Home-based pre-exposure prophylaxis (PrEP services for gay and bisexual men: An opportunity to address barriers to PrEP uptake and persistence.

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Steven A John

Full Text Available Gay, bisexual, and other men who have sex with men (GBM are disproportionately affected by the HIV epidemic. Despite the promise of pre-exposure prophylaxis (PrEP in reducing HIV transmission risk, barriers for uptake and persistence exist. We sought to identify whether GBM in a nationwide cohort who have not yet initiated PrEP (n = 906 would prefer to get PrEP-related care from a primary care provider (PCP compared to a specialist clinic or provider. We then sought to identify their level of interest and factors associated with preference for using home-based PrEP services (i.e., HB-PrEP, defined to participants as conducting HIV/STI self-testing from home with PrEP prescription mailing after an initial in-person clinic visit. We examined the associations of demographics, sexual HIV transmission risk, concern about frequent medical checkups associated with PrEP, health care access, and PrEP intentions with preferences for healthcare provider type and HB-PrEP. Concern about frequent medical checkups were associated with preferring a PCP for PrEP-related care, but men who perceived a barrier to bringing up the topic of PrEP with a doctor preferred a specialist clinic or provider more than a PCP. HB-PrEP was more appealing for younger men and those engaged in sexual HIV transmission risk, suggesting HB-PrEP could help reach GBM most vulnerable to HIV and in need of PrEP. HB-PrEP expansion has potential to increase PrEP uptake and persistence among GBM, particularly for men with barriers to clinic-based care and higher intentions to initiate PrEP. Clinical guidelines regarding HB-PrEP are needed to expand its use.

Tech Prep Marketing Guide. The Complete Book of Strategies and Practical Experiences.

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Williamson, Patty

This guide explains the concept of marketing tech prep and provides marketing principles and strategies to promote tech prep programs. The guide covers the following topics: (1) why it is necessary to market tech prep; (2) what a comprehensive tech prep marketing plan should include; (3) targeting the benefits message; (4) marketing tech prep to…

Moving beyond Test-Prep Pedagogy: Dialoguing with Multicultural Preservice Teachers for a Quality Education

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Rodríguez, Louie F.

2013-01-01

In a "post-NCLB era," the schooling experiences of mostly low-income students of color continue to be consumed by a test-prep pedagogy--narrowed curriculum, low expectations, and ignored relationships. In this article the author describes a pedagogical approach using educational dialogues to engage preservice teachers to critically…

Best Practices: A Cure for the New Prep Headache?

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Burns, Alan T.; Steinbach, Theresa A.

2010-01-01

The teaching of a new course is colloquially known among faculty as a "new prep." New preps are often time-consuming and laborious for instructors. They can be particularly frustrating when this effort does not yield results in the classroom. This research explores how a best practice approach can make the transfer of new preps across…

A Closer Look at Racism and Heterosexism in Medical Students' Clinical Decision-Making Related to HIV Pre-Exposure Prophylaxis (PrEP): Implications for PrEP Education.

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Calabrese, Sarah K; Earnshaw, Valerie A; Krakower, Douglas S; Underhill, Kristen; Vincent, Wilson; Magnus, Manya; Hansen, Nathan B; Kershaw, Trace S; Mayer, Kenneth H; Betancourt, Joseph R; Dovidio, John F

2018-04-01

Social biases among healthcare providers could limit PrEP access. In this survey study of 115 US medical students, we examined associations between biases (racism and heterosexism) and PrEP clinical decision-making and explored prior PrEP education as a potential buffer. After viewing a vignette about a PrEP-seeking MSM patient, participants reported anticipated patient behavior (condomless sex, extra-relational sex, and adherence), intention to prescribe PrEP to the patient, biases, and background characteristics. Minimal evidence for racism affecting clinical decision-making emerged. In unadjusted analyses, heterosexism indirectly affected prescribing intention via all anticipated behaviors, tested as parallel mediators. Participants expressing greater heterosexism more strongly anticipated increased risk behavior and adherence problems, which were associated with lower prescribing intention. The indirect effect via condomless sex remained significant adjusting for background characteristics. Prior PrEP education did not buffer any indirect effects. Heterosexism may compromise PrEP provision to MSM and should be addressed in PrEP-related medical education.

Factors associated with bed and room sharing in Chinese school-aged children.

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Li, S; Jin, X; Yan, C; Wu, S; Jiang, F; Shen, X

2009-03-01

Co-sleeping (bed or room sharing) has potential implications for children's development. Previous studies showed that co-sleeping was more prevalent in non-Western countries than in Western countries, which demonstrated that co-sleeping was marked with ethnic and socio-cultural background characteristics. The purpose of this study was to survey the prevalence of bed and room sharing and to examine related factors among school-aged children in an Asian country - China. A cross-sectional questionnaire survey was conducted in 10 districts of Shanghai, China from November to December 2005. A total of 4108 elementary school children, 49.2% boys and 50.8% girls with a mean age of 8.79 years, participated. Parent-administered questionnaires were used to collect information about children's sleeping arrangements and socio-demographic characteristics. The prevalence of routine bed sharing, room sharing and sleeping alone in Chinese school-aged children was 21.0%, 19.1% and 47.7%, respectively. Bed and room sharing didn't show significant gender difference but gradually decreased with increasing age. Multivariate logistic regression identified those factors associated with bed and room sharing: younger age, large family, children without their own bedroom and parents' approval of a co-sleeping arrangement. Co-sleeping arrangement was a common practice in Chinese school-aged children. Associated factors were characterized by intrinsic socio-cultural values and socio-economic status in China.

Preferences for Long-Acting Pre-exposure Prophylaxis (PrEP), Daily Oral PrEP, or Condoms for HIV Prevention Among U.S. Men Who Have Sex with Men.

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Greene, George J; Swann, Greg; Fought, Angela J; Carballo-Diéguez, Alex; Hope, Thomas J; Kiser, Patrick F; Mustanski, Brian; D'Aquila, Richard T

2017-05-01

HIV prevention method preferences were evaluated among 512 U.S. men who have sex with men (MSM; median age: 22 years). Approximately 90 % consistently preferred one option across pairwise comparisons of condoms, daily oral pre-exposure prophylaxis (PrEP), and long-acting PrEP delivered via either an injectable or one of two types of PrEP implants differing in visibility. Condoms were most frequently preferred (33.8 %), followed by non-visible implants (21.5 %), and oral PrEP (17.0 %); HIV risk was reported by more choosing implants. In a follow-up question comparing the four PrEP options only, daily oral pills and non-visible implants were most frequently preferred (35.5 and 34.3 %, respectively), followed by injections (25.2 %) and visible implants (4.3 %). An inductive, open-coding approach determined that convenience, duration of protection, and privacy were the most commonly cited reasons for a PrEP method choice, and associated with self-report of HIV risk. Tailoring PrEP product development to privacy and other concerns important to those at highest HIV risk may improve HIV prevention.

Who Will Use Pre-Exposure Prophylaxis (PrEP) and Why?: Understanding PrEP Awareness and Acceptability amongst Men Who Have Sex with Men in the UK--A Mixed Methods Study.

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Frankis, Jamie; Young, Ingrid; Flowers, Paul; McDaid, Lisa

2016-01-01

Recent clinical trials suggest that pre-exposure prophylaxis (PrEP) may reduce HIV transmission by up to 86% for men who have sex with men (MSM), whilst relatively high levels of PrEP acceptability have been reported to date. This study examines PrEP awareness amongst sub-groups of MSM communities and acceptability amongst MSM in a low prevalence region (Scotland, UK), using a mixed methods design. Quantitative surveys of n = 690 MSM recruited online via social and sociosexual media were analysed using descriptive statistics and multivariate logistic regression. In addition, n = 10 in-depth qualitative interviews with MSM were analysed thematically. Under one third (29.7%) of MSM had heard of PrEP, with awareness related to living in large cities, degree level education, commercial gay scene use and reporting an HIV test in the last year. Just under half of participants (47.8%) were likely to use PrEP if it were available but there was no relationship between PrEP acceptability and previous PrEP awareness. Younger men (18-25 years) and those who report higher risk UAI were significantly more likely to say they would use PrEP. Qualitative data described specific PrEP scenarios, illustrating how risk, patterns of sexual practice and social relationships could affect motivation for and nature of PrEP use. These findings suggest substantial interest PrEP amongst MSM reporting HIV risk behaviours in Scotland. Given the Proud results, there is a strong case to investigate PrEP implementation within the UK. However, it appears that disparities in awareness have already emerged along traditional indicators of inequality. Our research identifies the need for comprehensive support when PrEP is introduced, including a key online component, to ensure equity of awareness across diverse MSM communities (e.g. by geography, education, gay scene use and HIV proximity), as well as to responding to the diverse informational and sexual health needs of all MSM communities.

Who Will Use Pre-Exposure Prophylaxis (PrEP and Why?: Understanding PrEP Awareness and Acceptability amongst Men Who Have Sex with Men in the UK--A Mixed Methods Study.

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Jamie Frankis

Full Text Available Recent clinical trials suggest that pre-exposure prophylaxis (PrEP may reduce HIV transmission by up to 86% for men who have sex with men (MSM, whilst relatively high levels of PrEP acceptability have been reported to date. This study examines PrEP awareness amongst sub-groups of MSM communities and acceptability amongst MSM in a low prevalence region (Scotland, UK, using a mixed methods design.Quantitative surveys of n = 690 MSM recruited online via social and sociosexual media were analysed using descriptive statistics and multivariate logistic regression. In addition, n = 10 in-depth qualitative interviews with MSM were analysed thematically.Under one third (29.7% of MSM had heard of PrEP, with awareness related to living in large cities, degree level education, commercial gay scene use and reporting an HIV test in the last year. Just under half of participants (47.8% were likely to use PrEP if it were available but there was no relationship between PrEP acceptability and previous PrEP awareness. Younger men (18-25 years and those who report higher risk UAI were significantly more likely to say they would use PrEP. Qualitative data described specific PrEP scenarios, illustrating how risk, patterns of sexual practice and social relationships could affect motivation for and nature of PrEP use.These findings suggest substantial interest PrEP amongst MSM reporting HIV risk behaviours in Scotland. Given the Proud results, there is a strong case to investigate PrEP implementation within the UK. However, it appears that disparities in awareness have already emerged along traditional indicators of inequality. Our research identifies the need for comprehensive support when PrEP is introduced, including a key online component, to ensure equity of awareness across diverse MSM communities (e.g. by geography, education, gay scene use and HIV proximity, as well as to responding to the diverse informational and sexual health needs of all MSM communities.

Houston Pre-Freshman Enrichment Program (Houston PREP). Final report, June 9, 1997--July 25, 1997

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NONE

1997-10-01

The 1997 Houston Pre-Freshman Enrichment Program (PREP) was conducted at the campus of the University of Houston-Downtown from June 9 to July 25, 1997. Program participants were recruited from the Greater Houston Area. All participants were identified as high-achieving students with an interest in learning about the engineering and science professions. The goal of the program was to better prepare our pre-college youth prior to entering college as mathematics, science and engineering majors. The program participants were middle school and high school students from the Aldine, Alief, Channel View, Clear Creek, Cypress-Fairbanks, Fort Bend, Galena Park, Houston, Humble, Katy, Klein, North Forest, Pasadena, Private, and Spring Branch Independent School Districts. Of the 194 students starting the program, 165 students were from economically and socially disadvantage groups under-represented in the engineering and science professions, and 118 of the 194 were women. Our First Year group for 1997 composed of 96% minority and women students. Second and Third Year students combined were 96% minority or women. With financial support from the Center for Computational Sciences and Advanced Distributed Simulation, the Fourth Year Program was added to PREP this year. Twelve students completed the program (83% minority or women).

Process to Obtain Quick Counts from PREP

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Martínez–Cruz M.Á.

2011-10-01

Full Text Available Considering the Preliminary Electoral Results Program (PERP as a database of the federal elections for president of the Mexican Republic, a methodology was developed in order to find representative samples of ballot boxes installed in the election’s day (quick count in different hours, due to its characteristics of gathering of information, the PREP in the first hours forms a non-representative sample of data. In a particular way, in the election of July 2, 2006, after 3 hours of opening the PREP, it was observed that the accuracy of the process of the quick counts was better than the one obtained by the IFE. Among other things, this allows to lower the cost, to increase the confidentiality of the ballot boxes used in the sampling and to distinguish in a precise moment the winning candidate long before PREP finishes.

Who Will Use Pre-Exposure Prophylaxis (PrEP) and Why?: Understanding PrEP Awareness and Acceptability amongst Men Who Have Sex with Men in the UK – A Mixed Methods Study

Science.gov (United States)

Frankis, Jamie; Young, Ingrid; Flowers, Paul; McDaid, Lisa

2016-01-01

Background Recent clinical trials suggest that pre-exposure prophylaxis (PrEP) may reduce HIV transmission by up to 86% for men who have sex with men (MSM), whilst relatively high levels of PrEP acceptability have been reported to date. This study examines PrEP awareness amongst sub-groups of MSM communities and acceptability amongst MSM in a low prevalence region (Scotland, UK), using a mixed methods design. Methods Quantitative surveys of n = 690 MSM recruited online via social and sociosexual media were analysed using descriptive statistics and multivariate logistic regression. In addition, n = 10 in-depth qualitative interviews with MSM were analysed thematically. Results Under one third (29.7%) of MSM had heard of PrEP, with awareness related to living in large cities, degree level education, commercial gay scene use and reporting an HIV test in the last year. Just under half of participants (47.8%) were likely to use PrEP if it were available but there was no relationship between PrEP acceptability and previous PrEP awareness. Younger men (18–25 years) and those who report higher risk UAI were significantly more likely to say they would use PrEP. Qualitative data described specific PrEP scenarios, illustrating how risk, patterns of sexual practice and social relationships could affect motivation for and nature of PrEP use. Conclusion These findings suggest substantial interest PrEP amongst MSM reporting HIV risk behaviours in Scotland. Given the Proud results, there is a strong case to investigate PrEP implementation within the UK. However, it appears that disparities in awareness have already emerged along traditional indicators of inequality. Our research identifies the need for comprehensive support when PrEP is introduced, including a key online component, to ensure equity of awareness across diverse MSM communities (e.g. by geography, education, gay scene use and HIV proximity), as well as to responding to the diverse informational and sexual health

PMP exam prep

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Mulcahy, Rita

2013-01-01

This book has been FULLY updated to reflect PMI's changes to the PMP exam, and should be used to prepare for all PMP exams delivered on or after July 30th of 2013. Can you imagine valuing a book so much that you send the author a Thank You letter? Hundreds of thousands of project managers know and understand why PMP Exam Prep is a worldwide best-seller. Years of PMP exam preparation experience, endless hours of ongoing research, interviews with project managers who failed the exam to identify gaps in their knowledge, and a razor-sharp focus on making sure project managers don't waste a single minute of their time studying are THE reasons this book is the best-selling PMP exam preparation guide in the world. PMP Exam Prep, Eighth Edition contains hundreds of updates and improvements from previous editions--including new exercises and sample questions never before in print. Offering hundreds of sample questions, critical time-saving tips plus games and activities available nowhere else, this book will help y...

Preparing for the Rollout of Pre-Exposure Prophylaxis (PrEP: A Vignette Survey to Identify Intended Sexual Behaviors among Women in Kenya and South Africa if Using PrEP.

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Amy Corneli

Full Text Available Several clinical trials have demonstrated the efficacy of pre-exposure prophylaxis (PrEP in reducing HIV risk. One concern with introducing PrEP is whether users will engage in riskier sexual behaviors.We assessed the effect that PrEP may have on sexual risk behaviors by administering a survey to 799 women in Bondo, Kenya, and Pretoria, South Africa. Participants were asked about their sexual behavior intentions twice--once as if they were taking PrEP and once as if they were not taking PrEP--within four risk situations (vignettes. They responded using a 5-point ordinal scale. We used a series of linear mixed effects models with an unstructured residual covariance matrix to estimate the between- and within-subject differences in the mean likelihood of engaging in risky sexual behavior across the PrEP and non-PrEP contexts. We also calculated the total percentage of participants who reported a greater likelihood of engaging in risky sexual behavior if taking PrEP than if not taking PrEP, by vignette.We found statistically significant differences in the mean likelihood of engaging in risky sexual behavior with the between-subject comparison (-0.17, p < 0.01 and with the within-subject comparison (-0.31, p < 0.001. Depending on the vignette, 27% to 40% of participants reported a greater likelihood of engaging in risky sexual behavior if taking PrEP than if not taking PrEP.Our findings indicate that modest increases in risky sexual behavior could occur with PrEP. Although responses from the majority of participants suggest they would not be more likely to engage in risky sexual behavior if they took PrEP, a substantial proportion might. Programs rolling out PrEP should be prepared to assist similar women in making informed choices about reducing their risk of HIV and about their sexual health beyond HIV prevention.

PrEP implementation: moving from trials to policy and practice.

Science.gov (United States)

Cáceres, Carlos F; O'Reilly, Kevin R; Mayer, Kenneth H; Baggaley, Rachel

2015-01-01

It is increasingly clear that the HIV response will not be sustainable if the number of infections is not significantly reduced. For two decades, research has been ongoing to identify new behavioural and biomedical strategies to prevent HIV infection. In the past few years, the efficacy of several new strategies has been demonstrated, including oral pre-exposure prophylaxis (PrEP; i.e. daily use of tenofovir/emtricitabine). Because several social, political and logistic barriers remain, however, optimal PrEP implementation will require a better dissemination of new evidence in a number of areas and additional implementation research from various disciplinary perspectives (i.e. social science, policy and ethics; health systems; and economics, including cost-effectiveness studies). Discussion of new evidence on those topics, as well as case studies of potential PrEP implementation in diverse environments, can improve the understanding of the role that PrEP may play in addressing the global HIV/AIDS epidemic.In light of these needs, the Network for Multidisciplinary Studies in ARV-based HIV Prevention (NEMUS) and the World Health Organization (WHO) were honoured to co-organize a special issue of JIAS aimed at contributing to a scholarly discussion of current conditions surrounding PrEP implementation, potential impact and efficiency, social science concerns and the study of PrEP implementation in specific country cases. The papers included in this monograph identify and cover many of the main aspects of the complex yet promising discussions around PrEP implementation today. This is a collection of timely contributions from global leaders in HIV research and policy that addresses geographic diversity, uses a trans-disciplinary approach and covers a variety of the complex issues raised by PrEP. As this publication will become accessible to all, we hope that it will remain a valuable resource for policy makers, programme managers, researchers and activists around the

Conditions of lighting in reading-rooms located in public and school libraries in Silesian Voivodeship

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Magdalena Sitek

2013-06-01

Full Text Available Introduction: Reading-room is a place where special lighting conditions are required to make the reader feel comfortable and satisfied.. Lighting requirements are enclosed in the Polish Standard PN-EN 12464-1:2004. Accordingly, illuminance in the reading-rooms should be 500 lx. The aim of the study was to measure illuminance in reading-rooms in various libraries and make relative comparisons to standard values. Material and methods: Measurements of illuminance were performed in 22 reading-rooms in Silesia Voivodeship. Half of them were made in public libraries and half in reading-rooms at junior lower high schools. Illuminance was measured in 5 measurement points in reading-rooms by digital lux meter Lx-105 manufactured by Lutron. Furthermore , 100 readers of school libraries and 89 readers of public libraries completed a questionnaire on lighting conditions in these places. Results: Only 5 out of 22 reading-rooms meet the requirements of the Polish Standard concerning illuminance. Only in one reading room at junior lower high school illuminance exceeded 500 lx. In two other reading places the requirements were met due to additional desk lamps. Despite the results, 76.4% of approached readers of public libraries and 60% of pupils think that lighting in readingrooms is satisfactory and almost 63% of the readers and 53% of the pupils don’t demand additional lighting. Conclusions: Most of the scrutinized reading rooms do not meet lighting requirements according to the Polish Standard. Lighting conditions in school libraries are worse than in public libraries. According to the respondents lighting in public libraries is adequate.

From modeling to morals: imagining the future of HIV PREP in Lesotho.

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Kenworthy, Nora J; Bulled, Nicola

2013-08-01

Amidst growing global endorsements of new biomedical HIV prevention strategies, ARV-based pre-exposure prophylaxis (ARV PrEP) has garnered considerable attention as a potentially promising prevention strategy. Though it may offer more effective protection for certain at-risk groups than conventional prevention strategies (such as sexual partner reduction, condom use, and prevention of mother-to-child transmission), PrEP is more costly. PrEP requires more ongoing contact between individuals and providers, and a level of surveillance from the health system that is not necessary with other preventive measures. In this sense, it represents a new bio-technology for HIV prevention that poses particular challenges for worldwide implementation, given developing countries' struggling health systems and incomplete HIV treatment programs. Since the emergence of PrEP has stimulated ethical discussions premised on incomplete knowledge of efficacy and implementation, this paper explores the ethical parameters of a likely scenario for PrEP usage in a single, resource-poor country. We first develop a plausible model for PrEP deployment and utilization based on current PrEP research, while carefully considering the reigning institutional values of feasibility and effectiveness in global health approaches. Drawing on ethnographic research of HIV treatment and prevention approaches in Lesotho, we address ethical questions arising from this scenario of PrEP delivery. Lesotho presents a compelling and emblematic case study of PrEP's potential successes and pitfalls in a developing country, given the country's high HIV prevalence, struggles to achieve universal access to HIV treatment regimes, continued existence of stigma around the epidemic, and difficulties in addressing persistent social inequalities that fuel infections. © 2013 John Wiley & Sons Ltd.

PrEP in Europe - expectations, opportunities and barriers.

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McCormack, Sheena Mary; Noseda, Veronica; Molina, Jean-Michel

2016-01-01

In contrast to the global trend showing a decline in new HIV infections, the number reported in the World Health Organization (WHO) region of Europe is increasing. Health systems are disparate, but even countries with free access to screening and treatment observe continuing high rates of new infections in key populations, notably men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) is only available in France. This commentary describes the European epidemics and healthcare settings where PrEP could be delivered, how need might be estimated for MSM and the residual barriers to access. Health systems and government commitment to HIV prevention and care, both financial and political, differ considerably between the countries that make up Europe. A common feature is that funds for prevention are a small fraction of funds for care. Although care is generally good, access is limited in the middle-income countries of Eastern Europe and central Asia, and only 19% of people living with HIV received antiretroviral therapy in 2014. It is challenging to motivate governments or civil society to implement PrEP in the context of this unmet treatment need, which is driven by limited national health budgets and diminishing assistance from foreign aid. The high-income countries of Western Europe have hesitated to embrace PrEP for different reasons, initially due to key gaps in the evidence. Now that PrEP has been shown to be highly effective in European MSM in two randomized controlled trials, it is clear that the major barrier is the cost of the drug which is still on patent, although inadequate health systems and diminishing investment in civil society are also key challenges to overcome. The momentum to implement PrEP in European countries is increasing and provides a welcome opportunity to expand and improve clinical services and civil society support focused on HIV and related infections including other sexually transmitted and blood-borne infections.

The future of pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) infection.

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Özdener, Ayşe Elif; Park, Tae Eun; Kalabalik, Julie; Gupta, Rachna

2017-05-01

People at high risk for HIV acquisition should be offered pre-exposure prophylaxis (PrEP). Tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) is currently the only medication recommended for pre-exposure prophylaxis (PrEP) by the Centers for Disease Control and Prevention (CDC) in people at high risk for HIV acquisition. This article will review medications currently under investigation and the future landscape of PrEP therapy. Areas covered: This article will review clinical trials that have investigated nontraditional regimens of TDF/FTC, antiretroviral agents from different drug classes such as integrase strand transfer inhibitors (INSTI), nucleoside reverse transcriptase inhibitors (NRTI), and non-nucleoside reverse transcriptase inhibitors (NNRTI) as potential PrEP therapies. Expert commentary: Currently, there are several investigational drugs in the pipeline for PrEP against HIV infection. Increased utilization of PrEP therapy depends on provider identification of people at high risk for HIV transmission. Advances in PrEP development will expand options and access for people and reduce the risk of HIV acquisition.

Cytomorphology of cervicovaginal melanoma: ThinPrep versus conventional Papanicolaou tests.

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Setia, Namrata; Goulart, Robert A; Leiman, Gladywn; Otis, Christopher N; Modem, Rukmini; Pantanowtiz, Liron

2010-12-31

Primary cervicovaginal melanoma is a rare malignancy associated with a high risk of recurrence. Prior studies discussing the cytomorphology of cervicovaginal melanoma have been based primarily on review of conventional Papanicolaou (Pap) smears. The aim of this study was to evaluate cervicovaginal melanomas identified in liquid-based Pap tests, in comparison with features seen on conventional Pap smear preparation. Cases of cervicovaginal melanoma identified on Pap tests with concurrent or subsequent histopathologic confirmation were collected from the Baystate Medical Center cytopathology files and personal archives of the authors over a total period of 34 years. All cytopathology (n = 6) and the available histology slides (n = 5) were reviewed. Cases were analyzed regarding clinical, histopathologic and cytomorphological findings. A total of six cases with invasive cervicovaginal melanoma diagnosed on Pap tests were identified. Most patients were postmenopausal with contact bleeding, correlating with surface ulceration (identified in biopsy/excision material in 5/5 cases). Most cases had deeply invasive tumors (5/5: modified Breslow's thickness > 5 mm and Chung's level of invasion IV/V). Pap tests included four ThinPrep and two conventional smears. Overall, ThinPrep Pap tests exhibited a higher ratio of tumor cells to background squamous cells. While all Pap tests were bloodstained, tumor diathesis was prominent only within conventional smears. Melanoma cells were present both as clusters and scattered single cells in each Pap test type. Both the preparations contained epithelioid tumor cells, whereas spindled tumor cells were seen in only two ThinPrep cases. Prominent nucleoli and binucleation of tumor cells were seen in both the preparations. Melanin pigment was identified in only ThinPrep (3/4) cases and nuclear pseudo-inclusions in one conventional Pap smear. Cell blocks were made in three ThinPrep cases and immunocytochemistry (S-100, HMB45, Melan

High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project.

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Hoagland, Brenda; Moreira, Ronaldo I; De Boni, Raquel B; Kallas, Esper G; Madruga, José Valdez; Vasconcelos, Ricardo; Goulart, Silvia; Torres, Thiago S; Marins, Luana M S; Anderson, Peter L; Luz, Paula M; Costa Leite, Iuri da; Liu, Albert Y; Veloso, Valdilea G; Grinsztejn, Beatriz

2017-04-06

The efficacy of pre-exposure prophylaxis (PrEP) in preventing sexual acquisition of human immunodeficiency virus (HIV) is well established. Little is known about the feasibility of PrEP implementation in middle-income settings with concentrated epidemics among men who have sex with men (MSM) and transgender women (TGW). PrEP Brasil is a prospective, multicentre, open-label demonstration project assessing PrEP delivery in the context of the Brazilian Public Health System. HIV-uninfected MSM and TGW in 3 referral centres in Rio de Janeiro and São Paulo were evaluated for eligibility and offered 48 weeks of daily emtricitabine/tenofovir for PrEP. Concentrations of tenofovir diphosphate in dried blood spot samples (DBS) at week 4 after enrolment (early adherence) were measured. Predictors of drug levels were assessed using ordinal logistic regression models considering the DBS drug level as a 3 level variable (<350 fmol/punch, ≥350-699 fmol/punch and ≥700 fmol/punch). 1,270 individuals were assessed for participation; n = 738 were potentially eligible and n = 450 were offered PrEP (PrEP uptake was 60.9%). Eligible but not enrolled individuals were younger, had lower HIV risk perception and had lower PrEP awareness. At week 4, 424 participants (of the 450 enrolled) had DBS TFV-DP concentrations, 94.1% in the protective range (≥350 fmol/punch, consistent with ≥2 pills per week), and 78% were in the highly protective range (≥700 fmol/punch, ≥4 pills per week). Participants with ≥12 years of schooling had 1.9 times the odds (95%CI 1.10-3.29) of a higher versus lower drug level than participants with <12 years of schooling. Condomless receptive anal intercourse in the prior 3 months was also associated with higher drug levels (adjusted OR = 1.78; 95% CI 1.08-2.94). The high uptake and early adherence indicate that PrEP for high-risk MSM and TGW can be successfully delivered in the context of the Brazilian Public Health System. Interventions to

Prolyl Endopeptidase (PREP) is Associated With Male Reproductive Functions and Gamete Physiology in Mice.

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Dotolo, Raffaele; Kim, Jung Dae; Pariante, Paolo; Minucci, Sergio; Diano, Sabrina

2016-03-01

Prolyl endopeptidase (PREP) is a serine protease which has been implicated in many biological processes, such as the maturation and degradation of peptide hormones and neuropeptides, learning and memory, cell proliferation and differentiation, and glucose metabolism. A small number of reports have also suggested PREP participation in both male and female reproduction-associated processes. In the present work, we examined PREP distribution in male germ cells and studied the effects of its knockdown (Prep(gt/gt)) on testis and sperm in adult mice. The protein is expressed and localized in elongating spermatids and luminal spermatozoa of wild type (wt) mice, as well as Sertoli, Leydig, and peritubular cells. PREP is also expressed in the head and midpiece of epididymal spermatozoa, whereas the remaining tail region shows a weaker signal. Furthermore, testis weight, histology of seminiferous tubules, and epididymal sperm parameters were assessed in wt and Prep(gt/gt) mice: wild type testes have larger average tubule and lumen diameter; in addition, lumenal composition of seminiferous tubules is dissimilar between wt and Prep(gt/gt), as the percentage of spermiated tubules is much higher in wt. Finally, total sperm count, sperm motility, and normal morphology are also higher in wt than in Prep(gt/gt). These results show for the first time that the expression of PREP could be necessary for a correct reproductive function, and suggest that the enzyme may play a role in mouse spermatogenesis and sperm physiology. © 2015 Wiley Periodicals, Inc.

Biochemistry of the tale transcription factors PREP, MEIS, and PBX in vertebrates.

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Longobardi, E; Penkov, D; Mateos, D; De Florian, G; Torres, M; Blasi, Francesco

2014-01-01

TALE (three amino acids loop extension) homeodomain transcription factors are required in various steps of embryo development, in many adult physiological functions, and are involved in important pathologies. This review focuses on the PREP, MEIS, and PBX sub-families of TALE factors and aims at giving information on their biochemical properties, i.e., structure, interactors, and interaction surfaces. Members of the three sets of protein form dimers in which the common partner is PBX but they can also directly interact with other proteins forming higher-order complexes, in particular HOX. Finally, recent advances in determining the genome-wide DNA-binding sites of PREP1, MEIS1, and PBX1, and their partial correspondence with the binding sites of some HOX proteins, are reviewed. These studies have generated a few general rules that can be applied to all members of the three gene families. PREP and MEIS recognize slightly different consensus sequences: PREP prefers to bind to promoters and to have PBX as a DNA-binding partner; MEIS prefers HOX as partner, and both PREP and MEIS drive PBX to their own binding sites. This outlines the clear individuality of the PREP and MEIS proteins, the former mostly devoted to basic cellular functions, the latter more to developmental functions. Copyright © 2013 Wiley Periodicals, Inc.

PREP advertisement features affect smokers’ beliefs regarding potential harm

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Strasser, Andrew A; Tang, Kathy Z; Tuller, Michael D; Cappella, Joseph N

2014-01-01

Background The Institute of Medicine report on potential reduced exposure products (PREPs) recommends that advertising and labelling be regulated to prevent explicitly or implicitly false or misleading claims. Belief that a product is less harmful may increase use or prevent smoking cessation. Objective To determine the effect of altering advertisement features on smokers’ beliefs of the harm exposure from a PREP. Methods A Quest advertisement was digitally altered using computer software and presented to participants using web-based television recruitment contracted through a survey company. 500 current smokers completed demographic and smoking history questions, were randomised to view one of three advertisement conditions, then completed eight items assessing their beliefs of the harmfulness of the product. Advertisement conditions included the original, unaltered advertisement; a “red” condition where the cigarette packages were digitally altered to the colour red, implying increased harm potential; and a “no text” condition where all text was removed to reduce explicit product information. Polytomous logistic regression, using “incorrect,” “unsure” and “correct” as outcomes, and advertisement type and covariates as predictors, was used for analyses. Results Participants randomised to the “no text” advertisement were less likely to be incorrect in their beliefs that Quest cigarettes are lower in tar, less addictive, less likely to cause cancer, have fewer chemicals, healthier and make smoking safer. Conclusions Smokers can form false beliefs about the harmfulness of PREP products based on how the PREPs are marketed. Careful examination must be undertaken to provide empirical evidence to better formulate regulatory principles of PREP advertising. PMID:18768457

PREP advertisement features affect smokers' beliefs regarding potential harm.

Science.gov (United States)

Strasser, A A; Tang, K Z; Tuller, M D; Cappella, J N

2008-09-01

The Institute of Medicine report on potential reduced exposure products (PREPs) recommends that advertising and labelling be regulated to prevent explicitly or implicitly false or misleading claims. Belief that a product is less harmful may increase use or prevent smoking cessation. To determine the effect of altering advertisement features on smokers' beliefs of the harm exposure from a PREP. A Quest advertisement was digitally altered using computer software and presented to participants using web-based television recruitment contracted through a survey company. 500 current smokers completed demographic and smoking history questions, were randomised to view one of three advertisement conditions, then completed eight items assessing their beliefs of the harmfulness of the product. Advertisement conditions included the original, unaltered advertisement; a "red" condition where the cigarette packages were digitally altered to the colour red, implying increased harm potential; and a "no text" condition where all text was removed to reduce explicit product information. Polytomous logistic regression, using "incorrect," "unsure" and "correct" as outcomes, and advertisement type and covariates as predictors, was used for analyses. Participants randomised to the "no text" advertisement were less likely to be incorrect in their beliefs that Quest cigarettes are lower in tar, less addictive, less likely to cause cancer, have fewer chemicals, are healthier and make smoking safer. Smokers can form false beliefs about the harmfulness of PREP products based on how the PREPs are marketed. Careful examination must be undertaken to provide empirical evidence to better formulate regulatory principles of PREP advertising.

Get on Board the Cost Effective Way: A Tech Prep Replication Process.

Science.gov (United States)

Moore, Wayne A.; Szul, Linda F.; Rivosecchi, Karen

1997-01-01

The Northwestern Pennsylvania Tech Prep Consortium model for replicating tech prep programs includes these steps: fact finding, local industry analysis, curriculum development, detailed description, marketing strategies, implementation, and program evaluation. (SK)

Gynecological applications of helical CT using SmartPrep

Energy Technology Data Exchange (ETDEWEB)

Sakurada, Akira; Kakizaki, Dai; Abe, Kimihiko [Tokyo Medical Coll. (Japan)

1999-11-01

SmartPrep is software program for scanning a given region of interest (ROI) at optimal contrast density. An operator can arbitrarily define ROI and preset the CT value at which scanning should be started. After the injection of a contrast medium, system conducts continuous monitoring of the ROI and the operator starts helical scanning of the planned region when the present CT value has been reached. In comparison with conventional helical CT that requires a period of time from the beginning of contrast medium injection to the beginning of scanning, SmartPrep minimizes personal error and better depicts the artery-predominant phase under optimal conditions. In this study we examine the usefulness of contrast-enhanced helical CT using SmartPrep in the evaluation of gynecological disease. When the contrast medium was injected into the dorsal vein of the hand at a rate of 3 ml/sec, strong staining of pelvic arteries was observed in the CT images started at 17 to 23 sec after injection. The early-phase helical CT obtained under these conditions provided good depiction of lesions in cases of placenta accreta and invasive mole, as well as clear demonstration of tumor angiogenesis and evaluation of laterality in cases of cervical cancer. Comparison of the early and delayed phase also facilitated easier evaluation of lymph nodes than conventional comparison of simple and contrast-enhanced CT. The results thus suggest the usefulness of contrast-enhanced helical CT using SmartPrep in gynecology. (author)

Review of HIV Pre exposure prophylaxis (PrEP) and example of HIV PrEP Toolkit

Science.gov (United States)

2017-08-28

at Initiation of Sexual Activity Correct & Consistent Condom Use Prevention of mother-to- child transmission July 16, 2012: FDA approves...Okulicz JF, Medicine 2016 PrEP Utilization in a Managed Care System (Kaiser Permanente) 1200 ~ 1045 1000 . 800 600 . 400 200 0 835 657 0

Evaluating the impact of prioritization of antiretroviral pre-exposure prophylaxis (PrEP) in New York City

Science.gov (United States)

Kessler, Jason; Myers, Julie E.; Nucifora, Kimberly A.; Mensah, Nana; Toohey, Christopher; Khademi, Amin; Cutler, Blayne; Braithwaite, R. Scott

2015-01-01

Objective To compare the value and effectiveness of different prioritization strategies of pre-exposure prophylaxis (PrEP) in New York City (NYC). Design Mathematical modeling utilized as clinical trial is not feasible. Methods Using a model accounting for both sexual and parenteral transmission of HIV we compare different prioritization strategies (PPS) for PrEP to two scenarios—no PrEP and PrEP for all susceptible at-risk individuals. The PPS included PrEP for all MSM, only high-risk MSM, high-risk heterosexuals, and injection drug users, and all combinations of these four strategies. Outcomes included HIV infections averted, and incremental cost effectiveness (per-infection averted) ratios. Initial assumptions regarding PrEP included a 44% reduction in HIV transmission, 50% uptake in the prioritized population and an annual cost per person of $9,762. Sensitivity analyses on key parameters were conducted. Results Prioritization to all MSM results in a 19% reduction in new HIV infections. Compared to PrEP for all persons at-risk this PPS retains 79% of the preventative effect at 15% of the total cost. PrEP prioritized to only high-risk MSM results in a reduction in new HIV infections of 15%. This PPS retains 60% of the preventative effect at 6% of the total cost. There are diminishing returns when PrEP utilization is expanded beyond this group. Conclusions PrEP implementation is relatively cost-inefficient under our initial assumptions. Our results suggest that PrEP should first be promoted among MSM who are at particularly high-risk of HIV acquisition. Further expansion beyond this group may be cost-effective, but is unlikely to be cost-saving. PMID:25493594

SWATMOD-PREP: Graphical user interface for preparing coupled SWAT-modflow simulations

Science.gov (United States)

This paper presents SWATMOD-Prep, a graphical user interface that couples a SWAT watershed model with a MODFLOW groundwater flow model. The interface is based on a recently published SWAT-MODFLOW code that couples the models via mapping schemes. The spatial layout of SWATMOD-Prep guides the user t...

PrEP as a feature in the optimal landscape of combination HIV prevention in sub-Saharan Africa.

Science.gov (United States)

McGillen, Jessica B; Anderson, Sarah-Jane; Hallett, Timothy B

2016-01-01

The new WHO guidelines recommend offering pre-exposure prophylaxis (PrEP) to people who are at substantial risk of HIV infection. However, where PrEP should be prioritised, and for which population groups, remains an open question. The HIV landscape in sub-Saharan Africa features limited prevention resources, multiple options for achieving cost saving, and epidemic heterogeneity. This paper examines what role PrEP should play in optimal prevention in this complex and dynamic landscape. We use a model that was previously developed to capture subnational HIV transmission in sub-Saharan Africa. With this model, we can consider how prevention funds could be distributed across and within countries throughout sub-Saharan Africa to enable optimal HIV prevention (that is, avert the greatest number of infections for the lowest cost). Here, we focus on PrEP to elucidate where, and to whom, it would optimally be offered in portfolios of interventions (alongside voluntary medical male circumcision, treatment as prevention, and behaviour change communication). Over a range of continental expenditure levels, we use our model to explore prevention patterns that incorporate PrEP, exclude PrEP, or implement PrEP according to a fixed incidence threshold. At low-to-moderate levels of total prevention expenditure, we find that the optimal intervention portfolios would include PrEP in only a few regions and primarily for female sex workers (FSW). Prioritisation of PrEP would expand with increasing total expenditure, such that the optimal prevention portfolios would offer PrEP in more subnational regions and increasingly for men who have sex with men (MSM) and the lower incidence general population. The marginal benefit of including PrEP among the available interventions increases with overall expenditure by up to 14% (relative to excluding PrEP). The minimum baseline incidence for the optimal offer of PrEP declines for all population groups as expenditure increases. We find that using

Pre-Exposure Prophylaxis: A Narrative Review of Provider Behavior and Interventions to Increase PrEP Implementation in Primary Care.

Science.gov (United States)

Silapaswan, Andrew; Krakower, Douglas; Mayer, Kenneth H

2017-02-01

Since FDA approval of HIV pre-exposure prophylaxis (PrEP) for HIV prevention, attention has been focused on PrEP implementation. The CDC estimates that 1.2 million U.S. adults might benefit from PrEP, but only a minority are using PrEP, so there is a significant unmet need to increase access for those at risk for HIV. Given the large numbers of individuals who have indications for PrEP, there are not enough practicing specialists to meet the growing need for providers trained in providing PrEP. Moreover, since PrEP is a preventive intervention for otherwise healthy individuals, primary care providers (PCPs) should be primary prescribers of PrEP. There are important clinical considerations that providers should take into account when planning to prescribe PrEP, which are highlighted in the clinical case discussed. A growing body of research also suggests that some providers may be cautious about prescribing PrEP because of concerns regarding its "real-world" effectiveness, anticipated unintended consequences associated with its use, and ambiguity as to who should prescribe it. This review summarizes findings from studies that have assessed prescriber behavior regarding provision of PrEP, and offers recommendations on how to optimize PrEP implementation in primary care settings. Development and dissemination of educational interventions for PCPs and potential PrEP users are needed, including improved methods to assist clinicians in identifying appropriate PrEP candidates, and programs to promote medication adherence and access to social and behavioral health services. PCPs are well-positioned to prescribe PrEP and coordinate health-related services to improve the sexual health of their patients, but tailored educational programs are needed.

Barriers and Facilitators to Oral PrEP Use Among Transgender Women in New York City.

Science.gov (United States)

Rael, Christine Tagliaferri; Martinez, Michelle; Giguere, Rebecca; Bockting, Walter; MacCrate, Caitlin; Mellman, Will; Valente, Pablo; Greene, George J; Sherman, Susan; Footer, Katherine H A; D'Aquila, Richard T; Carballo-Diéguez, Alex

2018-03-27

Transgender women may face a disparate risk for HIV/AIDS compared to other groups. In 2012, Truvada was approved for daily use as HIV pre-exposure prophylaxis (PrEP). However, there is a dearth of research about barriers and facilitators to PrEP in transgender women. This paper will shed light on transgender women living in New York City's perceived and actual challenges to using PrEP and potential strategies to overcome them. After completing an initial screening process, four 90-min focus groups were completed with n = 18 transgender women. Participants were asked what they like and dislike about PrEP. Participants identified the following barriers: uncomfortable side effects, difficulty taking pills, stigma, exclusion of transgender women in advertising, and lack of research on transgender women and PrEP. Facilitators included: reducing pill size, increasing the types of available HIV prevention products, and conducting scientific studies to evaluate PrEP in transgender women.

Who Will Use Pre-Exposure Prophylaxis (PrEP) and Why?: Understanding PrEP Awareness and Acceptability amongst Men Who Have Sex with Men in the UK ? A Mixed Methods Study

OpenAIRE

Frankis, Jamie; Young, Ingrid; Flowers, Paul; McDaid, Lisa

2016-01-01

Background:\\ud Recent clinical trials suggest that pre-exposure prophylaxis (PrEP) may reduce HIV transmission by up to 86% for men who have sex with men (MSM), whilst relatively high levels of PrEP acceptability have been reported to date. This study examines PrEP awareness amongst sub-groups of MSM communities and acceptability amongst MSM in a low prevalence region (Scotland, UK), using a mixed methods design.\\ud Methods:\\ud Quantitative surveys of n = 690 MSM recruited online via social a...

Implications of HIV PrEP Trials Results

Science.gov (United States)

Anton, Peter; Fletcher, Courtney V.; DeGruttola, Victor; McGowan, Ian; Becker, Stephen; Zwerski, Sheryl; Burns, David

2011-01-01

Abstract Six randomized clinical trials have been implemented to examine the efficacy of tenofovir disoproxil fumarate (TDF) and/or TDF/emtricitabine (TDF/FTC) as preexposure prophylaxis for HIV-1 infection (PrEP). Although largely complementary, the six trials have many similar features. As the earliest results become available, an urgent question may arise regarding whether changes should be made in the conduct of the other trials. To consider this in advance, a Consultation on the Implications of HIV Pre-Exposure Prophylaxis (PrEP) Trials Results sponsored by the Division of AIDS (DAIDS) of the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), and the Bill and Melinda Gates Foundation (BMGF) was held on January 29, 2010, at the Natcher Conference Center, NIH, Bethesda, MD. Participants included basic scientists, clinical researchers (including investigators performing the current PrEP trials), and representatives from the U.S. Food and Drug Administration (FDA) and the agencies sponsoring the trials: the U.S. Centers for Disease Control and Prevention (CDC), the U.S. Agency for International Development (USAID), the BMGF, and the U.S. NIH. We report here a summary of the presentations and highlights of salient discussion topics from this workshop. PMID:20969483

The Pre-Exposure Prophylaxis-Stigma Paradox: Learning from Canada's First Wave of PrEP Users.

Science.gov (United States)

Grace, Daniel; Jollimore, Jody; MacPherson, Paul; Strang, Matthew J P; Tan, Darrell H S

2018-01-01

With the emergence of daily oral tenofovir disoproxil fumarate and emtricitabine-based pre-exposure prophylaxis (PrEP) use in Canada, questions have emerged concerning the impacts of this HIV prevention tool on gay men's social and sexual lives. We conducted small focus groups and individual qualitative interviews with 16 gay men in Toronto who were part of the 'first wave' of Canadian PrEP users. Participants were on PrEP for at least one year as part of a demonstration project (November 2014-June 2016). These participants accessed PrEP before regulatory approval by Health Canada in February 2016. The mean age of participants was 37.6 years (SD 11.02); 94% completed secondary education, and 69% were white. Sex-stigma emerged as a complex theme in men's accounts of PrEP use across three overlapping domains: (1) PrEP-related stigma, including discussions of concealment and stigma from friends, family, and sexual partners, (2) PrEP as a perceived tool for combating HIV-related stigma, where some men said that they no longer discussed HIV status with sexual partners, and (3) PrEP as illuminating structural stigma, where it was attributed to unmasking stigma related to sex and sexuality. For some participants, PrEP has allowed for liberating sex and a self-described return to normalcy-normal, exciting, pleasurable sex that was no longer reliant on condom use. Paradoxically, some men said that PrEP use both led them to experience stigmatizing reactions within their social and sexual networks, while also helping to remove stigma, shame, and fear related to HIV, sexuality, and sex with gay men living with HIV.

Houston prefreshman enrichment program (Houston PREP). Final report, June 10, 1996--August 1, 1996

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-10-01

The 1996 Houston Pre-freshman Enrichment Program (PREP) was conducted on the campus of the University of Houston-Downtown from June 10 to August 1, 1996. Program Participants were recruited from the Greater Houston area. All participants were identified as high achieving students with an interest in learning about the engineering and science professions. The goal of the program was to better prepare our pre-college youth prior to entering college as mathematics, science and engineering majors. The program participants were middle school and high school students from the Aldine, Alief, Channel View, Crockett, Cypress-Fairbanks, Fort Bend, Galena Park, Houston, Humble, Katy, Klein, North Forest, Pasadena, Private, and Spring Branch Independent School Districts. Of the 197 students starting the program, 170 completed, 142 students were from economically and socially disadvantage groups underrepresented in the engineering and science professions, and 121 of the 197 were female. Our First Year group for 1996 composed of 96% minority and women students. Our Second and Third Year students were 100% and 93.75% minority or women respectively. This gave an overall minority and female population of 93.75%. This year, special efforts were again made to recruit students from minority groups, which caused a significant increase in qualified applicants. However, due to space limitations, 140 applicants were rejected. Investigative and discovery learning were key elements of PREP. The academic components of the program included Algebraic Structures, Engineering, Introduction to Computer Science, Introduction to Physics, Logic and Its Application to Mathematics, Probability and Statistics, Problem Solving Seminar using computers and PLATO software, SAT Preparatory Seminars, and Technical Writing.

Automated SmartPrep tracker positioning in liver MRI scans

International Nuclear Information System (INIS)

Goto, Takao; Kabasawa, Hiroyuki

2013-01-01

This paper presents a new method for automated SmartPrep tracker positioning in liver MRI scans. SmartPrep is used to monitor the contrast bolus signal in order to detect the arrival time of the bolus. Accurately placing the tracker in the aorta while viewing three planar scout images is a difficult task for the operator and is an important problem from the workflow standpoint. The development of an automated SmartPrep tracker would therefore help to improve workflow in liver MRI scans. In our proposed method, the aorta is detected using AdaBoost (which is a machine learning technique) by searching around the cerebral spinal fluid (CSF) in the spinal cord. Analysis of scout scan images showed that our detection method functioned properly for a variety of axial MR images without intensity correction. A total of 234 images reconstructed from the datasets of 64 volunteers were analyzed, and the results showed that the detection error for the aorta was approximately 3 mm. (author)

elPrep: High-Performance Preparation of Sequence Alignment/Map Files for Variant Calling.

