Developmental Progression in Children's Knowledge of AIDS: Implications for Education and Attitudinal Change

The effectiveness of curricula designed to enhance a child'sunderstanding of AIDS may hinge partially upon incorporatinginformation adjusted to the child's developmental status. Accordingly,we examined the developmental progression of children's understandingof illness transmission in general and AIDS in particular, aswell as explored the relation between a child's knowledge ofAIDS and his/her attitudes toward persons with AIDS. Knowledgeof AIDS was manipulated through use of a brief educational intervention.Results support a developmental progression in knowledge aboutAIDS that is consistent with progressions related to illnessesin general. Knowledge enhancement was associated with positivechanges in attitude.     

Is oral contraceptive therapy advisable in woman with family history of breast cancer?

A 20-year-old single woman suffers from severe dysmenorrhea, unresponsive to analgesic medication. Findings for gynecological examination were normal. Her mother died of mammary cancer at the age of 47. This cancer was diagnosed at age 42 while she was taking oral contraceptives. The patient in question, and her 3 sisters, had been warned against taking oral contraceptives. Now it is suggested that her dysmenorrhea might respond to contraceptive therapy. The question is asked regarding the use of oral contraceptives. In response, a diagnostic laparoscopy is recommended to determine if endometriosis is present. If endometriosis is found, medroxyprogesterone acetate may be used for suppression of ovulation, but ovulation may continue to be suppressed for 12-18 months after discontinuing this medication. Danazol is also effective in treating endometriosis and dysmenorrhea but has no estrogenic effect. Available data do not show an increased incidence of mammary cancer in users of oral contraceptives.     

Reproducibility of ultrasound scan in the assessment of volume flow in the veins of the lower extremities

PURPOSE: The purpose of this study was the identification of the optimal settings of ultrasound scan flow measurement in the veins and the determination of whether the standardization of these settings can provide acceptable reproducibility of the venous flow measurements in individual segments of the lower extremity veins. METHODS: The venous cross-sectional area, the time average mean velocity, and the venous volume flow of 25 healthy volunteers were examined with duplex ultrasound scanning. Reproducibility was examined with different measurement settings. Doppler scan sample volume size, ultrasound scan beam incident angle, and time interval of measurement were varied across a spectrum for arrival at the setting for highest reproducibility of the flow volume measurements. Test-retest reproducibility of venous flow volume measurements then was investigated with optimized settings. RESULTS: The highest repeatability of volume flow measurements was achieved when the full lumen of the vein was insonated (coefficient of repeatability [CR] = 1.88 cm/s), the ultrasound scan beam incident angle was equal to 60 degrees (CR = 1.56 cm/s), and the measurement time was more than 40 seconds (CR = 1.64 cm/s). The mean values of volume flow were 360 mL/min in the common femoral vein, 147 mL/min in the superficial femoral vein, 86 mL/min in the profunda femoral vein, and 38 mL/min in the greater saphenous vein. Test-retest repeatability coefficients were 96.9 mL/min for the common femoral vein, 70.2 mL/min for the superficial femoral vein, 40.8 mL/min for the profunda femoral vein, and 16.8 mL/min for the greater saphenous vein. CONCLUSION: The reproducibility of ultrasound scan measurements of volume flow in veins is optimized with the use of sampling volumes that cover the entire venous lumen, with an incident angle of 60 degrees and measuring for 40-second intervals or longer. With these defined variables, volumetric measurements are sufficiently repeatable. the values of flow volume measured with duplex ultrasound scanning were comparable to those with thermodilution techniques that were reported previously.     

Risk factors for venous thromboembolism following prolonged air travel. Coach class thrombosis

Venous thromboembolism (VTE) in legs and lungs is a potentially life-threatening condition. The incidence of VTE associated with air travel is still unknown, but it may have increased. Most travelers who develop symptoms do so within 24 hours after their flight takes off. Predisposing risk factors may be divided into patient-related and cabin-related factors, both of which are described. It is emphasized that better information and better inflight precautions can minimize these risk factors.     

A new European perspective of influenza pandemic planning with a particular focus on the role of mammalian cell culture vaccines

Sixteen EU scientists and doctors were interviewed about pandemic planning using psychometric methods applied to a scientific problem for the first time. Criticism was aimed at countries which have no plan whatsoever, the majority of nations. Many such countries have not invested in scientific infrastructure and public health. Amongst the 15 or so published pandemic plans a lack of detail was identified. Of particular need was investment into avian virus vaccine stocks (H1-15), prepared licenses of vaccine and pre purchase and agreed distribution, investment into stocks of antivirals, antibiotics and masks. Most but not all members of the group predicted a global outbreak within 5 years, most probably starting in SE Asia. However it was recognised that a pandemic could start anywhere in the world which had juxtaposition of young people, chickens, ducks and pigs. Mammalian cell culture production using wild type virus with the production factory at category III levels of security was exemplified. Antivirals would be essential to ameliorate the first wave of infection although significant quantities of cell grown vaccine could be produced if, as in 1918, 1957 and 1968 there is a long period between the first virus isolation and person to person spread. The wider scientific community is more energised than previously for very serious preparations to be in place way before the outbreak begins as this is a major public health problem, completely dwarfing concerns about bioterrorism.