference analyses suggest that the psychological buffering and immunomodulating effects of the CBSM manipulation may be attributable, in part, to relaxation skills learned and practiced or to a general willingness to comply with the intervention guidelines.     

Biological processes in prevention and intervention: the promotion of self-regulation as a means of preventing school failure

This paper examines interrelations between biological and social influences on the development of self-regulation in young children and considers implications of these interrelations for the promotion of self-regulation and positive adaptation to school. Emotional development and processes of emotion regulation are seen as influencing and being influenced by the development of executive cognitive functions, including working memory, inhibitory control, and mental flexibility important for the effortful regulation of attention and behavior. Developing self-regulation is further understood to reflect an emerging balance between processes of emotional arousal and cognitive regulation. Early childhood educational programs that effectively link emotional and motivational arousal with activities designed to exercise and promote executive functions can be effective in enhancing self-regulation, school readiness, and school success.     

Fertility desires and intentions of HIV-positive patients at a suburban specialist center

OBJECTIVES: To determine the extent of fertility desires and intentions of HIV-positive patients receiving care at a suburban specialist clinic and assess how these may vary by their sociodemographic and health-related factors. METHODS: Questionnaire-based interview of a consecutive sample of HIV-positive men (18-55 years) and HIV-positive women (18-45 years) who presented at the HIV clinic of the Center for Special Studies, Sagamu, Nigeria, between November and December 2004. RESULTS: 63.3% of the 147 studied participants expressed the desire for childbearing, even though 50.4% of them already had > or = 2 children. Respectively, 71.5% and 93.8% of men and women who desired children intended to have > or = 2 in the near future. Only 4.3% of those who desired children did not intend to have any. All 30 individuals who had no children intended to bear children in the future, and they constituted 32.3% of those who expressed the desire for childbearing. Multivariate logistic regression analyses of associated factors indicated that decreasing age, shorter time since diagnosis of HIV infection and nondisclosure of serostatus to current partner significantly increase the odds of desire for childbearing, while having no children and a poor most-recent CD4 count significantly increase the odds of intention to have > or = 3 children instead of 1-2. CONCLUSION: The extent of the fertility desires and intentions of these patients poses a threat to the preventive strategies against vertical and heterosexual transmission of HIV in this region. In view of their compelling desire for parenthood, it may be wise for caregivers to desist from the conventional systematic advice against pregnancy but, in addition to laying emphasis on the risks, provide adequate information on practicable reproductive options for HIV-positive individuals.     

The effectiveness of a trauma focused spiritually integrated intervention for veterans exposed to trauma

Building Spiritual Strength (BSS) is an 8-session, spiritually integrated group intervention designed to address religious strain and enhance religious meaning making for military trauma survivors. It is based upon empirical research on the relationship between spirituality and adjustment to trauma. To assess the intervention's effectiveness, veterans with histories of trauma who volunteered for the study were randomly assigned to a BSS group (n = 26) or a wait-list control group (n = 28). BSS participants showed statistically significant reductions in PTSD symptoms based on self-report measures as compared with those in a wait-list control condition. Further research on spiritually integrated interventions for trauma survivors is warranted.     

Cryoheater as a means of cryosurgery control

A new concept for cryosurgery control is presented in this paper, a concept which has the potential to dramatically change the outcome of cryosurgery. Unlike other cryosurgery control techniques, which are based on controlling the thermal performance of the cryoprobe, this new concept is based on heating the treated tissue as a means of shaping the frozen region. The new controlling heater is termed a 'cryoheater'. The cryoheater is a complementary device to the cryoprobe and can work with any cryosurgery cooling technique. In the current pilot study, the new cryoheater is demonstrated in a gelatin solution and, using heat transfer simulations, it is studied in simulated cases of prostate cryosurgery. It is suggested that cryosurgery planning tools and optimization techniques must be developed before the concept of the cryoheater can be applied in its full capacity.     

Evaluation of fluorescent-antibody tests as a means of confirming infant botulism.

Fluorescent-antibody techniques were evaluated for confirming infant botulism. Seventy-seven stool specimens from suspected cases were examined. All 34 specimens containing viable Clostridium botulinum at time of study gave positive results (29 on direct smears and 34 on enrichments). Two false-positive reactions were observed.     

Discriminant analysis of antibiotic susceptibility as a means of bacterial identification.

This study shows that antibiotic susceptibility data can be used effectively in the presumptive identification of bacteria. Using 12 antibiotics and determining the zone sizes for each, 82% of the isolates considered were correctly identified without any other information. If the inability to distinguish between Escherichia coli and Shigella is disregarded, the percentage of correct identification is 92%. The method involves determining a set of discriminant functions and defining each taxon by a unique function. An unknown isolate is identified by evaluating each discriminant function and assigning the isolate to the taxon whose discriminant function has the largest value. A total of 468 isolates were examined. After eliminating the multiply resistant isolates, the remaining 369 isolates were used to determine the discriminant functions for the eight taxa considered.     

Bacterial competition as a means of preventing neonatal diarrhea in pigs.

Baby pigs orally inoculated with a porcine strain of enterotoxigenic Escherichia coli (K88+,Ent+) showed signs of depression, severe diarrhea, and, in some instances, death. Few, if any, signs of illness occurred if baby pigs were first inoculated with a K88 possessing non-enterotoxin-producing strain of E. coli.