Directory of Open Access Journals (Sweden)

Charlotte Herzeel

Full Text Available elPrep is a high-performance tool for preparing sequence alignment/map files for variant calling in sequencing pipelines. It can be used as a replacement for SAMtools and Picard for preparation steps such as filtering, sorting, marking duplicates, reordering contigs, and so on, while producing identical results. What sets elPrep apart is its software architecture that allows executing preparation pipelines by making only a single pass through the data, no matter how many preparation steps are used in the pipeline. elPrep is designed as a multithreaded application that runs entirely in memory, avoids repeated file I/O, and merges the computation of several preparation steps to significantly speed up the execution time. For example, for a preparation pipeline of five steps on a whole-exome BAM file (NA12878, we reduce the execution time from about 1:40 hours, when using a combination of SAMtools and Picard, to about 15 minutes when using elPrep, while utilising the same server resources, here 48 threads and 23GB of RAM. For the same pipeline on whole-genome data (NA12878, elPrep reduces the runtime from 24 hours to less than 5 hours. As a typical clinical study may contain sequencing data for hundreds of patients, elPrep can remove several hundreds of hours of computing time, and thus substantially reduce analysis time and cost.

Gendered differences in the perceived risks and benefits of oral PrEP among HIV-serodiscordant couples in Kenya.

Science.gov (United States)

Carroll, Jennifer J; Ngure, Kenneth; Heffron, Renee; Curran, Kathryn; Mugo, Nelly R; Baeten, Jared M

2016-08-01

Pre-exposure prophylaxis (PrEP) is effective for preventing HIV among HIV-serodiscordant heterosexual couples. Gender roles may influence perceived personal and social risks related to HIV-prevention behaviors and may affect use of PrEP. In this study, interviews and focus groups were conducted with 68 individuals from 34 mutually disclosed serodiscordant heterosexual partnerships in Thika, Kenya. Sociocultural factors that affect adherence to PrEP were explored using grounded analysis. Three factors were identified, which shape perceptions of PrEP: gendered power dynamics and control over decision-making in the household; conflicts between risk-reduction strategies and male sexual desire; culture-bound definitions of women's work. Adherence to PrEP in the Partners PrEP Study was high; however, participants articulated conflicting interests related to PrEP in connection with traditional gender roles. The successful delivery of PrEP will require understanding of key social factors, particularly related to gender and dyadic dynamics around HIV serostatus.

PrEP adopted by the brazilian national health system: What is the size of the demand?

Science.gov (United States)

Luz, Paula M; Benzaken, Adele; Alencar, Tatianna M de; Pimenta, Cristina; Veloso, Valdilea G; Grinsztejn, Beatriz

2018-05-01

Brazil's response to the HIV epidemic now includes free access to preexposure prophylaxis (PrEP) to populations at substantial risk for HIV infection including men who have sex with men (MSM). We used nationally representative demographic, epidemiologic, and surveillance data to offer estimates for the number of MSM at substantial risk for HIV infection who might be eligible and willing to use PrEP in Brazil. Starting from the age/sex-stratified population, we calculated the number of men aged 15 to 64 years, in 5-year age groups, and the proportion of those who report sex with other men during their lifetime. We focused on 11 cities (representing all regions) that are responsible for a significant fraction of the HIV burden of the country and used city-specific HIV prevalence estimates to infer the fraction of MSM who are HIV-negative. We then derived the proportion of HIV-negative MSM under substantial risk for HIV infection defined as having unprotected receptive anal intercourse in the 6 months before study participation. Finally, PrEP uptake among the eligible was inferred from the PrEP Brazil study. Our results show that PrEP demand in these 11 cities is of 66,120 men aged 15 to 64 years. When we consider the lower and upper bounds for the available parameters, we find that PrEP demand in these 11 cities might vary from 33,378 to 97,962 men. If PrEP is restricted to those aged 15 to 49 years, demand drops by 20%. PrEP demand varies considerably by city, mostly because of the differences in population size and city-specific HIV prevalence. We have shed light on the probable size of PrEP demand in Brazil certain that the incorporation of PrEP as part of Brazil's combination prevention for populations at substantial risk for HIV infection is a necessary challenge. PrEP will not only prevent HIV infections, it will also expand testing among the most vulnerable with the added benefit of offering combination prevention for the uninfected and immediate treatment for

Towards a fair consideration of PrEP as part of combination HIV prevention in Latin America.

Science.gov (United States)

Ravasi, Giovanni; Grinsztejn, Beatriz; Baruch, Ricardo; Guanira, Juan Vicente; Luque, Ricardo; Cáceres, Carlos F; Ghidinelli, Massimo

2016-01-01

Despite progress in scaling up antiretroviral treatment, HIV prevention strategies have not been successful in significantly curbing HIV incidence in Latin America. HIV prevention interventions need to be expanded to target the most affected key populations with a combination approach, including new high impact technologies. Oral pre-exposure prophylaxis (PrEP) is recommended as additional prevention choice for individuals at higher risk of infection and could become a cost-effective prevention tool. We discuss the barriers and solutions for a fair consideration of PrEP as part of combination HIV prevention strategies in Latin America. Although demonstration projects are ongoing or being planned in a number of countries, to date no Latin American country has implemented a public PrEP programme. The knowledge of policymakers about PrEP implementation needs to be strengthened, and programmatic guidance and cost estimate tools need to be developed to support adequate planning. Despite high levels of awareness among health providers, especially if engaged in HIV or key population care, willingness to prescribe PrEP is still low due to the lack of national policies and guidelines. Key populations, especially men who have sex with men, transgender women and sex workers, have been engaged in demonstration projects, and qualitative research shows high awareness and willingness to use PrEP, especially if accessible in the public sector for free or at affordable price. Concerns of safety, adherence, effectiveness and risk compensation need to be addressed through targeted social communication strategies to improve PrEP knowledge and stimulate demand. Alliance among policymakers, civil society and representatives from key populations, healthcare providers and researchers will be critical for the design and successful implementation of PrEP demonstration projects of locally adapted delivery models. The use of mechanisms of joint negotiation and procurement of antiretrovirals

Prep1, A Homeodomain Transcription Factor Involved in Glucose and Lipid Metabolism

Directory of Open Access Journals (Sweden)

Francesco Oriente

2018-06-01

Full Text Available The three-amino acid loop extension (TALE homeodomain proteins are a family of transcription factor including the mammalian Pbx, MEIS and Prep proteins. TALE proteins can bind other transcription factors such as Pdx-1 and play an important role in the regulation of glucose metabolism. Experiments performed in mutant mice have shown that while the single Pbx1 or Pdx-1 knockout mice feature pancreatic islet malformations, impaired glucose tolerance and hypoinsulinemia, the trans-heterozygous Pbx1+/−Pdx1+/− mice develop age-dependent overt diabetes mellitus. In contrast, Prep1 plays a different role with respect to these proteins. Indeed, Prep1 hypomorphic mice, expressing low levels of protein, feature pancreatic islet hypoplasia accompanied by hypoinsulinemia similar to Pbx1 or Pdx1. Nevertheless, these animals show increased insulin sensitivity in skeletal muscle, liver and adipose tissue accompanied by protection from streptozotocin-induced diabetes. In addition, Prep1 hypomorphic mice feature reduced triglyceride synthesis and do not develop steatohepatitis after a methionine and coline deficient diet. In this review we have underlined how important metabolic functions are controlled by TALE proteins, in particular by Prep1, leading to hypothesis that its suppression might represent beneficial effect in the care of metabolic diseases.

Knowledge, Practices, and Barriers to HIV Pre-Exposure Prophylaxis (PrEP) Prescribing Among Washington State Medical Providers.

Science.gov (United States)

Wood, Brian R; McMahan, Vanessa M; Naismith, Kelly; Stockton, Jonathan B; Delaney, Lori A; Stekler, Joanne D

2018-01-04

We aimed to assess HIV pre-exposure prophylaxis (PrEP) awareness and prescribing practices among Washington State medical providers from diverse professional disciplines and practice types. In May 2016, we administered an anonymous online survey to licensed medical practitioners who provide primary, longitudinal, walk-in, emergency, obstetric, gynecologic, sexually transmitted infection (STI), or family planning care. Of 735 eligible providers, 64.8% had heard of PrEP. Younger providers and providers with a Doctor of Medicine (MD) degree were more likely to be aware of PrEP compared to older providers (p=0.0001) and providers of other training backgrounds (Advanced Registered Nurse Practitioner [ARNP], Doctor of Osteopathic Medicine [DO], or Physician Assistant [PA]) (p=0.04). Among providers aware of PrEP, most frequent reported concerns about prescribing were adherence (46.0%) and costs (42.9%). Providers felt very (20.1%) or somewhat (33.8%) comfortable discussing PrEP overall, but very (26.8%) or somewhat (44.7%) uncomfortable discussing cost and insurance issues. The 124 PrEP prescribers reported a median of 2 (range 1-175, total 1,142) patients prescribed PrEP. Prior authorizations and insurance denials had prevented prescriptions for 28.7% and 12.1% of prescribers, respectively. Interventions to improve PrEP access should include education to inform medical providers about PrEP, with particular attention to provider types less likely to be aware. Continued efforts to eliminate cost and insurance barriers and educate providers regarding financial resources would help improve PrEP access.

PRESTO-PREP: a data preprocessor for the PRESTO-II code

Energy Technology Data Exchange (ETDEWEB)

Bell, M.A.; Emerson, C.J.; Fields, D.E.

1984-07-01

PRESTO-II is a computer code developed to evaluate possible health effects from shallow land disposal of low level radioactive wastes. PRESTO-PREP is a data preprocessor that has been developed to expedite the formation of input data sets for PRESTO-II. PRESTO-PREP utilizes a library of nuclide and risk-specific data. Given an initial waste inventory, the code creates the radionuclide portion of the associated input data set for PRESTO-II. 2 references.

PRESTO-PREP: a data preprocessor for the PRESTO-II code

International Nuclear Information System (INIS)

Bell, M.A.; Emerson, C.J.; Fields, D.E.

1984-07-01

PRESTO-II is a computer code developed to evaluate possible health effects from shallow land disposal of low level radioactive wastes. PRESTO-PREP is a data preprocessor that has been developed to expedite the formation of input data sets for PRESTO-II. PRESTO-PREP utilizes a library of nuclide and risk-specific data. Given an initial waste inventory, the code creates the radionuclide portion of the associated input data set for PRESTO-II. 2 references

The DELTA PREP Initiative: Accelerating Coalition Capacity for Intimate Partner Violence Prevention

Science.gov (United States)

Zakocs, Ronda; Freire, Kimberley E.

2018-01-01

Background The DELTA PREP Project aimed to build the prevention capacity of 19 state domestic violence coalitions by offering eight supports designed to promote prevention integration over a 3-year period: modest grant awards, training events, technical assistance, action planning, coaching hubs, the Coalition Prevention Capacity Assessment, an online workstation, and the online documentation support system. Objectives Using quantitative and qualitative data, we sought to explain how coalitions integrated prevention within their structures and functions and document how DELTA PREP supports contributed to coalitions’ integration process. Results We found that coalitions followed a common pathway to integrate prevention. First, coalitions exhibited precursors of organizational readiness, especially having prevention champions. Second, coalitions engaged in five critical actions: engaging in dialogue, learning about prevention, forming teams, soliciting input from the coalition, and action planning. Last, by engaging in these critical actions, coalitions enhanced two key organizational readiness factors—developing a common understanding of prevention and an organizational commitment to prevention. We also found that DELTA PREP supports contributed to coalitions’ abilities to integrate prevention by supporting learning about prevention, fostering a prevention team, and engaging in action planning by leveraging existing opportunities. Two DELTA PREP supports—coaching hubs and the workstation—did not work as initially intended. From the DELTA PREP experience, we offer several lessons to consider when designing future prevention capacity-building initiatives. PMID:26245934

ThinPrep Pap-smear and cervical intraepithelial neoplasia in reproductive-aged Thai women.

Science.gov (United States)

Rugpao, S; Koonlertkit, S; Ruengkrist, T; Lamlertkittikul, S; Pinjaroen, S; Limtrakul, A; Werawatakul, Y; Sinchai, W

2009-06-01

To estimate the incidence of abnormal cervical cytology by ThinPrep Pap-tests and cervical intraepithelial neoplasia (CIN) in young adult reproductive-aged Thai women. A total of 1254 women distributed in all regions of Thailand were monitored from 2002 through 2004. Women were screened for abnormal cervical cytology using the ThinPrep method every 6 months. Interpretation of cervical cytology was based on the Bethesda system, version 2001. Women who had the ThinPrep Pap results as atypical squamous cells of undetermined significance or worse underwent colposcopic examination. The ThinPrep and all cervical tissue samples obtained from diagnostic or therapeutic procedures were analyzed and reviewed by Covance Central Laboratory Service, Inc., Indianapolis, USA. The cumulative incidence of abnormal ThinPrep Pap-tests was as follows: 15.3 per 100 woman years (WY) (95% confidence interval [CI] 12.3, 18.9) at 6 months; 12.3 per 100 WY (95% CI 10.3, 14.6) at 12 months; and 11.6 per 100 WY (95% CI 10.0, 13.5) at 18 months. Of 1448.6 woman years of follow up, the incidence of CIN1 was 4.1 per 100 WY (95% CI 3.2, 5.3); CIN2 0.8 per 100 WY (95% CI 0.4, 1.4); and CIN3 0.6 per 100 WY (95% CI 0.3, 1.2). The incidence of abnormal ThinPrep Pap-test and CIN in young adult Thai women had been reported. No comparable data is available.

Evaluating the effectiveness of PrepSTART for promoting oral language and emergent literacy skills in disadvantaged preparatory students.

Science.gov (United States)

Lennox, Maria; Westerveld, Marleen F; Trembath, David

2018-04-01

This study examined the effectiveness of a classroom-based intervention programme aimed at improving the oral language and emergent literacy skills of students from low socio-economic, culturally diverse backgrounds within their first formal year of schooling ("prep"). Data from 137 students were available for analysis. Participants were from three primary schools located in Queensland, Australia. Eight classes were allocated to intervention and two classes acted as a business as usual control. All students received literacy instruction as per the Australian Curriculum. However, the intervention group received 24 weeks of scripted, classroom-based, book-based intervention targeting code- and meaning-related emergent literacy skills. All students were assessed individually pre- and post-intervention on code-related measures (i.e. letter identification and phonological awareness) and meaning-related measures (i.e. vocabulary, oral narrative comprehension and retell). All students made significant improvement over time for all measures. Students in the intervention group showed significantly more progress than the business as usual group on all measures, except for letter identification and oral narrative comprehension. This classroom-based book-based intervention can improve the code- and meaning-related emergent literacy skills of prep students from low socio-economic backgrounds and provide these students with the building blocks for successful literacy acquisition.

'PrEP is not ready for our community, and our community is not ready for PrEP': pre-exposure prophylaxis for HIV for people who inject drugs and limits to the HIV prevention response.

Science.gov (United States)

Guise, Andy; Albers, Eliot Ross; Strathdee, Steffanie A

2017-04-01

Pre-exposure prophylaxis for HIV, or 'PrEP', is the use of antiretroviral medicines by people who are HIV-negative to protect themselves against acquiring HIV. PrEP has shown efficacy for preventing HIV acquisition. Despite the potential, many concerns have been voiced by people who inject drugs (PWID) and their organizations. There is a need to engage with these views and ensure their integration in to policy and strategy. This paper presents PWID views on PrEP to foster the uptake of these opinions into scientific and policy debate around PrEP METHODS: Critical analysis of a report of a community consultation led by the International Network of People who Use Drugs (INPUD). The INPUD report highlights enthusiasm from PWID for PrEP, but also three main concerns: the feasibility and ethics of PrEP, its potential use as a substitute for other harm reduction strategies and how a focus on PrEP heralds a re-medicalization of HIV. Each concern relates to evidenced gaps in essential services or opposition to harm reduction and PWID human rights. People who use drugs have fundamental concerns about the potential impacts of pre-exposure prophylaxis for HIV which reflect a 'fault line' in HIV prevention: a predominance of biomedical approaches over community perspectives. Greater community engagement in HIV prevention strategy is needed, or we risk continuing to ignore the need for action on the underlying structural drivers and social context of the HIV epidemic. © 2016 Society for the Study of Addiction.

Acceptability of Daily Use of Free Oral Pre-exposure Prophylaxis (PrEP) Among Transgender Women Sex Workers in Shenyang, China.

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Wang, Zixin; Lau, Joseph T F; Yang, Xueying; Cai, Yong; Gross, Danielle L; Ma, Tiecheng; Liu, Yan

2017-12-01

This study investigated the acceptability of daily use of free oral pre-exposure prophylaxis (PrEP) and associated factors among transgender women sex workers in Shenyang, China, following a briefing on PrEP. A total of 183 HIV negative or sero-status unknown participants completed the cross-sectional survey. The prevalence of acceptability of daily use of free oral PrEP was 61.2%. Adjusting for education level and monthly income, variables on negative attitudes toward PrEP (i.e., having concerns about the side-effects of PrEP) [Adjusted odds ratios (AOR): 0.26], perceived subjective norms (i.e., perceiving support from male partners to take PrEP) (AOR: 2.08), and perceived behavioral control (e.g., perceiving complete control over using PrEP) (AOR: 2.10-16.72) were significantly associated with acceptability of daily use of free oral PrEP. In addition, experiencing violence during sex work, perceived risk of contracting HIV from clients and probable anxiety were also significant. Future PrEP promotion campaigns should consider these factors.

Electronics Technology. Tech Prep Competency Profile.

Science.gov (United States)

Lakeland Tech Prep Consortium, Kirtland, OH.

This tech prep competency profile covers the occupation of electronics technician. Section 1 provides the occupation definition. Section 2 lists development committee members. Section 3 provides the leveling codes--abbreviations for grade level, (by the end of grade 12, by the end of associate degree), academic codes (communications, math, or…

Framing HIV Pre-Exposure Prophylaxis (PrEP) for the General Public: How Inclusive Messaging May Prevent Prejudice from Diminishing Public Support.

Science.gov (United States)

Calabrese, Sarah K; Underhill, Kristen; Earnshaw, Valerie A; Hansen, Nathan B; Kershaw, Trace S; Magnus, Manya; Krakower, Douglas S; Mayer, Kenneth H; Betancourt, Joseph R; Dovidio, John F

2016-07-01

Strategic framing of public messages about HIV pre-exposure prophylaxis (PrEP) may influence public support for policies and programs affecting access. This survey study examined how public attitudes toward PrEP differed based on the social group PrEP was described as benefiting ("beneficiary") and the moderating effect of prejudice. Members of the general public (n = 154) recruited online were randomly assigned to three beneficiary conditions: general population, gay men, or Black gay men. All participants received identical PrEP background information before completing measures of PrEP attitudes (specifying beneficiary), racism, and heterosexism. Despite anticipating greater PrEP adherence among gay men and Black gay men and perceiving PrEP as especially beneficial to the latter, participants expressed lower support for policies/programs making PrEP affordable for these groups vs. the general population. This disparity in support was stronger among participants reporting greater prejudice. Inclusive framing of PrEP in public discourse may prevent prejudice from undermining implementation efforts.

Threefold Increase in PrEP Uptake Over Time with High Adherence Among Young Men Who Have Sex With Men in Chicago.

Science.gov (United States)

Morgan, Ethan; Moran, Kevin; Ryan, Daniel T; Mustanski, Brian; Newcomb, Michael E

2018-05-04

The goal of this work is to better understand utilization and uptake of pre-exposure prophylaxis (PrEP) among young men who have sex with men (YMSM) and transgender women (TGW). We assessed trends and correlates of PrEP use and adherence across three time points of longitudinal data collection among 885 YMSM and TGW (aged 16-29) from the RADAR cohort in Chicago, 2015-2017. Past 6-month PrEP use increased across three visits: from 6.6 to 17.5%. In multivariable models, past 6-month PrEP use was significantly associated with participation in condomless sex, having more sexual partners, and older age. At least three-quarters of current PrEP users reported being ≥ 90% adherent to PrEP medication across all visits. Past 6-month PrEP use increased over time with those who participated in high-risk HIV behaviors also those most likely to have taken PrEP. As PrEP uptake continues to rise, more research will be needed to understand predictors of PrEP usage, as well as patterns of sexual behavior change following uptake.

The transcription factor Prep1 controls hepatic insulin sensitivity and gluconeogenesis by targeting nuclear localization of FOXO1

International Nuclear Information System (INIS)

Kulebyakin, Konstantin; Penkov, Dmitry; Blasi, Francesco; Akopyan, Zhanna; Tkachuk, Vsevolod

2016-01-01

Liver plays a key role in controlling body carbohydrate homeostasis by switching between accumulation and production of glucose and this way maintaining constant level of glucose in blood. Increased blood glucose level triggers release of insulin from pancreatic β-cells. Insulin represses hepatic glucose production and increases glucose accumulation. Insulin resistance is the main cause of type 2 diabetes and hyperglycemia. Currently thiazolidinediones (TZDs) targeting transcriptional factor PPARγ are used as insulin sensitizers for treating patients with type 2 diabetes. However, TZDs are reported to be associated with cardiovascular and liver problems and stimulate obesity. Thus, it is necessary to search new approaches to improve insulin sensitivity. A promising candidate is transcriptional factor Prep1, as it was shown earlier it could affect insulin sensitivity in variety of insulin-sensitive tissues. The aim of the present study was to evaluate a possible involvement of transcriptional factor Prep1 in control of hepatic glucose accumulation and production. We created mice with liver-specific Prep1 knockout and discovered that hepatocytes derived from these mice are much more sensitive to insulin, comparing to their WT littermates. Incubation of these cells with 100 nM insulin results in almost complete inhibition of gluconeogenesis, while in WT cells this repression is only partial. However, Prep1 doesn't affect gluconeogenesis in the absence of insulin. Also, we observed that nuclear content of gluconeogenic transcription factor FOXO1 was greatly reduced in Prep1 knockout hepatocytes. These findings suggest that Prep1 may control hepatic insulin sensitivity by targeting FOXO1 nuclear stability. - Highlights: • A novel model of liver-specific Prep1 knockout is established. • Ablation of Prep1 in hepatocytes increases insulin sensitivity. • Prep1 controls hepatic insulin sensitivity by regulating localization of FOXO1. • Prep1 regulates

Commentary: the value of PrEP for people who inject drugs

OpenAIRE

Rosalind L Coleman; Susie McLean

2016-01-01

Introduction: The offer of pre-exposure prophylaxis (PrEP) is recommended as an additional option for HIV prevention for people at substantial risk of HIV infection as part of combination HIV prevention approaches. Implementing this depends on integrating PrEP in public health programmes that address risky practices with evidence-based interventions, and that operate in an enabling legal and policy environment for the delivery of health services to those at higher risk of HIV infection. What ...

A tale of TALE, PREP1, PBX1, and MEIS1: Interconnections and competition in cancer.

Science.gov (United States)

Blasi, Francesco; Bruckmann, Chiara; Penkov, Dmitry; Dardaei, Leila

2017-05-01

We report the latest structural information on PREP1 tumor suppressor, the specific "oncogene" and "tumor suppressive" signatures of MEIS1 and PREP1, the molecular rules regulating PREP1 and MEIS1 binding to DNA, and how these can change depending on the interaction with PBX1, cell-type, neoplastic transformation, and intracellular concentration. As both PREP1 and MEIS1 interact with PBX1 they functionally compete with each other. PREP1, PBX1, and MEIS1 TALE-class homeodomain transcription factors act in an interdependent and integrated way in experimental tumorigenesis. We also pool together the plethora of data available in human cancer databanks and connect them with the available molecular information. The emerging picture suggests that a similarly basic approach might be used to better dissect and define other oncogenes and suppressors and better understand human cancer. © 2017 The Authors. BioEssays Published by WILEY Periodicals, Inc.

Provider perspectives on PrEP for adolescent girls and young women in Tanzania: The role of provider biases and quality of care.

Directory of Open Access Journals (Sweden)

Nanlesta Pilgrim

Full Text Available Oral pre-exposure prophylaxis (PrEP has the potential to reduce HIV acquisition among adolescent girls and young women (AGYW in sub-Saharan Africa. However, health care providers' (HCPs perspectives and interactions with potential clients can substantially influence effective provision of quality health services. We examine if HCPs' knowledge, attitude, and skills, as well as their perceptions of facility readiness to provide PrEP are associated with their willingness to provide PrEP to AGYW at high risk of HIV in Tanzania.A self-administered questionnaire was given to 316 HCPs from 74 clinics in two districts and 24 HCPs participated in follow-up in-depth interviews (IDIs. We conducted bivariate and multivariable Poisson regression to assess factors associated with willingness to provide PrEP to AGYW. Thematic content analysis was used to analyze the IDIs, which expanded upon the quantitative results.Few HCPs (3.5% had prior PrEP knowledge, but once informed, 61.1% were willing to prescribe PrEP to AGYW. Higher negative attitudes toward adolescent sexuality and greater concerns about behavioral disinhibition due to PrEP use were associated with lower willingness to prescribe PrEP. Qualitatively, HCPs acknowledged that biases, rooted in cultural norms, often result in stigmatizing and discriminatory care toward AGYW, a potential barrier for PrEP provision. However, better training to provide HIV services was associated with greater willingness to prescribe PrEP. Conversely, HCPs feared the potential negative impact of PrEP on the provision of existing HIV services (e.g., overburdened staff, and suggested the integration of PrEP into non-HIV services and the use of paramedical professionals to facilitate PrEP provision.Preparing for PrEP introduction requires more than solely training HCPs on the clinical aspects of providing PrEP. It requires a two-pronged strategy: addressing HCPs' biases regarding sexual health services to AGYW; and preparing

Poppers and PrEP: Use of Pre-exposure Prophylaxis Among Men Who Have Sex with Men Who Use Inhaled Nitrites.

Science.gov (United States)

Hambrick, H Rhodes; Park, Su Hyun; Schneider, John A; Mayer, Kenneth H; Carrico, Adam W; Sherman, Scott E; Duncan, Dustin T

2018-05-09

Men who have sex with men (MSM) commonly use inhaled nitrites, or poppers, though their use is a risk factor HIV seroconversion. Pre-exposure prophylaxis, or PrEP, is effective for HIV prevention, but is not widely used, and little is known regarding PrEP use and acceptability among MSM who use inhaled nitrites. We surveyed 580 MSM in Paris, France in 2016 about popper use, sexual behaviors including condomless anal intercourse (CAI), serosorting, and sexual positioning, PrEP use, PrEP candidacy, and interest in alternate PrEP delivery modalities. We included 444 HIV negative participants for the current study. 46.2% reported popper use in the prior 3 months. Using multivariate adjusted logistic regression, we found that popper users were more likely than non-users to consider themselves candidates for PrEP [adjusted relative risk ratio (aRRR) = 2.73; 95% CI 1.54-4.83], but they were not more likely to be current (aRRR = 1.54; 95% CI 0.71-3.33) or past (aRRR = 1.37; 95% CI 0.44-4.28) PrEP users. Mediation analyses indicated that increased CAI and serosorting partly explained the relationship between popper use and PrEP candidacy. There was considerable interest in alternate proposed PrEP delivery modalities, particularly long-acting injectable PrEP [adjusted risk ratio (aRR) = 1.43; 95% CI 1.15-1.79].

Lessons learned from the experiences of informal PrEP users in France: results from the ANRS-PrEPage study.

Science.gov (United States)

Rivierez, I; Quatremere, G; Spire, B; Ghosn, J; Rojas Castro, D

2018-05-30

Before January 2016, Pre-Exposure Prophylaxis (PrEP), a new biomedical HIV-prevention tool, was only available in France via ANRS-Ipergay clinical study but informal use was reported outside this setting. PrEPage qualitative study reports profiles and experiences of participants who used PrEP outside of a biomedical trial before this prevention method was authorized. Between March 2015 and February 2016, a cross-section of twenty-four informal PrEP users, mostly MSM, was recruited to complete in-depth semi-structured interviews. While ANRS-Ipergay was still ongoing (2012-2016), participants described their initiation to PrEP, the way they used it and the difficulties they faced to acquire antiretroviral drugs in an environment where PrEP was still not widely known and often criticized . Through the testimonies, different user profiles and motivation toward informal PrEP use emerged: (a) participants who have increasing difficulties using condoms, (b) "opportunists" who tried PrEP without the intention of using it regularly and (c) participants with a risk aversion who sought additional protection against HIV. Participants chose to use PrEP and/or their usual prevention strategies depending on available supplies, type of partners and individual attitudes toward risk. The feeling of living a safer sex life helped participants to outweigh the fear of possible toxicity and drug resistance. Participants' needs and expectations about PrEP implementation in France were also presented.

The impact of pre-exposure prophylaxis (PrEP) on HIV epidemics in Africa and India: A simulation study

NARCIS (Netherlands)

D.C.J. Vissers (Debby); H.A.C.M. Voeten (Hélène); N.J.D. Nagelkerke (Nico); J.D.F. Habbema (Dik); S.J. de Vlas (Sake)

2008-01-01

textabstractBackground: Pre-exposure prophylaxis (PrEP) is a promising new HIV prevention method, especially for women. An urgent demand for implementation of PrEP is expected at the moment efficacy has been demonstrated in clinical trials. We explored the long-term impact of PrEP on HIV

What Primary Care Providers Need to Know about Pre-Exposure Prophylaxis (PrEP) for HIV Prevention: Narrative Review

Science.gov (United States)

Krakower, Douglas; Mayer, Kenneth H.

2013-01-01

As HIV prevalence climbs globally, including more than 50,000 new infections per year in the United States, we need effective HIV prevention strategies. The use of antiretrovirals for pre-exposure prophylaxis (known as “PrEP”) among high-risk HIV-uninfected persons is emerging as one such strategy. Randomized controlled trials have demonstrated that once daily oral PrEP decreased HIV incidence among at-risk MSM and African heterosexuals, including HIV serodiscordant couples. An additional randomized control trial of a pericoital topical application of antiretroviral microbicide gel reduced HIV incidence among at-risk heterosexual South African women. Two other studies in African women did not demonstrate the efficacy of oral or topical PrEP, raising concerns about adherence patterns and efficacy in this population. The FDA Antiretroviral Advisory Panel reviewed these studies and additional data in May 2012 and recommended the approval of oral tenofovir-emtricitabine for PrEP in high-risk populations. Patients may seek PrEP from their primary care providers and those on PrEP require monitoring. Thus, primary care providers should become familiar with PrEP. This review outlines the current state of knowledge about PrEP as it pertains to primary care including identification of individuals likely to benefit from PrEP, counseling to maximize adherence and minimize potential increases in risky behavior, and monitoring for potential drug toxicities, HIV acquisition, and antiretroviral drug resistance. Issues related to cost and insurance coverage are also discussed. Recent data suggest that PrEP, in conjunction with other prevention strategies, holds promise in helping to curtail the HIV epidemic. PMID:22821365

Role of the pharmacist in pre-exposure chemoprophylaxis (PrEP therapy for HIV prevention

Directory of Open Access Journals (Sweden)

Clauson KA

2009-03-01

Full Text Available With a global estimate of 2.5 million new infections of HIV occurring yearly, discovering novel methods to help stem the spread of the virus is critical. The use of antiretroviral chemoprophylaxis for preventing HIV after accidental or occupational exposure and in maternal to fetal transmission has become a widely accepted method to combat HIV. Based on this success, pre-exposure chemoprophylaxis (PrEP is being explored in at-risk patient populations such as injecting drug users, female sex workers and men who have sex with men. This off-label and unmonitored use has created a need for education and intervention by pharmacists and other healthcare professionals. Pharmacists should educate themselves on PrEP and be prepared to counsel patients about their means of obtaining it (e.g. borrowing or sharing medications and ordering from disreputable Internet pharmacies. They should also be proactive about medication therapy management in these patients due to clinically important drug interactions with PrEP medications. Only one trial exploring the safety and efficacy of tenofovir as PrEP has been completed thus far. However, five ongoing trials are in various stages and two additional studies are scheduled for the near future. Unfortunately, studies in this arena have met with many challenges that have threatened to derail progress. Ethical controversy surrounding post-trial care of participants who seroconvert during studies, as well as concerns over emerging viral resistance and logistical site problems, have already halted several PrEP trials. Information about these early trials has already filtered down to affected individuals who are experimenting with this unproven therapy as an “evening before pill”. The potential for PrEP is promising; however, more extensive trials are necessary to establish its safety and efficacy. Pharmacists are well-positioned to play a key role in helping patients make choices about PrEP, managing their therapy

Knowledge of Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Men Who Have Sex with Men in Denver, Colorado

Science.gov (United States)

Al-Tayyib, Alia A.; Thrun, Mark W.; Haukoos, Jason S.; Walls, N. Eugene

2014-01-01

As part of the National HIV Behavioral Surveillance System among men who have sex with men (MSM) in Denver, Colorado, we assessed knowledge of pre-exposure prophylaxis (PrEP); willingness to use PrEP; and potential changes in risk behaviors among HIV-negative participants reporting sexual activity with a male partner in the preceding 12 months. We examined knowledge of PrEP before (2008) and after (2011) results of the iPrEx trial were available. Of the 425 participants in the 2008 sample, 91 (21 %) were aware of PrEP compared to 131 (28 %) of the 461 participants in the 2011 sample (adjusted prevalence ratio: 1.43, 95 % confidence interval: 1.18, 1.72). Despite the increase in 2011, few MSM in Denver were aware of PrEP. Educating high-risk MSM about the potential utility of PrEP as an adjunct to other effective prevention methods is needed when considering the addition of PrEP to the HIV prevention arsenal. PMID:23824227

Knowledge, Attitudes, and Experiences of HIV Pre-Exposure Prophylaxis (PrEP) Trial Participants in Botswana.

Science.gov (United States)

Toledo, Lauren; McLellan-Lemal, Eleanor; Henderson, Faith L; Kebaabetswe, Poloko M

2015-03-01

Recent clinical trials have shown that a daily dose of oral TDF/FTC pre-exposure prophylaxis (PrEP) is effective in reducing human immunodeficiency (HIV) risk. Understanding trial participants' perspectives about retention and PrEP adherence is critical to inform future PrEP trials and the scale-up and implementation of PrEP programs. We analyzed 53 in-depth interviews conducted in April 2010 with participants in the TDF2 study, a Phase 3, randomized, double-blind, placebo-controlled clinical trial of daily oral TDF/FTC with heterosexual men and women in Francistown and Gaborone, Botswana. We examined participants' knowledge, attitudes, and experiences of the trial, identified facilitators and barriers to enrollment and retention, and compared participant responses by study site, sex, and study drug adherence. Our findings point to several factors to consider for participant retention and adherence in PrEP trials and programs, including conducting pre-enrollment education and myth reduction counseling, providing accurate estimates of participant obligations and side effect symptoms, ensuring participant understanding of the effects of non-adherence, gauging personal commitment and interest in study outcomes, and developing a strong external social support network for participants.

What Is the Tech Prep/Associate Degree Program?

Science.gov (United States)

Parnell, Dale

1993-01-01

Discusses the nature, importance, and future of the Tech Prep/Associate Degree program. Suggests that these programs must move beyond simple articulation and become aggressive in jointly examining, developing, and sustaining high quality educational programs. (JOW)

Protecting children from rabies with education and pre-exposure prophylaxis: A school-based campaign in El Nido, Palawan, Philippines.

Science.gov (United States)

Deray, Raffy; Rivera, Cesar; Gripon, Shiela; Ulanday, Corazon; Roces, Maria Concepcion; Amparo, Anna Charinna; Attlan, Michael; Demont, Clarisse; Kieffer, Alexia; Miranda, Mary Elizabeth

2018-01-01

Rabies remains endemic in the Philippines. A study was conducted in El Nido, Palawan, Philippines to: (i) detect the true incidence of animal bites in school children aged 5-14 years using active surveillance and compare these data to estimates from the existing passive surveillance system, (ii) evaluate the impact of rabies prevention education and pre-exposure prophylaxis (PrEP) on animal bite incidence, and (iii) assess the health economic impact of the interventions. A cohort of 4,700 school children was followed-up for any suspect rabies exposures between January 2011 and December 2012. Data on animal bite incidence from the study cohort were compared to that obtained from a review of consultation records at the Animal Bite Treatment Center (ABTC). PrEP was offered to children in all 27 public elementary schools in El Nido (in January to February 2012). Teachers were given a manual for integrating rabies in the public elementary school curriculum during the school year 2012-13. Active surveillance of the cohort revealed a higher incidence of suspect rabies exposures than that from passive surveillance. Despite a decrease in the number of Category III bites, there was no significant decrease in overall bite incidence as a result of the interventions. However, there was an increase in rabies awareness among school children in all grade levels. There was also a high level of acceptability of PrEP. Children who received PrEP and subsequently were bitten only needed two booster doses for post-exposure prophylaxis, resulting in substantial cost-savings. The true burden of animal bites remains underestimated in ABTC records. PrEP is advantageous in selected population groups, i.e. school-aged children in rabies endemic areas with limited access to animal and human rabies prevention services. Educating school children is beneficial. Strengthening veterinary interventions to target the disease at source is important.

Cost-effectiveness of Pre-Exposure Prophylaxis (PrEP) in preventing HIV-1 infections in rural Zambia: a modeling study

NARCIS (Netherlands)

Nichols, B.E.; Boucher, C.A.B.; van Dijk, J.H.; Thuma, P.E.; Nouwen, J.L.; Baltussen, R.; van de Wijgert, J.; Sloot, P.M.A.; van de Vijver, D.A.M.C.

2013-01-01

Background: Pre-exposure prophylaxis (PrEP) with tenofovir and emtricitabine effectively prevents new HIV infections. The optimal scenario for implementing PrEP where most infections are averted at the lowest cost is unknown. We determined the impact of different PrEP strategies on averting new

The Role of Social Relationships in PrEP Uptake and Use Among Transgender Women and Men Who Have Sex with Men.

Science.gov (United States)

Mehrotra, Megha L; Rivet Amico, K; McMahan, Vanessa; Glidden, David V; Defechereux, Patricia; Guanira, Juan V; Grant, Robert M

2018-05-12

Qualitative studies suggest that social relationships play an important role in HIV pre-exposure prophylaxis (PrEP) use, but there have been few quantitative assessments of the role of social relationships in PrEP uptake or adherence. We examined the association between disclosure of study participation or LGBT identity and PrEP use in the 1603 HIV-negative participants enrolled in the iPrEx OLE study. We also evaluated the association between LGBT social group involvement and PrEP use. Study participation disclosure to parents and LGBT identity disclosure to anyone in a participant's social network were associated with greater PrEP uptake. Study participation disclosure to partners was associated with higher probability of having protective PrEP drug concentrations compared [risk difference 0.15 95% CI (0.01, 0.30)]. For each additional type of LGBT organization a participant was involved in, the probability of PrEP uptake and having protective drug concentrations increased by 0.04 [95% CI (0.03, 0.06)] and 0.04 (95% CI (0.02, 0.07)] respectively. Overall, social context was associated with PrEP use in iPrEx OLE, and should be taken into consideration when designing future PrEP implementation programs.

Commentary: the value of PrEP for people who inject drugs.

Science.gov (United States)

Coleman, Rosalind L; McLean, Susie

2016-01-01

The offer of pre-exposure prophylaxis (PrEP) is recommended as an additional option for HIV prevention for people at substantial risk of HIV infection as part of combination HIV prevention approaches. Implementing this depends on integrating PrEP in public health programmes that address risky practices with evidence-based interventions, and that operate in an enabling legal and policy environment for the delivery of health services to those at higher risk of HIV infection. What does this recommendation mean in terms of the diverse range of HIV prevention needs of key populations, some of whom are so discriminated against that they exist essentially outside formal systems such as national public health services, and for whom a substantial risk of HIV is part of a larger adverse and hostile situation? We discuss this question with reference to people who inject drugs, informed by concerns and comments that emerged from a series of consultations. HIV prevention is part of a spectrum of injecting drug users' priorities, and their access and uptake of HIV prevention services is contingent on their wider "risk environment." The need to address structural barriers to services and human rights violations, and to improve access to comprehensive harm reduction programmes are of prime importance and would have higher value than a mono-focus on HIV prevention. Where existing harm reduction activities are inadequate, fragile or dependent on external donors, shifts in funding priorities, including, for example, towards PrEP, could threaten investment in the broader programmes. For these reasons, it cannot be assumed that PrEP promotion will always be supported by people who inject drugs.The sexual partners of people who inject drugs, non-opioid users who also inject and for whom there is no established substitution treatment, as well as drug users who are unable to negotiate safe sex may value PrEP. As for all key populations, the involvement of people who inject drugs in

Are Thai MSM willing to take PrEP for HIV prevention? An analysis of attitudes, preferences and acceptance.

Directory of Open Access Journals (Sweden)

Ana Wheelock

Full Text Available We aimed to understand the attitudes, preferences and acceptance of oral and parenteral PrEP among men who have sex with men (MSM in Thailand.Pre-exposure prophylaxis (PrEP, the use of antiretrovirals to prevent HIV acquisition, has shown promising results in recent trials. To assess the potential impact of this new HIV prevention method, in addition to efficacy data, we need to understand which psychosocial factors are likely to determine its uptake among members of potential user groups.Surveys of willingness to use PrEP products were administered to MSM. Spearman's rank tests were used to uncover associations between questionnaire items. Mann-Whitney tests were performed to ascertain differences between groups. Conjoint analysis was used to examine the attitudes and preferences of MSM towards PrEP attributes. Most participants were willing to consider taking PrEP (39.2% "yes, definitely" and 49.2% "yes, probably" and perceived PrEP as giving them new possibilities in their lives (38.5% "a lot of hope" and 55.8% "some hope", even after being instructed of potential side effects and costs. HIV testing was considered the most important attribute and a daily pill and longer lasting injection in the arm were the preferred routes of administration.Despite its multiple challenges, MSM in Thailand would be willing to take PrEP, even if they had to experience inconvenience and expense. If PrEP were to be implemented in Thailand, our findings show that its uptake could be considerable.

76 FR 51037 - Determination That Halflytely and Bisacodyl Tablets Bowel Prep Kit (Containing Two Bisacodyl...

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2011-08-17

... determined that Halflytely and Bisacodyl Tablets Bowel Prep Kit (polyethylene glycol (PEG) 3350, sodium... kits containing PEG-3350, sodium chloride, sodium bicarbonate, and potassium chloride for oral solution... that the Agency determine whether Halflytely and Bisacodyl Tablets Bowel Prep Kit (PEG- 3350, sodium...

Complex and Conflicting Social Norms: Implications for Implementation of Future HIV Pre-Exposure Prophylaxis (PrEP Interventions in Vancouver, Canada.

Directory of Open Access Journals (Sweden)

Rod Knight

Full Text Available HIV Pre-Exposure Prophylaxis (PrEP has been found to be efficacious in preventing HIV acquisition among seronegative individuals in a variety of risk groups, including men who have sex with men and people who inject drugs. To date, however, it remains unclear how socio-cultural norms (e.g., attitudes towards HIV; social understandings regarding HIV risk practices may influence the scalability of future PrEP interventions. The objective of this study is to assess how socio-cultural norms may influence the implementation and scalability of future HIV PrEP interventions in Vancouver, Canada.We conducted 50 interviews with young men (ages 18-24 with a variety of HIV risk behavioural profiles (e.g., young men who inject drugs; MSM. Interviews focused on participants' experiences and perceptions with various HIV interventions and policies, including PrEP.While awareness of PrEP was generally low, perceptions about the potential personal and public health gains associated with PrEP were interconnected with expressions of complex and sometimes conflicting social norms. Some accounts characterized PrEP as a convenient form of reliable protection against HIV, likening it to the female birth control pill. Other accounts cast PrEP as a means to facilitate 'socially unacceptable' behaviour (e.g., promiscuity. Stigmatizing rhetoric was used to position PrEP as a tool that could promote some groups' proclivities to take 'risks'.Stigma regarding 'risky' behaviour and PrEP should not be underestimated as a serious implementation challenge. Pre-implementation strategies that concomitantly aim to improve knowledge about PrEP, while addressing associated social prejudices, may be key to effective implementation and scale-up.

HIV providers' likelihood to prescribe pre-exposure prophylaxis (PrEP) for HIV prevention differs by patient type: a short report.

Science.gov (United States)

Adams, Leah M; Balderson, Benjamin H

2016-09-01

Pre-exposure prophylaxis (PrEP), the antiretroviral treatment regimen for HIV-negative people at high risk of acquiring HIV, has demonstrated efficacy across clinical trials in several patient populations. The Centers for Disease Control (CDC) have released detailed guidelines to aid providers in prescribing PrEP for their high-risk patients, including men who have sex with men (MSM), high-risk heterosexuals, and injection drug users (IDUs). Given that much attention in PrEP has focused on MSM patients, the present study used an online survey to assess factors involved in HIV care providers' (n = 363) decisions about prescribing PrEP, along with their willingness to prescribe PrEP to patients from various risk populations (e.g., MSM, heterosexuals, IDUs). The efficacy of PrEP was an important factor in providers' decisions about prescribing PrEP, as were considerations about patients' adherence to the regimen, regular follow-up for care, and medication costs. This survey's findings also suggest that providers' willingness to prescribe PrEP varies by patient group, with providers most willing to initiate the regimen with MSM who have an HIV-positive partner, and least willing to prescribe to high-risk heterosexuals or IDUs. In the context of the current CDC recommendations for PrEP that include MSM, heterosexuals, and IDUs, examining providers' rationales for and barriers against supporting this HIV prevention strategy across patient groups merits further attention.

Uptake of PrEP and condom and sexual risk behavior among MSM during the ANRS IPERGAY trial.

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Sagaon-Teyssier, Luis; Suzan-Monti, Marie; Demoulin, Baptiste; Capitant, Catherine; Lorente, Nicolas; Préau, Marie; Mora, Marion; Rojas Castro, Daniela; Chidiac, Christian; Chas, Julie; Meyer, Laurence; Molina, Jean-Michel; Spire, Bruno

2016-01-01

The double-blind phase of the randomized ANRS IPERGAY trial, evaluating sexual activity-based oral HIV pre-exposure prophylaxis (PrEP), was conducted among high-risk men who have sex with men (MSM). Results showed an 86% (95% CI: 40-98) relative reduction in HIV incidence among participants with tenofovir disoproxil fumarate-emtricitabine vs. placebo. The present pooled analysis aimed to analyze (i) participants' adherence to the prescribed treatment and/or condom use during sexual intercourse and (ii) sexual behavior during the double-blind phase of the study. Four hundred MSM were enrolled in the trial. Every 2 months they completed online questionnaires collecting sexual behavior and PrEP adherence data regarding their most recent sexual intercourse. A total of 2232 questionnaires (M0-M24) were analyzed. Changes over time were evaluated using a mixed model accounting for multiple measures. Irrespective of sexual partner and practice type, on average, 42.6% (min: 32.1-max: 45.8%) reported PrEP use only during their most recent episode of sexual intercourse; 29% (22.9-35.6%) reported both PrEP and condom use; 11.7% (7.2-18.9%) reported condom-use only, and 16.7% (10.8-29.6%) reported no PrEP or condom use with no significant change during the study. Scheduled (i.e., correct) PrEP use was reported on average by 59.0% (47.2-68.5%) of those reporting PrEP use during their most recent sexual intercourse. Overall, 70.3% (65.3-79.4%) and 69.3% (58.3-75.4%) of participants reported, respectively, condomless anal and condomless receptive anal intercourse during their most recent sexual encounter without significant change during follow-up. Overall, on average 83.3% (min: 70.4-max: 89.2%) of participants protected themselves by PrEP intake or condom use or both during the trial, and no increase in at-risk sexual practices was observed. None of these indicators showed significant trend during the follow-up, although we found a tendency toward decrease (p = .19) of the

Surveillance indicators for potential reduced exposure products (PREPs: developing survey items to measure awareness

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McNeill Ann

2009-10-01

Full Text Available Abstract Background Over the past decade, tobacco companies have introduced cigarettes and smokeless tobacco products (known as Potential Reduced Exposure Products, PREPs with purportedly lower levels of some toxins than conventional cigarettes and smokeless products. It is essential that public health agencies monitor awareness, interest, use, and perceptions of these products so that their impact on population health can be detected at the earliest stages. Methods This paper reviews and critiques existing strategies for measuring awareness of PREPs from 16 published and unpublished studies. From these measures, we developed new surveillance items and subjected them to two rounds of cognitive testing, a common and accepted method for evaluating questionnaire wording. Results Our review suggests that high levels of awareness of PREPs reported in some studies are likely to be inaccurate. Two likely sources of inaccuracy in awareness measures were identified: 1 the tendency of respondents to misclassify "no additive" and "natural" cigarettes as PREPs and 2 the tendency of respondents to mistakenly report awareness as a result of confusion between PREPs brands and similarly named familiar products, for example, Eclipse chewing gum and Accord automobiles. Conclusion After evaluating new measures with cognitive interviews, we conclude that as of winter 2006, awareness of reduced exposure products among U.S. smokers was likely to be between 1% and 8%, with the higher estimates for some products occurring in test markets. Recommended measurement strategies for future surveys are presented.

Surveillance indicators for potential reduced exposure products (PREPs): developing survey items to measure awareness

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Bogen, Karen; Biener, Lois; Garrett, Catherine A; Allen, Jane; Cummings, K Michael; Hartman, Anne; Marcus, Stephen; McNeill, Ann; O'Connor, Richard J; Parascandola, Mark; Pederson, Linda

2009-01-01

Background Over the past decade, tobacco companies have introduced cigarettes and smokeless tobacco products (known as Potential Reduced Exposure Products, PREPs) with purportedly lower levels of some toxins than conventional cigarettes and smokeless products. It is essential that public health agencies monitor awareness, interest, use, and perceptions of these products so that their impact on population health can be detected at the earliest stages. Methods This paper reviews and critiques existing strategies for measuring awareness of PREPs from 16 published and unpublished studies. From these measures, we developed new surveillance items and subjected them to two rounds of cognitive testing, a common and accepted method for evaluating questionnaire wording. Results Our review suggests that high levels of awareness of PREPs reported in some studies are likely to be inaccurate. Two likely sources of inaccuracy in awareness measures were identified: 1) the tendency of respondents to misclassify "no additive" and "natural" cigarettes as PREPs and 2) the tendency of respondents to mistakenly report awareness as a result of confusion between PREPs brands and similarly named familiar products, for example, Eclipse chewing gum and Accord automobiles. Conclusion After evaluating new measures with cognitive interviews, we conclude that as of winter 2006, awareness of reduced exposure products among U.S. smokers was likely to be between 1% and 8%, with the higher estimates for some products occurring in test markets. Recommended measurement strategies for future surveys are presented. PMID:19840394

Awareness and Willingness to Use Pre-exposure Prophylaxis (PrEP) Among Men Who Have Sex with Men and Transgender Women in Brazil.

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Hoagland, Brenda; De Boni, Raquel B; Moreira, Ronaldo I; Madruga, José Valdez; Kallas, Esper G; Goulart, Silvia Pereira; Cerqueira, Natalia; Torres, Thiago S; Luz, Paula M; Fernandes, Nilo Martinez; Liu, Albert Y; Grinsztejn, Beatriz; Veloso, Valdilea G

2017-05-01

Antiretroviral pre-exposure prophylaxis (PrEP) is recommended to prevent HIV infection among high-risk men who have sex with men (MSM) though not available in Brazil where the HIV epidemic persists unabated in this group. This cross-sectional study describes PrEP awareness and willingness and associated factors among MSM and transvestite/transgender women (trans women) pre-screened for the PrEP Brasil study. Awareness was reported by 61.3 % of the participants and was associated with age, education, site, study period and prior HIV testing. Most participants (82.1 %) were willing to use PrEP, which was associated with site, study period, number of male condomless anal sexual partners and anal sex with HIV positive/unknown partners. PrEP information is need among young and less educated individuals. Willingness to use PrEP was high and future studies should be conducted to confirm PrEP acceptability and the characteristics of the population who chose to adopt this intervention.

75 FR 13292 - Determination That HalfLytely and Bisacodyl Tablets Bowel Prep Kit (Containing 4 Bisacodyl...

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2010-03-19

... determined that HALFLYTELY AND BISACODYL TABLETS BOWEL PREP KIT (polyethylene glycol (PEG) 3350, sodium... kits containing PEG-3350, sodium chloride, sodium bicarbonate, and potassium chloride for oral solution... whether HALFLYTELY AND BISACODYL TABLETS BOWEL PREP KIT (PEG-3350, sodium chloride, sodium bicarbonate...

Pre-Exposure Prophylaxis (PrEP) Use and Condomless Anal Sex: Evidence of Risk Compensation in a Cohort of Young Men Who Have Sex with Men.

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Newcomb, Michael E; Moran, Kevin; Feinstein, Brian A; Forscher, Emily; Mustanski, Brian

2018-04-01

Young men who have sex with men (YMSM) are disproportionately impacted by HIV. Pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV acquisition. It remains unclear if PrEP use increases rates of condomless sex (ie, risk compensation), which may increase risk of infection if PrEP adherence is not optimal. This study aimed to examine whether PrEP use and PrEP adherence were associated with change in sexual risk behaviors in a large longitudinal cohort of YMSM reporting on multiple sexual partnerships over time. Data were obtained from the first 3 visits of an ongoing cohort study of YMSM in Chicago (analytic N = 953; 14.1% HIV-positive at baseline). Participants reported up to 4 sexual partnerships at each visit, including sexual behavior, PrEP use, and PrEP adherence within partnerships. YMSM reported higher rates of receptive condomless anal sex (CAS) in partnerships during which they were on PrEP compared with those when they were not on PrEP. This association was consistent across both HIV-negative and HIV-positive participants reporting on partnerships with both perceived HIV-negative/unknown and HIV-positive partners. The rate of receptive CAS was higher in PrEP nonadherent partnerships compared with non-PrEP partnerships. The rate of receptive CAS was also higher in PrEP nonadherent than adherent partnerships, but this was not statistically significant. These analyses provide compelling data suggesting that YMSM are engaging in risk compensation when on PrEP. If rates of receptive CAS are highest among YMSM who are PrEP nonadherent, PrEP as a prevention strategy could fail to curb HIV incidence among YMSM.

Exploring strategies for PrEP adherence and dosing preferences in the context of sexualized recreational drug use among MSM: a qualitative study.

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Closson, Elizabeth F; Mitty, Jennifer A; Malone, Jowanna; Mayer, Kenneth H; Mimiaga, Matthew J

2018-02-01

The use of recreational drugs while having sex is associated with increased HIV incidence among men who have sex with men (MSM). Taking a daily antiretroviral pill, or pre-exposure prophylaxis (PrEP) is a biomedical intervention to prevent HIV. However, the efficacy of PrEP is closely tied with high levels of adherence. While PrEP has the potential to reduce HIV acquisition, the use of recreational drugs may impede adherence. We explored perceptions of PrEP utilization and regimen preferences among 40 HIV-negative, MSM who reported concurrent recreational drug use and condomless anal sex with a man. Semi-structured qualitative interviews were conducted and the data were analyzed using a qualitative descriptive approach. Participants perceived that it would be challenging to take PrEP while high on crystal meth, crack, powder cocaine, ecstasy and/or GHB. However, men identified strategies for using PrEP when they were not high on these drugs, including taking the pill when they started their day and integrating PrEP into an established routine, such as when taking other medications or preparing for sex. PrEP regimen preferences seemed to be shaped by the frequency in which participants used drugs and their ability to plan for sex. Taking PrEP everyday was appealing for those who regularly engaged in sexualized recreational drug use. Accounts depict these sexual interactions as frequent but unpredictable. A daily regimen would allow them to be prepared for sex without having to plan. An event-driven regimen was acceptable to men who occasionally used recreational drugs in the context of sex. For this group, sex usually occurred was generally prearranged. Patterns of sex and recreational drug use figured largely into participants' framings of how they would use PrEP. These behaviors will likely play a role in the uptake of and adherence to PrEP among this population.

Pre-exposure Prophylaxis (PrEP) Use, Seroadaptation, and Sexual Behavior Among Men Who Have Sex with Men, San Francisco, 2004-2014.

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Chen, Yea-Hung; Snowden, Jonathan M; McFarland, Willi; Raymond, H Fisher

2016-12-01

The Food and Drug Administration approved pre-exposure prophylaxis (PrEP) to prevent HIV infection, and the Centers for Disease Control and Prevention has presented PrEP as a prevention option for groups at high risk such as men who have sex with men (MSM). Intervention data provide some information on how PrEP affects sexual behavior of MSM in trials, open label extensions, or clinics. However, it is unclear whether sexual risk and preventive behavioral patterns are changing in the population as a whole as PrEP becomes more widely available, whether due to PrEP use or other factors. We examined trends in PrEP use, numbers of condomless anal sex partners, consistent condom use, and seroadaptive strategies in San Francisco-a city which has actively promoted PrEP-using data from National HIV Behavioral Surveillance (NHBS). NHBS recruited 1211, 383, 373, and 268 HIV-negative MSM in 2004, 2008, 2011, and 2014, respectively. PrEP use increased from zero in 2004, 2008, and 2011 to 9.6 % in 2014. The proportion of men with no condomless anal sex partners dropped from 60.6 % in 2004, to 58.2 % in 2008, to 54.2 % in 2011, to 40.2 % in 2014. Consistent condom use decreased from 36.8 % in 2004, and 30.5 % in 2008 and 2011, to 18.3 % in 2014. PrEP's introduction and scale-up enters in a pre-existing trend of decreasing condom use and increasing sexually transmitted infections among MSM which may be accelerating in recent years. While PrEP use should be scaled up as a prevention option among those who would benefit most, we believe that public health officials need to be realistic about the possibility that condom use could very well continue to decline as PrEP use increases, and to an extent that may not be directly or indirectly offset by PrEP.

Oral Pre-Exposure Prophylaxis (PrEP) for Prevention of HIV in Serodiscordant Heterosexual Couples in the United States: Opportunities and Challenges

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Myers, Julie E.; Kurth, Ann E.; Cohen, Stephanie E.; Mannheimer, Sharon B.; Simmons, Janie; Pouget, Enrique R.; Trabold, Nicole; Haberer, Jessica E.

2014-01-01

Abstract Oral HIV pre-exposure prophylaxis (PrEP) is a promising new biomedical prevention approach in which HIV-negative individuals are provided with daily oral antiretroviral medication for the primary prevention of HIV-1. Several clinical trials have demonstrated efficacy of oral PrEP for HIV prevention among groups at high risk for HIV, with adherence closely associated with level of risk reduction. In the United States (US), three groups have been prioritized for initial implementation of PrEP—injection drug users, men who have sex with men at substantial risk for HIV, and HIV-negative partners within serodiscordant heterosexual couples. Numerous demonstration projects involving PrEP implementation among MSM are underway, but relatively little research has been devoted to study PrEP implementation in HIV-serodiscordant heterosexual couples in the US. Such couples face a unique set of challenges to PrEP implementation at the individual, couple, and provider level with regard to PrEP uptake and maintenance, adherence, safety and toxicity, clinical monitoring, and sexual risk behavior. Oral PrEP also provides new opportunities for serodiscordant couples and healthcare providers for primary prevention and reproductive health. This article provides a review of the critical issues, challenges, and opportunities involved in the implementation of oral PrEP among HIV-serodiscordant heterosexual couples in the US. PMID:25045996

A qualitative study of provider thoughts on implementing pre-exposure prophylaxis (PrEP in clinical settings to prevent HIV infection.

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Emily A Arnold

Full Text Available A recent clinical trial demonstrated that a daily dose tenofovir disoproxil fumarate and emtricitabrine (TDF-FTC can reduce HIV acquisition among men who have sex with men (MSM and transgender (TG women by 44%, and up to 90% if taken daily. We explored how medical and service providers understand research results and plan to develop clinical protocols to prescribe, support and monitor adherence for patients on PrEP in the United States.Using referrals from our community collaborators and snowball sampling, we recruited 22 healthcare providers in San Francisco, Oakland, and Los Angeles for in-depth interviews from May-December 2011. The providers included primary care physicians seeing high numbers of MSM and TG women, HIV specialists, community health clinic providers, and public health officials. We analyzed interviews thematically to produce recommendations for setting policy around implementing PrEP. Interview topics included: assessing clinician impressions of PrEP and CDC guidance, considerations of cost, office capacity, dosing schedules, and following patients over time.Little or no demand for PrEP from patients was reported at the time of the interviews. Providers did not agree on the most appropriate patients for PrEP and believed that current models of care, which do not involve routine frequent office visits, were not well suited for prescribing PrEP. Providers detailed the need to build capacity and were concerned about monitoring side effects and adherence. PrEP was seen as potentially having impact on the epidemic but providers also noted that community education campaigns needed to be tailored to effectively reach specific vulnerable populations.While PrEP may be a novel and clinically compelling prevention intervention for MSM and TG women, it raises a number of important implementation challenges that would need to be addressed. Nonetheless, most providers expressed optimism that they eventually could prescribe and monitor PrEP

A qualitative study of provider thoughts on implementing pre-exposure prophylaxis (PrEP) in clinical settings to prevent HIV infection.

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Arnold, Emily A; Hazelton, Patrick; Lane, Tim; Christopoulos, Katerina A; Galindo, Gabriel R; Steward, Wayne T; Morin, Stephen F

2012-01-01

A recent clinical trial demonstrated that a daily dose tenofovir disoproxil fumarate and emtricitabrine (TDF-FTC) can reduce HIV acquisition among men who have sex with men (MSM) and transgender (TG) women by 44%, and up to 90% if taken daily. We explored how medical and service providers understand research results and plan to develop clinical protocols to prescribe, support and monitor adherence for patients on PrEP in the United States. Using referrals from our community collaborators and snowball sampling, we recruited 22 healthcare providers in San Francisco, Oakland, and Los Angeles for in-depth interviews from May-December 2011. The providers included primary care physicians seeing high numbers of MSM and TG women, HIV specialists, community health clinic providers, and public health officials. We analyzed interviews thematically to produce recommendations for setting policy around implementing PrEP. Interview topics included: assessing clinician impressions of PrEP and CDC guidance, considerations of cost, office capacity, dosing schedules, and following patients over time. Little or no demand for PrEP from patients was reported at the time of the interviews. Providers did not agree on the most appropriate patients for PrEP and believed that current models of care, which do not involve routine frequent office visits, were not well suited for prescribing PrEP. Providers detailed the need to build capacity and were concerned about monitoring side effects and adherence. PrEP was seen as potentially having impact on the epidemic but providers also noted that community education campaigns needed to be tailored to effectively reach specific vulnerable populations. While PrEP may be a novel and clinically compelling prevention intervention for MSM and TG women, it raises a number of important implementation challenges that would need to be addressed. Nonetheless, most providers expressed optimism that they eventually could prescribe and monitor PrEP in their

Acceptability of HIV Pre-Exposure Prophylaxis (PrEP) and Implementation Challenges Among Men Who Have Sex with Men in India: A Qualitative Investigation.

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Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali; Mengle, Shruta; Varghese, Jarvis; Nelson, Ruban; Bharat, Shalini

2015-10-01

This qualitative study explored the acceptability of HIV pre-exposure prophylaxis (PrEP) among MSM in India, and identified facilitators and barriers to future PrEP uptake. In 2014, we conducted 10 focus groups (n=61) among a purposive sample of diverse MSM recruited through community-based organizations in Chennai and Mumbai, and 10 key informant interviews with community leaders and health care providers. Participants' mean age was 26.1 years (SD 4.8); 62% completed secondary education, and 42% engaged in sex work. No focus group participants had heard of PrEP, but once explained, most reported they would likely use it. PrEP was alternately perceived as a 'back-up plan', a condom substitute, or a burden with concurrent condom use. Facilitators were potential for covert use, sex without condoms, and anxiety-less sex. Potential barriers emerged around stigma associated with PrEP use, fear of disclosures to one's family, wife, or male steady partner, and being labeled as HIV-positive or promiscuous by peers. Preferences emerged for intermittent rather than daily PrEP use, injectable PrEP, and free or subsidized access through community organizations or government hospitals. Key informants expressed additional concerns about risk compensation, non-adherence, and impact on ART availability for treatment. Demonstration projects are needed in India to support PrEP implementation tailored for at-risk MSM. Educational interventions for MSM should address concerns about PrEP effectiveness, side effects, and mitigate risk compensation. Community engagement may facilitate broad acceptability and challenge stigma around PrEP use. Importantly, provision of free or subsidized PrEP is necessary to making implementation feasible among low socioeconomic status MSM in India.

The Clock Is Ticking: Library Orientation as Puzzle Room

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Reade, Tripp

2017-01-01

Tripp Reade is the school librarian at Cardinal Gibbons High School in Raleigh, North Carolina. This article describes how he redesigned his school's library orientation program after learning about escape rooms and a variant known as puzzle rooms. Puzzle rooms present players with a set of challenges to solve; they require "teamwork,…

Sex, PrEP, and Stigma: Experiences with HIV Pre-exposure Prophylaxis Among New York City MSM Participating in the HPTN 067/ADAPT Study.

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Franks, Julie; Hirsch-Moverman, Yael; Loquere, Avelino S; Amico, K Rivet; Grant, Robert M; Dye, Bonnie J; Rivera, Yan; Gamboa, Robert; Mannheimer, Sharon B

2018-04-01

The HPTN 067/Alternative Dosing to Augment Pre-Exposure Prophylaxis Pill Taking (ADAPT) study evaluated daily and non-daily dosing schedules for oral pre-exposure prophylaxis (PrEP) to prevent HIV. A qualitative sub-study including focus groups and in-depth interviews was conducted among men who have sex with men participating in New York City to understand their experience with PrEP and study dosing schedules. The 37 sub-study participants were 68% black, 11% white, and 8% Asian; 27% were of Hispanic/Latino ethnicity. Mean age was 34 years. Themes resulting from qualitative analysis include: PrEP is a significant advance for HIV prevention; non-daily dosing of PrEP is congruent with HIV risk; and pervasive stigma connected to HIV and risk behavior is a barrier to PrEP adherence, especially for non-daily dosing schedules. The findings underscore how PrEP intersects with other HIV prevention practices and highlight the need to understand and address multidimensional stigma related to PrEP use.

Preferences for Injectable PrEP Among Young U.S. Cisgender Men and Transgender Women and Men Who Have Sex with Men.

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Biello, Katie B; Hosek, Sybil; Drucker, Morgan T; Belzer, Marvin; Mimiaga, Matthew J; Marrow, Elliot; Coffey-Esquivel, Julia; Brothers, Jennifer; Mayer, Kenneth H

2017-09-19

Young men who have sex with men account for approximately 20% of incident HIV infections in the U.S. Antiretroviral pre-exposure prophylaxis (PrEP) administered as a daily pill has been shown to decrease HIV acquisition in at-risk individuals. New modalities for PrEP are being developed and tested, including injectable PrEP; however, acceptability of these emerging modalities has not yet been examined in youth. We conducted six focus groups with 36 young men and transgender men and women who have sex with men in Boston, Chicago, and Los Angeles in 2016 to assess interest in and preference for different PrEP modalities. Youth were purposively recruited based on diversity of age, race/ethnicity, and prior PrEP experience. Data were coded using content coding based on key domains of the interview guide, in particular around the central themes of interest in and barriers and facilitators to injectable PrEP use. Participants were knowledgeable about oral PrEP but suggested barriers to broader uptake, including stigma, marginalization, and access to information. While participants were split on preference for injectable versus oral PrEP, they agreed quarterly injections may be more manageable and better for those who have adherence difficulties and for those who engage in sex more frequently. Concerns specific to injectable PrEP included: severity/duration of side effects, pain, level of protection prior to next injection, distrust of medical system and injections, and cost. Understanding barriers to and preferences for diverse prevention modalities will allow for more HIV prevention options, improved products, and better interventions, thus allowing individuals to make informed HIV prevention choices.

Comparing the impact of increasing condom use or HIV pre-exposure prophylaxis (PrEP use among female sex workers

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Zindoga Mukandavire

2016-03-01

Full Text Available In many settings, interventions targeting female sex workers (FSWs could significantly reduce the overall transmission of HIV. To understand the role HIV pre-exposure prophylaxis (PrEP could play in controlling HIV transmission amongst FSWs, it is important to understand how its impact compares with scaling-up condom use—one of the proven HIV prevention strategies for FSWs. It is important to remember that condoms also have other benefits such as reducing the incidence of sexually transmitted infections and preventing pregnancy. A dynamic deterministic model of HIV transmission amongst FSWs, their clients and other male partners (termed ‘pimps’ was used to compare the protection provided by PrEP for HIV-negative FSWs with FSWs increasing their condom use with clients and/or pimps. For different HIV prevalence scenarios, levels of pimp interaction, and baseline condom use, we estimated the coverage of PrEP that gives the same reduction in endemic FSW HIV prevalence or HIV infections averted as different increases in condom use. To achieve the same impact on FSW HIV prevalence as increasing condom use by 1%, the coverage of PrEP has to increase by >2%. The relative impact of PrEP increases for scenarios where pimps contribute to HIV transmission, but not greatly, and decreases with higher baseline condom use. In terms of HIV infections averted over 10 years, the relative impact of PrEP compared to condoms was reduced, with a >3% increase in PrEP coverage achieving the same impact as a 1% increase in condom use. Condom promotion interventions should remain the mainstay HIV prevention strategy for FSWs, with PrEP only being implemented once condom interventions have been maximised or to fill prevention gaps where condoms cannot be used.

Perceived Advantages and Disadvantages of Using Pre-Exposure Prophylaxis (PrEP) among Sexually Active Black Women

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Bond, Keosha T.; Gunn, Alana J.

2017-01-01

Knowledge of pre-exposure prophylaxis (PrEP) continues to remain scarce among Black women who are disproportionally affected by HIV in the United States. A thematic analysis of open-ended questions from a sample of Black women (n=119) who completed a mix-methods, online, e-health study was conducted to examine the perceived advantages and disadvantages of using PrEP. Being a female controlled method, empowerment, option for women with risky sex partners, and serodiscordant couples were advantages described. Disadvantages of PrEP were identified as the complexity of the choice, encouragement of sex with risky partners, increased burden, promotion of unprotected sex, and newness of the drug. PMID:28725660

Distinguishing hypothetical willingness from behavioral intentions to initiate HIV pre-exposure prophylaxis (PrEP): Findings from a large cohort of gay and bisexual men in the U.S.

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Rendina, H Jonathon; Whitfield, Thomas H F; Grov, Christian; Starks, Tyrel J; Parsons, Jeffrey T

2017-01-01

Much of the data on the acceptability of HIV Pre-Exposure Prophylaxis (PrEP) is based on willingness to take PrEP (i.e., hypothetical receptivity) rather than actual intentions (i.e., planned behavioral action) to do so. We sought to examine differences between hypothetical willingness and behavioral intentions to begin PrEP in a national sample of gay and bisexual men (GBM) across the U.S. We utilized data collected in 2015 to examine differences between those Unwilling (42.6% n = 375), Willing but not intending (41.4%, n = 365), and willing and Intending to take PrEP (15.9%, n = 140) in a multivariable, multinomial logistic regression. Men with less education had higher odds of Intending to take PrEP. Compared to men unsure about PrEP's efficacy, those who believed PrEP was at least 90% efficacious had higher odds of Intending to take PrEP. Those who saw themselves as appropriate candidates for PrEP had higher odds of Intending to take PrEP while those who saw themselves as inappropriate candidates for PrEP had lower odds of Intending to take PrEP in comparison to men unsure if they were appropriate candidates. Increased motivation for condom non-use because of perceived sexual pressure by partners was associated with higher odds of Intending to take PrEP. The groups did not differ by risk behavior nor recent STI diagnosis. Overall, the distinction between willingness and intentions to take PrEP was meaningful and may help explain disparities between PrEP acceptability and uptake. While much of the literature has focused on hypothetical willingness to take PrEP, these results highlight the importance of simultaneously assessing willingness and intentions when examining correspondence with uptake and developing interventions to increase PrEP uptake. Copyright © 2016 Elsevier Ltd. All rights reserved.

[PrEP Forum: an on-line debate on pre-exposure prophylaxis in Brazil].

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Queiroz, Artur Acelino Francisco Luz Nunes; Sousa, Alvaro Francisco Lopes de

2017-11-21

This study aimed to identify health-promoting contents focused on HIV/Aids prevention in messages posted in a Facebook group for debates on the use of pre-exposure prophylaxis (PrEP). This was a prospective observational study using systematic non-participant observation. From July 2015 to June 2016, all the posts in the group were catalogued and formed a corpus. Everything was processed in IRaMuTeQ and analyzed by descending hierarchical classification. The collected data were grouped in three classes: (1) HIV/Aids prevention: discussing prophylaxis, treatment, target public, and side effects; (2) universal access to PrEP in Brazil: discussing government responsibilities; (3) on-line purchase of truvada: exposing a situation of vulnerability. The findings call attention to a potential public health problem and provide backing for understanding facilitators and barriers to the use of PrEP in Brazil through the identification of health-promoting content linked to individual, social, and institutional markers.

How Much Do We Know about Drug Resistance Due to PrEP Use? Analysis of Experts' Opinion and Its Influence on the Projected Public Health Impact.

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Dobromir T Dimitrov

Full Text Available Randomized controlled trials reported that pre-exposure prophylaxis (PrEP with tenofovir and emtricitabine rarely selects for drug resistance. However, drug resistance due to PrEP is not completely understood. In daily practice, PrEP will not be used under the well-controlled conditions available in the trials, suggesting that widespread use of PrEP can result in increased drug resistance.We surveyed expert virologists with questions about biological assumptions regarding drug resistance due to PrEP use. The influence of these assumptions on the prevalence of drug resistance and the fraction of HIV transmitted resistance was studied with a mathematical model. For comparability, 50% PrEP-coverage of and 90% per-act efficacy of PrEP in preventing HIV acquisition are assumed in all simulations.Virologists disagreed on the following: the time until resistance emergence (range: 20-180 days in infected PrEP users with breakthrough HIV infections; the efficacy of PrEP against drug-resistant HIV (25%-90%; and the likelihood of resistance acquisition upon transmission (10%-75%. These differences translate into projections of 0.6%- 1% and 3.5%-6% infected individuals with detectable resistance 10 years after introducing PrEP, assuming 100% and 50% adherence, respectively. The rate of resistance emergence following breakthrough HIV infection and the rate of resistance reversion after PrEP use is discontinued, were the factors identified as most influential on the expected resistance associated with PrEP. Importantly, 17-23% infected individuals could virologically fail treatment as a result of past PrEP use or transmitted resistance to PrEP with moderate adherence.There is no broad consensus on quantification of key biological processes that underpin the emergence of PrEP-associated drug resistance. Despite this, the contribution of PrEP use to the prevalence of the detectable drug resistance is expected to be small. However, individuals who become

Does Pre-exposure prophylaxis (PrEP) for HIV prevention in men who have sex with men (MSM) change risk behavior? A systematic review.

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Freeborn, Kellie; Portillo, Carmen J

2017-08-03

Pre-exposure prophylaxis (PrEP) for HIV has been available since 2012. Even so, PrEP has not been widely accepted among healthcare providers and MSM some of whom are convinced that PrEP decreases condom use, and increases sexually transmitted infections (STIs). A systematic review of the state of the evidence regarding the association of PrEP with condom use, STI incidence and change in sexual risk behaviors in MSM. A structured search of databases resulted in 142 potential citations, but only ten publications met inclusion criteria and underwent data abstraction and critical appraisal. An adapted Cochrane Collaboration domain based assessment tool was used to critically appraise the methodological components of each quantitative study, and the Mixed Methods Appraisal Tool (MMAT) was used to critically appraise qualitative and mixed-methods studies. Condom use in MSM utilizing PrEP is influenced by multiple factors. Studies indicate rates of STIs in treatment and placebo groups were high. PrEP did not significantly change STI rates between baseline and follow-up. Reporting of sexual risk improved when questionnaires were completed in private by clients. Our review found that PrEP may provide an opportunity for MSM to access sexual health care, testing, treatment and counselling services. We did not find any conclusive evidence that PrEP users increase sexual risk behaviors. The perception among healthcare providers that PrEP leads to increased sexual risk behaviors has yet to be confirmed. In order to provide effective sexual health services, clinicians need to be knowledgeable about PrEP as an HIV prevention tool. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

'WTF is PrEP?': attitudes towards pre-exposure prophylaxis among men who have sex with men and transgender women in New York City.

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Thomann, Matthew; Grosso, Ashley; Zapata, Richard; Chiasson, Mary Ann

2017-10-06

In the USA, gay and other men who have sex with men and transgender women are disproportionately affected by HIV. Uptake of pre-exposure prophylaxis (PrEP), anti-retroviral therapy to prevent HIV-negative individuals from seroconverting if exposed to HIV, by members of this population remains low, particularly among African-Americans. We conducted two focus groups to assess responses to an online social media campaign focusing on PrEP use in New York City. We designed, produced and disseminated the campaign to address knowledge of PrEP; its physical and psychological side effects; and psychosocial barriers related to PrEP adherence and sex shaming. Focus group participants demonstrated a relatively high knowledge of PrEP, although considerable concern remained about side effects, particularly among Black participants. Participants suggested that stigma against PrEP users was declining as PrEP use became more common, but stigma remained, particularly for those not using condoms. Many focus group participants reported distrust of medical providers and were critical of the commodification of HIV prevention by the pharmaceutical industry. Participants reported that those in romantic relationships confronted unique issues regarding PrEP, namely suspicions of infidelity. Finally, Black participants spoke of the need for more tailored and sensitive representations of Black gay men in future programmes and interventions.

Transitioning to HIV Pre-Exposure Prophylaxis (PrEP) from Non-Occupational Post-Exposure Prophylaxis (nPEP) in a Comprehensive HIV Prevention Clinic: A Prospective Cohort Study.

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Siemieniuk, Reed A C; Sivachandran, Nirojini; Murphy, Pauline; Sharp, Andrea; Walach, Christine; Placido, Tania; Bogoch, Isaac I

2015-08-01

The uptake of pre-exposure prophylaxis (PrEP) for HIV prevention remains low. We hypothesized that a high proportion of patients presenting for HIV non-occupational post-exposure prophylaxis (nPEP) would be candidates for PrEP based on current CDC guidelines. Outcomes from a comprehensive HIV Prevention Clinic are described. We evaluated all patients who attended the HIV Prevention Clinic for nPEP between January 1, 2013 and September 30, 2014. Each patient was evaluated for PrEP candidacy based on current CDC-guidelines and subjectively based on physician opinion. Patients were then evaluated for initiation of PrEP if they met guideline suggestions. Demographic, social, and behavioral factors were then analyzed with logistic regression for associations with PrEP candidacy and initiation. 99 individuals who attended the nPEP clinic were evaluated for PrEP. The average age was 32 years (range, 18-62), 83 (84%) were male, of whom 46 (55%) men who had have sex with men (MSM). 31 (31%) met CDC guidelines for PrEP initiation, which had very good agreement with physician recommendation (kappa=0.88, 0.78-0.98). Factors associated with PrEP candidacy included sexual exposure to HIV, prior nPEP use, and lack of drug insurance (p<0.05 for all comparisons). Combining nPEP and PrEP services in a dedicated clinic can lead to identification of PrEP candidates and may facilitate PrEP uptake. Strategies to ensure equitable access of PrEP should be explored such that those without drug coverage may also benefit from this effective HIV prevention modality.

PreP+07: improvements of a user friendly tool to preprocess and analyse microarray data

Directory of Open Access Journals (Sweden)

Claros M Gonzalo

2009-01-01

Full Text Available Abstract Background Nowadays, microarray gene expression analysis is a widely used technology that scientists handle but whose final interpretation usually requires the participation of a specialist. The need for this participation is due to the requirement of some background in statistics that most users lack or have a very vague notion of. Moreover, programming skills could also be essential to analyse these data. An interactive, easy to use application seems therefore necessary to help researchers to extract full information from data and analyse them in a simple, powerful and confident way. Results PreP+07 is a standalone Windows XP application that presents a friendly interface for spot filtration, inter- and intra-slide normalization, duplicate resolution, dye-swapping, error removal and statistical analyses. Additionally, it contains two unique implementation of the procedures – double scan and Supervised Lowess-, a complete set of graphical representations – MA plot, RG plot, QQ plot, PP plot, PN plot – and can deal with many data formats, such as tabulated text, GenePix GPR and ArrayPRO. PreP+07 performance has been compared with the equivalent functions in Bioconductor using a tomato chip with 13056 spots. The number of differentially expressed genes considering p-values coming from the PreP+07 and Bioconductor Limma packages were statistically identical when the data set was only normalized; however, a slight variability was appreciated when the data was both normalized and scaled. Conclusion PreP+07 implementation provides a high degree of freedom in selecting and organizing a small set of widely used data processing protocols, and can handle many data formats. Its reliability has been proven so that a laboratory researcher can afford a statistical pre-processing of his/her microarray results and obtain a list of differentially expressed genes using PreP+07 without any programming skills. All of this gives support to scientists

"I Did Not Want to Give Birth to a Child Who has HIV": Experiences Using PrEP During Pregnancy Among HIV-Uninfected Kenyan Women in HIV-Serodiscordant Couples.

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Pintye, Jillian; Beima-Sofie, Kristin M; Kimemia, Grace; Ngure, Kenneth; Trinidad, Susan Brown; Heffron, Renee A; Baeten, Jared M; Odoyo, Josephine; Mugo, Nelly; Bukusi, Elizabeth A; Kelley, Maureen C; John-Stewart, Grace C

2017-11-01

The perceptions, motivations, and beliefs of HIV-uninfected women about pre-exposure prophylaxis (PrEP) use during pregnancy can influence its uptake and adherence. This study elicited the views of HIV-uninfected women with personal experience taking PrEP during pregnancy. Qualitative interviews were conducted with HIV-uninfected women who had personal experience taking PrEP while pregnant. Semistructured interviews were conducted with 21 HIV-uninfected Kenyan women in HIV-serodiscordant couples enrolled in an open-label PrEP demonstration project who became pregnant while using PrEP and continued PrEP through their pregnancy. Interviews were audio-recorded and transcribed into English. A qualitative descriptive analysis was performed, using a constant comparison approach to identify key themes related to PrEP use in pregnancy. Desire to remain HIV uninfected and have an HIV-free infant were strong motivators influencing continued use of PrEP during pregnancy. Supporting HIV-infected partners and childbearing within an HIV-serodiscordant relationship were also motivators. Women had challenges distinguishing normal pregnancy symptoms from PrEP side effects and were concerned that observed side effects could be signs of danger for the infant related to PrEP exposure. Health care providers were important conduits of knowledge about PrEP, and continuity of PrEP providers throughout pregnancy facilitated adherence. HIV-uninfected women in HIV-serodiscordant couples were motivated to use PrEP during pregnancy to remain HIV uninfected and to have an HIV-free child but had concerns about side effects. Health care providers will be important for PrEP messaging and adherence support in this unique population.

Principals' Views on the Importance of Numeracy as Children Start Primary School

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Goff, Wendy; Dockett, Sue; Perry, Bob

2013-01-01

This paper addresses data arising from initial discussion with school principals concerning the implementation of a doctoral project at their schools. The doctoral project involved the prep teacher working with the preschool teacher to support children's numeracy practices as they made the transition to school. The findings presented in this paper…

Sexual Behavior, Risk Compensation, and HIV Prevention Strategies Among Participants in the San Francisco PrEP Demonstration Project: A Qualitative Analysis of Counseling Notes.

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Carlo Hojilla, J; Koester, Kimberly A; Cohen, Stephanie E; Buchbinder, Susan; Ladzekpo, Deawodi; Matheson, Tim; Liu, Albert Y

2016-07-01

Pre-exposure prophylaxis (PrEP) is a viable HIV prevention strategy but risk compensation could undermine potential benefits. There are limited data that examine this phenomenon outside of clinical trials. We conducted a qualitative analysis of counseling notes from the San Francisco site of the US PrEP demonstration project to assess how men who have sex with men used PrEP as a prevention strategy and its impact on their sexual practices. Four major themes emerged from our analysis of 130 distinct notes associated with 26 participants. Prevention strategy decision-making was dynamic, often influenced by the context and perceived risk of a sexual encounter. Counselors noted that participants used PrEP in conjunction with other health promotion strategies like condoms, asking about HIV status of their sex partners, and seroadaptation. With few exceptions, existing risk reduction strategies were not abandoned upon initiation of PrEP. Risk-taking behavior was 'seasonal' and fluctuations were influenced by various personal, psychosocial, and health-related factors. PrEP also helped relieve anxiety regarding sex and HIV, particularly among serodiscordant partners. Understanding sexual decision-making and how PrEP is incorporated into existing prevention strategies can help inform future PrEP implementation efforts.

Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships.

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Gamarel, Kristi E; Golub, Sarit A

2015-04-01

In the USA, men who have sex with men (MSM) in primary partnerships are at elevated risk for human immunodeficiency virus (HIV) infection. Pre-exposure prophylaxis (PrEP), a new biomedical prevention strategy, has potential to reduce HIV transmission. This study examined predictors of PrEP adoption intentions among HIV-negative MSM in primary partnerships. The sample included HIV-negative MSM (n = 164) who participated in an ongoing cross-sectional study with an in-person interview examining PrEP adoption intentions. Higher HIV risk perception, intimacy motivations for condomless sex, recent condomless anal sex with outside partners, education, and age were each independently associated with PrEP adoption intentions. In a multivariate model, only age, education, and intimacy motivations for condomless sex were significantly associated with PrEP adoption intentions. Intimacy motivations may play a central role in PrEP adoption for MSM couples. Incorporating relationship dynamics into biomedical strategies is a promising avenue for research and intervention.

Perceptions of pre-exposure prophylaxis (PrEP) among HIV-negative and HIV-positive men who have sex with men.

OpenAIRE

Jaspal, Rusi; Daramilas, C.

2016-01-01

open access article Pre-exposure prophylaxis (PrEP) is a novel bio-medical HIV prevention op- tion for individuals at high risk of HIV exposure. This qualitative interview study ex- plores perceptions and understandings of PrEP among a sample of 20 HIV-negative and HIV-positive men who have sex with men (MSM) in the UK, where there is a debate about the feasibility of o ering PrEP on the NHS. Data were analysed using qualitative thematic analysis and social representations theory from soci...

Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature.

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Koechlin, Florence M; Fonner, Virginia A; Dalglish, Sarah L; O'Reilly, Kevin R; Baggaley, Rachel; Grant, Robert M; Rodolph, Michelle; Hodges-Mameletzis, Ioannis; Kennedy, Caitlin E

2017-05-01

Daily oral pre-exposure prophylaxis (PrEP) is the use of antiretroviral drugs by HIV-negative people to prevent HIV infection. WHO released new guidelines in 2015 recommending PrEP for all populations at substantial risk of HIV infection. To prepare these guidelines, we conducted a systematic review of values and preferences among populations that might benefit from PrEP, women, heterosexual men, young women and adolescent girls, female sex workers, serodiscordant couples, transgender people and people who inject drugs, and among healthcare providers who may prescribe PrEP. A comprehensive search strategy reviewed three electronic databases of articles and HIV-related conference abstracts (January 1990-April 2015). Data abstraction used standardised forms to categorise by population groups and relevant themes. Of 3068 citations screened, 76 peer-reviewed articles and 28 conference abstracts were included. Geographic coverage was global. Most studies (N = 78) evaluated hypothetical use of PrEP, while 26 studies included individuals who actually took PrEP or placebo. Awareness of PrEP was low, but once participants were presented with information about PrEP, the majority said they would consider using it. Concerns about safety, side effects, cost and effectiveness were the most frequently cited barriers to use. There was little indication of risk compensation. Healthcare providers would consider prescribing PrEP, but need more information before doing so. Findings from a rapidly expanding evidence base suggest that the majority of populations most likely to benefit from PrEP feel positively towards it. These same populations would benefit from overcoming current implementation challenges with the shortest possible delay.

Awareness of pre-exposure prophylaxis (PrEP) among women who inject drugs in NYC: the importance of networks and syringe exchange programs for HIV prevention.

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Walters, Suzan M; Reilly, Kathleen H; Neaigus, Alan; Braunstein, Sarah

2017-06-29

Women who inject drugs (WWID) are at heightened risk for HIV due to biological, behavioral, and structural factors. Pre-exposure prophylaxis (PrEP) could aid in HIV prevention for WWID. However, little is known about WWID awareness of PrEP, which is a necessary step that must occur before PrEP uptake. We report factors associated with greater awareness among WWID to identify efficient means of awareness dissemination. Data from the 2015 National HIV Behavioral Surveillance (NHBS) system cycle on injection drug use collected in New York City (NYC) were used. Bivariable analyses, using chi-squared statistics, were conducted to examine correlates of awareness of PrEP with socio-demographic, behavioral, and health care variables. Multivariable logistic regression was used to estimate adjusted associations and determine differences in awareness of PrEP. The analysis consisted of 118 WWID. Awareness of PrEP was relatively low (31%), and risk factors were high. In the last 12 months, almost two thirds (65%) reported condomless sex, approximately one third (31%) reported transactional sex, and one third (32%) reported sharing injection equipment. In multivariable logistic regression, increased PrEP awareness was associated with reported transactional sex (AOR 3.32, 95% CI 1.22-9.00) and having a conversation about HIV prevention at a syringe exchange program (SEP) (AOR 7.61, 95% CI 2.65-21.84). We did not find race, education, household income, age, binge drinking, or sexual identity to be significantly associated with PrEP awareness. Large proportions of WWID were unaware of PrEP. These findings suggest that social networks (specifically sex work and SEP networks) are an efficient means for disseminating messaging about prevention materials such as PrEP. We recommend that SEP access increase, SEP processes be adopted in other health care settings, and WWID networks be utilized to increase PrEP awareness.

Secondhand smoke exposure in cars and rooms: trend comparisons among subpopulations of nonsmoking U.S. middle and high school students.

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McIntire, Russell K; Macy, Jonathan T; Seo, Dong-Chul; Nelson, Ashlyn A; Kolbe, Lloyd J

2014-06-01

Young people in the United States are exposed to secondhand smoke (SHS) primarily in 2 settings: homes and cars. Recently, researchers reported that the prevalence of U.S students exposed to SHS in cars decreased from 2000 to 2009; however, comparisons of trends across school levels, gender, and racial/ethnic groups were not assessed. Moreover, no studies have examined trends of exposure to SHS in rooms. We used data from the 2000, 2002, 2004, 2006, and 2009 waves of the National Youth Tobacco Survey, a nationally representative cross-sectional survey of U.S. middle and high school students. For SHS in cars and rooms, we identified exposure trends among nonsmokers from 2000 to 2009 and compared trends across subpopulations with binary logistic regression. We identified significant downward linear trends in SHS in cars and rooms for nearly all measured subpopulations of nonsmoking students from 2000 to 2009. SHS exposure in cars and rooms declined at a significantly greater rate for males than for females. SHS exposure in cars declined at a significantly greater rate for non-Hispanic (NH) Blacks than for NH Whites. SHS exposure in rooms declined at a significantly greater rate for NH Whites than for Hispanics and Native Hawaiians/Pacific Islanders. Although prevalence of exposure to SHS in cars and rooms among nonsmoking U.S. middle and high school students has declined from 2000 to 2009, the rates of decline were not equal across genders and racial/ethnic groups. Identification of these differing rates of exposure can help the public health community advocate for interventions focused on reducing adolescent SHS exposure.

No association between the PREP gene and lithium responsive bipolar disorder

Directory of Open Access Journals (Sweden)

Grof Paul

2007-02-01

Full Text Available Abstract Background Bipolar disorder (BD is a major psychiatric condition that commonly requires prophylactic and episodic treatment. Lithium (Li has been used for over 40 years now as an effective prophylactic agent. Response to Li treatment seems to be, at least in part, genetically determined. Although we ignore how Li specifically prevents mood episodes, it has previously been suggested that Li exerts an effect on the phosphoinositide pathway, and more recently, it has been proposed that Li may modulate prolyl endopeptidase (PREP. Methods In this study we carried out an association study looking at the PREP gene, located on ch 6q22. Five intronic single nucleotide polymorphisms (SNP, three coding SNPs and one SNP in the 5' UTR were investigated for their frequency in a BD sample of 180 excellent Li responders, 69 Li nonresponders and 126 controls. Genotyping was carried out using the SNaPshot reaction from Applied Biosystems, which is a modified fluorescent single base pair extension procedure. Results Following correction for multiple testing, no significant genotypic, allelic or estimated haplotypic differences were found between responders and nonresponders or between BD patients and controls. Conclusion PREP is an interesting candidate gene to investigate in genetic studies of BD, but our findings do not support the hypothesis that genetic variation in this gene plays a major role in the etiology of BD or Li response.

Effects on Student Achievement in General Chemistry Following Participation in an Online Preparatory Course. ChemPrep, a Voluntary, Self-Paced, Online Introduction to Chemistry

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Botch, Beatrice; Day, Roberta; Vining, William; Stewart, Barbara; Rath, Kenneth; Peterfreund, Alan; Hart, David

2007-03-01

ChemPrep was developed to be a stand-alone preparatory short-course to help students succeed in general chemistry. It is Web-based and delivered using the OWL system. Students reported that the ChemPrep materials (short information pages, parameterized questions with detailed feedback, tutorials, and answers to questions through the OWL message system) permitted them to work independently without the need for textbook or lecture. On average, students who completed ChemPrep had higher grades in the subsequent GenChem, Nursing, and Honors chemistry courses, with a greater percentage achieving a grade of C- or higher. Participation in ChemPrep was voluntary, and more women than men responded. Students in the Honors course enrolled in ChemPrep in higher percentages than students in GenChem and Nursing. SAT and departmental math placement exam scores were used as proxy measures of prior achievement and ability. Based on these, Honors chemistry ChemPrep users were on par with their peers but performed better in the course than non-users. In GenChem and Nursing chemistry courses, ChemPrep helped students of high prior achievement and ability perform better than their achievement scores would predict. Weaker or less motivated students did not respond to the voluntary offerings of ChemPrep in the same numbers as stronger or more motivated students, and we are seeking alternate ways to reach this population.

The transcription factor Prep1 controls hepatic insulin sensitivity and gluconeogenesis by targeting nuclear localization of FOXO1.

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Kulebyakin, Konstantin; Penkov, Dmitry; Blasi, Francesco; Akopyan, Zhanna; Tkachuk, Vsevolod

2016-12-02

Liver plays a key role in controlling body carbohydrate homeostasis by switching between accumulation and production of glucose and this way maintaining constant level of glucose in blood. Increased blood glucose level triggers release of insulin from pancreatic β-cells. Insulin represses hepatic glucose production and increases glucose accumulation. Insulin resistance is the main cause of type 2 diabetes and hyperglycemia. Currently thiazolidinediones (TZDs) targeting transcriptional factor PPARγ are used as insulin sensitizers for treating patients with type 2 diabetes. However, TZDs are reported to be associated with cardiovascular and liver problems and stimulate obesity. Thus, it is necessary to search new approaches to improve insulin sensitivity. A promising candidate is transcriptional factor Prep1, as it was shown earlier it could affect insulin sensitivity in variety of insulin-sensitive tissues. The aim of the present study was to evaluate a possible involvement of transcriptional factor Prep1 in control of hepatic glucose accumulation and production. We created mice with liver-specific Prep1 knockout and discovered that hepatocytes derived from these mice are much more sensitive to insulin, comparing to their WT littermates. Incubation of these cells with 100 nM insulin results in almost complete inhibition of gluconeogenesis, while in WT cells this repression is only partial. However, Prep1 doesn't affect gluconeogenesis in the absence of insulin. Also, we observed that nuclear content of gluconeogenic transcription factor FOXO1 was greatly reduced in Prep1 knockout hepatocytes. These findings suggest that Prep1 may control hepatic insulin sensitivity by targeting FOXO1 nuclear stability. Copyright © 2016 Elsevier Inc. All rights reserved.

Risk Perception, Sexual Behaviors, and PrEP Adherence Among Substance-Using Men Who Have Sex with Men: a Qualitative Study.

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Storholm, Erik D; Volk, Jonathan E; Marcus, Julia L; Silverberg, Michael J; Satre, Derek D

2017-08-01

The antiretroviral drug combination emtricitabine and tenofovir disoproxil fumarate (TDF/FTC) taken as pre-exposure prophylaxis (PrEP) is effective in preventing HIV infection, yet it also requires adherence and potentially decreases condom use. This study sought to examine these issues among a key population at risk of HIV infection, substance-using men who have sex with men (MSM). We conducted semi-structured interviews with an ethnically diverse sample of 30 young (aged 20-35) MSM prescribed PrEP within a large integrated healthcare system in San Francisco, who had reported recent drug use or hazardous drinking and one or more missed doses of PrEP. We explored participants' risk perception and sexual risk behavior, drug and alcohol use, and PrEP adherence in the context of substance use. Interviews were transcribed and coded using a directed content analysis approach to identify key categories and commonalities, and differences across participants. Salient subcategories included positive psychological effects of being on PrEP (e.g., decreased anxiety, feelings of empowerment), social effects (e.g., reduced HIV stigma), and reduction in overall perceptions of HIV risk. While overall reported use of condoms went down and many reported a brief period of increased condomless sex following PrEP initiation, others continued condom use with most of their sexual partners. Contextual factors influencing their decision to engage in condomless sex included how well they knew the partner and whether the partner was on PrEP or HIV antiretroviral treatment. Factors associated with poor adherence included disruptions in daily routine and use of alcohol and methamphetamine. PrEP-prescribing clinicians should support their patients in making informed decisions about condom use and identifying strategies to maximize adherence in the context of substance use.

Success at Scale in Charter Schooling. Education Outlook. No. 3

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Wilson, Steven F.

2009-01-01

KIPP KEY Academy in Washington, D.C. North Star Academy in Newark. Roxbury Prep in Boston. Amistad Academy in New Haven. These, and perhaps two hundred other high-performing schools nationwide, are the bright lights of the charter school movement. Despite social and economic disadvantages, their students not only trounce their district peers on…

Geographic and Individual Associations with PrEP Stigma: Results from the RADAR Cohort of Diverse Young Men Who have Sex with Men and Transgender Women.

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Mustanski, Brian; Ryan, Daniel T; Hayford, Christina; Phillips, Gregory; Newcomb, Michael E; Smith, Justin D

2018-05-22

Increasing the uptake of pre-exposure prophylaxis (PrEP) to prevent HIV acquisition among at-risk populations, such as young men who have sex with men (YMSM), is of vital importance to slowing the HIV epidemic. Stigma and negative injunctive norms, such as the so called "Truvada Whore" phenomenon, hamper this effort. We examined the prevalence and types of PrEP stigma and injunctive norm beliefs among YMSM and transgender women and associated individual and geospatial factors. A newly created measure of PrEP Stigma and Positive Attitudes was administered to 620 participants in an ongoing longitudinal cohort study. Results indicated lower stigma among White, compared to Black and Latino participants, and among participants not identifying as male. Prior knowledge about PrEP was associated with lower stigma and higher positive attitudes. PrEP stigma had significant geospatial clustering and hotspots were identified in neighborhoods with high HIV incidence and concentration of racial minorities, whereas coldspots were identified in areas with high HIV incidence and low LGBT stigma. These results provide important information about PrEP attitudes and how PrEP stigma differs between individuals and across communities.

Perceived Advantages and Disadvantages of Using Pre-Exposure Prophylaxis (PrEP) among Sexually Active Black Women: An Exploratory Study.

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Bond, Keosha T; Gunn, Alana J

2016-01-01

Knowledge of pre-exposure prophylaxis (PrEP) continues to remain scarce among Black women who are disproportionally affected by HIV in the United States. A thematic analysis of open-ended questions from a sample of Black women (n=119) who completed a mix-methods, online, e-health study was conducted to examine the perceived advantages and disadvantages of using PrEP. Being a female controlled method, empowerment, option for women with risky sex partners, and serodiscordant couples were advantages described. Disadvantages of PrEP were identified as the complexity of the choice, encouragement of sex with risky partners, increased burden, promotion of unprotected sex, and newness of the drug.

Fertility Intentions, Pregnancy, and Use of PrEP and ART for Safer Conception Among East African HIV Serodiscordant Couples.

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Heffron, Renee; Thomson, Kerry; Celum, Connie; Haberer, Jessica; Ngure, Kenneth; Mugo, Nelly; Bukusi, Elizabeth; Katabira, Elly; Odoyo, Josephine; Bulya, Nulu; Asiimwe, Stephen; Tindimwebwa, Edna; Baeten, Jared M

2017-09-11

African HIV serodiscordant couples often desire pregnancy, despite sexual HIV transmission risk during pregnancy attempts. Pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) reduce HIV risk and can be leveraged for safer conception but how well these strategies are used for safer conception is not known. We conducted an open-label demonstration project of the integrated delivery of PrEP and ART among 1013 HIV serodiscordant couples from Kenya and Uganda followed quarterly for 2 years. We evaluated fertility intentions, pregnancy incidence, the use of PrEP and ART during peri-conception, and peri-conception HIV incidence. At enrollment, 80% of couples indicated a desire for more children. Pregnancy incidence rates were 18.5 and 18.7 per 100 person years among HIV-uninfected and HIV-infected women, and higher among women who recently reported fertility intention (adjusted odds ratio 3.43, 95% CI 2.38-4.93) in multivariable GEE models. During the 6 months preceding pregnancy, 82.9% of couples used PrEP or ART and there were no HIV seroconversions. In this cohort with high pregnancy rates, integrated PrEP and ART was readily used by HIV serodiscordant couples, including during peri-conception periods. Widespread scale-up of safer conception counseling and services is warranted to respond to strong desires for pregnancy among HIV-affected men and women.

Predictors of Placement in Lower Level versus Higher Level High School Mathematics

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Archbald, Doug; Farley-Ripple, Elizabeth N.

2012-01-01

Educators and researchers have long been interested in determinants of access to honors level and college prep courses in high school. Factors influencing access to upper level mathematics courses are particularly important because of the hierarchical and sequential nature of this subject and because students who finish high school with only lower…

Brief Report: Medication Sharing Is Rare Among African HIV-1 Serodiscordant Couples Enrolled in an Efficacy Trial of Oral Pre-exposure Prophylaxis (PrEP) for HIV-1 Prevention.

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Thomson, Kerry A; Haberer, Jessica E; Marzinke, Mark A; Mujugira, Andrew; Hendrix, Craig W; Celum, Connie; Ndase, Patrick; Ronald, Allan; Bangsberg, David R; Baeten, Jared M

2017-06-01

Sharing of pre-exposure prophylaxis (PrEP) medications is a concern for PrEP implementation. For HIV-1 serodiscordant couples, sharing may undermine the HIV-1 prevention benefit and also cause antiretroviral resistance if taken by HIV-1 infected partners. Within a PrEP efficacy trial among HIV-1 serodiscordant couples, we assessed the occurrence of PrEP sharing by self-report and plasma tenofovir concentrations in HIV-1 infected partners. PrEP sharing was self-reported at <0.01% of visits, and 0%-1.6% of randomly selected and 0% of purposively selected specimens from HIV-1 infected participants had detectable tenofovir concentrations (median: 66.5 ng/mL, range: 1.3-292 ng/mL). PrEP sharing within HIV-1 serodiscordant couples was extremely rare.

Willingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment.

Science.gov (United States)

Shrestha, Roman; Altice, Frederick L; Huedo-Medina, Tania B; Karki, Pramila; Copenhaver, Michael

2017-05-01

Evidence from recent pre-exposure prophylaxis (PrEP) trials has demonstrated its safety and efficacy in significantly reducing the risk of HIV acquisition for those who are at considerable risk of acquiring HIV infection. With a rapid increase in the amount of research on the efficacy of PrEP for HIV prevention, complementary research on the willingness to use PrEP has grown, especially among MSM, but limited research has been focused among people who use drugs (PWUD). As part of the formative process, we utilized the information-motivation-behavioral skills (IMB) model of health behavior change to characterize and guide intervention development for promoting willingness to use PrEP among high-risk PWUD. The analysis included 400 HIV-negative high-risk PWUD enrolled in a community-based methadone maintenance treatment who reported drug- and/or sex-related HIV risk behaviors in the past 6-months. Analyses revealed support for the IMB model as PrEP-related behavioral skills were found to mediate the influence of PrEP-related information and motivation on willingness to use PrEP. The results provide evidence as to the utility of the IMB model to increase willingness to use PrEP among high-risk PWUD. It therefore makes an important contribution to our understanding of the applicability of theoretically-grounded models of willingness to use PrEP among high-risk PWUD, who are one of the key risk populations who could benefit from the use of PrEP.

Expanded HIV pre-exposure prophylaxis (PrEP) implementation in communities in New South Wales, Australia (EPIC-NSW): design of an open label, single arm implementation trial.

Science.gov (United States)

Zablotska, Iryna B; Selvey, Christine; Guy, Rebecca; Price, Karen; Holden, Jo; Schmidt, Heather-Marie; McNulty, Anna; Smith, David; Jin, Fengyi; Amin, Janaki; Cooper, David A; Grulich, Andrew E

2018-02-02

The New South Wales (NSW) HIV Strategy 2016-2020 aims for the virtual elimination of HIV transmission in NSW, Australia, by 2020. Despite high and increasing levels of HIV testing and treatment since 2012, the annual number of HIV diagnoses in NSW has remained generally unchanged. Pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV infection among gay and bisexual men (GBM) when taken appropriately. However, there have been no population-level studies that evaluate the impact of rapid PrEP scale-up in high-risk GBM. Expanded PrEP Implementation in Communities in NSW (EPIC-NSW) is a population-level evaluation of the rapid, targeted roll-out of PrEP to high-risk individuals. EPIC-NSW, is an open-label, single-arm, multi-centre prospective observational study of PrEP implementation and impact. Over 20 public and private clinics across urban and regional areas in NSW have participated in the rapid roll-out of PrEP, supported by strong community mobilization and PrEP promotion. The study began on 1 March 2016, aiming to enroll at least 3700 HIV negative people at high risk of HIV. This estimate took into consideration criteria for PrEP prescription in people at high risk for acquiring HIV as defined in the NSW PrEP guidelines. Study participants receive once daily co-formulated tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) and are followed for up to 24 months. Follow-up includes: testing for HIV at 1 month, HIV and other sexually transmissible infections three-monthly, HCV annually and monitoring of renal function six-monthly. Optional online behavioural surveys are conducted quarterly. The co-primary endpoints are (i) HIV diagnoses and incidence in the cohort and (ii) HIV diagnoses in NSW. EPIC-NSW is a population-based PrEP implementation trial which targets the entire estimated population of GBM at high risk for HIV infection in NSW. It will provide a unique opportunity to evaluate the population impact of PrEP on a concentrated HIV

Role of oral pre-exposure prophylaxis (PrEP) in current and future HIV prevention strategies.

Science.gov (United States)

Burns, David N; Grossman, Cynthia; Turpin, Jim; Elharrar, Vanessa; Veronese, Fulvia

2014-12-01

Treatment as prevention is expected to have a major role in reducing HIV incidence, but other prevention interventions will also be required to bring the epidemic under control, particularly among key populations. One or more forms of pre-exposure prophylaxis (PrEP) will likely play a critical role. Oral PrEP with emtricitabine-tenofovir (Truvada®) is currently available in the US and some other countries, but uptake has been slow. We review the concerns that have contributed to this slow uptake and discuss current and future research in this critical area of HIV prevention research.

What's so Inclusive about an Inclusion Room? Staff Perspectives on Student Participation, Diversity and Equality in an English Secondary School

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Gilmore, Gwen

2012-01-01

This article by Gwen Gilmore, a lecturer in the School of Curriculum and Pedagogy at Massey University, draws on a research project which explored the nature, extent and characteristics of a disciplinary inclusion room (IR) in a secondary school in the south-west of England using a Cultural Historical Activity Theory framework. In five years to…

Use of Pre-exposure Prophylaxis (PrEP) in Young Men Who Have Sex with Men is Associated with Race, Sexual Risk Behavior and Peer Network Size.

Science.gov (United States)

Kuhns, Lisa M; Hotton, Anna L; Schneider, John; Garofalo, Robert; Fujimoto, Kayo

2017-05-01

Pre-exposure prophylaxis (PrEP) is efficacious to prevent HIV infection, however, uptake among young men who have sex with men (YMSM) is relatively low. The purpose of this study was to describe PrEP use and related factors in a representative sample of YMSM in two cities, Chicago and Houston. YMSM, ages 16-29, were recruited via respondent-driven sampling (RDS) from 2014 to 2016. Correlates of PrEP uptake were assessed in weighted multivariable logistic regression models. A total of 12.2% of participants (of 394) reported ever taking PrEP; Black YMSM had the lowest rates of uptake (4.7%) and Whites the highest (29.5%). In a multivariable regression model, having an HIV positive sex partner, reporting recent group sex, peer network size, and city (Chicago) were significantly and positively associated with use of PrEP, while Black race was negatively associated with it. Given evidence of racial/ethnic disparities in PrEP uptake in this study, further research is needed to identify potential mechanisms of action and points of intervention.

Using data from a behavioural survey of men who have sex with men (MSM) to estimate the number likely to present for HIV pre-exposure prophylaxis (PrEP) in Ireland, 2017.

Science.gov (United States)

Nic Lochlainn, Laura; O'Donnell, Kate; Hurley, Caroline; Lyons, Fiona; Igoe, Derval

2017-11-01

In Ireland, men who have sex with men (MSM) have increased HIV risk. Pre-exposure prophylaxis (PrEP), combined with safe sex practices, can reduce HIV acquisition. We estimated MSM numbers likely to present for PrEP by applying French PrEP criteria to Irish MSM behavioural survey data. We adjusted for survey bias, calculated proportions accessing testing services and those likely to take PrEP. We estimated 1-3% of MSM in Ireland were likely to present for PrEP.

The Effect of PrEP on HIV Incidence Among Men Who Have Sex With Men in the Context of Condom Use, Treatment as Prevention, and Seroadaptive Practices.

Science.gov (United States)

LeVasseur, Michael T; Goldstein, Neal D; Tabb, Loni P; Olivieri-Mui, Brianne L; Welles, Seth L

2018-01-01

HIV preexposure prophylaxis (PrEP) is an effective tool in preventing HIV infection among high-risk men who have sex with men (MSM). It is unknown how effective PrEP is in the context of other implemented HIV prevention strategies, including condom use, seroadaption, and treatment as prevention (TasP). We evaluate the impact of increasing uptake of PrEP in conjunction with established prevention strategies on HIV incidence in a high-risk population of MSM through simulation. Agent-based simulation models representing the sexual behavior of high-risk, urban MSM in the United States over the period of 1 year were used to evaluate the effect of PrEP on HIV infection rates. Simulations included data for 10,000 MSM and compared increasing rates of PrEP uptake under 8 prevention paradigms: no additional strategies, TasP, condom use, seroadaptive behavior, and combinations thereof. We observed a mean of 103.2 infections per 10,000 MSM in the absence of any prevention method. PrEP uptake at 25% without any additional prevention strategies prevented 30.7% of infections. In the absence of PrEP, TasP, condom use, and seroadaptive behavior independently prevented 27.1%, 48.8%, and 37.7% of infections, respectively, and together prevented 72.2%. The addition of PrEP to the 3 aforementioned prevention methods, at 25% uptake, prevented an additional 5.0% of infections. To achieve a 25% reduction in HIV infections by 2020, HIV prevention efforts should focus on significantly scaling up access to PrEP in addition to HIV testing, access to antiretroviral therapy, and promoting condom use.

Vulnerable infected populations and street markets for ARVs: Potential implications for PrEP rollout in the USA.

Science.gov (United States)

Kurtz, Steven P; Buttram, Mance E; Surratt, Hilary L

2014-04-01

Widespread diversion of antiretroviral (ARV) medications to illicit markets has recently been documented among indigent patients in South Florida. The recent approval of ARVs for pre-exposure prophylaxis (PrEP) has the potential to broaden these illicit markets, as high-risk individuals seek ARVs without a prescription or medical supervision. Nonadherence among diverters and unsupervised use of ARVs for treatment or PrEP increase risks of treatment failure, drug resistance, and disease transmission. We report the scope of ARV diversion among substance-using men who have sex with men in South Florida. Structured interviews (N = 515) queried demographics, HIV status, mental distress, substance dependence, and sexual risks. HIV-positive participants answered questions about medical care, treatment, and ARV adherence and diversion. Median age was 39. Of 46.4% who were HIV-positive, 79.1% were prescribed ARVs. Of these, 27% reported selling/trading ARVs. Reasons for diversion were sharing/trading with friends, sale/trade for money/drugs, and sale/trade of unused medications. ARV diverters, compared to nondiverters, were more likely to be substance dependent (74.5% vs. 58.7%, p = 0.046) and have traded sex for money/drugs (60.8% vs. 32.6%, p increased risks of treatment failure, disease transmission, and PrEP failure should be carefully considered in developing policy and behavioral supports to scaling up treatment as prevention and PrEP.

Physics escape room as an educational tool

Science.gov (United States)

Vörös, Alpár István Vita; Sárközi, Zsuzsa

2017-12-01

Escape rooms have flourished in the last decade. These are adventure games in which players work together to solve puzzles using hints, clues and a strategy to escape from a locked room. In many cases they use different phenomena related to physics. Hence the idea of using escape rooms in science centers or even in classroom activities. Escape rooms are designed for one single team of players, the method is more suitable for activities in a science centre. In our paper, we show that escape rooms' puzzle solving methods could be used in physics classroom activities as well, taking into account that several teams have to work together in the same room/place. We have developed an educational escape game for physics of fluids, as this topic is left out from the Romanian high-school curriculum. We have tried out our game during the project week called "Şcoala altfel" ("school in a different way") and in a physics camp for gifted students. We present the designed physics escape game and the results.

Blackstone Valley Prep Mayoral Academy: BVP High School

Science.gov (United States)

EDUCAUSE, 2015

2015-01-01

This Rhode Island charter high school serves an intentionally diverse population of students from two urban and two suburban communities. The blended learning model is tailored by grade level and emphasizes differentiation, deeper learning in a community, and assessment. The two-page grantee profiles from Next Generation Learning Challenges (NGLC)…

Barriers to uptake and use of pre-exposure prophylaxis (PrEP) among communities most affected by HIV in the UK: findings from a qualitative study in Scotland.

Science.gov (United States)

Young, Ingrid; Flowers, Paul; McDaid, Lisa M

2014-11-20

To explore the acceptability of pre-exposure prophylaxis (PrEP) among gay, bisexual and men who have sex with men (MSM) and migrant African communities in Scotland, UK. Consecutive mixed qualitative methods consisting of focus groups (FGs) and in-depth interviews (IDIs) explored PrEP acceptability. Data were digitally recorded, transcribed and analysed thematically to identify anticipated and emerging themes. Participants were recruited through community sexual health and outreach support services, and from non-sexual health settings across Scotland. Inclusion criteria included identification as either MSM and/or from migrant African communities; 18 years and older; living in Scotland at the time of participation. 7 FGs were conducted (n=33): 5 with MSM (n=22) and 2 mixed-sex groups with African participants (n=11, women=8), aged 18-75 years. 34 IDIs were conducted with MSM (n=20) and African participants (n=14, women=10), aged 19-60 years. The sample included participants who were HIV-positive and HIV-negative or untested (HIV-positive FG participants, n=22; HIV-positive IDI participants, n=17). Understandings of PrEP effectiveness and concerns about maintaining regular adherence were identified as barriers to potential PrEP uptake and use. Low perception of HIV risk due to existing risk management strategies meant few participants saw themselves as PrEP candidates. Participants identified risk of other sexually transmitted infections and pregnancy as a concern which PrEP did not address for either themselves or their sexual partners. PrEP emerged as a contentious issue because of the potentially negative implications it had for HIV prevention. Many participants viewed PrEP as problematic because they perceived that others would stop using condoms if PrEP was to become available. PrEP implementation needs to identify appropriate communication methods in the context of diverse HIV literacy; address risk-reduction concerns and; demonstrate how PrEP can be part of a

Significance of atypical squamous cells of undetermined significance on ThinPrep papanicolaou smears.

Science.gov (United States)

Eltabbakh, G H; Lipman, J N; Mount, S L; Morgan, A

2000-10-01

The aim of this study was to assess the prevalence and risk factors predictive of dysplasia among women seen in a gynecologic oncology service with the cytologic diagnosis of atypical squamous cells of undetermined significance (ASCUS) on Papanicolaou smears obtained by the ThinPrep method. Patients with ASCUS ThinPrep Papanicolaou smears seen at the Division of Gynecologic Oncology, University of Vermont, between 1997 and 1999 were identified. The cytologic smears were reviewed and subtyped into reactive or suggestive of squamous intraepithelial lesion (SIL). The charts of these patients were reviewed and the following information was abstracted: age, gravidity, parity, menopausal status, use of hormonal replacement therapy, smoking, history of pelvic cancer, history of radiation therapy, history of abnormal Papanicolaou smear and its treatment, history of human papillomavirus (HPV) infection, and follow-up information including results of repeat Papanicolaou smears, colposcopy, and biopsies. The prevalence of dysplasia was calculated. The demographic features of women with ASCUS, reactive, were compared with those with ASCUS, SIL, using a two-sample t test, chi(2), and Fisher's exact test. Risk factors predictive of dysplasia were calculated using the odds ratio and the 95% confidence interval. P ASCUS on ThinPrep Papanicolaou smear were identified; 63 patients had ASCUS, reactive, and 63 patients had ASCUS, SIL. The demographic features of both groups were similar. The overall prevalence of dysplasia was 15.9% and was significantly higher among women with ASCUS, SIL, than among women with ASCUS, reactive (25.4% versus 6.4%, P = 0.003). The type of ASCUS cytology (reactive versus SIL), smoking, and history of HPV were significant risk factors for dysplasia (P = 0.003, 0.037, and 0. 042, respectively). The prevalence of dysplasia among women seen in a gynecologic oncology service with ASCUS cytology on ThinPrep Papanicolaou smears is 15.9%. Women with ASCUS favor

Willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia: findings from a qualitative study.

Science.gov (United States)

Bourne, Adam; Cassolato, Matteo; Thuan Wei, Clayton Koh; Wang, Bangyuan; Pang, Joselyn; Lim, Sin How; Azwa, Iskandar; Yee, Ilias; Mburu, Gitau

2017-08-02

Men who have sex with men (MSM) continue to be disproportionately affected by HIV in Malaysia. Recent success has been observed within demonstration projects examining the efficacy of HIV pre-exposure prophylaxis (PrEP), an antiretroviral -based medication taken by HIV-negative men to prevent sero-conversion. In order for such promising findings to be translated in real-world settings, it is important to understand the acceptability of PrEP, including perceived barriers to access or uptake. As part of a larger mixed-methods study exploring acceptability and willingness to use PrEP among MSM in Malaysia, 19 men took part in audio-recorded focus group discussions hosted by a community-based HIV organization and facilitated by a trained researcher. Discussions focussed on awareness and potential information management, general perceptions of PrEP and potential motivations or barriers to the use of PrEP, including those at the personal, social, health system or structural level. Data were transcribed verbatim and underwent a detailed thematic analysis. Rather than perceiving PrEP as a replacement for condoms in terms of having safer sex, many participants viewed it as an additional layer protection, serving as a crucial barrier to infection on occasions where condom use was intended, but did not occur. It was also perceived as more valuable to "at-risk" men, such as those in HIV sero-discordant relationships or those with a higher number of sexual partners. Elements of discussion tended to suggest that some men taking PrEP may be subject to stigma from others, on the assumption they may be promiscuous or engage in high-risk sexual behaviours. This qualitative study indicates that, broadly speaking, PrEP may be acceptable to MSM in Malaysia. However, in order for its potential to be realized, and uptake achieved, educative interventions are required to inform the target population as to the efficacy and potential, positive impact of PrEP. Given concerns for how those

Prioritizing Risk in Preparation for a Demonstration Project: A Mixed Methods Feasibility Study of Oral Pre-Exposure Prophylaxis (PREP) among Female Sex Workers in South India.

Science.gov (United States)

Reza-Paul, Sushena; Lazarus, Lisa; Doshi, Monika; Hafeez Ur Rahman, Syed; Ramaiah, Manjula; Maiya, Raviprakash; Ms, Venugopal; Venukumar, K T; Sundararaman, Sundar; Becker, Marissa; Moses, Stephen; Lorway, Robert

2016-01-01

HIV prevalence among female sex workers (FSWs) in India remains well above the national average. Pre-exposure prophylaxis (PrEP), a new HIV prevention technology, may help to reduce HIV incidence, but there is a dearth of research that can inform the potential scale-up of PrEP in India. In partnership with Ashodaya Samithi, a local sex worker collective, we conducted a feasibility study to assess acceptance of a planned PrEP demonstration project, willingness to use PrEP, and recommendations for project roll-out among FSWs in southern Karnataka. From January-April 2015, 6 focus group discussions, 47 in-depth interviews, and 427 interviewer-administered questionnaires were completed by female sex workers. All participants were 18 years of age or older and practiced sex work. Qualitative data were coded for key themes and emergent categories. Univariate descriptive analysis was employed to summarise the quantitative data. Qualitative. PrEP was described as an exciting new prevention technology that places control in the hands of FSWs and provides a "double safety" in combination with condom use. Participants expressed agreement that women who may experience more HIV risk in their occupational environments should be prioritized for enrollment into a demonstration project. Quantitative. 406 participants (95%) expressed interest in PrEP. Participants prioritized the inclusion of FSWs under the age of 25 (79%), those who do not use condoms when clients offer more money (58%), who do not consistently use condoms with regular partners (57%), who drink alcohol regularly (49%), and who do not use condoms consistently with clients (48%). This feasibility study indicated strong interest in PrEP and a desire to move forward with the demonstration project. Participants expressed their responses in terms of public health discourses surrounding risk, pointing to the importance of situating PrEP scale up within the trusted spaces of community-based organizations as a means of

Prioritizing Risk in Preparation for a Demonstration Project: A Mixed Methods Feasibility Study of Oral Pre-Exposure Prophylaxis (PREP among Female Sex Workers in South India.

Directory of Open Access Journals (Sweden)

Sushena Reza-Paul

Full Text Available HIV prevalence among female sex workers (FSWs in India remains well above the national average. Pre-exposure prophylaxis (PrEP, a new HIV prevention technology, may help to reduce HIV incidence, but there is a dearth of research that can inform the potential scale-up of PrEP in India. In partnership with Ashodaya Samithi, a local sex worker collective, we conducted a feasibility study to assess acceptance of a planned PrEP demonstration project, willingness to use PrEP, and recommendations for project roll-out among FSWs in southern Karnataka.From January-April 2015, 6 focus group discussions, 47 in-depth interviews, and 427 interviewer-administered questionnaires were completed by female sex workers. All participants were 18 years of age or older and practiced sex work. Qualitative data were coded for key themes and emergent categories. Univariate descriptive analysis was employed to summarise the quantitative data.Qualitative. PrEP was described as an exciting new prevention technology that places control in the hands of FSWs and provides a "double safety" in combination with condom use. Participants expressed agreement that women who may experience more HIV risk in their occupational environments should be prioritized for enrollment into a demonstration project. Quantitative. 406 participants (95% expressed interest in PrEP. Participants prioritized the inclusion of FSWs under the age of 25 (79%, those who do not use condoms when clients offer more money (58%, who do not consistently use condoms with regular partners (57%, who drink alcohol regularly (49%, and who do not use condoms consistently with clients (48%.This feasibility study indicated strong interest in PrEP and a desire to move forward with the demonstration project. Participants expressed their responses in terms of public health discourses surrounding risk, pointing to the importance of situating PrEP scale up within the trusted spaces of community-based organizations as a means

The PREP Pipeline: Standardized preprocessing for large-scale EEG analysis

Directory of Open Access Journals (Sweden)

Nima eBigdelys Shamlo

2015-06-01

Full Text Available The technology to collect brain imaging and physiological measures has become portable and ubiquitous, opening the possibility of large-scale analysis of real-world human imaging. By its nature, such data is large and complex, making automated processing essential. This paper shows how lack of attention to the very early stages of an EEG preprocessing pipeline can reduce the signal-to-noise ratio and introduce unwanted artifacts into the data, particularly for computations done in single precision. We demonstrate that ordinary average referencing improves the signal-to-noise ratio, but that noisy channels can contaminate the results. We also show that identification of noisy channels depends on the reference and examine the complex interaction of filtering, noisy channel identification, and referencing. We introduce a multi-stage robust referencing scheme to deal with the noisy channel-reference interaction. We propose a standardized early-stage EEG processing pipeline (PREP and discuss the application of the pipeline to more than 600 EEG datasets. The pipeline includes an automatically generated report for each dataset processed. Users can download the PREP pipeline as a freely available MATLAB library from http://eegstudy.org/prepcode/.

The PREP pipeline: standardized preprocessing for large-scale EEG analysis.

Science.gov (United States)

Bigdely-Shamlo, Nima; Mullen, Tim; Kothe, Christian; Su, Kyung-Min; Robbins, Kay A

2015-01-01

The technology to collect brain imaging and physiological measures has become portable and ubiquitous, opening the possibility of large-scale analysis of real-world human imaging. By its nature, such data is large and complex, making automated processing essential. This paper shows how lack of attention to the very early stages of an EEG preprocessing pipeline can reduce the signal-to-noise ratio and introduce unwanted artifacts into the data, particularly for computations done in single precision. We demonstrate that ordinary average referencing improves the signal-to-noise ratio, but that noisy channels can contaminate the results. We also show that identification of noisy channels depends on the reference and examine the complex interaction of filtering, noisy channel identification, and referencing. We introduce a multi-stage robust referencing scheme to deal with the noisy channel-reference interaction. We propose a standardized early-stage EEG processing pipeline (PREP) and discuss the application of the pipeline to more than 600 EEG datasets. The pipeline includes an automatically generated report for each dataset processed. Users can download the PREP pipeline as a freely available MATLAB library from http://eegstudy.org/prepcode.

Evaluation of three-dimensional gadolinium-enhanced MR angiography using the timing monitoring function of contrast material (Smart Prep technique)

International Nuclear Information System (INIS)

Tsuchihashi, Toshio; Sasaki, Sadayuki; Yoshizawa, Satoshi; Maki, Toshio; Kitagawa, Matsuo; Suzuki, Takeshi

1998-01-01

The Smart Prep technique for gadolinium-enhanced three-dimensional MR angiography (3D-MRA) was evaluated in clinical practice. By monitoring signal intensity in the region of interest (tracking volume) in the target vessel, start timing after contrast injection can be optimized using the Smart Prep technique. Successful triggering was obtained in the chest, abdomen, and pelvic areas in about 80% of the cases in this study. Failures with this technique were mainly due to changes in tracking volume caused by patient motion and respiration. We noted that the scan started earlier than expected in the thoracic aorta when part of the heart or pulmonary artery was included in the tracking volume. Thus, care must be taken in defining the size and location of the tracking volume in gadolinium-enhanced 3D-MRA using the Smart Prep technique. (author)

A Multi-US City Assessment of Awareness and Uptake of Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Black Men and Transgender Women Who Have Sex with Men.

Science.gov (United States)

Eaton, Lisa A; Matthews, Derrick D; Driffin, Daniel D; Bukowski, Leigh; Wilson, Patrick A; Stall, Ron D

2017-07-01

The HIV epidemic among Black men and transgender women who have sex with men (BMTW) demands an urgent public health response. HIV point prevalence among this population ranges from 25 to 43%-a rate far exceeding any other group. Pre-exposure prophylaxis (PrEP) for HIV prevention is a very promising prevention tool; however, its full potential to slow the epidemic has yet to be realized. For the current study, random time-location sampling at Black Gay Pride Events was used to collect data from N = 1274 BMTW, from five US cities, reporting HIV-negative/unknown status. In-field HIV testing was also provided to participants. Participants were assessed on awareness and use of PrEP, health care factors, HIV testing history, psychosocial variables, and sex behaviors. About one third of participants were aware of PrEP (39%), and a small percentage of participants were users of PrEP (4.6%). In multivariable analyses, being in a relationship, testing for HIV in the past 6 months, and others being aware of one's sexuality were positively associated with PrEP awareness. Higher levels of internalized homophobia and greater numbers of female sex partners were positively associated with PrEP use, while education and condom use were negatively associated. Based on study findings, messaging and uptake of PrEP needs greater expansion and requires novel approaches for scale-up. Improving linkage to HIV testing services is likely critical for engaging BMTW with PrEP. The potential for PrEP to slow the HIV epidemic is high; however, we must strengthen efforts to ensure universal availability and uptake.

A comparison of temporal Facebook networks of young men who have sex with men (MSM), differentiated by awareness and use of preexposure prophylaxis (PrEP)

Science.gov (United States)

Khanna, Aditya S.; Schumm, Phil; Schneider, John A.

2016-01-01

Young Black men who have sex with men (YBMSM) are the only population in the U.S. who have experienced rising HIV incidence over the past decade. Consistent preexposure prophylaxis (PrEP) use can substantially reduce the risk of HIV acquisition. What differentiates those who become aware of PrEP, and those who do not, remains largely unknown. The social networks of YBMSM can impact their awareness of PrEP; to examine this impact, we used two waves of Facebook data from the “uConnect” study – a longitudinal cohort study of YBMSM in Chicago (n=266). While PrEP awareness increased from 45% at baseline to 75% at follow-up, its use remained low (4% and 6%). There were 88 PrEP-unaware individuals at baseline who became aware (BA) by follow-up, and 56 who remained persistently unaware (PU). While the PUs had a higher median number of total Facebook friends, the BAs had a higher median numbers of friends who participated in uConnect, who were PrEP-aware, and who practiced behaviors previously found to be associated with individual-level awareness of PrEP at baseline. The BAs also had substantially more “influential” friends. These findings demonstrate the potential of social networks in raising PrEP awareness and use among YBMSM. PMID:28003117

Pre-exposure prophylaxis (PrEP) for men who have sex with men in Europe: review of evidence for a much needed prevention tool.

Science.gov (United States)

Reyniers, Thijs; Hoornenborg, Elske; Vuylsteke, Bea; Wouters, Kristien; Laga, Marie

2017-08-01

In many Western countries with good coverage of antiretroviral treatment (ART) programmes the annual number of HIV infections is still high and not (yet) declining among men who have sex with men (MSM). This might indicate that antiretroviral treatment roll-out alone will not turn around the course of the epidemic and that new, additional tools are needed. Antiretrovirals used as prevention tools for people not yet infected with HIV, such as pre-exposure prophylaxis (PrEP) could be such important additional tools. PrEP is a new type of biomedical prevention, which involves the use of antiretrovirals before, during and after (periods of) sexual exposure to HIV. In this review, we will focus on PrEP as a new prevention tool for MSM at high risk in Europe, including its evidence for effectiveness, challenges for implementation, ongoing European demonstration studies; as well as how PrEP relates to other existing prevention tools. In light of European Medicines Agency's recent recommendation for approval of PrEP we briefly review the potential implications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Creating an Arms Race? Examining School Costs and Motivations for Providing NAPLEX and PCOA Preparation.

Science.gov (United States)

Lebovitz, Lisa; Shuford, Veronica P; DiVall, Margarita V; Daugherty, Kimberly K; Rudolph, Michael J

2017-09-01

Objective. To examine the extent of financial and faculty resources dedicated to preparing students for NAPLEX and PCOA examinations, and how these investments compare with NAPLEX pass rates. Methods. A 23-item survey was administered to assessment professionals in U.S. colleges and schools of pharmacy (C/SOPs). Institutions were compared by type, age, and student cohort size. Institutional differences were explored according to the costs and types of NAPLEX and PCOA preparation provided, if any, and mean NAPLEX pass rates. Results. Of 134 C/SOPs that received the survey invitation, 91 responded. Nearly 80% of these respondents reported providing some form of NAPLEX preparation. Significantly higher 2015 mean NAPLEX pass rates were found in public institutions, schools that do not provide NAPLEX prep, and schools spending less than $10,000 annually on NAPLEX prep. Only 18 schools reported providing PCOA preparation. Conclusion. Investment in NAPLEX and PCOA preparation resources vary widely across C/SOPs but may increase in the next few years, due to dropping NAPLEX pass rates and depending upon how PCOA data are used.

Could FDA approval of pre-exposure prophylaxis make a difference? A qualitative study of PrEP acceptability and FDA perceptions among men who have sex with men.

Science.gov (United States)

Underhill, Kristen; Morrow, Kathleen M; Operario, Don; Mayer, Kenneth H

2014-02-01

The FDA has approved tenofovir-emtricitabine for use as HIV pre-exposure prophylaxis, but it is unknown how approval may affect PrEP acceptability among US men who have sex with men. We conducted 8 focus groups among 38 Rhode Island MSM, including 3 groups among 16 male sex workers and 5 groups among 22 men in the general MSM community. Participants reported wide-ranging beliefs regarding consequences and meanings of FDA approval. Some participants would not use PrEP without approval, while others perceived approval as irrelevant or less significant than other sources of information. Our results suggest that FDA approval sends a signal that directly shapes PrEP acceptability among some MSM, while indirect influences of approval may affect uptake by others. Efforts to educate MSM about PrEP can increase acceptability by incorporating information about FDA approval, and outreach strategies should consider how this information may factor into personal decisions about PrEP use.

Room for both qualification and inclusion?

DEFF Research Database (Denmark)

Ringskou, Lea Thomsen; Gravesen, David Thore

2017-01-01

Our research project concerns the work of leisure time pedagogues in the Danish primary school, more precisely the rooms and roles they practice in and construct. A reform in 2014 invited the pedagogues into a series of new activities and curriculum based school activities. Activities dominated...

PREP-PWR-1.0: a WIMS-D/4 pre-processor code for the generation of data for PWR fuel assemblies

International Nuclear Information System (INIS)

Ball, G.

1991-06-01

The PREP-PWR-1.0 computer code is a substantially modified version of the PREWIM code which formed part of the original MARIA System (Report J.E.N. 543). PREP-PWR-1.0 is a comprehensive pre-processor code which generates input data for the WIMS-D/4.1 code (Report PEL 294) for PWR fuel assemblies, with or without control and burnable poison rods. This data is generated at various base and off-base conditions. The overall cross section generation methodology is described, followed by a brief overview of the model. Aspects of the base/off-base calculational scheme are outlined. Additional features of the code are described while the input data format of PREP-PWR-1.0 is listed. The sample problems and suggestions for further improvements to the code are also described. 2 figs., 2 tabs., 12 refs

PrEP Chicago: A randomized controlled peer change agent intervention to promote the adoption of pre-exposure prophylaxis for HIV prevention among young Black men who have sex with men.

Science.gov (United States)

Young, Lindsay E; Schumm, Phil; Alon, Leigh; Bouris, Alida; Ferreira, Matthew; Hill, Brandon; Khanna, Aditya S; Valente, Thomas W; Schneider, John A

2018-02-01

Advances in biomedical prevention strategies such as pre-exposure prophylaxis (PrEP) represent a new opportunity for reducing HIV incidence among young Black men who have sex with men, for whom the number of new HIV infections continues to rise. However, studies have documented low rates of PrEP uptake in this community. Research suggests that the peer networks of young Black men who have sex with men play important roles in their sexual health decisions. PrEP Chicago is a randomized controlled trial network intervention designed to increase PrEP uptake among young Black men who have sex with men living in Chicago. The aims of this study are twofold. Aim 1 is to estimate the effectiveness of a peer change agent intervention for (1) increasing the number of referrals made to a PrEP information line, (2) increasing the rate of PrEP adoption among non-participant peers, and (3) increasing PrEP knowledge, attitudes, and intentions among participants. Aim 2 is to determine the individual and network variables that explain peer change agent effectiveness. PrEP Chicago is a social network intervention that utilizes the influence of peer change agents to link young Black men who have sex with men in Chicago to PrEP. Young Black men who have sex with men were recruited using respondent-driven sampling. Once screened for eligibility, participants were randomly assigned to either one of two treatment sequences: (1) intervention treatment in Year 1 followed by a minimal contact attention control in Year 2 or (2) the minimal contact attention control in Year 1 followed by treatment in Year 2. The treatment consists of a PrEP/peer change agent training workshop followed by booster calls for 12 months. The attention control consists of a sex diary activity designed to help participants assess sexual risk. Psychosocial, sexual health, and network data are collected from all participants at baseline and at 12- and 24-month follow-ups. In total, 423 participants aged 18-35 have

Comparison of Plasmagel with LeucoPREP-Macrodex methods for separation of leukocytes for virus isolation.

Science.gov (United States)

Woods, G L; Proffitt, M R

1987-10-01

Plasmagel (Cellular Products, Inc., Buffalo, NY), which can separate both polymorphonuclear leukocytes (PMN) and mononuclear cells from other blood components, and LeucoPREP (Becton Dickinson Immunocytometry Systems, Mountain View, CA), which can separate mononuclear cells from other blood components, were used to harvest leukocytes from whole blood for the purpose of virus isolation. Macrodex was combined with the later, in a second step, for recovery of PMN. Of 90 peripheral blood specimens examined, cytomegalovirus was recovered from 10: in six by both methods, in three from Plasmagel prepared cells only, and in one from cells from the LeucoPREP-Macrodex preparation only. Total leukocyte counts, differential counts, and leukocyte viability did not differ significantly for the two methods. Plasmagel provided an efficient, inexpensive means of harvesting leukocytes from whole blood for virus isolation.

Partner Disclosure of PrEP Use and Undetectable Viral Load on Geosocial Networking Apps: Frequency of Disclosure and Decisions About Condomless Sex.

Science.gov (United States)

Newcomb, Michael E; Mongrella, Melissa C; Weis, Benjamin; McMillen, Samuel J; Mustanski, Brian

2016-02-01

Recent advances in biomedical prevention strategies, including pre-exposure prophylaxis (PrEP) and achieving an undetectable viral load (UVL) among HIV-infected persons, show promise in curbing the rising incidence of HIV among men who have sex with men (MSM) in the United States. This mixed-methods study aimed to investigate the frequency with which MSM encounter potential sex partners on geosocial networking apps who disclose biomedical prevention use, and how MSM make decisions about condom use after these disclosures. Participants were recruited through advertisements placed on a large geosocial networking app for MSM. A total of 668 and 727 participants, respectively, responded to questionnaires assessing partner disclosure of PrEP use and UVL. Each questionnaire included an open-ended item assessing reasons for condomless anal sex (CAS) with partners using biomedical prevention. Across both surveys, most respondents encountered potential sex partners who disclosed PrEP use or UVL, and the majority of those who met up with these partners engaged in CAS at least once. Qualitative analyses found that most participants who reported CAS did so after making a calculated risk about HIV transmission. We also describe a novel risk reduction strategy, "biomed-matching," or having CAS only when both individuals use PrEP or have UVL. We report serostatus differences in both quantitative and qualitative findings. Disclosure of PrEP use and UVL is not uncommon among MSM. Many MSM make accurate appraisals of the risks of CAS with biomedical prevention, and mobile apps may aid with disclosing biomedical prevention use.

NPT: the issues facing the Geneva PrepCom

International Nuclear Information System (INIS)

Hautecouverture, Benjamin

2013-04-01

The second session of the Preparatory Committee (PrepCom) for the 2015 Review Conference of the Parties to the Treaty on the Non- Proliferation of Nuclear Weapons (NPT) will meet from 22 April-3 May 2013 in Geneva, and will be chaired by Ambassador Cornel Feruta of Romania. Three years on from the adoption by consensus at the end of the 8. NPT Review Conference in New York of an Action Plan on non-proliferation, disarmament, and peaceful uses of nuclear energy - the three pillars of the NPT - as well as the Middle East, this session provides the opportunity both to take stock of the commitments undertaken in 2010 and to prepare the ground for the 2015 meeting. It is first worth noting that the beginning of the 9. five-year NPT review cycle in Vienna last year was marked by tangible optimism and revealed a constructive mindset on the part of the 110 delegations present. This was largely to be expected as a result of the success of the 2010 Review Conference. The two final PrepComs of 2010 cycle (Geneva in 2008 and New York in 2009) were also deemed a success by the delegations present, characterised by the rich and constructive nature of the discussion. Overall, the tension that marred the 2005 cycle has eased over the last few years. Yet, this positive development is sadly insufficient to ensure that the Treaty remains topical. Regarding the commitments undertaken in 2010 under the Action Plan, it is well known that it was impossible for the States concerned to come together in 2012 at a conference on establishment of a weapon-of-mass-destruction-free zone (WMDFZ) in the Middle East (chapter 4, 'The Middle East, particularly implementation of the 1995 Resolution on the Middle East'). Nevertheless, in accordance with the Action Plan, H.E. Mr Jaakko Laajava was appointed as the facilitator, Finland was named as the host country, and a rigorous consultative process is underway. Moreover, the EU has maintained its commitment to support this process by

PREP KITT, System Reliability by Fault Tree Analysis. PREP, Min Path Set and Min Cut Set for Fault Tree Analysis, Monte-Carlo Method. KITT, Component and System Reliability Information from Kinetic Fault Tree Theory

International Nuclear Information System (INIS)

Vesely, W.E.; Narum, R.E.

1997-01-01

1 - Description of problem or function: The PREP/KITT computer program package obtains system reliability information from a system fault tree. The PREP program finds the minimal cut sets and/or the minimal path sets of the system fault tree. (A minimal cut set is a smallest set of components such that if all the components are simultaneously failed the system is failed. A minimal path set is a smallest set of components such that if all of the components are simultaneously functioning the system is functioning.) The KITT programs determine reliability information for the components of each minimal cut or path set, for each minimal cut or path set, and for the system. Exact, time-dependent reliability information is determined for each component and for each minimal cut set or path set. For the system, reliability results are obtained by upper bound approximations or by a bracketing procedure in which various upper and lower bounds may be obtained as close to one another as desired. The KITT programs can handle independent components which are non-repairable or which have a constant repair time. Any assortment of non-repairable components and components having constant repair times can be considered. Any inhibit conditions having constant probabilities of occurrence can be handled. The failure intensity of each component is assumed to be constant with respect to time. The KITT2 program can also handle components which during different time intervals, called phases, may have different reliability properties. 2 - Method of solution: The PREP program obtains minimal cut sets by either direct deterministic testing or by an efficient Monte Carlo algorithm. The minimal path sets are obtained using the Monte Carlo algorithm. The reliability information is obtained by the KITT programs from numerical solution of the simple integral balance equations of kinetic tree theory. 3 - Restrictions on the complexity of the problem: The PREP program will obtain the minimal cut and

Prenatal to Preschool: An Integrated Approach to School Readiness for Native Hawaiian Children.

Science.gov (United States)

Herman, Hannah; And Others

This report outlines the Pre-kindergarten Educational Program (PREP) of Kamehameha Schools Bishop Estate in Hawaii, an integrated early education program serving families with children from the prenatal stage through age 5. The paper first discusses the program's three components and how they adapt to developmental changes in children and…

Including an Exam P/1 Prep Course in a Growing Actuarial Science Program

Science.gov (United States)

Wakefield, Thomas P.

2014-01-01

The purpose of this article is to describe the actuarial science program at our university and the development of a course to enhance students' problem solving skills while preparing them for Exam P/1 of the Society of Actuaries (SOA) and the Casualty Actuary Society (CAS). The Exam P/1 prep course, formally titled Mathematical Foundations of…

Evaluation of a new preparative supercritical fluid chromatography system for compound library purification: the TharSFC SFC-MS Prep-100 system.

Science.gov (United States)

Ebinger, Katalin; Weller, Harold N; Kiplinger, Jeffrey; Lefebvre, Paul

2011-06-01

Preparative HPLC-MS is often the method of choice for purification of small amounts (libraries for drug discovery. The method is robust, well proven, and widely applicable. In contrast, preparative supercritical fluid chromatography coupled with mass spectrometry (SFC-MS) has seen only slow acceptance for the same application--despite some potential scientific and economic advantages. One of the reasons for slow adoption of SFC-MS is the lack of well-proven, robust, and commercially available instrumentation. In early 2009, TharSFC (a Waters Company, Pittsburgh, PA) introduced a new fully integrated system for preparative SFC-MS: The SFC-MS Prep-100. We report herein an objective evaluation of the SFC-MS Prep-100, including tests for pump and autosampler performance, sample recovery, sample carryover, fraction triggering, detector/fraction collector synchronization, and overall robustness. Our results suggest that the SFC-MS Prep-100 represents a significant advance over previous generation instrumentation. Copyright © 2011 Society for Laboratory Automation and Screening. Published by Elsevier Inc. All rights reserved.

The Use of Online Posts to Identify Barriers to and Facilitators of HIV Pre-exposure Prophylaxis (PrEP) Among Men Who Have Sex with Men: A Comparison to a Systematic Review of the Peer-Reviewed Literature.

Science.gov (United States)

Hannaford, Alisse; Lipshie-Williams, Madeleine; Starrels, Joanna L; Arnsten, Julia H; Rizzuto, Jessica; Cohen, Phillip; Jacobs, Damon; Patel, Viraj V

2018-04-01

Pre-exposure prophylaxis (PrEP) remains an under-utilized HIV prevention tool among men who have sex with men (MSM). To more comprehensively elucidate barriers and facilitators to PrEP use among US MSM, we conducted a systematic review of peer-reviewed published articles and content analysis of online posts about PrEP. We searched peer-reviewed databases (Medline, Web of Science, Google Scholar) using MESH headings and keywords about PrEP and/or HIV prevention from 2005 to 2015. We included original studies among MSM in the US that reported on barriers, facilitators, or other factors related to PrEP use. We also searched online posts and associated comments (news articles, opinion pieces, blogs and other social media posts) in diverse venues (Facebook, Slate Outward, Huffington Post Gay Voices, Queerty, and My PrEP Experience blog) to identify posts about PrEP. We used content analysis to identify themes and compare potential differences between the peer-reviewed literature and online posts. We identified 25 peer-reviewed articles and 28 online posts meeting inclusion criteria. We identified 48 unique barriers and 46 facilitators to using PrEP. These 94 themes fit into six overarching categories: (1) access (n = 14), (2) attitudes/beliefs (n = 24), (3) attributes of PrEP (n = 13), (4) behaviors (n = 11), (5) sociodemographic characteristics (n = 8), and (6) social network (n = 6). In all categories, analysis of online posts resulted in identification of a greater number of unique themes. Thirty-eight themes were identified in the online posts that were not identified in the peer-reviewed literature. We identified barriers and facilitators to PrEP in online posts that were not identified in a systematic review of the peer-reviewed literature. By incorporating data both from a systematic review of peer-reviewed articles and from online posts, we have identified salient and novel information about barriers to and facilitators of PrEP use. Traditional

The Safety of Tenofovir-Emtricitabine for HIV Pre-Exposure Prophylaxis (PrEP) in Individuals With Active Hepatitis B.

Science.gov (United States)

Solomon, Marc M; Schechter, Mauro; Liu, Albert Y; McMahan, Vanessa M; Guanira, Juan V; Hance, Robert J; Chariyalertsak, Suwat; Mayer, Kenneth H; Grant, Robert M

2016-03-01

Pre-exposure prophylaxis (PrEP) with daily oral emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) prevents HIV infection. The safety and feasibility of HIV PrEP in the setting of hepatitis B virus (HBV) infection were evaluated. The Iniciativa Profilaxis Pre-Exposición study randomized 2499 HIV-negative men and transgender women who have sex with men to once-daily oral FTC/TDF versus placebo. Hepatitis serologies and transaminases were obtained at screening and at the time PrEP was discontinued. HBV DNA was assessed by polymerase chain reaction, and drug resistance was assessed by population sequencing. Vaccination was offered to individuals susceptible to HBV infection. Of the 2499 participants, 12 (0.5%; including 6 randomized to FTC/TDF) had chronic HBV infection. After stopping FTC/TDF, 5 of the 6 participants in the active arm had liver function tests performed at follow-up. Liver function tests remained within normal limits at post-stop visits except for a grade 1 elevation in 1 participant at post-stop week 12 (alanine aminotransferase = 90, aspartate aminotransferase = 61). There was no evidence of hepatic flares. Polymerase chain reaction of stored samples showed that 2 participants in the active arm had evidence of acute HBV infection at enrollment. Both had evidence of grade 4 transaminase elevations with subsequent resolution. Overall, there was no evidence of TDF or FTC resistance among tested genotypes. Of 1633 eligible for vaccination, 1587 (97.2%) received at least 1 vaccine; 1383 (84.7%) completed the series. PrEP can be safely provided to individuals with HBV infection if there is no evidence of cirrhosis or substantial transaminase elevation. HBV vaccination rates at screening were low globally, despite recommendations for its use, yet uptake and efficacy were high when offered.

The Safety of Tenofovir–Emtricitabine for HIV Pre-Exposure Prophylaxis (PrEP) in Individuals With Active Hepatitis B

Science.gov (United States)

Schechter, Mauro; Liu, Albert Y.; McManhan, Vanessa M.; Guanira, Juan V.; Hance, Robert J.; Chariyalertsak, Suwat; Mayer, Kenneth H.; Grant, Robert M.

2016-01-01

Background: Pre-exposure prophylaxis (PrEP) with daily oral emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) prevents HIV infection. The safety and feasibility of HIV PrEP in the setting of hepatitis B virus (HBV) infection were evaluated. Methods: The Iniciativa Profilaxis Pre-Exposición study randomized 2499 HIV-negative men and transgender women who have sex with men to once-daily oral FTC/TDF versus placebo. Hepatitis serologies and transaminases were obtained at screening and at the time PrEP was discontinued. HBV DNA was assessed by polymerase chain reaction, and drug resistance was assessed by population sequencing. Vaccination was offered to individuals susceptible to HBV infection. Results: Of the 2499 participants, 12 (0.5%; including 6 randomized to FTC/TDF) had chronic HBV infection. After stopping FTC/TDF, 5 of the 6 participants in the active arm had liver function tests performed at follow-up. Liver function tests remained within normal limits at post-stop visits except for a grade 1 elevation in 1 participant at post-stop week 12 (alanine aminotransferase = 90, aspartate aminotransferase = 61). There was no evidence of hepatic flares. Polymerase chain reaction of stored samples showed that 2 participants in the active arm had evidence of acute HBV infection at enrollment. Both had evidence of grade 4 transaminase elevations with subsequent resolution. Overall, there was no evidence of TDF or FTC resistance among tested genotypes. Of 1633 eligible for vaccination, 1587 (97.2%) received at least 1 vaccine; 1383 (84.7%) completed the series. Conclusions: PrEP can be safely provided to individuals with HBV infection if there is no evidence of cirrhosis or substantial transaminase elevation. HBV vaccination rates at screening were low globally, despite recommendations for its use, yet uptake and efficacy were high when offered. PMID:26413853

Correlates of Awareness of and Willingness to Use Pre-exposure Prophylaxis (PrEP) in Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Geosocial-Networking Smartphone Applications in New York City.

Science.gov (United States)

Goedel, William C; Halkitis, Perry N; Greene, Richard E; Duncan, Dustin T

2016-07-01

Geosocial-networking smartphone applications are commonly used by gay, bisexual, and other men who have sex with men (MSM) to meet sexual partners. The purpose of the current study was to evaluate awareness of and willingness to use pre-exposure prophylaxis (PrEP) among MSM who use geosocial-networking smartphone applications residing in New York City. Recruitment utilizing broadcast advertisements on a popular smartphone application for MSM yielded a sample of 152 HIV-uninfected MSM. Multivariable models were used to assess demographic and behavioral correlates of awareness of and willingness to use PrEP. Most participants (85.5 %) had heard about PrEP but few (9.2 %) reported current use. Unwillingness to use PrEP was associated with concerns about side effects (PR = 0.303; 95 % CI 0.130, 0.708; p = 0.006). Given that more than half (57.6 %) of participants were willing to use PrEP, future research is needed to elucidate both individual and structural barriers to PrEP use among MSM.

Performance evaluation of the new Roche cobas AmpliPrep/cobas TaqMan HCV test, version 2.0, for detection and quantification of hepatitis C virus RNA

NARCIS (Netherlands)

S.D. Pas (Suzan); R. Molenkamp (Richard); J. Schinkel (Janke); S. Rebers; C. Copra (Cederick); S. Seven-Deniz; D. Thamke (Diana); R.J. de Knegt (Robert); B.L. Haagmans (Bart); M. Schutten (Martin)

2013-01-01

textabstractTo evaluate the analytical performance and explore the clinical applicability of the new Roche cobas AmpliPrep/cobas TaqMan HCV test, v2.0 (CAP/CTM v2.0), a platform comparison was performed on panels and diagnostic samples with the Roche cobas AmpliPrep/cobas TaqMan HCV test (CAP/CTM

Prep/Tech: Volume 1, No. 1, Youth on homelessness

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-12-31

PREP/TECH is a skill development, academic enrichment program of U. of Toledo in Toledo OH and The Engineers Foundation of Ohio; it addresses the mathematics, science, language, and intellectual needs of about 100 African-American and Hispanic-American 7th, 8th, and 9th graders in Toledo. This summer, after 3 weeks of classes, the 80 students returned for a second 3 week session and were divided into two groups, one studying the growing problem of homelessness in America. This group researched and published a pamphlet on homelessness. This report is divided into: myths, causes, descriptions, and solutions. Finally, a brief account is given of the homelessness project.

Indoor air radon concentration in schools in Prizren, Kosovo

International Nuclear Information System (INIS)

Bahtijari, M.; Stegnar, P.; Shemsidini, Z.; Kobal, I.; Vaupotic, J.

2006-01-01

Indoor air radon ( 222 Rn) concentrations were measured in spring and winter in 30 rooms of 9 elementary schools and 19 rooms of 6 high schools in Prizren, Kosovo, using alpha scintillation cells. Only in three rooms of elementary schools and four rooms of high schools did winter concentrations exceed 400 Bq m -3 . (authors)

Can an inadequate cervical cytology sample in ThinPrep be converted to a satisfactory sample by processing it with a SurePath preparation?

Science.gov (United States)

Sørbye, Sveinung Wergeland; Pedersen, Mette Kristin; Ekeberg, Bente; Williams, Merete E Johansen; Sauer, Torill; Chen, Ying

2017-01-01

The Norwegian Cervical Cancer Screening Program recommends screening every 3 years for women between 25 and 69 years of age. There is a large difference in the percentage of unsatisfactory samples between laboratories that use different brands of liquid-based cytology. We wished to examine if inadequate ThinPrep samples could be satisfactory by processing them with the SurePath protocol. A total of 187 inadequate ThinPrep specimens from the Department of Clinical Pathology at University Hospital of North Norway were sent to Akershus University Hospital for conversion to SurePath medium. Ninety-one (48.7%) were processed through the automated "gynecologic" application for cervix cytology samples, and 96 (51.3%) were processed with the "nongynecological" automatic program. Out of 187 samples that had been unsatisfactory by ThinPrep, 93 (49.7%) were satisfactory after being converted to SurePath. The rate of satisfactory cytology was 36.6% and 62.5% for samples run through the "gynecology" program and "nongynecology" program, respectively. Of the 93 samples that became satisfactory after conversion from ThinPrep to SurePath, 80 (86.0%) were screened as normal while 13 samples (14.0%) were given an abnormal diagnosis, which included 5 atypical squamous cells of undetermined significance, 5 low-grade squamous intraepithelial lesion, 2 atypical glandular cells not otherwise specified, and 1 atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion. A total of 2.1% (4/187) of the women got a diagnosis of cervical intraepithelial neoplasia 2 or higher at a later follow-up. Converting cytology samples from ThinPrep to SurePath processing can reduce the number of unsatisfactory samples. The samples should be run through the "nongynecology" program to ensure an adequate number of cells.

Comparison of a prepCheck-supported self-assessment concept with conventional faculty supervision in a pre-clinical simulation environment.

Science.gov (United States)

Wolgin, M; Grabowski, S; Elhadad, S; Frank, W; Kielbassa, A M

2018-03-25

This study aimed to evaluate the educational outcome of a digitally based self-assessment concept (prepCheck; DentsplySirona, Wals, Austria) for pre-clinical undergraduates in the context of a regular phantom-laboratory course. A sample of 47 third-year dental students participated in the course. Students were randomly divided into a prepCheck-supervised (self-assessment) intervention group (IG; n = 24); conventionally supervised students constituted the control group (CG; n = 23). During the preparation of three-surface (MOD) class II amalgam cavities, each IG participant could analyse a superimposed 3D image of his/her preparation against the "master preparation" using the prepCheck software. In the CG, several course instructors performed the evaluations according to pre-defined assessment criteria. After completing the course, a mandatory (blinded) practical examination was taken by all course participants (both IG and CG students), and this assessment involved the preparation of a MOD amalgam cavity. Then, optical impressions by means of a CEREC-Omnicam were taken to digitalize all examination preparations, followed by surveying and assessing the latter using prepCheck. The statistical analysis of the digitalized samples (Mann-Whitney U test) revealed no significant differences between the cavity dimensions achieved in the IG and CG (P = .406). Additionally, the sum score of the degree of conformity with the "master preparation" (maximum permissible 10% of plus or minus deviation) was comparable in both groups (P = .259). The implemented interactive digitally based, self-assessment learning tool for undergraduates appears to be equivalent to the conventional form of supervision. Therefore, such digital learning tools could significantly address the ever-increasing student to faculty ratio. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The intention to use HIV-pre-exposure prophylaxis (PrEP) among men who have sex with men in Switzerland: testing an extended explanatory model drawing on the unified theory of acceptance and use of technology (UTAUT).

Science.gov (United States)

Nideröst, Sibylle; Gredig, Daniel; Hassler, Benedikt; Uggowitzer, Franziska; Weber, Patrick

2018-01-01

The aim of this study was to determine the intention to use pre-exposure prophylaxis (PrEP) when available and to identify predictors of the intention to use PrEP among men who have sex with men (MSM) living in Switzerland. The theoretical model drew on the Unified Theory of Acceptance and Use of Technology and considered additional variables related specifically to PrEP, HIV protection and the resources of MSM. For data collection, we used an anonymous, standardized self-administered online questionnaire. In 2015, we gathered a convenience sample of 556 HIV-negative MSM living in Switzerland. We analyzed the data using descriptive and bivariate statistics and used structural equation modeling to test the hypothesized model. Predictors of respondents' moderate intention to use PrEP were performance expectancy, effort expectancy, perceived social influence, concerns about using PrEP, attitudes toward condom use, negative experiences of condom use and age. These variables were predicted by HIV protection-related aspects and resources. The findings provide insights into the complex dynamic underlying the intention to use PrEP.

Not Your Run-of-the-Mill Art-Room Stools

Science.gov (United States)

Chrzanowski, Rose-Ann C.

2010-01-01

An art room should be a garden of visual stimulation, born of creativity, inquiry, critical thinking and intellectual conversation--and a little collaboration is not a bad thing either! When the author unpacked the new stools for her art room at the high school, she envisioned something more beautiful than the brown masonite circles that…

Radon measurements in 130 schools

International Nuclear Information System (INIS)

Peake, R.T.; Schmidt, A.; MacWaters, J.T.; Chmelynski, H.

1990-01-01

During the winter of 1989, Rn screening measurements were made in 130 schools distributed across the United States. The primary purpose of the paper is to identify schools suitable for a year-long follow-up study, the results of which will be used to update EPA's guidance for Rn testing in schools. The 130 schools were selected nonrandomly using school characteristics and accessibility in areas where there were known or suspected Rn problems in homes. Levels found in this screening study may indicate the potential for Rn problems in US schools. Over half of the 130 schools tested had at least one radon measurement ≥4 pCi/L, and nearly 20% of the 3028 rooms measured ≥4 pCi/L. The number of rooms ≥4 pCi/L is often three rooms or less. However, schools with more than five rooms ≥4 pCi/L are common in some areas. The data include schools that could be typical of much of the US school population as well as schools which exhibit extreme radon problems, such as those tested in Nashville, TN and Spokane, WA

Appraisal of the PREP, KITT, and SAMPLE computer codes for the evaluation of the reliability characteristics of engineered systems

Energy Technology Data Exchange (ETDEWEB)

Shaw, P; White, R F

1976-01-01

For the probabilistic approach to reactor safety assessment by the use of event tree and fault tree techniques it is essential to be able to estimate the probabilities of failure of the various engineered safety features provided to mitigate the effects of postulated accident sequences. The PREP, KITT and SAMPLE computer codes, which incorporate Kinetic Tree Theory, perform these calculations and have been used extensively to evaluate the reliability characteristics of engineered safety features of American nuclear reactors. Working versions of these computer codes are now available in SRD, and this report explains the merits, capabilities and ease of application of the PREP, KITT, and SAMPLE programs for the solution of system reliability problems.

Sexuality and school shootings: what role does teasing play in school massacres?

Science.gov (United States)

Klein, Jessie

2006-01-01

Conventional explanations - lax gun control laws, media violence, single and working parents - do not adequately explain the recent spate of school shootings, and neither does bullying by itself, an explanation recently gaining more traction. A certain type of bullying, however, is revealed as particularly culpable. Many of the recent shootings share a disturbing component: The perpetrators were repeatedly, even relentlessly, accused by "preps and jocks" of being gay. Gay harassment is proposed as a point of departure for understanding the causes of school shootings. When boys who believe on some level that they warrant privilege, are instead harassed, they may feel driven to avenge the "wrong," and re-assert a more dominant, powerful, and victorious masculinity. These circumstances call for a cultural transformation such that "boys will be boys" is no longer used as an alibi for violence. The author presents implications for school-based social work practice, teacher and administrator interventions, as well as other prevention strategies.

Achilles’ heel: from greek mythology to challenges in the routines of school avaliation in the resources rooms

Directory of Open Access Journals (Sweden)

Denise Meyrelles de Jesus

2012-11-01

Full Text Available Based on the study entitled “National Observatory for Special Education: Network Studies on Multifunctional Resource Rooms" (Mendes, 2010, this article aims at discussing the assessment processes that took place in these rooms for multifunctional resources. The Greek mythology metaphor “Achilles’ Heel” in the title above is justified by the vulnerability of assessment in the process of inclusion. The main strategy for gathering data in this study was the adoption of focus groups led by the researchers. We sought to understand the meaning of initial assessment in the routines of the teachers involved in this study. Based on data analysis, we verified that the initial assessment procedures strongly resemble medical records issued by clinical professionals. The specialist teacher, together with the regular teacher, is in charge of identifying only students’ initial “learning inability”. Specialist teachers are not aware of the fact that they are responsible for this assessment, including for school census purposes. The data point to an unclear view of assessment, with poor interaction between these identification processes and the intervention procedures. The data also show the poor interaction between the relevant public services, which makes the family responsible for obtaining the student’s report. The results point to the need of more significant investments to restructure schools, providing them with collective spaces for discussing such serious issues and allowing us to develop more inclusive pedagogical practices regarding students' assessment.

Explaining the Efficacy of Pre-exposure Prophylaxis (PrEP) for HIV Prevention: A Qualitative Study of Message Framing and Messaging Preferences Among US Men Who have Sex with Men.

Science.gov (United States)

Underhill, Kristen; Morrow, Kathleen M; Colleran, Christopher; Calabrese, Sarah K; Operario, Don; Salovey, Peter; Mayer, Kenneth H

2016-07-01

We investigated message comprehension and message framing preferences for communicating about PrEP efficacy with US MSM. We conducted eight focus groups (n = 38) and n = 56 individual interviews with MSM in Providence, RI. Facilitators probed comprehension, credibility, and acceptability of efficacy messages, including percentages, non-numerical paraphrases, efficacy ranges versus point estimates, and success- versus failure-framed messages. Our findings indicated a range of comprehension and operational understandings of efficacy messages. Participants tended to prefer percentage-based and success-framed messages, although preferences varied for communicating about efficacy using a single percentage versus a range. Participants reported uncertainty about how to interpret numerical estimates, and many questioned whether trial results would predict personal effectiveness. These results suggest that providers and researchers implementing PrEP may face challenges in communicating with users about efficacy. Efforts to educate MSM about PrEP should incorporate percentage-based information, and message framing decisions may influence message credibility and overall PrEP acceptability.

PREP inside and out: marriage education for inmates.

Science.gov (United States)

Einhorn, Lindsey; Williams, Tamara; Stanley, Scott; Wunderlin, Nicole; Markman, Howard; Eason, Joanne

2008-09-01

Although research has demonstrated that marriage education has positive effects on relationship quality, little is known about how such services impact relationships where one partner is incarcerated. The current study implemented an adapted version of the Prevention and Relationship Enhancement Program (PREP Inside and Out) for inmates in Oklahoma correctional facilities. Inmates, with or without their partners, participated in the 12-hour program. The impact of the program was investigated on a range of relationship variables including satisfaction with relationship, dedication, confidence, communication skills, friendship, and negative interactions as reported by the inmate partner. Participants reported substantial gains in all variables and in overall satisfaction with their relationship after completing the program, regardless of their gender and racial/ethnic background. Implications for future marriage education programs and research in prisons are discussed.

Effects of Room Color on Mirror-Tracing by Junior High School Girls.

Science.gov (United States)

Bross, Cindy; Jackson, Karen

1981-01-01

Girls in Grades 7, 8, and 9 practiced mirror-tracing in a neutral colored room to a criterion before being tested in their preferred or nonpreferred colored rooms. The errors decreased significantly in the preferred room, while the time to complete changed minimally. (Author)

Science in Schools Project

Science.gov (United States)

Waugh, Mike

As part of a program to increase learning and engagement in science classes 124 Victorian schools are trialing a best practice teaching model. The Science in Schools Research Project is a DEET funded project under the Science in Schools Strategy, developed in response to recent research and policy decisions at national and state levels through which literacy, numeracy and science have been identified as key priorities for learning. This major science research project aims to identify, develop and trial best practice in Science teaching and learning. The Department will then be able to provide clear advice to Victoria's schools that can be adopted and sustained to: * enhance teaching and learning of Science * enhance student learning outcomes in Science at all year levels * increase student access to, and participation in Science learning from Prep through to Year 10, and hence in the VCE as well. The nature of the SiS program will be detailed with specific reference to the innovative programs in solar model cars, robotics and environmental science developed at Forest Hill College in response to this project.

Getting to the Point: Storying the United States Military Academy’s and Its Preparatory School’s English Program.

Science.gov (United States)

1998-01-01

34modules" identified as key to the needed changes at the Prep School (Final 11). Three modules— composition/grammar, precalculus mathematics, and...composition/grammar and performance enhancement, and precalculus mathematics) set out to determine how to define mathematics "gateways," to examine

Risk perception and sex behaviour in pregnancy and breastfeeding in high HIV prevalence settings: Programmatic implications for PrEP delivery

Science.gov (United States)

Farley, Elise; Towriss, Catriona; Gomba, Yolanda; Bekker, Linda-Gail; Gorbach, Pamina; Shoptaw, Steven; Coates, Thomas; Myer, Landon

2018-01-01

HIV acquisition during pregnancy and breastfeeding significantly contributes toward paediatric HIV infection; however, little is known about risk behaviours in HIV-uninfected pregnant and postpartum women. We conducted twenty-six in-depth-interviews between July and December 2016 using a semi-structured interview guide among HIV-uninfected pregnant and recently postpartum women at-risk of HIV acquisition (defined as reporting ≥1 of the following: partner’s serostatus unknown or HIV-infected, recent condomless sex in pregnancy, and/or alcohol use during pregnancy) who attended primary healthcare services. Our study contextualizes factors related to risky sexual behaviours during pregnancy and postpartum periods and assesses knowledge and hypothetical acceptability of pre-exposure prophylaxis (PrEP) in pregnancy. Translated and transcribed data were coded and analysed by three researchers using a thematic analysis approach. In interviews with HIV-uninfected pregnant/postpartum women at-risk of HIV acquisition, we identified common themes associated with sexual risk behaviours during pregnancy, including: lack of control over decisions in sex and condom use in pregnancy, low perceived risk (e.g. beliefs that their partner has the same HIV-negative serostatus), and socio-cultural beliefs around condom use during pregnancy (e.g. contact with sperm is essential for baby’s development). PrEP knowledge was low among HIV-uninfected pregnant and breastfeeding women, and potential acceptability was good, though primary concerns were around the potential impact on the infant. While mothers presented a clear desire to protect themselves from HIV acquisition once pregnant, they also reported lack of control, and socio-cultural beliefs, like sex is good for the baby, that increased their risk of seroconversion. Mothers had limited PrEP awareness but reported hypothetical willingness to use PrEP because of concerns over HIV acquisition and onward mother to child transmission

Perspectives on HIV Pre- and Post-Exposure Prophylaxes (PrEP and PEP) Among Female and Male Sex Workers in Mombasa, Kenya: Implications for Integrating Biomedical Prevention into Sexual Health Services.

Science.gov (United States)

Restar, Arjee J; Tocco, Jack Ume; Mantell, Joanne E; Lafort, Yves; Gichangi, Peter; Masvawure, Tsitsi B; Chabeda, Sophie Vusha; Sandfort, Theo G M

2017-04-01

Pre- and post-exposure prophylaxes (PrEP and PEP) can reduce the risk of HIV acquisition, yet often are inaccessible to and underutilized by most-vulnerable populations, including sex workers in sub-Saharan Africa. Based on in-depth interviews with 21 female and 23 male HIV-negative sex workers in Mombasa, Kenya, we found that awareness and knowledge of PrEP and PEP were low, although willingness to use both was high. Participants felt PrEP would be empowering and give added protection against infection, although some expressed concerns about side effects. Despite PEP's availability, few knew about it and even fewer had used it, but most who had would use it again. Sex workers valued confidentiality, privacy, trustworthiness, and convenient location in health services and wanted thorough HIV/STI assessments. These findings suggest the importance of situating PrEP and PEP within sex worker-friendly health services and conducting outreach to promote these biomedical prevention methods for Kenyan sex workers.

Planets in a Room

Science.gov (United States)

Giacomini, l.; Aloisi, F.; De Angelis, I.

2017-09-01

Teaching planetary science using a spherical projector to show the planets' surfaces is a very effective but usually very expensive idea. Whatsmore, it usually assumes the availability of a dedicated space and a trained user. "Planets in a room" is a prototypal low cost version of a small, spherical projector that teachers, museum, planetary scientists and other individuals can easily build and use on their own, to show and teach the planets The project of "Planets in a Room" was made by the italian non-profit association Speak Science with the collaboration of INAF-IAPS of Rome and the Roma Tre University (Dipartimento di Matematica e Fisica). This proposal was funded by the Europlanet Outreach Funding Scheme in 2016. "Planets in a room" will be presented during EPSC 2017 to give birth to the second phase of the project, when the outreach and research community will be involved and schools from all over Europe will be invited to participate with the aim of bringing planetary science to a larger audience.

Acceptability of Condoms, Circumcision and PrEP among Young Black Men Who Have Sex with Men: A Descriptive Study Based on Effectiveness and Cost

Directory of Open Access Journals (Sweden)

Richard A. Crosby

2014-02-01

Full Text Available The current study examined and compared the willingness of young Black men who have sex with men (YBMSM to accept pre-exposure prophylaxis (PrEP, adult male circumcision, and condoms for reducing their risk of HIV acquisition. The majority (67% reported unprotected receptive anal sex in the last six months. About three-quarters (71% would accept using PrEP if it was 100% effective. Cost influenced PrEP acceptance with 19% indicating acceptance at $100 per month co-pay. Of those not circumcised, 50% indicated willingness if circumcision was 100% effective. Acceptance of circumcision decreased markedly to 17% with co-pays of $100. About 73% of men were willing to use condoms if they were 100% effective and 50% indicated a willingness at the cost of $10 per month. The findings suggest that condom use promotion strategies should remain at the forefront of public health efforts to control HIV incidence among YBMSM.

Quantification of Parvovirus B19 DNA Using COBAS AmpliPrep Automated Sample Preparation and LightCycler Real-Time PCR

Science.gov (United States)

Schorling, Stefan; Schalasta, Gunnar; Enders, Gisela; Zauke, Michael

2004-01-01

The COBAS AmpliPrep instrument (Roche Diagnostics GmbH, D-68305 Mannheim, Germany) automates the entire sample preparation process of nucleic acid isolation from serum or plasma for polymerase chain reaction analysis. We report the analytical performance of the LightCycler Parvovirus B19 Quantification Kit (Roche Diagnostics) using nucleic acids isolated with the COBAS AmpliPrep instrument. Nucleic acids were extracted using the Total Nucleic Acid Isolation Kit (Roche Diagnostics) and amplified with the LightCycler Parvovirus B19 Quantification Kit. The kit combination processes 72 samples per 8-hour shift. The lower detection limit is 234 IU/ml at a 95% hit-rate, linear range approximately 104-1010 IU/ml, and overall precision 16 to 40%. Relative sensitivity and specificity in routine samples from pregnant women are 100% and 93%, respectively. Identification of a persistent parvovirus B19-infected individual by the polymerase chain reaction among 51 anti-parvovirus B19 IgM-negative samples underlines the importance of additional nucleic acid testing in pregnancy and its superiority to serology in identifying the risk of parvovirus B19 transmission via blood or blood products. Combination of the Total Nucleic Acid Isolation Kit on the COBAS AmpliPrep instrument with the LightCycler Parvovirus B19 Quantification Kit provides a reliable and time-saving tool for sensitive and accurate detection of parvovirus B19 DNA. PMID:14736825

Safety and adherence to intermittent pre-exposure prophylaxis (PrEP) for HIV-1 in African men who have sex with men and female sex workers.

Science.gov (United States)

Mutua, Gaudensia; Sanders, Eduard; Mugo, Peter; Anzala, Omu; Haberer, Jessica E; Bangsberg, David; Barin, Burc; Rooney, James F; Mark, David; Chetty, Paramesh; Fast, Patricia; Priddy, Frances H

2012-01-01

Little is known about safety of and adherence to intermittent HIV PrEP regimens, which may be more feasible than daily dosing in some settings. We present safety and adherence data from the first trial of an intermittent PrEP regimen among Kenyan men who have sex with men (MSM) and female sex workers (FSW). MSM and FSW were randomized to daily oral FTC/TDF or placebo, or intermittent (Monday, Friday and within 2 hours after sex, not to exceed one dose per day) oral FTC/TDF or placebo in a 2:1:2:1 ratio; volunteers were followed monthly for 4 months. Adherence was assessed with the medication event monitoring system (MEMS). Sexual activity data were collected via daily text message (SMS) queries and timeline followback interviews with a one-month recall period. Sixty-seven men and 5 women were randomized into the study. Safety was similar among all groups. Median MEMS adherence rates were 83% [IQR: 63-92] for daily dosing and 55% [IQR:28-78] for fixed intermittent dosing (p = 0.003), while adherence to any post-coital doses was 26% [IQR:14-50]. SMS response rates were low, which may have impaired measurement of post-coital dosing adherence. Acceptability of PrEP was high, regardless of dosing regimen. Adherence to intermittent dosing regimens, fixed doses, and in particular coitally-dependent doses, may be more difficult than adherence to daily dosing. However, intermittent dosing may still be appropriate for PrEP if intracellular drug levels, which correlate with prevention of HIV acquisition, can be attained with less than daily dosing and if barriers to adherence can be addressed. Additional drug level data, qualitative data on adherence barriers, and better methods to measure sexual activity are necessary to determine whether adherence to post-coital PrEP could be comparable to more standard regimens. ClinicalTrials.gov NCT00971230.

[Exposure of schoolchildren and teachers to noise at school].

Science.gov (United States)

Koszarny, Z; Goryński, P

1990-01-01

The factor of decisive influence on the acoustic climate in rooms is the inner noise, which is dependent in schools on the activity of children, overcrowding of classes and inadequate use of technical protective means. The inappropriate location of schools, although also important from the standpoint of acoustics, is a much lower source of noise than it is generally assumed. Particularly unfavourable acoustic conditions are in elementary schools with over 300 children in one shift. The spaces with the highest noise level include corridors, especially during recesses between lessons. The noise level in them is in the range of an equivalent sound A 60-95 dB, and the most frequent noise level is 80 dB. In a large part of schools the acoustic conditions in the corridors during recesses approach the critical values accepted for hearing protection in industrial plants, in some schools they are even exceeded. The situation is also unfavourable in other rooms such as doctor's office, director's room, reading rooms, rooms for teachers. These rooms are situated usually without taking into consideration of the acoustic conditions. This is particularly true of teachers' rooms which should give the teachers the possibility of resting before the next lesson. During lessons the noise level decreases in all rooms. However, the noisiest among them, corridors, classes situated near the hall for physical exercises and day-room, have still up to about 65 dB noise level. Generally speaking, in about 60% of rooms the acoustic conditions are below the recommended standard. The main cause, apart from overcrowding of schools, is low acoustic absorption ability of school rooms, and poor acoustic insulation ability of the doors in schools.

Little Schools on the Prairie Still Teach a Big Lesson.

Science.gov (United States)

Kindley, Mark M.

1985-01-01

Uses Cherry County, Nebraska, to exemplify current experiences of learning and teaching in a one-room school--Nebraska has 350 of the nation's nearly 800 one-room schools. Interviews parents and teachers who cherish their one-room schools because they provide quality education, convenience (relative to consolidated schools), and support for rural…

Willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia: findings from a qualitative study

OpenAIRE

Adam Bourne; Matteo Cassolato; Clayton Koh Thuan Wei; Bangyuan Wang; Joselyn Pang; Sin How Lim; Iskandar Azwa; Ilias Yee; Gitau Mburu

2017-01-01

Abstract Background: Men who have sex with men (MSM) continue to be disproportionately affected by HIV in Malaysia. Recent success has been observed within demonstration projects examining the efficacy of HIV pre-exposure prophylaxis (PrEP), an antiretroviral -based medication taken by HIV-negative men to prevent sero-conversion. In order for such promising findings to be translated in real-world settings, it is important to understand the acceptability of PrEP, including perceived barriers t...

The Classroom, Board Room, Chat Room, and Court Room: School Computers at the Crossroads.

Science.gov (United States)

Stewart, Michael

2000-01-01

In schools' efforts to maximize technology's benefits, ethical considerations have often taken a back seat. Computer misuse is growing exponentially and assuming many forms: unauthorized data access, hacking, piracy, information theft, fraud, virus creation, harassment, defamation, and discrimination. Integrated-learning activities will help…

Views of policymakers, healthcare workers and NGOs on HIV pre-exposure prophylaxis (PrEP): a multinational qualitative study

NARCIS (Netherlands)

Wheelock, Ana; Eisingerich, Andreas B.; Gomez, Gabriela B.; Gray, Emily; Dybul, Mark R.; Piot, Peter

2012-01-01

To examine policymakers and providers' views on pre-exposure prophylaxis (PrEP) and their willingness to support its introduction, to inform policy and practice in this emerging field. Semistructured qualitative interview study. Peru, Ukraine, India, Kenya, Uganda, Botswana and South Africa. 35

Liquid-based cervical cytology using ThinPrep technology: weighing the pros and cons in a cost-effectiveness analysis.

Science.gov (United States)

de Bekker-Grob, Esther W; de Kok, Inge M C M; Bulten, Johan; van Rosmalen, Joost; Vedder, Judith E M; Arbyn, Marc; Klinkhamer, Paul J J M; Siebers, Albertus G; van Ballegooijen, Marjolein

2012-08-01

Cervical cancer screening with liquid-based cytology (LBC) has been developed as an alternative to the conventional Papanicolaou (CP) smear. Cost-effectiveness is one of the issues when evaluating LBC. Based on the results of a Dutch randomised controlled trial, we conducted cost-effectiveness threshold analyses to investigate under what circumstances manually screened ThinPrep LBC is cost-effective for screening. The MISCAN-Cervix microsimulation model and data from the Dutch NETHCON trial (including 89,784 women) were used to estimate the costs and (quality-adjusted) life years ((QA)LYs) gained for EU screening schedules, varying cost-effectiveness threshold values. Screening strategies were primary cytological screening with LBC or CP, and triage with human papillomavirus (HPV) testing. Threshold analyses showed that screening with LBC as a primary test can be cost-effective if LBC is less than 3.2 more costly per test than CP, if the sensitivity of LBC is at least 3-5 % points higher than CP, if the quality of life for women in triage follow-up is only 0.39, or if the rate of inadequate CP smears is at least 16.2 %. Regarding test characteristics and costs of LBC and CP, only under certain conditions will a change from CP to manually screened ThinPrep LBC be cost-effective. If none of these conditions are met, implementation of manually screened ThinPrep LBC seems warranted only if there are advantages other than cost-effectiveness. Further research is needed to establish whether other LBC systems will be more favorable with regard to cost-effectiveness.

The cobas p 630 instrument: a dedicated pre-analytic solution to optimize COBAS® AmpliPrep/COBAS® TaqMan® system workflow and turn-around-time.

Science.gov (United States)

Vallefuoco, L; Sorrentino, R; Spalletti Cernia, D; Colucci, G; Portella, G

2012-12-01

The cobas p 630, a fully automated pre-analytical instrument for primary tube handling recently introduced to complete the Cobas(®) TaqMan systems portfolio, was evaluated in conjunction with: the COBAS(®) AmpliPrep/COBAS(®) TaqMan HBV Test, v2.0, COBAS(®) AmpliPrep/COBAS(®) TaqMan HCV Test, v1.0 and COBAS(®) AmpliPrep/COBAS(®) TaqMan HIV Test, v2.0. The instrument performance in transferring samples from primary to secondary tubes, its impact in improving COBAS(®) AmpliPrep/COBAS(®) TaqMan workflow and hands-on reduction and the risk of possible cross-contamination were assessed. Samples from 42 HBsAg positive, 42 HCV and 42 HIV antibody (Ab) positive patients as well as 21 healthy blood donors were processed with or without automated primary tubes. HIV, HCV and HBsAg positive samples showed a correlation index of 0.999, 0.987 and of 0.994, respectively. To assess for cross-contamination, high titer HBV DNA positive samples, HCV RNA and HIV RNA positive samples were distributed in the cobas p 630 in alternate tube positions, adjacent to negative control samples within the same rack. None of the healthy donor samples showed any reactivity. Based on these results, the cobas p 630 can improve workflow and sample tracing in laboratories performing molecular tests, and reduce turnaround time, errors, and risks. Copyright © 2012 Elsevier B.V. All rights reserved.

"What I Did over My Summer Vacation..."

Science.gov (United States)

Techniques: Making Education and Career Connections, 1997

1997-01-01

A tech prep summer camp was designed to give ninth graders a taste of tech prep before they were asked to choose a high school path. Parents were invited to dinner to learn about tech prep programs and their potential for successful careers. (JOW)

Safety, adherence and acceptability of intermittent tenofovir/emtricitabine as HIV pre-exposure prophylaxis (PrEP among HIV-uninfected Ugandan volunteers living in HIV-serodiscordant relationships: a randomized, clinical trial.

Directory of Open Access Journals (Sweden)

Freddie M Kibengo

Full Text Available BACKGROUND: Efficacy of oral pre-exposure prophylaxis (PrEP in prevention of HIV acquisition has been evaluated using a daily regimen. However, adherence to long term daily medication is rarely perfect. Intermittent regimen may be a feasible alternative. Preclinical studies have demonstrated effectiveness of intermittent PrEP in SHIV prevention among animals. However, little is known about intermittent PrEP regimens. DESIGN: Seventy two HIV-uninfected volunteers in HIV serodiscordant couple relationships in Uganda were randomly assigned to receive daily oral Tenofovir/Emtricitabine (TDF/FTC-Truvada or placebo, or intermittent (Monday, Friday and within 2 hours after sex, not to exceed one dose per day oral TDF/FTC or placebo in a 2:1:2:1 ratio. Volunteers and study staff were blinded to drug assignment, but not to regimen assignment. METHODS: Volunteers were followed for 4 months after randomization, with monthly clinical and laboratory safety assessments and comprehensive HIV risk reduction services. Adherence was monitored using medication event monitoring system (MEMS and self-report. Sexual activity data were collected via daily short text message (SMS and self-report. HIV-specific immune responses were assessed by IFN-γ ELISPOT. RESULTS: Both daily and intermittent oral TDF/FTC regimens were well tolerated. Median MEMS adherence rates were 98% (IQR: 93-100 for daily PrEP regimen, 91% (IQR: 73-97 for fixed intermittent dosing and 45% (IQR: 20-63 for post-coital dosing. SMS response rate was 74%, but increased to 80% after excluding server outages; results may have been affected by the novelty of this measure. The majority of volunteers expressed willingness with no particular preference for either regimen. CONCLUSIONS: Both daily and intermittent oral PrEP dosing regimens were safe. Adherence was high for daily and fixed intermittent dosing; post-coital dosing was associated with poor adherence. Fixed intermittent PrEP regimens may be

Something Happens in Room 13: Bringing Truths into the World

Science.gov (United States)

Grube, Vicky

2015-01-01

This qualitative study looks at how an art studio run by children in crisis impacts what we can learn about art and relationships. Room 13, an art studio on school grounds managed by children ages 7-11 years old, began in Scotland in the 1980's and is now worldwide. Room 13 young artists manage the studio, raise funds, and even hire an adult…

Safety and adherence to intermittent pre-exposure prophylaxis (PrEP for HIV-1 in African men who have sex with men and female sex workers.

Directory of Open Access Journals (Sweden)

Gaudensia Mutua

Full Text Available Little is known about safety of and adherence to intermittent HIV PrEP regimens, which may be more feasible than daily dosing in some settings. We present safety and adherence data from the first trial of an intermittent PrEP regimen among Kenyan men who have sex with men (MSM and female sex workers (FSW.MSM and FSW were randomized to daily oral FTC/TDF or placebo, or intermittent (Monday, Friday and within 2 hours after sex, not to exceed one dose per day oral FTC/TDF or placebo in a 2:1:2:1 ratio; volunteers were followed monthly for 4 months. Adherence was assessed with the medication event monitoring system (MEMS. Sexual activity data were collected via daily text message (SMS queries and timeline followback interviews with a one-month recall period. Sixty-seven men and 5 women were randomized into the study. Safety was similar among all groups. Median MEMS adherence rates were 83% [IQR: 63-92] for daily dosing and 55% [IQR:28-78] for fixed intermittent dosing (p = 0.003, while adherence to any post-coital doses was 26% [IQR:14-50]. SMS response rates were low, which may have impaired measurement of post-coital dosing adherence. Acceptability of PrEP was high, regardless of dosing regimen.Adherence to intermittent dosing regimens, fixed doses, and in particular coitally-dependent doses, may be more difficult than adherence to daily dosing. However, intermittent dosing may still be appropriate for PrEP if intracellular drug levels, which correlate with prevention of HIV acquisition, can be attained with less than daily dosing and if barriers to adherence can be addressed. Additional drug level data, qualitative data on adherence barriers, and better methods to measure sexual activity are necessary to determine whether adherence to post-coital PrEP could be comparable to more standard regimens.ClinicalTrials.gov NCT00971230.

A case study of chewed Truvada® for PrEP maintaining protective drug levels as measured by a novel urine tenofovir assay.

Science.gov (United States)

Lalley-Chareczko, Linden; Clark, Devon; Zuppa, Athena F; Moorthy, Ganesh; Conyngham, Caitlin; Mounzer, Karam; Koenig, Helen

2017-01-01

Emtricitabine/tenofovir disoproxil fumarate (FTC/TDF; Truvada ® ) given as pre-exposure prophylaxis (PrEP) successfully blocks HIV when taken once daily prior to potential HIV exposure. A 22-year-old male reported difficulty swallowing FTC/TDF for PrEP and subsequently began chewing the FTC/TDF tablets. Monthly urine samples assessed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) indicated tenofovir levels >1,000 ng/ml, indicative of protection from HIV acquisition, over a 48-week period. Data from observational studies of HIV-positive patients details the successful treatment of HIV using crushed FTC/TDF delivered via feeding and gastronomy tubes while small, randomized trials of healthy volunteers demonstrate bioequivalence between whole and crushed FTC/TDF.

The self-created outdoor class-room "Michelbachpark": Practical experiences of 5 years project work in every-day school life

Science.gov (United States)

Brake, Jens; Istler, Katharina; Kisser, Thomas

2015-04-01

"Economy and ethos" is the guiding principle of the Evangelic Paul-Distelbarth-Gymnasia in Obersulm, located in Baden-Württemberg, Germany. Starting with class 5, the pupils have every year another project to accomplish. Since 5 years, the project in class 10 is the creation of a 1.35 hectare outdoor-class-room near the Michelbach, the "Michelbachpark". The "Michelbachpark" is a consortium project of the school, the community Obersulm, the company Cartondruck and the forestry commission office of the county Heilbronn. The focus of the project "Michelbachpark" is on several aspects of sustainable development. In the years from 2009 to 2013, there was a highlight on the ecological aspect. Since 2012, the social facet is the centre. The aim is to construct an area, which is a place for recreation and also a learning-place for people interested in nature science. Therefore the pupils designed and manufactured different experimental set-ups for younger pupils from about age 6 to 14, and some experiential education stations. Starting from 2014, the outdoor class-room is going to be combined with the use of mobile devices. Several problems aroused in the design-work: - Pupils from age 6 to 14 do not have a mobile device for certain. - The pupils maybe do not know how to handle a mobile device. - The mobile internet in the rural area may not be fast enough for about 30 pupils. - Someone has to pay for the mobile devices and the mobile internet, if it would be used. So, there is need for easily manageable mobile device and also easy manageable application, and the data should be provided without ongoing costs and with acceptable speed. Since the media plays a great part in the prize-winning curricula of the school, a set of tablets is available. The founded solution could be a blue print for other, similar outdoor education settings: The learning modules are working with QR-Codes and the data will be provided through a temporarily available local Webserver. Hence the

Helping Families Succeed in Two Worlds.

Science.gov (United States)

Murray, Vivian

Kamehameha Schools' Prekindergarten Educational Program (PREP) was started in 1978 to prepare at-risk Hawaiian families and their children for success in school. PREP's direct services include: (1) parent-infant educational services, including home visits to help parents prepare for a new baby and later learn appropriate child development…

Lunchbox contents of Australian school children: room for improvement.

Science.gov (United States)

Sanigorski, A M; Bell, A C; Kremer, P J; Swinburn, B A

2005-11-01

In light of the increasing prevalence of obesity in children and the potential of schools as a setting for intervention, we aimed to identify the main foods and beverages consumed at primary school and to determine differences in consumption patterns between children who used the school canteen and those who did not. Cross-sectional survey of school foods in 1681 5-12 y old children, 2003-2004. Barwon South-Western region of Victoria, Australia. The school food provided an average (+/-s.e.m.) of 3087+/-26 kJ. Bread was the most frequently consumed food and contributed 20% of total energy at school, biscuits 13%, fruit 10%, muesli/fruit bars 8%, packaged snacks 7%, and fruit juice/cordial 6%. About 10% of children used the school canteen and these children obtained more total energy and more energy from cakes, fast foods and soft drink than noncanteen users (Pjunk food'). Fruit intake in primary schools seems reasonably high but could be targeted for further increase as part of promoting a healthy diet. Of concern, however, are the excessive amounts of energy-dense foods in school lunchboxes. These should be considered a priority for health promotion efforts along with reducing the consumption of sweetened drinks. These measures are urgently needed to improve the school-based diets of Australian children and attempt to curb the increasing prevalence of childhood obesity.

Lecture to inquiry: The transformation of a tech prep biology teacher

Science.gov (United States)

Haskell, Deborah Harris

As teachers implement the National Science Education Standards (NRC, 1996) many have to reform the instructional methods they have used throughout their careers. This case study examines the transformation of Laurie, a 20-year teacher, during her first year of change from a "traditional" textbook/lecture style of teaching to a facilitator of an inquiry-based classroom. Implementing change requires not only pedagogical expertise, but also the belief that the modifications can be made and that the outcomes are significant. Using Bandura's social cognitive theory as a framework, changes in Laurie's self-efficacy, outcome expectancy, and motivation are followed throughout the transition. During her first year of change, Laurie used worksheets, small group activities, and guided inquiry activities, all strategies in which she had high self-efficacy and experienced positive student outcomes. She rarely used class forums, authentic assessment, and formative assessment. Factors that influenced her change were experiential professional development opportunities that allowed her to practice inquiry-based techniques, a change in her teaching environment from college prep chemistry to tech prep biology, autonomy regarding classroom decisions, and reflective decision making as she learned through experience. Using a standards-based biology textbook increased her self-efficacy toward using inquiry-based practices. The textbook format of embedding text in activities rather than adding activities to the text resulted in an increase of the number and frequency of activities done. Facilitating the textbook's Guided Inquiries and Extended Inquiries helped Laurie gain experience with inquiry-based methods. She also realized that when building from the students' concrete experiences, her students were able to attain higher-level thinking skills. The study revealed six factors contributing to Laurie's change process: (a) experiential professional development, (b) motivation for change

Could FDA approval of pre-exposure prophylaxis make a difference? A qualitative study of PrEP acceptability and FDA perceptions among men who have sex with men

OpenAIRE

Underhill, Kristen; Morrow, Kathleen M.; Operario, Don; Mayer, Kenneth H.

2014-01-01

The FDA has approved tenofovir-emtricitabine for use as HIV pre-exposure prophylaxis, but it is unknown how approval may affect PrEP acceptability among US men who have sex with men. We conducted 8 focus groups among 38 Rhode Island MSM, including 3 groups among 16 male sex workers and 5 groups among 22 men in the general MSM community. Participants reported wide-ranging beliefs regarding consequences and meanings of FDA approval. Some participants would not use PrEP without approval, while o...

Pre-exposure prophylaxis (PrEP against HIV: efficacy, safety and uncertainties

Directory of Open Access Journals (Sweden)

Santiago Moreno Guillen

2017-09-01

Full Text Available Despite the global stabilization of the number of new HIV infections in recent years, there has been an increase in new infections among men who have sex with men. This fact indicates the lack of effectiveness of the measures and prevention campaigns established so far for this group. It is therefore necessary to implement alternative preventive measures for them. Pre-exposure pharmacological prophylaxis (PrEP is one of the best evaluated options and has had high protection rates in both clinical and real-life trials. The strategy has also shown an adequate profile in terms of safety, tolerance, adverse effects and cost-effectiveness in the studies carried out to assess this important topic.

Cervical cancer incidence after normal cytological sample in routine screening using SurePath, ThinPrep, and conventional cytology

DEFF Research Database (Denmark)

Rozemeijer, Kirsten; Naber, Steffie K; Penning, Corine

2017-01-01

of histo- and cytopathology in the Netherlands (PALGA), January 2000 to March 2013.Population Women with 5 924 474 normal screening samples (23 833 123 person years).Exposure Use of SurePath or ThinPrep versus conventional cytology as screening test.Main outcome measure 72 month cumulative incidence...

Stigma, medical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts.

Science.gov (United States)

Cahill, Sean; Taylor, S Wade; Elsesser, Steven A; Mena, Leandro; Hickson, DeMarc; Mayer, Kenneth H

2017-11-01

Gay and bisexual men and other men who have sex with men (MSM) account for more than two thirds of new HIV infections in the U.S., with Black MSM experiencing the greatest burden. Antiretroviral pre-exposure prophylaxis (PrEP) can reduce MSM's vulnerability to HIV infection. Uptake of PrEP has been limited, particularly among racial and ethnic minority MSM. Four semi-structured focus groups with gay and bisexual men and other MSM at risk for HIV infection were convened in Boston and Jackson in late 2013. The analysis plan utilized a within-case, across-case approach to code and analyze emerging themes, and to compare results across the two cities. Participants recruited in Jackson were primarily Black gay men, while Boston participants were mostly non-Hispanic White gay men. Participants in both sites shared concerns about medication side effects and culturally insensitive health care for gay men. Jackson participants described stronger medical mistrust, and more frequently described experiences of anti-gay and HIV related stigma. Multiple addressable barriers to PrEP uptake were described. Information about side effects should be explicitly addressed in PrEP education campaigns. Providers and health departments should address medical mistrust, especially among Black gay and bisexual men and other MSM, in part by training providers in how to provide affirming, culturally competent care. Medicaid should be expanded in Mississippi to cover low-income young Black gay and bisexual men and other MSM.

Improved removal of blood contamination from ThinPrep cervical cytology samples for Raman spectroscopic analysis.

Science.gov (United States)

Traynor, Damien; Duraipandian, Shiyamala; Martin, Cara M; O'Leary, John J; Lyng, Fiona M

2018-05-01

There is an unmet need for methods to help in the early detection of cervical precancer. Optical spectroscopy-based techniques, such as Raman spectroscopy, have shown great potential for diagnosis of different cancers, including cervical cancer. However, relatively few studies have been carried out on liquid-based cytology (LBC) pap test specimens and confounding factors, such as blood contamination, have been identified. Previous work reported a method to remove blood contamination before Raman spectroscopy by pretreatment of the slides with hydrogen peroxide. The aim of the present study was to extend this work to excessively bloody samples to see if these could be rendered suitable for Raman spectroscopy. LBC ThinPrep specimens were treated by adding hydrogen peroxide directly to the vial before slide preparation. Good quality Raman spectra were recorded from negative and high grade (HG) cytology samples with no blood contamination and with heavy blood contamination. Good classification between negative and HG cytology could be achieved for samples with no blood contamination (sensitivity 92%, specificity 93%) and heavy blood contamination (sensitivity 89%, specificity 88%) with poorer classification when samples were combined (sensitivity 82%, specificity 87%). This study demonstrates for the first time the improved potential of Raman spectroscopy for analysis of ThinPrep specimens regardless of blood contamination. (2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

To improve training methods in an engine room simulator-based training

OpenAIRE

Lin, Chingshin

2016-01-01

The simulator based training are used widely in both industry and school education to reduce the accidents nowadays. This study aims to suggest the improved training methods to increase the effectiveness of engine room simulator training. The effectiveness of training in engine room will be performance indicators and the self-evaluation by participants. In the first phase of observation, the aim is to find out the possible shortcomings of current training methods based on train...

High acceptability of HIV pre-exposure prophylaxis but challenges in adherence and use: qualitative insights from a phase I trial of intermittent and daily PrEP in at-risk populations in Kenya.

Science.gov (United States)

Van der Elst, Elisabeth Maria; Mbogua, Judie; Operario, Don; Mutua, Gaudensia; Kuo, Caroline; Mugo, Peter; Kanungi, Jennifer; Singh, Sagri; Haberer, Jessica; Priddy, Frances; Sanders, Eduard Joachim

2013-07-01

This paper used qualitative methods to explore experiences of men who have sex with men and female sex workers in Nairobi and Mtwapa, Kenya, who used oral pre-exposure prophylaxis (PrEP) for HIV prevention as part of a four-month trial of safety, acceptability and adherence. Fifty-one of 72 volunteers who took part in a randomized, placebo-controlled, blinded trial that compared daily and intermittent dosage of PrEP underwent qualitative assessments after completing the trial. Analyses identified three themes: (i) acceptability of PrEP was high, i.e. side effects were experienced early in the study but diminished over time, however characteristics of pills could improve comfort and use; (ii) social impacts such as stigma, rumors, and relationship difficulties due to being perceived as HIV positive were prevalent; (iii) adherence was challenged by complexities of daily life, in particular post-coital dosing adherence suffered from alcohol use around time of sex, mobile populations, and transactional sex work. These themes resonated across dosing regimens and gender, and while most participants favored the intermittent dosing schedule, those in the intermittent group noted particular challenges in adhering to the post-coital dose. Culturally appropriate and consistent counseling addressing these issues may be critical for PrEP effectiveness.

Impact of the COBAS AmpliPrep/COBAS AMPLICOR HIV-1 MONITOR Test, Version 1.5, on Clinical Laboratory Operations▿

Science.gov (United States)

Germer, Jeffrey J.; Bendel, Jordan L.; Dolenc, Craig A.; Nelson, Sarah R.; Masters, Amanda L.; Gerads, Tara M.; Mandrekar, Jayawant N.; Mitchell, P. Shawn; Yao, Joseph D. C.

2007-01-01

The COBAS AmpliPrep/COBAS AMPLICOR HIV-1 MONITOR Test, version 1.5 (CAP/CA), and the COBAS AMPLICOR HIV-1 MONITOR Test, version 1.5, were compared. CAP/CA reduced and consolidated labor while modestly increasing assay throughput without increased failure rates or direct costs, regardless of batch size and assay format. PMID:17634308

Evaluation of DELTA PREP: A Project Aimed at Integrating Primary Prevention of Intimate Partner Violence within State Domestic Violence Coalitions

Science.gov (United States)

Freire, Kimberley E.; Zakocs, Ronda; Le, Brenda; Hill, Jessica A.; Brown, Pamela; Wheaton, Jocelyn

2015-01-01

Background: Intimate partner violence (IPV) has been recognized as a public health problem since the late 20th century. To spur IPV prevention efforts nationwide, the DELTA PREP Project selected 19 state domestic violence coalitions to build organizational prevention capacity and catalyze IPV primary prevention strategies within their states.…

Do Students Need Special Rooms to Release Negative Emotions?

Institute of Scientific and Technical Information of China (English)

无

2011-01-01

Before this year’s national college entrance examination,a middle school in Zhenjiang,a city of east China’s Jiangsu Province,established a room for students to take out their negative emotions,such ass tress,sorrow and anxiety,to enable a better frame of mind when sitting exams.

PREP: Production and Reprocessing management tool for CMS

International Nuclear Information System (INIS)

Cossutti, F; Lenzi, P; Naziridis, N; Samyn, D; Stöckli, F

2012-01-01

The production of simulated samples for physics analysis at LHC represents a noticeable organization challenge, because it requires the management of several thousands different workflows. The submission of a workflow to the grid based computing infrastructure starts with the definition of the general characteristics of a given set of coherent samples (called a ‘campaign'), up to the definition of the physics settings to be used for each sample corresponding to a specific process to be simulated, both at hard event generation and detector simulation level. In order to have an organized control of the of the definition of the large number of MC samples needed by CMS, a dedicated management tool, called PREP, has been built. Its basic component is a database storing all the relevant information about the sample and the actions implied by the workflow definition, approval and production. A web based interface allows the database to be used from experts involved in production to trigger all the different actions needed, as well as by normal physicists involved in analyses to retrieve the relevant information. The tool is integrated through a set of dedicated APIs with the production agent and information storage utilities of CMS.

Operating room fires: a closed claims analysis.

Science.gov (United States)

Mehta, Sonya P; Bhananker, Sanjay M; Posner, Karen L; Domino, Karen B

2013-05-01

To assess patterns of injury and liability associated with operating room (OR) fires, closed malpractice claims in the American Society of Anesthesiologists Closed Claims Database since 1985 were reviewed. All claims related to fires in the OR were compared with nonfire-related surgical anesthesia claims. An analysis of fire-related claims was performed to identify causative factors. There were 103 OR fire claims (1.9% of 5,297 surgical claims). Electrocautery was the ignition source in 90% of fire claims. OR fire claims more frequently involved older outpatients compared with other surgical anesthesia claims (P fire claims (P fires (n = 93) increased over time (P fires occurred during head, neck, or upper chest procedures (high-fire-risk procedures). Oxygen served as the oxidizer in 95% of electrocautery-induced OR fires (84% with open delivery system). Most electrocautery-induced fires (n = 75, 81%) occurred during monitored anesthesia care. Oxygen was administered via an open delivery system in all high-risk procedures during monitored anesthesia care. In contrast, alcohol-containing prep solutions and volatile compounds were present in only 15% of OR fires during monitored anesthesia care. Electrocautery-induced fires during monitored anesthesia care were the most common cause of OR fires claims. Recognition of the fire triad (oxidizer, fuel, and ignition source), particularly the critical role of supplemental oxygen by an open delivery system during use of the electrocautery, is crucial to prevent OR fires. Continuing education and communication among OR personnel along with fire prevention protocols in high-fire-risk procedures may reduce the occurrence of OR fires.

Control room philosophy: Principles of control room design and control room work

International Nuclear Information System (INIS)

Skriver, Jan; Ramberg, Jasmine; Allwin, Pernilla

2006-01-01

In order to provide insights for improvement of work in control rooms several factors have to be considered. Knowledge of principles including control room philosophies will guide the recommended improvements. In addition to knowledge about specific principles an advantage for an organization can be an understanding of similarities and policies used in other high risk industry. The report has been developed on the basis of a document analysis of international standards and other guiding documents. (NUREG 0711, ISO 11064, ISO 6385, IEC 60964). In addition to the document analysis which has strived to compare the documents to see similarities in important principals, experience from working with control room design, modifications and evaluations in other high risk industries has pervaded the report. Important principles have been identified which are recommended to be included in a control room philosophy. Many of these are similar to the principles identified in the international standards. An additional principal which is regarded as important is the utilization of Key Performance Indicators (KPI) which can be used as a measure to target preventative means. Further more it is critical that the control room philosophy is easy to access and comprehend for all users. One of the challenges that remain after having developed a control room philosophy is how to utilize it in the daily work situation. It is vital that the document remains as a living document, guiding the continual improvement of the control room in the various life cycle stages

EPA urges schools to check for radon

International Nuclear Information System (INIS)

Anon.

1989-01-01

In April recommended that schools test their facilities for radioactive radon gas after examining preliminary test data from 130 schools scattered across the country which indicated that elevated radon levels may be at least as prevalent in schools as in private residences. EPA is recommending that schools test 100 percent of frequently-used rooms on the basement-level and ground-level floors. The agency also recommends that testing be conducted in the cooler months of the year when doors and windows are likely to be closed. As part of a study to gather more information about measuring radon in schools, EPA tested approximately 3000 classrooms in 16 states. The states are widely distributed across the country. Of the total number of rooms, 54 percent had at least one room with a radon level above four picocuries per liter of air pCi/L. Nineteen percent had radon levels above four pCi/L. Three percent of the classrooms measured had radon level over 20 pCi/L. Each of the 16 states had a school with one measurement over four pCi/L, and one school had levels as high as 136 pCi/L

Strong relationship between oral dose and tenofovir hair levels in a randomized trial: hair as a potential adherence measure for pre-exposure prophylaxis (PrEP.

Directory of Open Access Journals (Sweden)

Albert Y Liu

Full Text Available Pre-exposure prophylaxis (PrEP trials using tenofovir-based regimens have demonstrated that high levels of adherence are required to evaluate efficacy; the incorporation of objective biomarkers of adherence in trial design has been essential to interpretation, given the inaccuracy of self-report. Antiretroviral measurements in scalp hair have been useful as a marker of long-term exposure in the HIV treatment setting, and hair samples are relatively easy and inexpensive to collect, transport, and store for analysis. To evaluate the relationship between dose and tenofovir concentrations in hair, we examined the dose proportionality of tenofovir in hair in healthy, HIV-uninfected adults.A phase I, crossover pharmacokinetic study was performed in 24 HIV-negative adults receiving directly-observed oral tenofovir tablets administered 2, 4, and 7 doses/week for 6 weeks, with a ≥3-week break between periods. Small samples of hair were collected after each six-week period and analyzed for tenofovir concentrations. Geometric-mean-ratios compared levels between each pair of dosing conditions. Intensive plasma pharmacokinetic studies were performed during the daily-dosing period to calculate areas-under-the-time-concentration curves (AUCs.Over 90% of doses were observed per protocol. Median tenofovir concentrations in hair increased monotonically with dose. A log-linear relationship was seen between dose and hair levels, with an estimated 76% (95% CI 60-93% increase in hair level per 2-fold dose increase. Tenofovir plasma AUCs modestly predicted drug concentrations in hair.This study found a strong linear relationship between frequency of dosing and tenofovir levels in scalp hair. The analysis of quantitative drug levels in hair has the potential to improve adherence measurement in the PrEP field and may be helpful in determining exposure thresholds for protection and explaining failures in PrEP trials. Hair measures for adherence monitoring may also

In the Absence of a Mechanical Bowel Prep, Does the Addition of Pre-Operative Oral Antibiotics to Parental Antibiotics Decrease the Incidence of Surgical Site Infection after Elective Segmental Colectomy?

Science.gov (United States)

Atkinson, Sarah J; Swenson, Brian R; Hanseman, Dennis J; Midura, Emily F; Davis, Bradley R; Rafferty, Janice F; Abbott, Daniel E; Shah, Shimul A; Paquette, Ian M

2015-12-01

Pre-operative oral antibiotics administered the day prior to elective colectomy have been shown to decrease the incidence of surgical site infections (SSI) if a mechanical bowel prep (MBP) is used. Recently, the role for mechanical bowel prep has been challenged as being unnecessary and potentially harmful. We hypothesize that if MBP is omitted, oral antibiotics do not alter the incidence of SSI following colectomy. We selected patients who underwent an elective segmental colectomy from the 2012 and 2013 National Surgical Quality Improvement Program colectomy procedure targeted database. Indications for surgery included colon cancer, diverticulitis, inflammatory bowel disease, or benign polyp. Patients who received mechanical bowel prep were excluded. The primary outcome measured was surgical site infection, defined as the presence of superficial, deep or, organ space infection within 30 d from surgery. A total of 6,399 patients underwent elective segmental colectomy without MBP. The incidence of SSI differed substantially between patients who received oral antibiotics, versus those who did not (9.7% vs. 13.7%, p=0.01). Multivariate analysis indicated that age, smoking status, operative time, perioperative transfusions, oral antibiotics, and surgical approach were associated with post-operative SSI. When controlling for confounding factors, the use of pre-operative oral antibiotics decreased the incidence of surgical site infection (odds ratio=0.66, 95% confidence interval=0.48-0.90, p=0.01). Even in the absence of mechanical bowel prep, pre-operative oral antibiotics appear to reduce the incidence of surgical site infection following elective colectomy.

Radon in schools. An elevation measurement in schools in Baden-Wuerttemberg

International Nuclear Information System (INIS)

Fesenbeck, I.; Naber, C.; Frank, G.; Wilhelm, C.; Schaller, M.

2016-01-01

With an effective dose of about 1.1 mSv per year, radon and its secondary products have the biggest share in the population's natural radiation exposure. For implementation of the new EU directive 2013/59/EURATOM dated January 17, 2014, it is now planned to adapt the limit values of the Radiation Protection Ordinance and to extend the scope of validity in the EU member states. The ''Radon at Schools'' project is to cover an area-wide survey of radon concentrations in room air of schools in Baden-Wuerttemberg. Potential hazards caused by radon-222 and secondary products of radon are to be studied. For the project, 1600 schools were selected and requested to participate by an information letter. Half of the schools is distributed over the entire area of Baden-Wuerttemberg. The other half is located in areas of increased radon potential. Radon concentration in room air is determined passively by Karlsruhe radon exposimeters. Subsequently, active radon measurements will be made at conspicuous schools and information events will be offered for municipalities, teachers, interested parents, and pupils.

Room escape at class: escape games activities to facilitate the motivation and learning in computer science

OpenAIRE

Borrego, Carlos; Fernández, Cristina; Blanes, Ian; Robles, Sergi

2017-01-01

Real-life room-escape games are ludic activities in which participants enter a room in order to get out of it only after solving some riddles. In this paper, we explain a Room Escape teaching experience developed in the Engineering School at Universitat Autònoma de Barcelona. The goal of this activity is to increase student’s motivation and to improve their learning on two courses of the second year in the Computer Engineering degree: Computer Networksand Information and Security Peer Revi...

Room Acoustics

Science.gov (United States)

Kuttruff, Heinrich; Mommertz, Eckard

The traditional task of room acoustics is to create or formulate conditions which ensure the best possible propagation of sound in a room from a sound source to a listener. Thus, objects of room acoustics are in particular assembly halls of all kinds, such as auditoria and lecture halls, conference rooms, theaters, concert halls or churches. Already at this point, it has to be pointed out that these conditions essentially depend on the question if speech or music should be transmitted; in the first case, the criterion for transmission quality is good speech intelligibility, in the other case, however, the success of room-acoustical efforts depends on other factors that cannot be quantified that easily, not least it also depends on the hearing habits of the listeners. In any case, absolutely "good acoustics" of a room do not exist.

New Ideas for School Construction.

Science.gov (United States)

Producers' Council, Inc., Washington, DC.

Present educators, architects, engineers, and building product manufacturers with a medium of common interest for discussion of mutual school construction problems, objectives, needs, ideas, capabilities and limitations. Contents include--(1) modern wood construction, (2) school room in a steel mill, (3) masonry in new school design, (4) the…

School food policy at Dutch primary schools: room for improvement? Cross-sectional findings from the INPACT study.

Science.gov (United States)

van Ansem, Wilke Jc; Schrijvers, Carola Tm; Rodenburg, Gerda; Schuit, Albertine J; van de Mheen, Dike

2013-04-12

Schools can play an important role in the prevention of obesity, e.g. by providing an environment that stimulates healthy eating habits and by developing a food policy to provide such an environment. The effectiveness of a school food policy is affected by the content of the policy, its implementation and its support by parents, teachers and principals. The aim of this study is to detect opportunities to improve the school food policy and/or implementation at Dutch primary schools. Therefore, this study explores the school food policy and investigates schools' (teachers and principals) and parents' opinion on the school food policy. Data on the schools' perspective of the food policy was collected from principals and teachers by means of semi-structured interviews. In total 74 principals and 72 teachers from 83 Dutch primary schools were interviewed. Data on parental perceptions about the school food policy were based on a cross-sectional survey among 1,429 parents from the same schools. Most principals (87.1%) reported that their school had a written food policy; however in most cases the rules were not clearly defined. Most of the principals (87.8%) believed that their school paid sufficient attention to nutrition and health. Teachers and principals felt that parents were primarily responsible to encourage healthy eating habits among children, while 49.8% of the parents believed that it is also a responsibility of the school to foster healthy eating habits among children. Most parents reported that they appreciated the school food policy and comply with the food rules. Parents' opinion on the enforcement of the school food policy varied: 28.1% believed that the school should enforce the policy more strongly, 32.1% was satisfied, and 39.8% had no opinion on this topic. Dutch primary schools could play a more important role in fostering healthy eating habits among children. The school food policy could be improved by clearly formulating food rules, simplifying

PREP-45, Input Preparation for CITATION-2

International Nuclear Information System (INIS)

Ramalho Carlos, C.A.

1995-01-01

1 - Description of program or function: A Fortran program has been created, which saves much effort in preparing sections 004 (intervals in the coordinates) and 005 (zone numbers) of the input data file for the multigroup theory code CITATION (version CITATION-2, NESC0387/09), particularly when a thin complicated mesh is used. 2 - Method of solution: A domain is defined for CITATION calculations through specifying its sub-domains (e.g. graphite, lead, beryllium, water and fuel sub-domains) in a compact and simple way. An independent and previous geometrical specification is made of the various types of elements which are envisaged to constitute the contents of the reactor core grid positions. Then the load table for the configuration is input and scanned throughout, thus enabling the geometric mesh description to be produced (section 004). Also the zone placement (section 005) is achieved by means of element description subroutines for the different types of element (which may require appropriate but simple changes in the actual cases). The output of PREP45 is directly obtained in a format which is compatible with CITATION-2 input. 3 - Restrictions on the complexity of the problem: Only rectangular two-dimensional Cartesian coordinates are considered. A maximum of 12 sub-domains in the x direction (18 in the y direction) and up to 8 distinct element types are considered in this version. Other limitations exist which can nevertheless be overcome with simple changes in the source program

Room escape at class: Escape games activities to facilitate the motivation and learning in computer science

Directory of Open Access Journals (Sweden)

Carlos Borrego

2017-06-01

Full Text Available Real-life room-escape games are ludic activities in which participants enter a room in order to get out of it only after solving some riddles. In this paper, we explain a Room Escape teaching experience developed in the Engineering School at Universitat Autònoma de Barcelona. The goal of this activity is to increase student’s motivation and to improve their learning on two courses of the second year in the Computer Engineering degree: Computer Networksand Information and Security.

Fossil Ridge School Intermediate: Restructure the Culture--Transform the School

Science.gov (United States)

Principal Leadership, 2013

2013-01-01

Ask a room full of sixth and seventh graders at Fossil Ridge Intermediate School in St. George, UT, to name their favorite part of the day and the answer is, in unison, always the same: REAL (respect, explore, achieve, lead) Time. This 35-minute block embedded into the school's schedule three days each week provides immediate, specific…

Cervical histology after routine ThinPrep or SurePath liquid-based cytology and computer-assisted reading in Denmark

DEFF Research Database (Denmark)

Rebolj, Matejka; Rask, Johanne; van Ballegooijen, Marjolein

2015-01-01

nationwide registers, technological phases were identified by slide preparation, reading technique, and triage of borderline cytology. Trends in the detection of cervical intraepithelial neoplasia (CIN) were an indicator of the technology's relative sensitivity, and trends in false-positive tests......BACKGROUND: We compared the sensitivity and specificity of liquid-based cytology (LBC) and computer-assisted reading for SurePath/FocalPoint and ThinPrep with those of manually read conventional cytology in routine cervical screening in four Danish laboratories. METHODS: Using data from five...

Three-dimensional point-cloud room model in room acoustics simulations

DEFF Research Database (Denmark)

Markovic, Milos; Olesen, Søren Krarup; Hammershøi, Dorte

2013-01-01

acquisition and its representation with a 3D point-cloud model, as well as utilization of such a model for the room acoustics simulations. A room is scanned with a commercially available input device (Kinect for Xbox360) in two different ways; the first one involves the device placed in the middle of the room...... and rotated around the vertical axis while for the second one the device is moved within the room. Benefits of both approaches were analyzed. The device's depth sensor provides a set of points in a three-dimensional coordinate system which represents scanned surfaces of the room interior. These data are used...... to build a 3D point-cloud model of the room. Several models are created to meet requirements of different room acoustics simulation algorithms: plane fitting and uniform voxel grid for geometric methods and triangulation mesh for the numerical methods. Advantages of the proposed method over the traditional...

Three-dimensional point-cloud room model for room acoustics simulations

DEFF Research Database (Denmark)

Markovic, Milos; Olesen, Søren Krarup; Hammershøi, Dorte

2013-01-01

acquisition and its representation with a 3D point-cloud model, as well as utilization of such a model for the room acoustics simulations. A room is scanned with a commercially available input device (Kinect for Xbox360) in two different ways; the first one involves the device placed in the middle of the room...... and rotated around the vertical axis while for the second one the device is moved within the room. Benefits of both approaches were analyzed. The device's depth sensor provides a set of points in a three-dimensional coordinate system which represents scanned surfaces of the room interior. These data are used...... to build a 3D point-cloud model of the room. Several models are created to meet requirements of different room acoustics simulation algorithms: plane fitting and uniform voxel grid for geometric methods and triangulation mesh for the numerical methods. Advantages of the proposed method over the traditional...

Radon remediation in irish schools

International Nuclear Information System (INIS)

Synnott, H.

2006-01-01

Full text: Commencing in 1998, the Radiological Protection Institute of Ireland carried out radon measurements in 3826 schools in the Republic of I reland on behalf of the Irish Department of Education and Science (D.E.S.). This represents approximately 97% of all schools in the country. Approximately 25% (984) schools had radon concentrations above the Irish national schools Reference Level for radon of 200 Bq/m 3 and required remedial work. The number of individual rooms with radon concentrations above 200 Bq/m 3 was 3020. Remedial work in schools commenced in early 2000. In general schools with maximum radon concentrations in the range 200 -400 Bq/m 3 in one or more rooms were remediated through the installation of passive systems such as an increase in permanent background ventilation mainly wall vents and trickle vents in windows. Schools with maximum radon concentrations greater than 400 Bq/m 3 were usually remediated through the provision of active systems mainly fan assisted sub -slab de pressurization or where this was not possible fan assisted under floor ventilation. The cost of the remedial programme was funded by central Government. Active systems were installed by specialized remedial contractors working to the specifications of a radon remedial expert appointed by the D.E.S. to design remedial systems for affected schools. Schools requiring increased ventilation were granted aided 190 pounds per affected room and had to organize the work themselves. In most schools radon remediation was successful in reducing existing radon concentrations to below the Reference Level. Average radon concentration reduction factors for sub-slab de pressurization systems and fan assisted fan assisted under floor ventilation ranged from 5 to 40 with greater reduction rates found at higher original radon concentrations. Increasing ventilation in locations with moderately elevated radon concentrations (200 - 400 Bq/m 3 ) while not as effective as active systems produced on

Room with a View: Ethical Encounters in Room 13

Science.gov (United States)

Grube, Vicky

2012-01-01

In this article, the author describes ethical encounters in Room 13, a schoolroom where children made what they wanted, posed their own questions, and ran an art room like a small business. In Room 13 children had the responsibility to maintain all aspects of the art studio. Specific decisions fell to an annually elected management team, a small…

Operating room management and operating room productivity: the case of Germany.

Science.gov (United States)

Berry, Maresi; Berry-Stölzle, Thomas; Schleppers, Alexander

2008-09-01

We examine operating room productivity on the example of hospitals in Germany with independent anesthesiology departments. Linked to anesthesiology group literature, we use the ln(Total Surgical Time/Total Anesthesiologists Salary) as a proxy for operating room productivity. We test the association between operating room productivity and different structural, organizational and management characteristics based on survey data from 87 hospitals. Our empirical analysis links improved operating room productivity to greater operating room capacity, appropriate scheduling behavior and management methods to realign interests. From this analysis, the enforcing jurisdiction and avoiding advance over-scheduling appear to be the implementable tools for improving operating room productivity.

Making Room for New Public Schools: How Innovative School Districts Are Learning to Share Public Education Facilities with Charter Schools

Science.gov (United States)

Sazon, Maria C.

2011-01-01

All public school children are entitled to quality public educational facilities--including those who attend public charter schools. Yet charter school leaders often spend substantial time and money searching for a facility. When they find one, they encounter significant costs associated with leasing or purchasing the building. They may have to…

The Impact of School-to-School Transitions on Academic Achievement: An Analysis of Various Grade-Span Configurations Utilized by Public School Districts in New York State

Science.gov (United States)

DelViscio, James J.

2013-01-01

At the beginning of the 20th century, there were essentially two types of organizational structures for primary and secondary education in the United States. There were either one-room K-12 schools or in larger systems K-8 buildings feeding into four-year high schools. Despite numerous experiments since then in reconfiguring schools resulting in a…

A Fast Solution to NGS Library Prep with Low Nanogram DNA Input

Science.gov (United States)

Liu, Pingfang; Lohman, Gregory J.S.; Cantor, Eric; Langhorst, Bradley W.; Yigit, Erbay; Apone, Lynne M.; Munafo, Daniela B.; Stewart, Fiona J.; Evans, Thomas C.; Nichols, Nicole; Dimalanta, Eileen T.; Davis, Theodore B.; Sumner, Christine

2013-01-01

Next Generation Sequencing (NGS) has significantly impacted human genetics, enabling a comprehensive characterization of the human genome as well as a better understanding of many genomic abnormalities. By delivering massive DNA sequences at unprecedented speed and cost, NGS promises to make personalized medicine a reality in the foreseeable future. To date, library construction with clinical samples has been a challenge, primarily due to the limited quantities of sample DNA available. Our objective here was to overcome this challenge by developing NEBNext® Ultra DNA Library Prep Kit, a fast library preparation method. Specifically, we streamlined the workflow utilizing novel NEBNext reagents and adaptors, including a new DNA polymerase that has been optimized to minimize GC bias. As a result of this work, we have developed a simple method for library construction from an amount of DNA as low as 5 ng, which can be used for both intact and fragmented DNA. Moreover, the workflow is compatible with multiple NGS platforms.

Hypoxia Room

Data.gov (United States)

Federal Laboratory Consortium — The Hypoxia Room is a 8x8x8 ft. clear vinyl plastic and aluminum frame construction enclosure located within USAREIM laboratory 028. The Hypoxia Room (manufactured...

Effect of Room Ventilation Rates in Rodent Rooms with Direct-Exhaust IVC Systems.

Science.gov (United States)

Geertsema, Roger S; Lindsell, Claire E

2015-09-01

When IVC are directly exhausted from a rodent housing room, the air quality of the room can become independent of the intracage air quality and may reduce the need for high room ventilation rates. This study assessed the effect of decreasing the ventilation rate in rodent rooms using direct-exhaust IVC systems. The study was conducted over 16 wk and compared conditions in 8 rodent rooms that had ventilation rates of 5 to 6 air changes per hour (ACH) with those in rooms at 10 to 12 ACH. At the low ventilation rate, rooms had higher CO₂ concentrations, higher dew point temperature, and lower particulate levels and spent a greater percentage of time above the temperature set point than did rooms at the high rate. The levels of allergens and endotoxins in room air were the same regardless of the ventilation rate. Differences seen in parameters within cages at the 2 ventilation rates were operationally irrelevant. We detected no total volatile organic compounds in the room that were attributable to ammonia, regardless of the ventilation rate. Clearing the air of ethanol after a spill took longer at the low compared with high rate. However, ethanol clearance was faster at the low rate when the demand-control system was activated than at the high ventilation rate alone. Air quality in the room and in the cages were acceptable with room ventilation rates of 5 to 6 ACH in rodent rooms that use direct-exhaust IVC systems.

Room temperature superconductors

International Nuclear Information System (INIS)

Sleight, A.W.

1995-01-01

If the Holy Grail of room temperature superconductivity could be achieved, the impact on could be enormous. However, a useful room temperature superconductor for most applications must possess a T c somewhat above room temperature and must be capable of sustaining superconductivity in the presence of magnetic fields while carrying a significant current load. The authors will return to the subject of just what characteristics one might seek for a compound to be a room temperature superconductor. 30 refs., 3 figs., 1 tab

Room acoustics modeling using a point-cloud representation of the room geometry

DEFF Research Database (Denmark)

Markovic, Milos; Olesen, Søren Krarup; Hammershøi, Dorte

2013-01-01

Room acoustics modeling is usually based on the room geometry that is parametrically described prior to a sound transmission calculation. This is a highly room-specific task and rather time consuming if a complex geometry is to be described. Here, a run time generic method for an arbitrary room...... geometry acquisition is presented. The method exploits a depth sensor of the Kinect device that provides a point based information of a scanned room interior. After post-processing of the Kinect output data, a 3D point-cloud model of the room is obtained. Sound transmission between two selected points...... level of user immersion by a real time acoustical simulation of a dynamic scenes....

TUGAS ROOM ATTENDANT DALAM MENANGANI COMPLAINT TAMU DELUXE ROOM HOTEL HYAAT REGENCY BANDUNG

Directory of Open Access Journals (Sweden)

Reza Gustia Purnama

2016-05-01

Full Text Available Abstract - The problem is how meticulous the duties and responsibilities of the room attendant in the deluxe room Hotel Hyatt Regency Bandung, standard operational procedures in the deluxe room Hotel Hyatt Regency Bandung, and handling guest complaint in deluxe room Hotel Hyatt Regency Bandung. Author uses descriptive analysis, which is a form of writing in the actual situation describes strive about the object of research, then the data obtained in the form of a report compiled in. Based on the results of observation it can be concluded that the task and responsibility of the room attendant in the deluxe room Hyatt Regency Bandung already carry it out in accordance with standard operational procedures (SOP which is divided into two shifts, morning and evening shift which has a slightly different task, standard operational procedures in the deluxe room Hyatt Regency Bandung has been standard operating procedure in applying it at the hotel Hyatt Regency Bandung, and Guest complaint handling in deluxe room Hyatt Regency Bandung Hotel how to deal with and resolve the complaint vary slightly in view of the type of complaint. Based on the results of observation and discussion, the authors conclude that the Duty room attendant in handling customers compaint deluxe room in the Hyatt Regency Bandung Hotel when his handlers was conducted appropriately and propesional effects will be good for the image of the hyatt regency hotel bandung.   Keywords: Room Attendant, Complaint, Deluxe room   Abstraksi - Masalah yang di teliti adalah tugas dan tanggung jawab room attendant di deluxe room Hotel Hyatt Regency Bandung, standar operasional prosedur di deluxe room Hotel Hyatt Regency Bandung, dan penanganan complaint tamu di deluxe room Hotel Hyatt Regency Bandung.  Metode yang di gunakan menggunakan analisis deskriptif, yaitu bentuk penulisan yang di upayakan menggambarkan keadaan yang sebenarnya tetang objek penelitian,kemudian data yang di peroleh disusun

Consensus builds on population policy as ICPD PrepCom meetings conclude. Vatican objections firm and vocal.

Science.gov (United States)

1994-04-29

In April, 1994, at UN headquarters in New York, delegates from almost 200 countries and nongovernmental organizations (NGOs) negotiated a Programme of Action to be ratified following more debate at the International Conference on Population and Development in Cairo in September. A sizable consensus emerged for this Preparatory Committee III (PrepCom) meeting. It has an expanded view of population policy that centers more on meeting individual needs and less on achieving strict demographic goals. Thus, it focuses on the unmet need for reproductive health services (family planning, basic women's health care, and services linked to sexually transmitted diseases). It considers women's status and female education as being important themselves as well as key determinants of fertility rates. Disagreement over access to abortion services and reproductive health services for adolescents remain. Unlike earlier world conferences, most of the world is working towards a consensus, while the Vatican and just a few small countries (Benin, Malta, Honduras, and Nicaragua) object to these services. Some topics that US National Conference of Catholic Bishops did not want in the Programme of Action were references to reducing the incidence of unsafe abortion, promoting condom use to prevent HIV/AIDS, and even safe motherhood. The US and Japan have committed sizable increases in population assistance. Some European countries are concerned about how their contributions would be allocated. US Undersecretary for Global Affairs and a mostly female 23-member US delegation attended PrepCom III. Most of the US delegates were from NGOs. Many country delegates were women. Many countries accepted recommendations of the women's caucus. The US's priorities are promotion of universal access to the full range of high quality family planning and reproductive health services; increasing women's status; child survival promotion; serving adolescent needs; augmenting the role and responsibility of men in

Single Nucleotide Polymorphism in Gene Encoding Transcription Factor Prep1 Is Associated with HIV-1-Associated Dementia

Science.gov (United States)

van Manen, Daniëlle; Bunnik, Evelien M.; van Sighem, Ard I.; Sieberer, Margit; Boeser-Nunnink, Brigitte; de Wolf, Frank; Schuitemaker, Hanneke; Portegies, Peter; Kootstra, Neeltje A.; van 't Wout, Angélique B.

2012-01-01

Background Infection with HIV-1 may result in severe cognitive and motor impairment, referred to as HIV-1-associated dementia (HAD). While its prevalence has dropped significantly in the era of combination antiretroviral therapy, milder neurocognitive disorders persist with a high prevalence. To identify additional therapeutic targets for treating HIV-associated neurocognitive disorders, several candidate gene polymorphisms have been evaluated, but few have been replicated across multiple studies. Methods We here tested 7 candidate gene polymorphisms for association with HAD in a case-control study consisting of 86 HAD cases and 246 non-HAD AIDS patients as controls. Since infected monocytes and macrophages are thought to play an important role in the infection of the brain, 5 recently identified single nucleotide polymorphisms (SNPs) affecting HIV-1 replication in macrophages in vitro were also tested. Results The CCR5 wt/Δ32 genotype was only associated with HAD in individuals who developed AIDS prior to 1991, in agreement with the observed fading effect of this genotype on viral load set point. A significant difference in genotype distribution among all cases and controls irrespective of year of AIDS diagnosis was found only for a SNP in candidate gene PREP1 (p = 1.2×10−5). Prep1 has recently been identified as a transcription factor preferentially binding the −2,518 G allele in the promoter of the gene encoding MCP-1, a protein with a well established role in the etiology of HAD. Conclusion These results support previous findings suggesting an important role for MCP-1 in the onset of HIV-1-associated neurocognitive disorders. PMID:22347417

Single nucleotide polymorphism in gene encoding transcription factor Prep1 is associated with HIV-1-associated dementia.

Directory of Open Access Journals (Sweden)

Sebastiaan M Bol

Full Text Available BACKGROUND: Infection with HIV-1 may result in severe cognitive and motor impairment, referred to as HIV-1-associated dementia (HAD. While its prevalence has dropped significantly in the era of combination antiretroviral therapy, milder neurocognitive disorders persist with a high prevalence. To identify additional therapeutic targets for treating HIV-associated neurocognitive disorders, several candidate gene polymorphisms have been evaluated, but few have been replicated across multiple studies. METHODS: We here tested 7 candidate gene polymorphisms for association with HAD in a case-control study consisting of 86 HAD cases and 246 non-HAD AIDS patients as controls. Since infected monocytes and macrophages are thought to play an important role in the infection of the brain, 5 recently identified single nucleotide polymorphisms (SNPs affecting HIV-1 replication in macrophages in vitro were also tested. RESULTS: The CCR5 wt/Δ32 genotype was only associated with HAD in individuals who developed AIDS prior to 1991, in agreement with the observed fading effect of this genotype on viral load set point. A significant difference in genotype distribution among all cases and controls irrespective of year of AIDS diagnosis was found only for a SNP in candidate gene PREP1 (p = 1.2 × 10(-5. Prep1 has recently been identified as a transcription factor preferentially binding the -2,518 G allele in the promoter of the gene encoding MCP-1, a protein with a well established role in the etiology of HAD. CONCLUSION: These results support previous findings suggesting an important role for MCP-1 in the onset of HIV-1-associated neurocognitive disorders.

Examination of hepatic contrast-enhanced CT monitored by Smart Prep

International Nuclear Information System (INIS)

Kakizaki, Dai; Saito, Kazuhiro; Sakurada, Toru; Abe, Kimihiko; Suzuki, Kenji

1999-01-01

The aim of the present study is to obtain the time density curves of the contrast-enhanced CT of hepatic portal vein, hepatic and splenic parenchyma, and to examine the relation with age, body weight, type of liver dysfunction. Subjects were 32 patients with liver tumors or liver diseases. For this purpose, the procedure of hepatic CT was monitored by Smart Prep and the images of whole liver was taken when the level of the contrast at the hepatic portal vein reached to the enhancement threshold. The contrast medium used was Iomeprol 300. The adverse reactions by Iomeprol 300 were mild and any treatment did not need. There was no correlation age and weight with enhancement threshold at the hepatic portal vein and peak time at the splenic parenchyma. The enhancement threshold at the hepatic portal vein was various in patients with chrrhosis and chronic hepatitis, and tended to be delayed in patients with chrrhosis. The peak time of the splenic parenchyma was up to 52 seconds in all patients with chronic hepatitis. The shortage of the enhancement threshold and the increase in blood flow at arterial early phase were observed in the patients with advanced acute hepatitis. This method should be examined more cases with various hepatic diseases. (K.H.)

What Orthopaedic Operating Room Surfaces Are Contaminated With Bioburden? A Study Using the ATP Bioluminescence Assay.

Science.gov (United States)

Richard, Raveesh Daniel; Bowen, Thomas R

2017-07-01

Contaminated operating room surfaces can increase the risk of orthopaedic infections, particularly after procedures in which hardware implantation and instrumentation are used. The question arises as to how surgeons can measure surface cleanliness to detect increased levels of bioburden. This study aims to highlight the utility of adenosine triphosphate (ATP) bioluminescence technology as a novel technique in detecting the degree of contamination within the sterile operating room environment. What orthopaedic operating room surfaces are contaminated with bioburden? When energy is required for cellular work, ATP breaks down into adenosine biphosphate (ADP) and phosphate (P) and in that process releases energy. This process is inherent to all living things and can be detected as light emission with the use of bioluminescence assays. On a given day, six different orthopaedic surgery operating rooms (two adult reconstruction, two trauma, two spine) were tested before surgery with an ATP bioluminescence assay kit. All of the cases were considered clean surgery without infection, and this included the previously performed cases in each sampled room. These rooms had been cleaned and prepped for surgery but the patients had not been physically brought into the room. A total of 13 different surfaces were sampled once in each room: the operating room (OR) preparation table (both pre- and postdraping), OR light handles, Bovie machine buttons, supply closet countertops, the inside of the Bair Hugger™ hose, Bair Hugger™ buttons, right side of the OR table headboard, tourniquet machine buttons, the Clark-socket attachment, and patient positioners used for total hip and spine positioning. The relative light units (RLUs) obtained from each sample were recorded and data were compiled and averaged for analysis. These values were compared with previously published ATP benchmark values of 250 to 500 RLUs to define cleanliness in both the hospital and restaurant industries. All

Improving operating room safety

Directory of Open Access Journals (Sweden)

Garrett Jill

2009-11-01

Full Text Available Abstract Despite the introduction of the Universal Protocol, patient safety in surgery remains a daily challenge in the operating room. This present study describes one community health system's efforts to improve operating room safety through human factors training and ultimately the development of a surgical checklist. Using a combination of formal training, local studies documenting operating room safety issues and peer to peer mentoring we were able to substantially change the culture of our operating room. Our efforts have prepared us for successfully implementing a standardized checklist to improve operating room safety throughout our entire system. Based on these findings we recommend a multimodal approach to improving operating room safety.

Condition of Public School Plants 1964-65.

Science.gov (United States)

Collins, George J.; Stormer, William L.

This report provides factual information on the adequacy in terms of number of schoolrooms in the nation's school facilities and the physical condition of schoolrooms. Data are presented regarding--(1) building and site deficiencies, (2) ratio of pupils to instructional rooms, and (3) new facilities needed to achieve desirable pupil-room ratios. A…

Control room philosophy: Principles of control room design and control room work; Kontrollrumsfilosofi: Principer foer kontrollrumsutformning och kontrollrumsarbete

Energy Technology Data Exchange (ETDEWEB)

Skriver, Jan; Ramberg, Jasmine; Allwin, Pernilla [Scandpower Risk Management AB, Uppsala (Sweden)

2006-01-15

In order to provide insights for improvement of work in control rooms several factors have to be considered. Knowledge of principles including control room philosophies will guide the recommended improvements. In addition to knowledge about specific principles an advantage for an organization can be an understanding of similarities and policies used in other high risk industry. The report has been developed on the basis of a document analysis of international standards and other guiding documents. (NUREG 0711, ISO 11064, ISO 6385, IEC 60964). In addition to the document analysis which has strived to compare the documents to see similarities in important principals, experience from working with control room design, modifications and evaluations in other high risk industries has pervaded the report. Important principles have been identified which are recommended to be included in a control room philosophy. Many of these are similar to the principles identified in the international standards. An additional principal which is regarded as important is the utilization of Key Performance Indicators (KPI) which can be used as a measure to target preventative means. Further more it is critical that the control room philosophy is easy to access and comprehend for all users. One of the challenges that remain after having developed a control room philosophy is how to utilize it in the daily work situation. It is vital that the document remains as a living document, guiding the continual improvement of the control room in the various life cycle stages.

Reliability of estimating the room volume from a single room impulse response

OpenAIRE

Kuster, M.

2008-01-01

The methods investigated for the room volume estimation are based on geometrical acoustics, eigenmode, and diffuse field models and no data other than the room impulse response are available. The measurements include several receiver positions in a total of 12 rooms of vastly different sizes and acoustic characteristics. The limitations in identifying the pivotal specular reflections of the geometrical acoustics model in measured room impulse responses are examined both theoretically and expe...

School Violence: Data & Statistics

Science.gov (United States)

... Social Media Publications Injury Center School Violence: Data & Statistics Recommend on Facebook Tweet Share Compartir The first ... Vehicle Safety Traumatic Brain Injury Injury Response Data & Statistics (WISQARS) Funded Programs Press Room Social Media Publications ...

Detailed survey of 60-Hz magnetic fields in schools

International Nuclear Information System (INIS)

Peralta, S.B.; Mader, D.L.; Scheer, R.R.

1991-01-01

Data concerning magnetic field exposure levels in schools is sparse in comparison with data for houses. Surveys were made of power frequency magnetic fields in two schools in the Toronto area of Ontario. One school was a small, older school with a relatively simple electrical network, while the other was a newer, larger facility with more a complex system. Measured field levels clustered around the 0.06-0.125 microTesla range, a factor of two less than the fields commonly encountered in homes. Classrooms exhibited low-level fields, typically of the order of 0.05 microTesla. While a transmission line near one school raised ambient levels slightly, fields were mainly due to local sources such as building wiring and distribution panels. In one school, the major field source is a site transformer. However, the highest fields outside the transformer room, 0.3 microTesla, are found right next to the room, and decay rapidly with distance from the transformer. 7 refs., 24 figs

The Effects of Advance Graphic Organizers Strategy Intervention on Academic Achievement, Self Efficacy, and Motivation to Learn Social Studies in Learning Disabled Second Year Prep Students

Science.gov (United States)

Eissa, Mourad Ali

2012-01-01

This study investigated the effect of using advance graphic organizers on academic achievement, self efficacy, and motivation to learn social studies in learning disabled second year prep students. A total of 60 students identified with LD were invited to participate. The sample was randomly divided into two groups; experimental (n = 30, 23 boys,…

Baseline Preferences for Daily, Event-Driven, or Periodic HIV Pre-Exposure Prophylaxis among Gay and Bisexual Men in the PRELUDE Demonstration Project

Directory of Open Access Journals (Sweden)

Stefanie J. Vaccher

2017-12-01

Full Text Available IntroductionThe effectiveness of daily pre-exposure prophylaxis (PrEP is well established. However, there has been increasing interest in non-daily dosing schedules among gay and bisexual men (GBM. This paper explores preferences for PrEP dosing schedules among GBM at baseline in the PRELUDE demonstration project.Materials and methodsIndividuals at high-risk of HIV were enrolled in a free PrEP demonstration project in New South Wales, Australia, between November 2014 and April 2016. At baseline, they completed an online survey containing detailed behavioural, demographic, and attitudinal questions, including their ideal way to take PrEP: daily (one pill taken every day, event-driven (pills taken only around specific risk events, or periodic (daily dosing during periods of increased risk.ResultsOverall, 315 GBM (98% of study sample provided a preferred PrEP dosing schedule at baseline. One-third of GBM expressed a preference for non-daily PrEP dosing: 20% for event-driven PrEP, and 14% for periodic PrEP. Individuals with a trade/vocational qualification were more likely to prefer periodic to daily PrEP [adjusted odds ratio (aOR = 4.58, 95% confidence intervals (95% CI: (1.68, 12.49], compared to individuals whose highest level of education was high school. Having an HIV-positive main regular partner was associated with strong preference for daily, compared to event-driven PrEP [aOR = 0.20, 95% CI: (0.04, 0.87]. Participants who rated themselves better at taking medications were more likely to prefer daily over periodic PrEP [aOR = 0.39, 95% CI: (0.20, 0.76].DiscussionIndividuals’ preferences for PrEP schedules are associated with demographic and behavioural factors that may impact on their ability to access health services and information about PrEP and patterns of HIV risk. At the time of data collection, there were limited data available about the efficacy of non-daily PrEP schedules, and clinicians only recommended daily PrEP to

Room temperature nanoindentation creep of hot-pressed B6O

CSIR Research Space (South Africa)

Machaka, R

2014-06-01

Full Text Available of the nanoindentation creep behavior in B6O ceramics. 1 Room temperature nanoindentation creep of hot-pressed B6O Ronald Machakaa,b,* , Trevor E. Derryb,d, Iakovos Sigalasb,c aLight Metals, Materials Science and Manufacturing, Council for Scientific..., University of the Witwatersrand, Private Bag 3, Wits, Johannesburg 2050, South Africa dSchool of Physics, University of the Witwatersrand, Private Bag 3, Wits, Johannesburg 2050, 2050 South Africa Abstract: Nanoindentation has become a widely...

Future control room design (modernization of control room systems)

International Nuclear Information System (INIS)

Reischl, Ludwig; Freitag, Timo; Dergel, Rene

2009-01-01

In the frame of lifetime extension for nuclear power plants the modernization of the complete safety and operational control technology will be digitalized. It is also recommended to modernize the operator facilities, monitoring systems in the control room, the back-up shut-down center and the local control stations. The authors summarize the reasons for the modernization recommendations and discuss possible solutions for display-oriented control rooms. A concept for control room backfitting includes generic requirements, requirements of the local authorities, ergonomic principles information content and information density, and the design process. The backfitting strategy should include a cooperation with the operational personnel, The quality assurance and training via simulator needs sufficient timing during the implementation of the backfitting.

Controlling the clean room atmosphere

International Nuclear Information System (INIS)

Meeks, R.F.

1979-01-01

Several types of clean rooms are commonly in use. They include the conventional clean room, the horizontal laminar flow clean room, the vertical laminar flow clean room and a fourth type that incorporates ideas from the previous types and is known as a clean air bench or hood. These clean rooms are briefly described. The origin of contamination and methods for controlling the contamination are discussed

School food policy at Dutch primary schools: Room for improvement? Cross-sectional findings from the INPACT study

NARCIS (Netherlands)

W.J.C. van Ansem (Wilke); C.Th.M. Schrijvers (Carola); G. Rodenburg (Gerda); A.J. Schuit (Jantine); H. van de Mheen (Dike)

2013-01-01

textabstractBackground: Schools can play an important role in the prevention of obesity, e.g. by providing an environment that stimulates healthy eating habits and by developing a food policy to provide such an environment. The effectiveness of a school food policy is affected by the content of the

Control room lay-out

International Nuclear Information System (INIS)

Toma, Violeta

2004-01-01

TRIUMF (Tri-University Meson Facility) is Canada's national laboratory for particle and nuclear physics. There are 6 accelerators and 3 Control Rooms at TRIUMF. The main control room serves the big cyclotron, the 500 MeV, and the adjacent experiment. The 42 MeV and two 32 MeV ones are production dedicated. These cyclotrons belong to a private company but are operated by TRIUMF staff from ATG (Applied Technology Group) Control Room. The last is ISAC (Isotope Acceleration and Separation) Control Room, from which the LINAC is controlled. Research areas cover theoretical (2 subjects), pure (5 subjects) and applied (8 subjects) physics. In the early '70s, as the 500 MeV was being completed, the first Control Room was built in the main accelerator building. The recent topics covered by this paper are proton and pion therapy, what are the operator's duties?, the CP42, TR30 and TR13 cyclotron control rooms, the ISAC control systems including control room modification. Due to the nature of an operator's job, the Control Room layout is pretty important. This is true for any work environment, but when working shifts it becomes essential. Lots of time and effort, not to mention money, were spent to figure out the optimum configuration. It seems to me that the key factor in the control room layout is versatility, and this is because it has to keep happy a group of people with different inclinations, which have a tendency to become quite moody after the second night shift. No matter what, there will still be unhappy people, but we are trying our best. (Y. Tanaka)

Results of the Abbott RealTime HIV-1 assay for specimens yielding "target not detected" results by the Cobas AmpliPrep/Cobas TaqMan HIV-1 Test.

Science.gov (United States)

Babady, N Esther; Germer, Jeffrey J; Yao, Joseph D C

2010-03-01

No significantly discordant results were observed between the Abbott RealTime HIV-1 assay and the COBAS AmpliPrep/COBAS TaqMan HIV-1 Test (CTM) among 1,190 unique clinical plasma specimens obtained from laboratories located in 40 states representing all nine U.S. geographic regions and previously yielding "target not detected" results by CTM.

School food policy at Dutch primary schools: room for improvement? Cross-sectional findings from the INPACT study

NARCIS (Netherlands)

van Ansem, Wilke Jc; Schrijvers, Carola Tm; Rodenburg, Gerda; Schuit, Albertine J; van de Mheen, Dike

2013-01-01

BACKGROUND: Schools can play an important role in the prevention of obesity, e.g. by providing an environment that stimulates healthy eating habits and by developing a food policy to provide such an environment. The effectiveness of a school food policy is affected by the content of the policy, its

Room Acoustical Fields

CERN Document Server

Mechel, Fridolin

2013-01-01

This book presents the theory of room acoustical fields and revises the Mirror Source Methods for practical computational use, emphasizing the wave character of acoustical fields.  The presented higher methods include the concepts of “Mirror Point Sources” and “Corner sources which allow for an excellent approximation of complex room geometries and even equipped rooms. In contrast to classical description, this book extends the theory of sound fields describing them by their complex sound pressure and the particle velocity. This approach enables accurate descriptions of interference and absorption phenomena.

Evaluation of DELTA PREP: A Project Aimed at Integrating Primary Prevention of Intimate Partner Violence Within State Domestic Violence Coalitions

Science.gov (United States)

Freire, Kimberley E.; Zakocs, Ronda; Le, Brenda; Hill, Jessica A.; Brown, Pamela; Wheaton, Jocelyn

2018-01-01

Background Intimate partner violence (IPV) has been recognized as a public health problem since the late 20th century. To spur IPV prevention efforts nationwide, the DELTA PREP Project selected 19 state domestic violence coalitions to build organizational prevention capacity and catalyze IPV primary prevention strategies within their states. Objective DELTA PREP’s summative evaluation addressed four major questions: (1) Did coalitions improve their prevention capacity during the project period? (2) Did coalitions serve as catalysts for prevention activities within their states during the project period? (3) Was initial prevention capacity associated with the number of prevention activity types initiated by coalitions by the end of the project? (4) Did coalitions sustain their prevention activities 6 months after the end of the project period? Results DELTA PREP achieved its capacity-building goal, with all 19 participant coalitions integrating prevention within their organizations and serving as catalysts for prevention activities in their states. At 6 months follow up, coalitions had sustained almost all prevention activities they initiated during the project. Baseline prevention capacity (Beginner vs. Intermediate) was not associated with the number of prevention activity types coalitions implemented by the end of the project. Conclusion Service and treatment organizations are increasingly asked to integrate a full spectrum of prevention strategies. Selecting organizations that have high levels of general capacity and readiness for an innovation like integrating a public health approach to IPV prevention will likely increase success in building an innovation-specific capacity, and in turn implementing an innovation. PMID:26245932

PREPS2 - a PC-based computer program for performing economic analysis of capital projects

International Nuclear Information System (INIS)

Blake, M.W.; Brand, D.O.; Chastain, E.T.; Johnson, E.D.

1990-01-01

In these times of increased spending to finance new capacity and to meet clean air act legislation, many electric utilities are giving a high priority to controlling capital expenditures at existing generating facilities. Determining the level of capital expenditures which are economically justified is very difficult; units which have higher capacity factors are worth more to the utility. Therefore, the utility can more readily justify higher capital expenditures to improve or maintain reliability and heat rate than on units with lower capacity factors. This paper describes a PC-based computer program (PREPS2) which performs an economic analysis of individual capital projects. The program incorporates tables which describe the worth to the system of making improvements in each unit. This computer program is currently being used by the six Southern Company operating companies to evaluate all production capital projects over $50,000. Approximately 500 projects representing about $300 million are being analyzed each year

Virtual Seminar Room

DEFF Research Database (Denmark)

Forchhammer, Søren Otto; Fosgerau, Anders; Hansen, Peter Søren Kirk

1999-01-01

The initial design considerations and research goals for an ATM network based virtual seminar room with 5 sites are presented.......The initial design considerations and research goals for an ATM network based virtual seminar room with 5 sites are presented....

Accuracy of reading liquid based cytology slides using the ThinPrep Imager compared with conventional cytology: prospective study

Science.gov (United States)

d'Assuncao, Jefferson; Irwig, Les; Macaskill, Petra; Chan, Siew F; Richards, Adele; Farnsworth, Annabelle

2007-01-01

Objective To compare the accuracy of liquid based cytology using the computerised ThinPrep Imager with that of manually read conventional cytology. Design Prospective study. Setting Pathology laboratory in Sydney, Australia. Participants 55 164 split sample pairs (liquid based sample collected after conventional sample from one collection) from consecutive samples of women choosing both types of cytology and whose specimens were examined between August 2004 and June 2005. Main outcome measures Primary outcome was accuracy of slides for detecting squamous lesions. Secondary outcomes were rate of unsatisfactory slides, distribution of squamous cytological classifications, and accuracy of detecting glandular lesions. Results Fewer unsatisfactory slides were found for imager read cytology than for conventional cytology (1.8% v 3.1%; Pcytology (7.4% v 6.0% overall and 2.8% v 2.2% for cervical intraepithelial neoplasia of grade 1 or higher). Among 550 patients in whom imager read cytology was cervical intraepithelial neoplasia grade 1 or higher and conventional cytology was less severe than grade 1, 133 of 380 biopsy samples taken were high grade histology. Among 294 patients in whom imager read cytology was less severe than cervical intraepithelial neoplasia grade 1 and conventional cytology was grade 1 or higher, 62 of 210 biopsy samples taken were high grade histology. Imager read cytology therefore detected 71 more cases of high grade histology than did conventional cytology, resulting from 170 more biopsies. Similar results were found when one pathologist reread the slides, masked to cytology results. Conclusion The ThinPrep Imager detects 1.29 more cases of histological high grade squamous disease per 1000 women screened than conventional cytology, with cervical intraepithelial neoplasia grade 1 as the threshold for referral to colposcopy. More imager read slides than conventional slides were satisfactory for examination and more contained low grade cytological

Class Room Exercises Using JMA-59-Type Seismograms for Earthquake Study at High-School Level

Science.gov (United States)

Okamoto, Y.; Furuta, S.; Hirota, N.

2013-12-01

The JMA-59-type electromagnetic seismograph was the standard seismograph for routine observations by the Japan Meteorological Agency (JMA) from the 1960's to the 1990's. Some features of those seismograms include 1) displacement wave records (electrically integrated from a velocity output by a moving-coil-type sensor), 2) ink records on paper (analog recording with time marks), 3) continuous drum recording for 12 h, and 4) lengthy operation time over several decades. However, the digital revolution in recording systems during the 1990's made these analog features obsolete, and their abundant and bulky paper-based records were stacked and sometimes disregarded in the library of every observatory. Interestingly, from an educational aspect, the disadvantages of these old-fashioned systems become highly advantageous for educational or outreach purposes. The updated digital instrument is essentially a 'black-box,' not revealing its internal mechanisms and being too fast for observing its signal processes. While the old seismometers and recording systems have been disposed of long since, stacks of analog seismograms continue to languish in observatories' back rooms. In our study, we develop some classroom exercises for studying earthquakes at the mid- to high-school level using these analog seismograms. These exercises include 1) reading the features of seismic records, 2) measuring the S-P time, 3) converting the hypocentral distance from Omori's distance formula, 4) locating the epicenter/hypocenter using the S-P times of surrounding stations, and 5) estimating earthquake magnitude using the Tsuboi's magnitude formula. For this calculation we developed a 'nomogram'--a graphical paper calculator created using a Python-based freeware tool named 'PyNomo.' We tested many seismograms and established the following rules: 1) shallow earthquakes are appropriate for using the Tsuboi's magnitude formula; 2) there is no saturation at peak amplitude; 3) seismograms make it easy to

Radon in schools. An elevation measurement in schools in Baden-Wuerttemberg; Radon in Schulen. Eine Erhebungsmessung in Baden-Wuerttemberg

Energy Technology Data Exchange (ETDEWEB)

Fesenbeck, I.; Naber, C.; Frank, G.; Wilhelm, C.; Schaller, M. [Karlsruher Institut fuer Technologie (Germany). Sicherheit und Umwelt

2016-07-01

With an effective dose of about 1.1 mSv per year, radon and its secondary products have the biggest share in the population's natural radiation exposure. For implementation of the new EU directive 2013/59/EURATOM dated January 17, 2014, it is now planned to adapt the limit values of the Radiation Protection Ordinance and to extend the scope of validity in the EU member states. The ''Radon at Schools'' project is to cover an area-wide survey of radon concentrations in room air of schools in Baden-Wuerttemberg. Potential hazards caused by radon-222 and secondary products of radon are to be studied. For the project, 1600 schools were selected and requested to participate by an information letter. Half of the schools is distributed over the entire area of Baden-Wuerttemberg. The other half is located in areas of increased radon potential. Radon concentration in room air is determined passively by Karlsruhe radon exposimeters. Subsequently, active radon measurements will be made at conspicuous schools and information events will be offered for municipalities, teachers, interested parents, and pupils.

Fighting the Normalization of Failure

Science.gov (United States)

Kundu, Anindya

2018-01-01

If students from all backgrounds and advantages were given equal opportunity to succeed, how would this change our schools? Anindya Kundu examines two New York City schools--Medgar Evers College Prep and The James Baldwin School--and how their energized school culture contributes to the success of all students. By leading with consistency,…

School District Officials' and City Stakeholders' Perceptions Regarding School Violence and Ways to Prevent School Violence

Science.gov (United States)

Patterson, Rita Mabon; Maldonado, Nancy; Howe, Mary

2014-01-01

Violence is a problem that affects the family structure, schools, and communities. Although some violence takes place behind closed doors, the effects are devastating to society and the community. The overwhelming results are seen with the increase of visits to abuse shelters and emergency rooms. Domestic violence in households tends to continue…

Radon testing in schools in New York State: a 20-year summary

International Nuclear Information System (INIS)

Kitto, Michael

2014-01-01

For nearly 20 years the Department of Health has conducted programs to assist in the measurement and reduction of indoor radon concentrations in 186 schools located primarily in Zone 1 areas of New York State. Although many schools had few or no rooms containing radon above 148 Bq/m 3 , some rooms had >740 Bq/m 3 and remediation techniques were utilized to reduce exposure. Short-term radon measurements in the schools showed little correlation to basement and first-floor radon results from single-family homes in the towns. - Highlights: • Relatively few schools in New York State have been tested for indoor radon. • We provide a summary of radon-testing results for measured schools. • The radon potential in schools is often less than in local houses. • Short-term measurement results exceeded their long-term counterparts in nearly every case

Results of the Abbott RealTime HIV-1 Assay for Specimens Yielding “Target Not Detected” Results by the Cobas AmpliPrep/Cobas TaqMan HIV-1 Test▿

OpenAIRE

Babady, N. Esther; Germer, Jeffrey J.; Yao, Joseph D. C.

2009-01-01

No significantly discordant results were observed between the Abbott RealTime HIV-1 assay and the COBAS AmpliPrep/COBAS TaqMan HIV-1 Test (CTM) among 1,190 unique clinical plasma specimens obtained from laboratories located in 40 states representing all nine U.S. geographic regions and previously yielding “target not detected” results by CTM.

Access to healthcare, HIV/STI testing, and preferred pre-exposure prophylaxis providers among men who have sex with men and men who engage in street-based sex work in the US.

Science.gov (United States)

Underhill, Kristen; Morrow, Kathleen M; Colleran, Christopher M; Holcomb, Richard; Operario, Don; Calabrese, Sarah K; Galárraga, Omar; Mayer, Kenneth H

2014-01-01

Pre-exposure prophylaxis (PrEP) is a promising strategy for HIV prevention among men who have sex with men (MSM) and men who engage in sex work. But access will require routine HIV testing and contacts with healthcare providers. This study investigated men's healthcare and HIV testing experiences to inform PrEP implementation. We conducted 8 focus groups (n = 38) in 2012 and 56 in-depth qualitative interviews in 2013-14 with male sex workers (MSWs) (n = 31) and other MSM (n = 25) in Providence, RI. MSWs primarily met clients in street-based sex work venues. Facilitators asked participants about access to healthcare and HIV/STI testing, healthcare needs, and preferred PrEP providers. MSWs primarily accessed care in emergency rooms (ERs), substance use clinics, correctional institutions, and walk-in clinics. Rates of HIV testing were high, but MSWs reported low access to other STI testing, low insurance coverage, and unmet healthcare needs including primary care, substance use treatment, and mental health services. MSM not engaging in sex work were more likely to report access to primary and specialist care. Rates of HIV testing among these MSM were slightly lower, but they reported more STI testing, more insurance coverage, and fewer unmet needs. Preferred PrEP providers for both groups included primary care physicians, infectious disease specialists, and psychiatrists. MSWs were also willing to access PrEP in substance use treatment and ER settings. PrEP outreach efforts for MSWs and other MSM should engage diverse providers in many settings, including mental health and substance use treatment, ERs, needle exchanges, correctional institutions, and HIV testing centers. Access to PrEP will require financial assistance, but can build on existing healthcare contacts for both populations.

Guidelines for control room design reviews

International Nuclear Information System (INIS)

1981-09-01

The control room design review is part of a broad program being undertaken by the nuclear industry and the government to ensure consideration of human factors in nuclear power plant design and operation. The purpose of the control room design review described by these guidelines is to (1) review and evaluate the control room workspace, instrumentation, controls, and other equipment from a human factors engineering point of view that takes into account both system demands and operator capabilities; and (2) to identify, assess, and implement control room design modifications that correct inadequate or unsuitable items. The scope of the control room design review described by these guidelines covers the human engineering review of completed control rooms; i.e., operational control rooms or those at that stage of the licensing process where control room design and equipment selection are committed. These guidelines should also be of use during the design process for new control rooms. However, additional analyses to optimize the allocation of functions to man and machine, and further examination of advanced control system technology, are recommended for new control rooms. Guidelines and references for comprehensive system analyses designed to incorporate human factors considerations into the design and development of new control rooms are presented in Appendix B. Where possible, a generic approach to the control room design review process is encouraged; for example, when control room designs are replicated wholly or in part in two or more units. Even when designs are not replicated exactly, generic reviews which can be modified to account for specific differences in particular control rooms should be considered. Industry organizations and owners groups are encouraged to coordinate joint efforts and share data to develop generic approaches to the design review process. The control room design review should accomplish the following specific objectives. To determine

Barriers to Asthma Management for School Nurses: An Integrative Review

Science.gov (United States)

Hanley Nadeau, Ellen; Toronto, Coleen E.

2016-01-01

Childhood asthma is a growing health concern. Asthma is the most common chronic illness of childhood and a leading cause of emergency room visits, hospitalizations, and school absenteeism. School nurses play a valuable role in asthma management. The purpose of this integrative review is to examine barriers to asthma management for school nurses in…

Acoustic comfort in high-school classrooms for students and teachers

NARCIS (Netherlands)

G.E. Puglisi; L.C. Cantor Cutiva (Lady Catherine); L. Pavese; A. Castellana; M. Bona; S. Fasolis; V. Lorenzatti; A. Carullo; A. Burdor; F. Bronuzzi; A. Astolfi

2015-01-01

textabstractThis work focuses on the evaluation of acoustical quality in high-school classrooms through in-field measurements and self-reports. Two school buildings that differ in location and typology, were considered. In-field measurements included sound insulation, room acoustics and

The Promise of Standardized Data Collection: School Health Variables Identified by States

Science.gov (United States)

Johnson, Kathleen H.; Bergren, Martha Dewey; Westbrook, Linda Oakes

2012-01-01

A gap in data prevents measurement of the needs of school-age children and the influence of school nursing interventions on student health and education outcomes. Its remedy is in the data collected in school health rooms. A national clinical database describing school health will allow education and health leaders to build evidence-based programs…

CSN's New Emergency Room

International Nuclear Information System (INIS)

Sendin, P.

2005-01-01

During the month of July 2005 the physical renovation works and technological updating of the basic infrastructures of the CSN Emergency Room (SALEM) were finished, allowing the Room to now have greater functionality and a broader technical capacity. Nevertheless, the technological improvement process of SALEM will reach its full potential within the next few years, once the installation currently underway of the new information integration and monitoring systems and the decision making support systems have been completed. This article describes the improvements introduced to the Room and the objectives pursued in this renovation project to convert the SALEM into a new generation room in accordance with its current technological context. (Author) 4 refs

Our Urban Living Room

DEFF Research Database (Denmark)

Hjortshøj, Rasmus

2016-01-01

Our Urban Living Room is an exhibition and a book, created by Cobe. The theme is based on Cobe’s ten years of practice, grounded in social livability and urban democracy, and our aim to create buildings and spaces that invite Copenhageners to use and define them; as an extended living room, where...... the boundaries between private and public space become fluid. Based on specific Cobe projects, Our Urban Living Room tells stories about the architectural development of Copenhagen, while exploring the progression of the Danish Capital - from an industrial city into an urban living room, known as one...... of the world’s most livable places. Photography by Rasmus Hjortshøj....

Gas explosion in a room with a window and passage to an adjacent room

Directory of Open Access Journals (Sweden)

Polandov Yuri

2016-01-01

Full Text Available Some publications describe an effect, produced during a physical model experiment, when an adjacent gas-free room influences the gas explosion pressure in a room with a window. The explosion pressure in this case significantly exceeds (2.5 times the explosion pressure in a room without an adjacent room. This result has been confirmed by our studies. Based on other available information about the influence of the ignition point location on the explosion pressure in one room, it was suggested that this could be true for an explosion in two rooms. In our studies we used a test unit with two connected chambers, each having a volume of 1.125 m3. It turned out that this influence of the adjacent volume was not so unambiguous as it was described in those publications. It was found out that the maximum effect of explosion pressure amplification by the adjacent room is achieved, when the igniter is located in the chamber filled with a gas-air mixture in the area between the center of the chamber and the window (maximum amplification by more than 3 times. This effect is lower directly by the window (1.8 times and is practically absent in case of ignition within the area near the passage connecting the chamber with the adjacent room. This suggests that the effect discovered earlier is a special case of the general dependence of the gas explosion pressure in two chambers on the igniter location.

Better learning in energy-efficient school buildings. A guideline; Besseres Lernen in energieeffizienten Schulen. Leitfaden

Energy Technology Data Exchange (ETDEWEB)

NONE

2010-07-01

Modernization of school buildings involves more than a reduction of energy cost, due to the fact that the room climate of a school affects the learning success of its pupils. Users' demands on architecture and technical systems are highly complex: Rooms are used at different times and for different lengths of time, there are vacation times when the building is not used, and the rooms must meet high demands in terms of air change, lighting, acoustics and blinding as well as in terms of safety, hygiene and pollutant-free air. All this necessitates an integral sanitation concept that takes account of all aspects. Further, the modernization of school buildings should also serve to enhance the pupils' environmental and energy awareness. This guide takes account of all these aspects. (orig./AKB)

Report card on school snack food policies among the United States' largest school districts in 2004–2005: Room for improvement

Directory of Open Access Journals (Sweden)

Rivara Frederick P

2006-01-01

Full Text Available Abstract Background Federal nutritional guidelines apply to school foods provided through the national school lunch and breakfast programs, but few federal regulations apply to other foods and drinks sold in schools (labeled "competitive foods", which are often high in calories, fat and sugar. Competitive food policies among school districts are increasingly viewed as an important modifiable factor in the school nutrition environment, particularly to address rising rates of childhood overweight. Congress passed legislation in 2004 requiring all school districts to develop a Wellness Policy that includes nutrition guidelines for competitive foods starting in 2006–2007. In addition, the Institute of Medicine (IOM recently published recommendations for schools to address childhood obesity. Methods Representatives of school districts with the largest student enrollment in each state and D.C. (N = 51 were interviewed in October-November 2004 about each school district's nutrition policies on "competitive foods." District policies were examined and compared to the Institute of Medicine's recommendations for schools to address childhood obesity. Information about state competitive food policies was accessed via the Internet, and through state and district contacts. Results The 51 districts accounted for 5.9 million students, representing 11% of US students. Nineteen of the 51 districts (39% had competitive food policies beyond state or federal requirements. The majority of these district policies (79% were adopted since 2002. School district policies varied in scope and requirements. Ten districts (53% set different standards by grade level. Most district policies had criteria for food and beverage content (74% and prohibited the sale of soda in all schools (63%; fewer policies restricted portion size of foods (53% or beverages (47%. Restrictions more often applied to vending machines (95%, cafeteria à la carte (79%, and student stores (79% than

Druthers! A Collection of Viable Ideas from Rural Schools.

Science.gov (United States)

Elliott, Richard D., Comp.

An individualized junior high school, a youth resources program that interweaves high school with supervised work experiences, multi-aged elementary family groupings that mainstream EMR (educable mentally retarded) children, and a single library room transformed into seven optional learning stations using a multi-channel audio system are real…

Use of counselling services by school-attending adolescent girls in Nigeria.

Science.gov (United States)

Azfredrick, Ezinwanne Christiana

2015-01-01

The purpose of this study was to examine the predictors and barriers to the use of school counselling services by school attending adolescent girls in south-east Nigeria. The study used a cross-sectional survey of 3065 adolescent girls, using a self-report counselling utilisation scale. Data were analysed using both descriptive and inferential statistics. About 80% of the participants had school counsellors and nearly half of the participants utilised the service. Regression results showed that father's level of education, availability of a counselling laboratory/room, contentment with the counselling services rendered predicted the use of the counselling service. Some of the barriers for non-use of school counselling services were shyness, fear and lack of confidentiality. School authorities will encourage uptake of counselling services by adolescents when adequate counselling consulting rooms are provided. This will increase confidence in adolescent clients and reduce fear attached to use of these services. This will improve their mental health and their academic performance.

Evaluating the auralization of a small room in a virtual sound environment using objective room acoustic measures

DEFF Research Database (Denmark)

Ahrens, Axel; Marschall, Marton; Dau, Torsten

2016-01-01

To study human auditory perception in realistic environments, loudspeaker-based reproduction techniques have recently become state-of-the-art. To evaluate the accuracy of a simulation-based room auralization of a small room, objective measures, such as early-decay-time (EDT), reverberation time...... of the room. The auralizations were generated using the loudspeaker-based room auralization toolbox (LoRA; Favrot and Buchholz, 2010) and reproduced in a 64-channel loudspeaker array, set up in an anechoic chamber. Differences between the objective measures evaluated in the real and the virtual room were......, clarity, interaural cross-correlation (IACC), and the speech transmission index were measured in an IEC listening room for 28 source-receiver combinations. The room was then modeled in the room acoustics software ODEON, and the same objective measures were also evaluated for the auralized version...

Confident in Their College Prep

Science.gov (United States)

Torres, Amanda

2016-01-01

Every year, the Higher Education Research Institute (HERI) at UCLA conducts The Freshman Survey, a national longitudinal study that covers a wide range of student characteristics--from secondary school achievement and activities to educational and career plans to values, attitudes, beliefs, and self concept. To identify the academic and personal…

Safety measures in exposure room

International Nuclear Information System (INIS)

Muhammad Jamal Md Isa

2004-01-01

The contents of this chapter are follows - The exposure room: location and dimension, material and thickness, windows, doors and other openings; Position of the Irradiating Apparatus, Use of Space Adjoining the Room, Warning Signs/Light, Dark Room. Materials and Apparatus: Classification of Areas, Local Rules, Other General Safety Requirements

Fire protection for clean rooms

International Nuclear Information System (INIS)

Kirson, D.

1990-01-01

The fire protection engineer often must decide what size fire can be tolerated before automatic fire suppression systems actuate. Is it a wastepaper basket fire, a bushel basket fire...? In the case of state-of-the-art clean rooms, the answer clearly is not even an incipient fire. Minor fires in clean rooms can cause major losses. This paper discusses what a clean room is and gives a brief overview of the unique fire protection challenges encountered. The two major causes of fire related to clean rooms in the semiconductor industry are flammable/pyrophoric gas fires in plastic ducts and polypropylene wet bench fires. This paper concentrates on plastic ductwork in clean rooms, sprinkler protection in ductwork, and protection for wet benches

Room for caring

DEFF Research Database (Denmark)

Timmermann, Connie; Uhrenfeldt, Lisbeth; Birkelund, Regner

2015-01-01

Aim This study explores how seriously ill hospitalized patients' experience and assign meaning to their patient room. Background Modern hospitals and the rational underlying care and treatment of today have their emphasis on diagnosis, cure and treatment. Consequently, aesthetics in the patient...... rooms such as a view of nature or natural light entering the room are often neglected in caring for these patients. Method A phenomenological-hermeneutic study design was applied and data was collected through multiple qualitative interviews combined with observations at a teaching hospital in Denmark......-being, relief and hope for the patients during serious illness. Therefore, these sensory impressions should be thought of as holding palliative potential and should be included as a part of caring for the seriously ill patients....

Control room design

International Nuclear Information System (INIS)

Zinke, H.

1980-01-01

To control a 1300 megawatt nuclear power plant, about 15000 plant parameters must be collected together to control and operate the plant. The control room design therefore is of particular importance. The main design criteria are: Required functions of the power plant process - Level of Automation - Ergonomics - Available Technology. Extensive analysis has resulted in a control room design method. This ensures that an objective solution will be reached. Resulting from this methodical approach are: 1. Scope, position and appearance of the instrumentation. 2. Scope, position and appearance of the operator controls. Process analysis dictates what instrumentation and operator controls are needed. The priority and importance of the control and instrumentation (this we define as the utilisation areas), dictates the rough layout of the control room. (orig./RW)

First installation of a dual-room IVR-CT system in the emergency room.

Science.gov (United States)

Wada, Daiki; Nakamori, Yasushi; Kanayama, Shuji; Maruyama, Shuhei; Kawada, Masahiro; Iwamura, Hiromu; Hayakawa, Koichi; Saito, Fukuki; Kuwagata, Yasuyuki

2018-03-05

Computed tomography (CT) embedded in the emergency room has gained importance in the early diagnostic phase of trauma care. In 2011, we implemented a new trauma workflow concept with a sliding CT scanner system with interventional radiology features (IVR-CT) that allows CT examination and emergency therapeutic intervention without relocating the patient, which we call the Hybrid emergency room (Hybrid ER). In the Hybrid ER, all life-saving procedures, CT examination, damage control surgery, and transcatheter arterial embolisation can be performed on the same table. Although the trauma workflow realized in the Hybrid ER may improve mortality in severe trauma, the Hybrid ER can potentially affect the efficacy of other in/outpatient diagnostic workflow because one room is occupied by one severely injured patient undergoing both emergency trauma care and CT scanning for long periods. In July 2017, we implemented a new trauma workflow concept with a dual-room sliding CT scanner system with interventional radiology features (dual-room IVR-CT) to increase patient throughput. When we perform emergency surgery or interventional radiology for a severely injured or ill patient in the Hybrid ER, the sliding CT scanner moves to the adjacent CT suite, and we can perform CT scanning of another in/outpatient. We believe that dual-room IVR-CT can contribute to the improvement of both the survival of severely injured or ill patients and patient throughput.

Secular Life Philosophy as a Subject in Schools in Norway.

Science.gov (United States)

Horn, Kristian

1981-01-01

In Norway changes in legislation in recent years have loosened the firm hold of Christian philosophy in the schools and given room for alternative secular philosophy. This article presents background information and an outline of the basic plan for life philosophy as a school subject. (Author/SJL)

The associations among family meal frequency, food preparation frequency, self-efficacy for cooking, and food preparation techniques in children and adolescents.

Science.gov (United States)

Woodruff, Sarah J; Kirby, Ashley R

2013-01-01

The purpose of this study was to describe family dinner frequency (FDF) by food preparation frequency (prep), self-efficacy for cooking (SE), and food preparation techniques (techniques) among a small sample in southwestern Ontario, Canada. A cross-sectional survey was administered under the supervision of the research team. After-school programs, sports programs, and 1 elementary school. The sample included 145 participants (41% boys, 59% girls) in grades 4-8. Demographics, prep, SE, techniques, FDF, and family meal attitudes and behaviors. Exploratory 1-way ANOVA and chi-square analyses were used. An ordinal regression analysis was used to determine the associations between FDF with descriptor variables (sex, grade, and ethnicity) and prep, SE, techniques, FDF, and family meal attitudes and behaviors (P < .05). Approximately 59% reported family dinners on 6 or 7 days per week. Half of participants were involved with prep 1-6 times per week. Mean SE was 25.3 (scale 1-32), and girls performed more techniques than boys (P = .02). Participants with greater SE (odds ratio = 1.15) and higher family meal attitudes and behaviors (odds ratio = 1.15) were more likely to have a higher FDF. Future health promotion strategies for family meals should aim at increasing children's and adolescents' SE. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The Virtual Dressing Room

DEFF Research Database (Denmark)

Holte, Michael Boelstoft; Gao, Yi; Petersson, Eva

2015-01-01

This paper presents the design and evaluation of a usability and user experience test of a virtual dressing room. First, we motivate and introduce our recent developed prototype of a virtual dressing room. Next, we present the research and test design grounded in related usability and user...... experience studies. We give a description of the experimental setup and the execution of the designed usability and user experience test. To this end, we report interesting results and discuss the results with respect to user-centered design and development of a virtual dressing room....

Teaching Foreign Languages in Slovenian School System: Is There any Room for Japanese?

Directory of Open Access Journals (Sweden)

Bronka STRAUS

2018-01-01

Full Text Available The article opens with a brief insight into the language policies of some international multilateral organisations of importance to Slovenia, and then continues to describe the place and roles of foreign languages in Slovene elementary and upper secondary schools. Chinese was the last foreign language to be integrated into the Slovene school system. The article introduces the process of its integration from the professional and organisational point of view as well as the one from the Slovenian school system. The whole integration process of Chinese into the Slovene curriculum was very complex and time consuming, but can as such serve as the bases for reflection on the way to integrate the Japanese language as well.

Control room habitability during severe accidents

International Nuclear Information System (INIS)

Siu, R.P.

1989-01-01

The requirements for protection of control room personnel against radiation hazards are specified in 10CFR50, Appendix A, GDC 19. The conventional approach involves a mechanistic evaluation of the radiation doses to control room personnel during design-basis accidents. In this study, an assessment of control room habitability during severe accidents is conducted. The potential levels of radiation hazards to control room personnel are evaluated in terms of both magnitude and probability of occurrence. The expected values for the probabilities of exceeding GDC-19 limits and the cumulative probability distributions of control room doses are determined. In this study, a pressurized water reactor with a large dry containment has been selected for analysis. The types of control rooms evaluated in this study include designs with: (a) filtered local intakes only, (b) filtered recirculation only, (c) filtered local intakes and recirculation, and (d) filtered dual remote intakes and recirculation. From the observations, it is concluded that, except for control room D, all other control room designs may require improvements in order to provide adequate radiation protection during severe accidents, particularly in terms of reducing whole-body gamma doses and skin doses. Potential design improvements include reduction of intake flows for concepts relying on pressurization, reduction in overall leakages, and control room pressurization through the use of bottled air supply

Films and dark room

International Nuclear Information System (INIS)

Abdul Nassir Ibrahim; Azali Muhammad; Ab. Razak Hamzah; Abd. Aziz Mohamed; Mohamad Pauzi Ismail

2008-01-01

After we know where the radiographic come from, then we must know about the film and also dark room. So, this chapter 5 discusses the two main components for radiography work that is film and dark room, places to process the film. Film are structured with three structured that are basic structured, emulsion and protection structured. So, this film can be classified either with their speed, screen and standard that used. The process to wash the film must be done in dark room otherwise the radiographer cannot get what are they inspected. The processing of film will be discussed briefly in next chapter.

The conference hybrid control room

International Nuclear Information System (INIS)

Gieci, A.; Caucik, J.; Macko, J.

2008-01-01

An original concept of a hybrid control room was developed for the Mochovce-3 and Mochovce-4 reactor units which are under construction. The basic idea underlying the concept is that the control room should be a main working place for the operators (reactor operator and turbine operator) and for the shift supervisor, designed as a comprehensive unit desk shaped so that all members of the control room crew are in a face-to-face contact constantly. The main desk consists of three clearly identified areas serving the operators and the unit supervisor as their main working places. A soft control system is installed at the main working places. A separate safety-related working place, designed as a panel with classical instrumentations at the conference hybrid control room, is provided in case of abnormal conditions or emergency situation. Principles of ergonomics and cognitive engineering were taken into account when designing the new conference hybrid control room for the Mochovce-3 and -4 reactor units. The sizes, propositions, shapes and disposition of the equipment at the control room have been created and verified by using virtual reality tools. (orig.)

Modern control room for AHWR

International Nuclear Information System (INIS)

Verghese, Clement C.; Joseph, Jose; Biswas, B.B.; Patil, R.K.

2005-01-01

Advanced Heavy Water Reactor (AHWR) is a next generation nuclear power plant being developed by Bhabha Atomic Research Centre. A modern control room has been conceived for operation and monitoring of the plant in tune with the advanced features of the reactor. A state of the art C and I architecture based on extensive use of computers and networking has been conceived for this plant. This architecture enables the implementation of a fully computerised operator friendly control room with soft HMIs. Features of the modern control room and control room and concept of soft HMI based operator interfaces have been described in the paper. (author)

Leadership in the control room

International Nuclear Information System (INIS)

McDougall, S.J.

2006-01-01

This paper discusses the importance of leadership within the control rooms at nuclear power facilities. the leadership capability of control room staff has a significant influence over the improvement of human performance and the development of an 'event free' culture within the business. The development of leadership competency in the control room must be an important part of any nuclear power utility business improvement plan. (author)

A Study of Leadership and Continuous Improvement at Leadership Preparatory Academy

Science.gov (United States)

Medina Araujo, Jacqueline

2013-01-01

This capstone project examines how an elementary school principal and her leadership team transformed Leadership Prep Academy in Capital City into a collaborative, high performing community school. This five-year process of continuous improvement involved engaging students, staff, parents, and members of the community in developing a culture of…

Concentrations Of Radon In Kindergartens And Schools In Like - Sen And Karlovac Counties

International Nuclear Information System (INIS)

Radolic, V.; Stanic, D.; Miklavcic, I.; Poje, M.; Muzevic, M.; Krpan, I.; Vukovic, B.

2015-01-01

Measurements of radon concentrations in schools and kindergartens were performed by means of passive, strippable, nuclear track etched detectors LR - 115 type II (Kodak - Pathe, France). The detectors are paired in the way that one detector (open detector), placed on the circumferential side of the plastic detector vessel, registers total number of alpha particles from radon and its short-lived progenies. At the same time, the other detector (diffusion detector) is placed inside the vessel and it registers only alpha particles emitted by radon. The average radon concentrations in kindergartens and schools of Lika-Senj County are 318 and 317 Bq m -3 while for Karlovac County they are 228 and 304 Bq m -3 respectively. Moreover, there are three schools in Karlovac County with the average radon concentration higher than 1000 Bq m -3 , which represents the action level for intervention measures in Croatia. Even more, there are 2.5 percent of rooms in kindergartens and 4 percent of rooms in schools in Lika - Senj County with measured radon concentrations higher than 1000 Bq m -3 . In Karlovac County there are 2.4 percent of such rooms in kindergartens and 7 percent in schools. Maps of spatial distribution of indoor radon concentrations for homes as well as for kindergartens and schools were created by using the Inverse Distance Weighting interpolation method. This is one of the useful methods for identifying radon prone areas. The authors propose a repetition of measurements in those kindergartens, schools and homes with higher radon concentrations in coordination with the local government. (author).

Find Your School's Analemma

Science.gov (United States)

Lough, Tom; Vanover, Courtney

2014-01-01

On any given sunny day, Courtney Vanover's third graders were like alarm clocks, making sure everyone in the room knew when 9:30 was approaching. Why? Because they were participating in a yearlong science project to answer the question, "Where is the tip of the shadow of the school flagpole each morning at 9:30?" Although they did not…

Operating room manager game

NARCIS (Netherlands)

Hans, Elias W.; Nieberg, T.

2007-01-01

The operating room (OR) department of a hospital forms the heart of the organization, where the single largest cost is incurred. This document presents and reports on the “Operating Room Manager Game,” developed to give insight into managing a large hospital's OR department at various levels of

Leadership in the control room

Energy Technology Data Exchange (ETDEWEB)

McDougall, S.J. [Bruce Power, Bruce B Operations Div., Tiverton, Ontario (Canada)

2006-07-01

This paper discusses the importance of leadership within the control rooms at nuclear power facilities. the leadership capability of control room staff has a significant influence over the improvement of human performance and the development of an 'event free' culture within the business. The development of leadership competency in the control room must be an important part of any nuclear power utility business improvement plan. (author)

Requirements for Control Room Computer-Based Procedures for use in Hybrid Control Rooms

Energy Technology Data Exchange (ETDEWEB)

Le Blanc, Katya Lee [Idaho National Lab. (INL), Idaho Falls, ID (United States); Oxstrand, Johanna Helene [Idaho National Lab. (INL), Idaho Falls, ID (United States); Joe, Jeffrey Clark [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2015-05-01

Many plants in the U.S. are currently undergoing control room modernization. The main drivers for modernization are the aging and obsolescence of existing equipment, which typically results in a like-for-like replacement of analogue equipment with digital systems. However, the modernization efforts present an opportunity to employ advanced technology that would not only extend the life, but enhance the efficiency and cost competitiveness of nuclear power. Computer-based procedures (CBPs) are one example of near-term advanced technology that may provide enhanced efficiencies above and beyond like for like replacements of analog systems. Researchers in the LWRS program are investigating the benefits of advanced technologies such as CBPs, with the goal of assisting utilities in decision making during modernization projects. This report will describe the existing research on CBPs, discuss the unique issues related to using CBPs in hybrid control rooms (i.e., partially modernized analog control rooms), and define the requirements of CBPs for hybrid control rooms.

Access to healthcare, HIV/STI testing, and preferred pre-exposure prophylaxis providers among men who have sex with men and men who engage in street-based sex work in the US.

Directory of Open Access Journals (Sweden)

Kristen Underhill

Full Text Available Pre-exposure prophylaxis (PrEP is a promising strategy for HIV prevention among men who have sex with men (MSM and men who engage in sex work. But access will require routine HIV testing and contacts with healthcare providers. This study investigated men's healthcare and HIV testing experiences to inform PrEP implementation.We conducted 8 focus groups (n = 38 in 2012 and 56 in-depth qualitative interviews in 2013-14 with male sex workers (MSWs (n = 31 and other MSM (n = 25 in Providence, RI. MSWs primarily met clients in street-based sex work venues. Facilitators asked participants about access to healthcare and HIV/STI testing, healthcare needs, and preferred PrEP providers.MSWs primarily accessed care in emergency rooms (ERs, substance use clinics, correctional institutions, and walk-in clinics. Rates of HIV testing were high, but MSWs reported low access to other STI testing, low insurance coverage, and unmet healthcare needs including primary care, substance use treatment, and mental health services. MSM not engaging in sex work were more likely to report access to primary and specialist care. Rates of HIV testing among these MSM were slightly lower, but they reported more STI testing, more insurance coverage, and fewer unmet needs. Preferred PrEP providers for both groups included primary care physicians, infectious disease specialists, and psychiatrists. MSWs were also willing to access PrEP in substance use treatment and ER settings.PrEP outreach efforts for MSWs and other MSM should engage diverse providers in many settings, including mental health and substance use treatment, ERs, needle exchanges, correctional institutions, and HIV testing centers. Access to PrEP will require financial assistance, but can build on existing healthcare contacts for both populations.

Study guide for 1Z0-071 Oracle Database 12c SQL : Oracle Certification Prep

CERN Document Server

Morris, Matthew

2016-01-01

This Study Guide is targeted at IT professionals who are working towards becoming an Oracle Database 12c SQL Certified Associate. The book provides information covering all of the exam topics for the Oracle certification exam: "1Z0-071: Oracle Database 12c SQL". The books in the Oracle Certification Prep series are built in lockstep with the test topics provided by Oracle Education's certification program. Each book is intended to provide the information that will be tested in a clean and concise format. The guides introduce the subject you'll be tested on, follow that with the information you'll need to know for it, and then move on to the next topic. They contain no drills or unrealistic self-tests to bump the page count without adding value. The series is intended to provide a concentrated source of exam information that is compact enough to be read through multiple times. This series is ideal for experienced Oracle professionals that are familiar with the topic being tested, but want a means to rapidly re...

Operating room fires in periocular surgery.

Science.gov (United States)

Connor, Michael A; Menke, Anne M; Vrcek, Ivan; Shore, John W

2018-06-01

A survey of ophthalmic plastic and reconstructive surgeons as well as seven-year data regarding claims made to the Ophthalmic Mutual Insurance Company (OMIC) is used to discuss operating room fires in periocular surgery. A retrospective review of all closed claim operating room fires submitted to OMIC was performed. A survey soliciting personal experiences with operating room fires was distributed to all American Society of Oculoplastic and Reconstructive Surgeons. Over the last 2 decades, OMIC managed 7 lawsuits resulting from an operating room fire during periocular surgery. The mean settlement per lawsuit was $145,285 (range $10,000-474,994). All six patients suffered burns to the face, and three required admission to a burn unit. One hundred and sixty-eight surgeons participated in the online survey. Approximately 44% of survey respondents have experienced at least one operating room fire. Supplemental oxygen was administered in 88% of these cases. Most surgical fires reported occurred in a hospital-based operating room (59%) under monitored anesthesia care (79%). Monopolar cautery (41%) and thermal, high-temperature cautery (41%) were most commonly reported as the inciting agents. Almost half of the patients involved in a surgical fire experienced a complication from the fire (48%). Sixty-nine percent of hospital operating rooms and 66% of ambulatory surgery centers maintain an operating room fire prevention policy. An intraoperative fire can be costly for both the patient and the surgeon. Ophthalmic surgeons operate in an oxygen rich and therefore flammable environment. Proactive measures can be undertaken to reduce the incidence of surgical fires periocular surgery; however, a fire can occur at any time and the entire operating room team must be constantly vigilant to prevent and manage operating room fires.

32 CFR 518.9 - Reading room.

Science.gov (United States)

2010-07-01

... RELATIONS THE FREEDOM OF INFORMATION ACT PROGRAM FOIA Reading Rooms § 518.9 Reading room. (a) Reading room... clearly unwarranted invasions of privacy, or competitive harm to business submitters. In appropriate cases... information concerning munitions, equipment, systems, and intelligence activities. (4) (a)(2)(D) records...

7 CFR 58.312 - Churn rooms.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Churn rooms. 58.312 Section 58.312 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....312 Churn rooms. Churn rooms in addition to proper construction and sanitation shall be so equipped...

School environment, sedentary behavior and physical activity in preschool children.

Science.gov (United States)

Barbosa, Sara Crosatti; Coledam, Diogo Henrique Constantino; Stabelini Neto, Antonio; Elias, Rui Gonçalves Marques; Oliveira, Arli Ramos de

2016-09-01

To analyze physical activity and sedentary behavior in preschool children during their stay at school and the associated factors. 370 preschoolers, aged 4 to 6 years, stratified according to gender, age and school region in the city of Londrina, PR, participated in the study. A questionnaire was applied to principals of preschools to analyze the school infrastructure and environment. Physical activity and sedentary behavior were estimated using accelerometers for five consecutive days during the children's stay at school. The odds ratio (OR) was estimated through binary logistic regression. At school, regardless of age, preschoolers spend relatively more time in sedentary behaviors (89.6%-90.9%), followed by light (4.6%-7.6%), moderate (1.3%-3.0%) and vigorous (0.5%-2.3%) physical activity. The indoor recreation room (OR=0.20; 95%CI 0.05 to 0.83) and the playground (OR=0.08; 95%CI 0.00 to 0.80) protect four-year-old schoolchildren from highly sedentary behavior. An inverse association was found between the indoor recreation room and physical activity (OR=0.20; 95%CI 0.00 to 0.93) in five-year-old children. The indoor recreation room (OR=1.54; 95%CI 1.35 to 1.77), the playground (OR=2.82; 95%CI 1.14 to 6.96) and the recess (OR=1.54; 95%CI 1.35 to 1.77) are factors that increase the chance of six-year-old schoolchildren to be active. The school infrastructure and environment should be seen as strategies to promote physical activity and reduce sedentary behavior in preschool children. Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Manufacturing of NAA laboratory clean room

International Nuclear Information System (INIS)

Suwoto; Hasibuan, Djaruddin

2001-01-01

The ''NAA laboratory clean room'' has been built in the Reactor Serba Guna G.A. Siwabessy building. The erection of ''AAN laboratory clean room'' doing by started of preparation of the ''manufacturing procedure'' refer to ''Design and manufacturing neutron activation analysis clean room laboratory''. Manufacturing process and erection doing refer to procedures makes. By providing of the ''AAN laboratory clean room'' can be cocluded that the research activity and the user sevises in P2TRR well meet to be done

Auditory modelling for assessing room acoustics

NARCIS (Netherlands)

Van Dorp Schuitman, J.

2011-01-01

The acoustics of a concert hall, or any other room, are generally assessed by measuring room impulse responses for one or multiple source and receiver location(s). From these responses, objective parameters can be determined that should be related to various perceptual attributes of room acoustics.

Cultural differences in room size perception.

Science.gov (United States)

Saulton, Aurelie; Bülthoff, Heinrich H; de la Rosa, Stephan; Dodds, Trevor J

2017-01-01

Cultural differences in spatial perception have been little investigated, which gives rise to the impression that spatial cognitive processes might be universal. Contrary to this idea, we demonstrate cultural differences in spatial volume perception of computer generated rooms between Germans and South Koreans. We used a psychophysical task in which participants had to judge whether a rectangular room was larger or smaller than a square room of reference. We systematically varied the room rectangularity (depth to width aspect ratio) and the viewpoint (middle of the short wall vs. long wall) from which the room was viewed. South Koreans were significantly less biased by room rectangularity and viewpoint than their German counterparts. These results are in line with previous notions of general cognitive processing strategies being more context dependent in East Asian societies than Western ones. We point to the necessity of considering culturally-specific cognitive processing strategies in visual spatial cognition research.

Cultural differences in room size perception.

Directory of Open Access Journals (Sweden)

Aurelie Saulton

Full Text Available Cultural differences in spatial perception have been little investigated, which gives rise to the impression that spatial cognitive processes might be universal. Contrary to this idea, we demonstrate cultural differences in spatial volume perception of computer generated rooms between Germans and South Koreans. We used a psychophysical task in which participants had to judge whether a rectangular room was larger or smaller than a square room of reference. We systematically varied the room rectangularity (depth to width aspect ratio and the viewpoint (middle of the short wall vs. long wall from which the room was viewed. South Koreans were significantly less biased by room rectangularity and viewpoint than their German counterparts. These results are in line with previous notions of general cognitive processing strategies being more context dependent in East Asian societies than Western ones. We point to the necessity of considering culturally-specific cognitive processing strategies in visual spatial cognition research.

A room of one's own--Being cared for in a hospital with a single-bed room design.

Science.gov (United States)

Persson, Eva; Anderberg, Patrice; Ekwall, Anna Kristensson

2015-06-01

To illuminate patients' experiences of being hospitalised in a hospital with a single-bed room design. Many patients seem to prefer single-bed hospital rooms. However, studies have also shown that patients do see the advantages of multiple-bed rooms. Interviews were conducted with 16 inpatients from a surgical ward in a hospital building with a single-bed room design. A hermeneutical-phenomenological approach guided by van Manen's four life-world existentials was used to analyse the interviews. The essential meaning was that patients felt secure because they could create a personal environment without disruptive elements. The room was private, and this implied feelings of homeliness, which allowed patients to focus on themselves and was thought to facilitate the recovery process. The patients preferred staying in their room, and the relationship with the personnel was central. Feelings of loneliness and isolation could occur and could be frightening. Being hospitalised in a single-bed room meant balancing between feeling secure and feeling insecure. The following four themes emerged: A homely environment, The need for company and security, Time as unpredictable and involving waiting and Focus on healing the body. Patients experienced that a single-bed room allowed them to focus on their recovery, have visitors without disturbing others and create a feeling of homeliness. However, mobilisation is not a natural part of the recovery process when patients have all they need in their rooms. The patients' need for social interaction and confirmation was not satisfied without effort and planning on the part of staff. © 2014 Nordic College of Caring Science.

ALICE’s new meeting room

CERN Multimedia

2009-01-01

There’s no reason to be late for a meeting in Wonderland (Point 2) anymore as ALICE gets a brand new conference room and a ‘clean up’. The new ALICE conference room.You won’t find Building 3294 on the CERN map yet, but it is already being used. If you follow the white rabbit just inside the entrance at point 2, you will find a new conference room and office space for 12 people. "Previously at Point 2 we’ve had very little office space at all. Our old conference room was inside the main building, SX2, but it was cramped and extremely noisy," explained Frank Cliff from ALICE. "As soon as they turned on the overhead cranes you could barely hear yourself think!" The plans for the new building were drawn up by the Civil Engineering Group, and construction started in August last year. The building was completed and already in use before Christmas. The 109 square metre conference room can fit up to 60 people and is fully equipped...

Room to Manoeuvre: Mobilising the "Active Partner" in Home-School Relations.

Science.gov (United States)

McNamara, Olwen; Hustler, David; Stronach, Ian; Rodrigo, Marta; Beresford, Emma; Botcherby, Sue

2000-01-01

Offers an interpretation of the dynamics of home-school relations in terms of a matrix of "mobilisations" and "demolisations" among parents, teachers, and children based upon data collected in an action research and development project. Aims to establish some bases for practical and theoretical "manoeuvers." (CMK)

An Optimisation Approach for Room Acoustics Design

DEFF Research Database (Denmark)

Holm-Jørgensen, Kristian; Kirkegaard, Poul Henning; Andersen, Lars

2005-01-01

This paper discuss on a conceptual level the value of optimisation techniques in architectural acoustics room design from a practical point of view. It is chosen to optimise one objective room acoustics design criterium estimated from the sound field inside the room. The sound field is modeled...... using the boundary element method where absorption is incorporated. An example is given where the geometry of a room is defined by four design modes. The room geometry is optimised to get a uniform sound pressure....

Hybrid control rooms: the effects of introducing new technology into existing control rooms

International Nuclear Information System (INIS)

Morisseau, Dolores S.

2001-02-01

The goal of this part of the Hybrid Control Room Project is to gain a perspective on the issues and problems that are an integral part of introducing new technology, automated systems, or support systems into nuclear power plant (NPP) control rooms, particularly when they are introduced on a system-by-system basis. For purposes of this project, hybrid control rooms are defined as those into which new technology, such as digital and computer-based controls are gradually incorporated as opposed to those that are completely, or nearly completely, refitted with new technology. Although the focus of this project is the introduction of computer based, digital systems into NPP control rooms, it is not possible to exclude the effects throughout the process that are inevitable when new technology is introduced anywhere in complex process control systems. Thus, this document examines the effects of such changes within the context of the organisation in which they occur, including the management of change, work procedures and work methods, communications and crew interaction, training, and the interdependent functions in the operational context. (Author)

Back-to-School Health Tips: Exercise and Sleep

Science.gov (United States)

... up the same times each day. Keep room temperature on the cool side. A TV or computer in the bedroom can be a distraction. Read More "Back-to-School" Articles Health Tips: Immunizations / Health Tips: Exercise and ...

Birth room images

DEFF Research Database (Denmark)

Bowden, Calida; Sheehan, Athena; Foureur, Maralyn Jean

2016-01-01

Objective: this study examined images of birth rooms in developed countries to analyse the messages and visual discourse being communicated through images. Design: a small qualitative study using Kress and van Leeuwen's (2006) social semiotic theoretical framework for image analysis, a form...... and implications for practice: as images on the Internet inform and persuade society about stereotypical behaviours, the trends of our time and sociocultural norms, it is important to recognise images of the technological birth room on the Internet may be influential in dictating women's attitudes, choices...

Creating Engaging Escape Rooms for the Classroom

Science.gov (United States)

Nicholson, Scott

2018-01-01

Escape rooms are "live-action team-based games where players discover clues, solve puzzles, and accomplish tasks in one or more rooms in order to accomplish a specific goal (usually escaping from the room) in a limited amount of time." Escape Rooms are one type of Escape Game, which are narrative-based challenges that use puzzles, tasks,…

Hospital Patient Room Design: The Issues Facing 23 Occupational Groups Who Work in Medical/Surgical Patient Rooms.

Science.gov (United States)

Lavender, Steven A; Sommerich, Carolyn M; Patterson, Emily S; Sanders, Elizabeth B-N; Evans, Kevin D; Park, Sanghyun; Umar, Radin Zaid Radin; Li, Jing

2015-01-01

The aim of this study was to learn from a wide range of hospital staff members about how the design of the patient room in which they work adversely affects their ergonomics or hinders their job performance. In addition to providing a healing space for patients, hospital patient rooms need to serve as functional workplaces for the people who provide clinical care, to clean, or to maintain room functions. Therefore, from a design perspective, it is important to understand the needs of all the users of hospital patient rooms with regard to room design. One hundred forty-seven people, representing 23 different occupational stakeholder groups, participated in either focus groups or interviews in which they were asked to identify room design issues that affect the performance of their work tasks. Key issues shared across multiple stakeholder groups included an inability to have eye contact with the patient when entering the room, inadequate space around the bed for the equipment used by stakeholders, the physical demands experienced as stakeholders move furnishings to accomplish their activities or access equipment, and a lack of available horizontal surfaces. Unique issues were also identified for a number of stakeholder groups. There are a number of issues that should be addressed in the next generation of hospital patient rooms, or when refurbishing existing facilities, so that all occupational stakeholder groups can work effectively, efficiently, and without undue physical stress. © The Author(s) 2015.

In the LEAR control room

CERN Multimedia

CERN PhotoLab

1983-01-01

View into the control room of the Low Energy Antiproton Ring (LEAR). Edgar Asseo (sitting) and Dieter Möhl and Georges Carron reflecting upon some beam dynamics (or hardware?) problem. Vassilis Agoritsas, in the background, leaning over a plan or a keyboard. LEAR in its early years (1982 to about 1990) was run from this local control room in building 363 close to the end of the PS South Hall, where the ring was installed. Later-on the operation was surveyed from the PS main control room.

Rescuing Middle School Astronomy

Science.gov (United States)

Mayo, L. A.; Janney, D.

2010-12-01

There is a crisis in education at the middle school level (Spellings, 2006). Recent studies point to large disparities in middle school performance in schools with high minority populations. The largest disparities exist in areas of math and science. Astronomy has a universal appeal for K-12 students but is rarely taught at the middle school level. When it is taught at all it is usually taught in isolation with few references in other classes such as other sciences (e.g. physics, biology, and chemistry), math, history, geography, music, art, or English. The problem is greatest in our most challenged school districts. With scores in reading and math below national averages in these schools and with most state achievement tests ignoring subjects like astronomy, there is little room in the school day to teach about the world outside our atmosphere. Add to this the exceedingly minimal training and education in astronomy that most middle school teachers have and it is a rare school that includes any astronomy teaching at all. In this presentation, we show how to develop and offer an astronomy education training program for middle school teachers encompassing a wide range of educational disciplines that are frequently taught at the middle school level. The prototype for this program was developed and launched in two of the most challenged and diverse school systems in the country; D.C. Public Schools, and Montgomery County (MD) Public Schools.

Radon in Irish schools: the results of a national survey

International Nuclear Information System (INIS)

Synnott, H; Hanley, O; Fenton, D; Colgan, P A

2006-01-01

This paper presents the results of a survey of radon concentrations in Irish primary and post-primary schools. The objective of this survey was to assess the distribution of radon in Irish schools and to identify those requiring remedial work to reduce radon exposure to children and staff. All primary and post-primary schools were invited to participate in the survey. Indoor radon concentrations were measured during the academic year using integrating passive alpha track-etch detectors with a measurement period from three to nine months. The survey was carried out on a phased basis from 1998 to 2004 and is one of the most comprehensive of its kind undertaken in Europe. Measurements were completed in 38 531 ground floor classrooms and offices in 3826 schools, representing over 95% of the approximate 4000 primary and post-primary schools in Ireland. Of these, 984 schools had radon concentrations greater than 200 Bq m -3 in 3028 rooms and 329 schools had radon concentrations in excess of 400 Bq m -3 in 800 rooms. The average radon concentration in schools was 93 Bq m -3 . This results in an annual average effective dose to an Irish child from exposure to radon of 0.3 mSv per year, assuming that the long-term radon concentration is equal to the radon concentration present during the working hours and that the annual average occupancy is 1000 h per year. A programme of remediation of schools with radon concentrations above 200 Bq m -3 has been put in place

Test Room Stability Plan

International Nuclear Information System (INIS)

1993-01-01

This plan documents the combination of designs, installations, programs, and activities that ensures that the underground excavations at the Waste Isolation Pilot Plant (WIPP), in which transuranic (TRU) waste may be emplaced during the Test Phase, will remain sufficiently stable and safe during that time. The current ground support systems installed at the WIPP are the result of over ten years of data collection from hundreds of geomechanical instruments and thousands of hours of direct observation of the changing conditions of the openings. In addition, some of the world's most respected experts on salt rock mechanics have provided input in the design process and concurrence on the suitability of the final design. The general mine rockbolt pattern and the ground support system for the test rooms are designed to specifically address the fracture and deformation geometries observed today at the WIPP. After an introductory chapter, this plan describes the general underground design, then proceeds to an account of general ground support performance, and finally focuses on the details of the special test room ground support systems. One such system already installed in Room 1, Panel 1, is described in comprehensive detail. Other test rooms in Panel 1, whether full-size or smaller, will be equipped with systems that ensure stability to the same or equivalent extent. They will benefit from the experience gained in the first test room, which in turn benefitted from the data and knowledge accumulated during previous stages (e.g., the Site and Preliminary Design Validation program) of the project

Effect of Thin Prep® imaging system on laboratory rate and relative sensitivity of atypical squamous cells, high-grade squamous intraepithelial lesion not excluded and high-grade squamous intraepithelial lesion interpretations

Directory of Open Access Journals (Sweden)

Brooke R Koltz

2013-01-01

Full Text Available Introduction: Automated screening of Thin Prep ® Papanicolaou Tests has become increasingly common in clinical practice. Increased productivity has initiated laboratory use of the Thin Prep ® Imaging System (TIS. Increased sensitivity is a potential additional benefit of TIS. Published studies have shown an increase in discovery of dysplastic cells. This study evaluates the effect of TIS on the incidence of atypical squamous cells high-grade squamous intraepithelial lesion not excluded (ASC-H and high-grade squamous intraepithelial lesion (HGSIL results on Thin Prep ® Pap Tests by comparing TIS-assisted and manual screening findings and the diagnoses on subsequent follow-up in a screening population over a 1-year time period. Materials and Methods: A compilation of all ASC-H and HGSIL cases was prepared by conducting a computerized search over a 1-year period (7/06-6/07. The accumulated cases include Thin Prep Pap tests that were both TIS and manually screened. Follow-up results of cytologic and histologic cervical specimens were obtained for a time period extending to 2010. Interpretation utilizing TIS was in place 10 months prior to the study′s initiation. Results: During the study period 70,522 Pap tests were performed in our laboratory. One third (33% of Pap tests were screened with assistance of TIS. Manual screening was performed on 47,380 Pap tests of which 153 (0.32% were interpreted as ASC-H and 164 (0.35% were interpreted as HGSIL. During the same time period automated screening (TIS was performed on 23,111 Pap tests. Interpretation of 62 (0.27% cases provided an ASC-H result, while 71 (0.31% were HGSIL. Follow-up cervical dysplasia by colposcopic biopsy and cone biopsy was distributed proportionally between TIS and manual screening for both ASC-H and HGSIL categories. Cervical intraepithelial neoplasia (CIN II/III was identified on follow-up biopsy of 41% TIS cases and 45% manually screened cases for ASC-H. In the HGSIL subset 71

Screening Criteria for a Room Cooling Failure of the AFW MDP Room

International Nuclear Information System (INIS)

Hwang, Mee Jeong; Yoon, Churl; Yang, Joon Eon; Park, Joo Hwan

2006-01-01

In this paper, we performed a heat up calculation for the Auxiliary Feedwater Motor Operated Pump (AFW MDP) room, PAB-077-11A with CFX-10 and RATT when the HVAC (Heating, Ventilation, and Air Condition) system is failed. We also reviewed the operability of the components under a loss of the HVAC. Room cooling failure does not need to be modeled if the components maintain their operability after a loss of a room cooling function during the mission time. ASME Standard describes that a recovery action can be credited if the related recovery action is included in the procedure or there are similar recovery experiences in the plant. However, there is no description about the recovery action of the HVAC in the EOP (Emergency Operation Procedure) of the UCN3, 4 under the situation of a loss of the HVAC. However, if we consider the HVAC failure in the PSA FT model, the problem is that the unavailability induced from a loss of the HVAC is unrealistically high. From a viewpoint of the PSA, it is not true that the related system always fails even if the HVAC system fails. Therefore, we reviewed the necessity of the HVAC model through two cases of a room heat up calculation under the situation of a loss of the HVAC system with conservative and realistic input data respectively

Evaluation of a dark-room

International Nuclear Information System (INIS)

Passos, J.C.

1987-01-01

The adequate operation conditions of a dark-room are essential to guarantee the image quality, the least exposure of the patient and the staff, contributing also to reduce the expenses with specific equipments and processing solutions. Therefore, to install a dark-room, it is necessary a previous study about its physical dimensions, the location of equipments, accessories, light safeguards and visual warning, besides adequate darkening and correct filme processing. We propose three basic tests to check the adequacy and the integrity of a dark-room: light safeguards test, hygiene test, developing time and temperature test. (Author) [pt

Recovery Room

African Journals Online (AJOL)

defined postoperative unit or on the hospital ward. Patients were frequently transferred from the operating room directly to the ward where they were placed close to the nursing station. In 1947 the. Anesthesia Study Commission of the Philadelphia.

The exploitation of "Exploitation" in the tenofovir prep trial in Cameroon: Lessons learned from media coverage of an HIV prevention trial.

Science.gov (United States)

Mack, Natasha; Robinson, Elizabeth T; MacQueen, Kathleen M; Moffett, Jill; Johnson, Laura M

2010-06-01

media coverage influences how clinical trials are perceived internationally and in communities where trials occur, affecting recruitment, retention, and political support for research. We conducted a discourse analysis of news coverage from 2004-2005 of a trial in Cameroon on oral PrEP for HIV prevention, to identify messages, communication techniques, and sources of messages that were amplified via media. We identified two parallel discourses: one on ethical concerns about the Cameroon trial, and a second, more general "science exploitation" discourse concerned with the potential for trials with vulnerable participant populations to be conducted unethically, benefiting only wealthy populations. Researchers should overtly address exploitation as an integral, ongoing component of research, particularly where historical or cultural conditions set the stage for controversy to emerge.

Evaluating the impact of a Biology I professional development series

Science.gov (United States)

Sampsell, Jacquelyn Scipper

2005-11-01

Effective professional development offers opportunities for teachers to reflect on their practices, modify and implement changes in the classroom, and eventually impact students' learning. However, professional development must be evaluated to determine whether the desired results are actually occurring in the classroom. The Program for Research and Evaluation for Public Schools, Inc. (PREPS) created a Biology I Workshop series to assist school districts in Mississippi in aligning curriculum, instruction, and assessment that will ultimately improve student achievement in the classroom and performance on the current high-stakes test. This study evaluated the PREPS Biology I Subject Area workshops by using Thomas Guskey's evaluation model as a guide for the process. This study used a mixed-method design and collected data from three primary sources: the PREPS Final Evaluation Form completed at the conclusion of workshops, a questionnaire created by the researcher, and interviews with six-case study teacher participants selected from the results of the questionnaire. According to the ratings and comments written on the two instruments and supporting evidence from the case-study teachers, the participants of the Biology I workshop found the workshops to be effective for all five levels of Guskey's evaluation model. The content was rated effective because the workshop materials were aligned to the curriculum frameworks and were focused on using student learning to improve student achievement. Working through the activities rather than simply being told about them and having a successful classroom biology teacher as a presenter were the factors that contributed to the increase in the participants' knowledge and skills. Organizational results indicate that the workshop was effective in that the goals of the workshop series aligned with the schools' mission and goals for student learning. Several issues, such as financial support, time for collaboration with peers, and

Future control room design (modernization of control room systems); Zukuenftiges Wartendesign (Modernisierung von Warteneinrichtungen)

Energy Technology Data Exchange (ETDEWEB)

Reischl, Ludwig; Freitag, Timo; Dergel, Rene [AREVA NP (Germany). NLLR-G ' ' Reactor I and C' '

2009-07-01

In the frame of lifetime extension for nuclear power plants the modernization of the complete safety and operational control technology will be digitalized. It is also recommended to modernize the operator facilities, monitoring systems in the control room, the back-up shut-down center and the local control stations. The authors summarize the reasons for the modernization recommendations and discuss possible solutions for display-oriented control rooms. A concept for control room backfitting includes generic requirements, requirements of the local authorities, ergonomic principles information content and information density, and the design process. The backfitting strategy should include a cooperation with the operational personnel, The quality assurance and training via simulator needs sufficient timing during the implementation of the backfitting.

Professional Satisfaction Of Nurses Working In Operating Room Of A Hospital School

Directory of Open Access Journals (Sweden)

Jéssica Helena Dantas de Oliveira

2017-05-01

Full Text Available Objective: to characterize in a sociodemographic way the nursing staff of the surgical center; Check the degree of importance assigned to each component of satisfaction: autonomy, interaction, professional status, task requirements, organizational policies, and pay; verify job satisfaction perceived by nurses. Method: exploratory, descriptive, quantitative study, consisting of 9 nurses working in the operating room. The research project was approved by the CEP/HULW, CAAE Nº 24597513.2.0000.5183. Data were collected through questionnaires and then analyzed using descriptive statistics in SPSS 20. Results: We found that the standby component was considered the most important for job satisfaction and Professional Status least important. Conclusion: nurses have a low level of job satisfaction, impacting the performance of its activities. Descriptors: Job Satisfaction. Perioperative Nursing. Quality of Life.

76 FR 56295 - Schools and Libraries Universal Service Support Mechanism and a National Broadband Plan for Our...

Science.gov (United States)

2011-09-13

... other individuals on social networking Web sites and in chat rooms, and regarding cyberbullying... in chat rooms and cyberbullying awareness and response. 3. We note that the Notice of Proposed... cyberbullying awareness and response.'' We believe this makes clear that, although a school's Internet safety...

Ergonomics influence on control room layout

International Nuclear Information System (INIS)

Hartfiel, H.D.

1984-01-01

Nowadays, human factors has become an important aspect of the design of work places. Since the control room in a nuclear power plant is a work place, too, its layout is also influenced by ergonomics. With the KWU control room concept for the 1300 MW PWR as an example, we show how assured and applicable ergonomic findings enter into the control room design. On the basis of general design principles for work places, specific methods for control room planning have been developed. By working with these methods a concept that makes it possible to build a man-machine interface able to fulfill the process control tasks with all their underlying conditions has been derived. (author)

Nuclear power station main control room habitability

International Nuclear Information System (INIS)

Paschal, W.B.; Knous, W.S.

1989-01-01

The main control room at a nuclear power station must remain habitable during a variety of plant conditions and postulated events. The control room habitability requirement and the function of the heating, ventilating, air-conditioning, and air treatment system are to control environmental factors, such as temperature, pressure, humidity, radiation, and toxic gas. Habitability requirements provide for the safety of personnel and enable operation of equipment required to function in the main control room. Habitability as an issue has been gaining prominence with the Advisor Committee of Reactor Safeguards and the Nuclear Regulatory Commission since the incident at Three Mile Island. Their concern is the ability of the presently installed habitability systems to control the main control room environment after an accident. This paper discusses main control room HVAC systems; the concern, requirements, and results of NRC surveys and notices; and an approach to control room habitability reviews

Identification of the Social Development in Early Childhood in Pakistan

Science.gov (United States)

Malik, Asif; Sarwar, Muhammad; Khan, Naeemullah

2010-01-01

This study was conducted to identify the social development in early childhood years. It was delimited to eight private schools of Lahore City from the area of Faisal Town and Shadman. Forty students (male and female) were randomly selected as the sample. Five students from Nursery, Prep and grade one were selected from each school. A checklist…

A remote control room at DIII-D

International Nuclear Information System (INIS)

Abla, G.; Schissel, D.P.; Penaflor, B.G.; Wallace, G.

2008-01-01

This paper describes a remote control room built at DIII-D to support remote participation activities of DIII-D research staff. In order to create a persistent, efficient, and reliable remote participation environment for DIII-D scientists, a remote control room has been built in a 640-ft 2 dedicated area. The purpose of this room is to experiment and define a remote control room framework that can facilitate the remote participation needs of current and future fusion experiments such as ITER. A variety of hardware equipment has been installed and several remote participation and collaboration technologies have been deployed. Objectivity and practical consideration has been the key while designing the room and deploying the technologies. Although, the DIII-D remote control room is still a work in progress and new software tools are being implemented, it has been already useful for a number of international remote participation activities. For example, it has been used for remote support of the EAST Tokamak in China during the start up operation and proven effective for other collaborative experiment activities. The description of the remote control room design is given along with technologies deployed for remote collaboration needs. We will also discuss our recent experiences involving the DIII-D remote control room as well as future plans for improvements

MINIMUM AREAS FOR ELEMENTARY SCHOOL BUILDING FACILITIES.

Science.gov (United States)

Pennsylvania State Dept. of Public Instruction, Harrisburg.

MINIMUM AREA SPACE REQUIREMENTS IN SQUARE FOOTAGE FOR ELEMENTARY SCHOOL BUILDING FACILITIES ARE PRESENTED, INCLUDING FACILITIES FOR INSTRUCTIONAL USE, GENERAL USE, AND SERVICE USE. LIBRARY, CAFETERIA, KITCHEN, STORAGE, AND MULTIPURPOSE ROOMS SHOULD BE SIZED FOR THE PROJECTED ENROLLMENT OF THE BUILDING IN ACCORDANCE WITH THE PROJECTION UNDER THE…

Where students turn into teachers: the sixth Inverted CERN School of Computing

CERN Multimedia

François Fluckiger, CSC Director

2013-01-01

For the sixth time since 2005, the CERN School of Commuting has scheduled its inverted school for February. iCSCs are part of the CSC series of events, together with the main summer school to be held this year in Cyprus and the thematic school in Split next June.   The inverted CSC, iCSC2013, will take place at CERN on 25 and 26 February, in Room 513-1-024. The inverted CSCs stem from the observation that at regular CSCs it is common to find someone in the room who knows more on a particular (usually advanced) topic than the lecturer. So why not try and exploit this and turn the students into teachers? CSC2012 students made proposals via an electronic discussion forum, from which a programme was designed. This year’s programme focuses on timely, challenging and innovative topics, inlcuding: GPU computing in High Energy Physics, Computer vision, Testing in large scale distributed systems and Grid Interpretation by LHC experiments. Attendanc...

Where students turn into teachers: the seventh Inverted CERN School of Computing

CERN Multimedia

Alberto Pace, CSC Director

2014-01-01

For the seventh time since 2005, the CERN School of Computing (see here) has scheduled its inverted school for February. iCSCs are part of the CSC series of events, together with the main summer school to be held this year in Portugal and the thematic school (see here) in Split next June.   The inverted CSC, iCSC2014, will take place at CERN on 24 and 25 February, in Room 31/3-004. The inverted CSCs stem from the observation that at regular CSCs it is common to find someone in the room who knows more on a particular (usually advanced) topic than the lecturer. So why not try and exploit this and turn the students into teachers? CSC2013 students made proposals via an electronic discussion forum, from which a programme was designed. This year’s programme focuses on timely, challenging and innovative topics, including: network programming, building distributed systems, a journey from quark to jet in physics, read-out electronics: where data come from, machine learning and data mining. At...

Stability of disposal rooms during waste retrieval

International Nuclear Information System (INIS)

Brandshaug, T.

1989-03-01

This report presents the results of a numerical analysis to determine the stability of waste disposal rooms for vertical and horizontal emplacement during the period of waste retrieval. It is assumed that waste retrieval starts 50 years after the initial emplacement of the waste, and that access to and retrieval of the waste containers take place through the disposal rooms. It is further assumed that the disposal rooms are not back-filled. Convective cooling of the disposal rooms in preparation for waste retrieval is included in the analysis. Conditions and parameters used were taken from the Nevada Nuclear Waste Storage Investigation (NNWSI) Project Site Characterization Plan Conceptual Design Report (MacDougall et al., 1987). Thermal results are presented which illustrate the heat transfer response of the rock adjacent to the disposal rooms. Mechanical results are presented which illustrate the predicted distribution of stress, joint slip, and room deformations for the period of time investigated. Under the assumption that the host rock can be classified as ''fair to good'' using the Geomechanics Classification System (Bieniawski, 1974), only light ground support would appear to be necessary for the disposal rooms to remain stable. 23 refs., 28 figs., 2 tabs

Consumer opinions of emergency room medical care.

Science.gov (United States)

McMillan, J R; Younger, M S; DeWine, L C

1984-12-01

If hospital management is to adapt successfully to an increasingly competitive environment, and to retain a viable emergency department, it well be necessary to objectively and accurately assess the hospital's image in the community served. Knowledge of the consumers' views is an essential input into the formulation of strategic plans. This article reports on a study in which consumer opinions on 15 dimensions of emergency room health care were obtained from 723 respondents using a mail questionnaire. Findings reveal that consumers view the emergency room as being more expensive than other health care providers. Except for being available or convenient, little or no advantage is perceived for the emergency room over the personal physician. Even though the emergency room has specialized staff and equipment, consumers do not believe patients receive better or faster treatment in an emergency room than would be obtained in a physician's office. Unless changed, these perceptions will diminish the role of the emergency room in the delivery of health care services.

46 CFR 111.105-41 - Battery rooms.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Battery rooms. 111.105-41 Section 111.105-41 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Hazardous Locations § 111.105-41 Battery rooms. Each electrical installation in a battery room...

Madness in Sartre's "The Room"

NARCIS (Netherlands)

Jongeneel, E.C.S.

2009-01-01

In "The Room," part of his short story collection, The Wall (1938), Jean-Paul Sartre investigates madness as an alternative way of bourgeois life and thus takes a stand in the contemporary debate on the existential status of mental illness. "The Room" is a case-study of a "limit situation," as well

Barriers to Asthma Management for School Nurses: An Integrative Review.

Science.gov (United States)

Hanley Nadeau, Ellen; Toronto, Coleen E

2016-04-01

Childhood asthma is a growing health concern. Asthma is the most common chronic illness of childhood and a leading cause of emergency room visits, hospitalizations, and school absenteeism. School nurses play a valuable role in asthma management. The purpose of this integrative review is to examine barriers to asthma management for school nurses in the school setting. Findings revealed multiple barriers school nurses encounter in managing asthma. Six themes emerged that included lack of resources and support, insufficient time, communication challenges, limited knowledge, and lack of awareness of school nurses' expertise. Students, parents, primary care physicians, school administration, staff, and school nurses themselves all play a role in constructing barriers to asthma management. There is a need for school nurses and school nurse leaders to focus efforts to develop strategies to overcome barriers to ensure evidence-based, best practice management of asthma in the school setting. © The Author(s) 2015.

School nurses' role in asthma management, school absenteeism, and cost savings: a demonstration project.

Science.gov (United States)

Rodriguez, Eunice; Rivera, Diana Austria; Perlroth, Daniella; Becker, Edmund; Wang, Nancy Ewen; Landau, Melinda

2013-12-01

With increasing budget cuts to education and social services, rigorous evaluation needs to document school nurses' impact on student health, academic outcomes, and district funding. Utilizing a quasi-experimental design, we evaluated outcomes in 4 schools with added full-time nurses and 5 matched schools with part-time nurses in the San Jose Unified School District. Student data and logistic regression models were used to examine predictors of illness-related absenteeism for 2006-2007 and 2008-2009. We calculated average daily attendance (ADA) funding and parent wages associated with an improvement in illness-related absenteeism. Utilizing parent surveys, we also estimated the cost of services for asthma-related visits to the emergency room (ER; N = 2489). Children with asthma were more likely to be absent due to illness; however, mean absenteeism due to illness decreased when full-time nurses were added to demonstration schools but increased in comparison schools during 2008-2009, resulting in a potential savings of $48,518.62 in ADA funding (N = 6081). Parents in demonstration schools reported fewer ER visits, and the estimated savings in ER services and parent wages were significant. Full-time school nurses play an important role in improving asthma management among students in underserved schools, which can impact school absenteeism and attendance-related economic costs. © 2013, American School Health Association.

27 CFR 24.166 - Buildings or rooms.

Science.gov (United States)

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Buildings or rooms. 24.166... OF THE TREASURY LIQUORS WINE Construction and Equipment § 24.166 Buildings or rooms. All buildings or... afford adequate protection to the revenue. Each building or room will be constructed of substantial...

New Radiation Protection training room

CERN Multimedia

HSE Unit

2013-01-01

From now on, the theory and practical components of the Radiation Protection training, developed by the RP Group and offered by the HSE Unit’s Safety Training team to people working in a Controlled Radiation Area, will take place in a dedicated teaching room, designed specifically for this kind of training.   The new room is in the Safety Training Centre on the Prévessin site and has been open since 16 October. It has an adjoining workshop that, like the room itself, can accommodate up to 12 people. It is also equipped with an interactive board as well as instruments and detectors to test for ionising radiation. This room is located near the recently inaugurated LHC tunnel mock-up where practical training exercises can be carried out in conditions almost identical to those in the real tunnel. To consult the safety training catalogue and/or sign up for Radiation Protection training, please go to: https://cta.cern.ch For further information, please contact the Safety Trainin...

Comparison of the Roche COBAS AmpliPrep/COBAS TaqMan HIV-1 test v1.0 with v2.0 in HIV-1 viral load quantification

Directory of Open Access Journals (Sweden)

Yi-Ching Tung

2015-04-01

Full Text Available Roche modified the COBAS AmpliPrep/COBAS TaqMan human immunodeficiency virus type 1 (HIV-1 test version 1.0 (CAP/CTM v1.0, resulting in the COBAS AmpliPrep/COBAS TaqMan HIV-1 test version 2.0 (CAP/CTM v2.0. The aim of this study was to evaluate the performance of the CAP/CTM v2.0 and to compare this performance with that of the CAP/CTM v1.0. The study was conducted in a small local study group in Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. A total of 86 plasma samples from HIV-1-seropositive patients were tested using the two assays. The correlation and concordance of results between the two assays were calculated. The CAP/CTM v2.0 generated higher values than did the CAP/CTM v1.0, and five samples (5.8% yielded a difference of > 1 log10 copies/mL. In addition, our data show that CAP/CTM v1.0 and CAP/CTM v2.0 yielded relatively consistent values for 23 samples with low viral loads (< 200 copies/mL. Furthermore, when viral loads were in a medium range (2–5 log10 copies/mL, the results of the two assays were more compatible. This study shows a good correlation between CAP/CTM v1.0 and v2.0 in HIV-1 viral load measurement. Further attention must be paid to those cases in which measured viral loads present larger differences between the two assays.

Measurement of low-frequency noise in rooms

DEFF Research Database (Denmark)

Pedersen, Steffen; Møller, Henrik; Persson-Waye, Kerstin

2006-01-01

Measurement of low-frequency noise in rooms is problematic due to standing wave patterns. The spatial variation in the sound pressure level can typically be as much as 20-30 dB. For assessment of annoyance from low-frequency noise in dwellings, it is important to measure a level close...... rooms. The sound pressure level was measured 1) in three-dimensional corners and 2) according to current Swedish and Danish measurement methods. Furthermore, the entire sound pressure distributions were measured by scanning. The Swedish and Danish measurement methods include a corner measurement...... to the highest level present in a room, rather than a room average level. In order to ensure representative noise measurements, different positions were investigated based on theoretical considerations and observations from numerical room simulations. In addition measurements were performed in three different...

Perceptual effects in auralization of virtual rooms

Science.gov (United States)

Kleiner, Mendel; Larsson, Pontus; Vastfjall, Daniel; Torres, Rendell R.

2002-05-01

By using various types of binaural simulation (or ``auralization'') of physical environments, it is now possible to study basic perceptual issues relevant to room acoustics, as well to simulate the acoustic conditions found in concert halls and other auditoria. Binaural simulation of physical spaces in general is also important to virtual reality systems. This presentation will begin with an overview of the issues encountered in the auralization of room and other environments. We will then discuss the influence of various approximations in room modeling, in particular, edge- and surface scattering, on the perceived room response. Finally, we will discuss cross-modal effects, such as the influence of visual cues on the perception of auditory cues, and the influence of cross-modal effects on the judgement of ``perceived presence'' and the rating of room acoustic quality.

Mathematical Models for Room Air Distribution

DEFF Research Database (Denmark)

Nielsen, Peter V.

1982-01-01

A number of different models on the air distribution in rooms are introduced. This includes the throw model, a model on penetration length of a cold wall jet and a model for maximum velocity in the dimensioning of an air distribution system in highly loaded rooms and shows that the amount of heat...... removed from the room at constant penetration length is proportional to the cube of the velocities in the occupied zone. It is also shown that a large number of diffusers increases the amount of heat which may be removed without affecting the thermal conditions. Control strategies for dual duct and single...... duct systems are given and the paper is concluded by mentioning a computer-based prediction method which gives the velocity and temperature distribution in the whole room....

7 CFR 58.211 - Packaging room for bulk products.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Packaging room for bulk products. 58.211 Section 58... Service 1 Rooms and Compartments § 58.211 Packaging room for bulk products. A separate room or area shall... dust within the packaging room and where needed, a dust collector shall be provided and properly...

Room acoustic transition time based on reflection overlap

DEFF Research Database (Denmark)

Jeong, Cheol-Ho; Brunskog, Jonas; Jacobsen, Finn

2010-01-01

A transition time is defined based on the temporal overlap of reflected pulses in room impulse responses. Assuming specular reflections only, the temporal distance between adjacent reflections, which is proportional to the volume of a room, is compared with the characteristic width of a pulse at ...... in a room with nonuniform absorption and furniture than in a room that satisfies the underlying assumptions....

Room acoustic transition time based on reflection overlap

DEFF Research Database (Denmark)

Jeong, Cheol-Ho; Brunskog, Jonas; Jacobsen, Finn

2013-01-01

A transition time is defined based on the temporal overlap of reflected pulses in room impulse responses. Assuming specular reflections only, the temporal distance between adjacent reflections, which is proportional to the volume of a room, is compared with the characteristic width of a pulse at ...... in a room with nonuniform absorption and furniture than in a room that satisfies the underlying assumptions....

Maintaining Breast Cancer Specimen Integrity and Individual or Simultaneous Extraction of Quality DNA, RNA, and Proteins from Allprotect-Stabilized and Nonstabilized Tissue Samples

LENUS (Irish Health Repository)

Mee, Blanaid C.

2011-12-29

The Saint James\\'s Hospital Biobank was established in 2008, to develop a high-quality breast tissue BioResource, as a part of the breast cancer clinical care pathway. The aims of this work were: (1) to ascertain the quality of RNA, DNA, and protein in biobanked carcinomas and normal breast tissues, (2) to assess the efficacy of AllPrep® (Qiagen) in isolating RNA, DNA, and protein simultaneously, (3) to compare AllPrep with RNEasy® and QIAamp® (both Qiagen), and (4) to examine the effectiveness of Allprotect® (Qiagen), a new tissue stabilization medium in preserving DNA, RNA, and proteins. One hundred eleven frozen samples of carcinoma and normal breast tissue were analyzed. Tumor and normal tissue morphology were confirmed by frozen sections. Tissue type, tissue treatment (Allprotect vs. no Allprotect), extraction kit, and nucleic acid quantification were analyzed by utilizing a 4 factorial design (SPSS PASW 18 Statistics Software®). QIAamp (DNA isolation), AllPrep (DNA, RNA, and Protein isolation), and RNeasy (RNA isolation) kits were assessed and compared. Mean DNA yield and A260\\/280 values using QIAamp were 33.2 ng\\/μL and 1.86, respectively, and using AllPrep were 23.2 ng\\/μL and 1.94. Mean RNA yield and RNA Integrity Number (RIN) values with RNeasy were 73.4 ng\\/μL and 8.16, respectively, and with AllPrep were 74.8 ng\\/μL and 7.92. Allprotect-treated tissues produced higher RIN values of borderline significance (P=0.055). No discernible loss of RNA stability was detected after 6 h incubation of stabilized or nonstabilized tissues at room temperature or 4°C or in 9 freeze-thaw cycles. Allprotect requires further detailed evaluation, but we consider AllPrep to be an excellent option for the simultaneous extraction of RNA, DNA, and protein from tumor and normal breast tissues. The essential presampling procedures that maintain the diagnostic integrity of pathology specimens do not appear to compromise the quality of molecular isolates.

THE IMPROVEMENT OF COMPUTER NETWORK PERFORMANCE WITH BANDWIDTH MANAGEMENT IN KEMURNIAN II SENIOR HIGH SCHOOL

Directory of Open Access Journals (Sweden)

Bayu Kanigoro

2012-05-01

Full Text Available This research describes the improvement of computer network performance with bandwidth management in Kemurnian II Senior High School. The main issue of this research is the absence of bandwidth division on computer, which makes user who is downloading data, the provided bandwidth will be absorbed by the user. It leads other users do not get the bandwidth. Besides that, it has been done IP address division on each room, such as computer, teacher and administration room for supporting learning process in Kemurnian II Senior High School, so wireless network is needed. The method is location observation and interview with related parties in Kemurnian II Senior High School, the network analysis has run and designed a new topology network including the wireless network along with its configuration and separation bandwidth on microtic router and its limitation. The result is network traffic on Kemurnian II Senior High School can be shared evenly to each user; IX and IIX traffic are separated, which improve the speed on network access at school and the implementation of wireless network.Keywords: Bandwidth Management; Wireless Network

Complete rooming-in care of newborn infants

Directory of Open Access Journals (Sweden)

Yoo Min Lee

2010-05-01

Full Text Available Purpose : In Kyung Hee East-West Neo Medical Center, Seoul,Korea, efforts to raise rooming-in care success rate have been undertaken since when the hospital was established in 2006. We intended to analyze our experience over the past 3 years of period and to discuss the advantages of rooming-in. Methods : We analyzed the rooming-in practice rate, failure rate, and the breast feeding rate. Subjects were 860 normal healthy neonates from June 2006 to June 2009. Results: Among these 860 cases, 83 babies were required separation out of rooming-in in the middle of the course. Among these 83 cases, 70 cases had to stop the course due to poor condition of babies and 13 cases due to maternal condition. 70 cases of infant’s causes consist of 68 cases of NICU admission and 2 cases of poor feeding support. The other 13 cases of separation include refusal by maternal condition. Therefore the success rate of rooming-in for the last 3 years was 90.3%, that is 777 cases among the total 860 cases. The percentage of exclusive breast feeding was 64%, that of mixed feeding with breast and formula feeding was 25%, and formula feeding only was 11%. Conclusion : We experienced successful rooming-in care for the last 3 years. Nursery facilities should educate and encourage the advantages of rooming-in, including the good formation of attachment between mother and infant, emotional stability, protection from infection, and increased breast feeding rate so that rooming-in care can be fully established.

Towards an Understanding of the Place of Ethics in School-Based Action Research in the United Kingdom

Science.gov (United States)

Brindley, Sue; Bowker, Anne

2013-01-01

As school-based action research has taken a higher profile in UK schools, the place of ethics warrants particular attention. This paper draws on evidence from a taught online Master of Education course collated via chat room discussion where 53 researching teachers were asked to explore policy within their own institution regarding school-based…

Foucault could have been an operating room nurse.

Science.gov (United States)

Riley, Robin; Manias, Elizabeth

2002-08-01

Operating room nursing is an under-researched area of nursing practice. The stereotypical image of operating room nursing is one of task- and technically-orientated aspects of practice, where nurses work in a medical model and are dominated by constraints from outside their sphere of influence. This paper explores the possibility of understanding operating room nursing in a different way. Using the work of Michel Foucault to analyse the work of operating room nursing, this paper argues the relevance of the framework for a more in-depth analysis of this specialty area of practice. The concepts of power, discipline and subjectivity are used to demonstrate how operating room nursing is constructed as a discipline and how operating room nurses act to govern and construct the specialty. Exemplars are drawn from extensive professional experience, from guidelines of professional operating room nursing associations, as well as published texts. The focus is predominantly on the regulation of space and time to maintain the integrity of the sterile surgical field and issues of management, as well as the use of the ethical concept of the 'surgical conscience'. This form of analysis provides a level and depth of inquiry that has rarely been undertaken in operating room nursing. As such, it has the potential to provide a much needed, different view of operation room nursing that can only help to strengthen its professional foundations and development.

Rethinking theatre in modern operating rooms.

Science.gov (United States)

Riley, Robin; Manias, Elizabeth

2005-03-01

Metaphor is a means through which a widely accepted meaning of a word is used in a different context to add understanding that would otherwise be difficult to conceive. Through etymological and metaphorical associations, we contend that aspects of "theatre" are still relevant in the modern operating rooms and that the use of dramaturgical metaphors can add another layer of understanding about the social reality in this setting. We begin by exploring the historical roots and derivation of the word theatre as it applied to anatomical dissection and surgery. Briefly, we touch on the work of Erving Goffman and examine how his work has been used by others to explore aspects of operating room nursing. Then, drawing on data from a postmodern ethnographic study that has been used to examine communication in operating room nursing, four dramaturgical metaphors are used to illustrate the argument. They are drama, the script and learning the lines, the show must go on, and changing between back stage and front stage. To conclude, the small amount of previously published literature on this topic is compared and contrasted, and the relevance of using dramaturgical metaphors to understand modern operating rooms is discussed. Being able to distinguish between the inherent drama in operating room work and the dramatic realisation of individuals who work within, can help operating room nurses to think differently about, and perhaps re-evaluate their social situation and how they function within it.

Assessment of abuse-related injuries: a comparative study of forensic physicians, emergency room physicians, emergency room nurses and medical students.

Science.gov (United States)

Reijnders, Udo J L; Giannakopoulos, Georgios F; de Bruin, Kim H

2008-01-01

A comparative study was made investigating whether emergency room physicians, emergency room nurses, forensic physicians, and interns are competent in describing, recognising and determining the possible cause of injuries. The injury assessment scores varied from good--adequate--fail and remained blank in various participant groups. Forensic physicians scored significantly better than emergency room staff and interns in the assessment of abuse-related injuries. There were almost no differences noted between emergency room physicians and emergency room nurses. For the functional group with more or less than 4 to 6 years of experience, no significant differences were noted for scoring good in all 5 cases. The fact that forensic physicians scored better than the emergency room staff is probably explained by the fact that almost all practicing forensic physicians have been officially qualified. Training in this field for all professionals involved in such assessment should be mandatory.

A control room lighting study

International Nuclear Information System (INIS)

Vaidya, V.V.; Iwasa-Madge, K.M.; Howard, B.; Willson, R.B.

1984-01-01

Operators at a Heavy Water Plant in Ontario, Canada complained about lighting-related difficulties in the control room. The Human Factors Engineering Unit was requested to perform a lighting survey and make recommendations to improve the control centre lighting conditions. This paper describes the control room, the operator tasks, the procedures used for the lighting survey, the findings, and the changes recommended

New thinking for the boiler room.

Science.gov (United States)

Rose, Wayne

2008-09-01

Wayne Rose, marketing manager at integrated plant room manufacturer Armstrong Integrated Systems, explains how increasing use of off-site manufacture, the latest 3D modelling technology, and advances in control technology, are revolutionising boiler room design and construction.

Role of Magnetocardiography in Emergency Room

International Nuclear Information System (INIS)

Kwon, H.; Kim, K.; Kim, J. M.; Lee, Y. H.; Kim, T. E.; Lim, H. K.; Park, Y. K.; Ko, Y. G.; Chung, N.

2006-01-01

In emergency rooms, patients with acute chest pain should be diagnosed as quickly as possible with higher diagnostic accuracy for an appropriate therapy to the patients with acute coronary syndrome or for avoiding unnecessary hospital admissions. At present, electrocardiography(ECG) and biochemical markers are generally used to detect myocardial infarction and coronary angiography is used as a gold standard to reveal the degree of narrowing of coronary artery. Magnetocardiography(MCG) has been proposed as a novel and non-invasive diagnostic tool fur the detection of cardiac electrical abnormality associated with myocardial ischemia. In this study, we examined whether the MCG can be used fur the detection of coronary artery disease(CAD) in patients, who were admitted to the emergency room with acute chest pain. MCG was recorded from 36 patients admitted to the emergency room with suspected acute coronary syndrome. The MCG recordings were obtained using a 64-channel SQUID MCG system in a magnetically shielded room. In result, presence of CAD could be found with a sensitivity of 88.2 % in patients with acute chest pain without 57 elevation in ECG, demonstrating a possible use in the emergency room to screen CAD patients.

Revisiting the Operating Room Basics

Directory of Open Access Journals (Sweden)

Tushar Chakravorty

2015-12-01

Full Text Available Young doctors walking into the operating room are eager to develop their skills to become efficient and knowledgeable professionals in future. But precious little is done to actively develop the basic practical skills of the budding doctors. They remain unaware about the layout of the operating room, the OR etiquette and often do not have sound scientific understanding and importance of meticulous execution of the basic operating room protocols. This article stresses the need to develop the basics of OR protocol and to improve the confidence of the young doctor by strengthening his foundation by showing him that attention to the basics of medical care and empathy for the patient can really make a difference to the outcome of a treatment.

The changing sensory room

DEFF Research Database (Denmark)

2018-01-01

In 2017 the kindergarten The Milky Way in the city Vejle in Denmark made a sensory room that has the special ability change whenever wanted by the children and social educators. Kjetil Sandvik (to the right) from Copenhagen University and Klaus Thestrup from Aarhus University reflects upon what...... they saw, took part in and talked with the social educators about. Jacob Knudsen from VIFIN filmed the two gentlemen and organised the project. it is a room composed around common experiments, many self-made objects, open narrative structures. and a combination of digital and analogue elements....

Empowering adolescents with life skills education in schools - School mental health program: Does it work?

Science.gov (United States)

Srikala, Bharath; Kishore, Kumar K V

2010-10-01

Mental Health Promotion among adolescents in schools using life skills education (LSE) and teachers as life skill educators is a novel idea. Implementation and impact of the NIMHANS model of life skills education program studied. The impact of the program is evaluated at the end of 1 year in 605 adolescents from two secondary schools in comparison to 423 age, sex, socioeconomic status-matched adolescents from nearby schools not in the program. The adolescents in the program had significantly better self-esteem (P=0.002), perceived adequate coping (P=0.000), better adjustment generally (P=0.000), specifically with teachers (P=0.000), in school (P=0.001), and prosocial behavior (P=0.001). There was no difference between the two groups in psychopathology (P - and adjustment at home and with peers (P=0.088 and 0.921). Randomly selected 100 life skill educator-teachers also perceived positive changes in the students in the program in class room behavior and interaction. LSE integrated into the school mental health program using available resources of schools and teachers is seen as an effective way of empowering adolescents.

SEP PREPÁRATE: modelos de educación a distancia en el nivel medio superior SEP PREPÁRATE: e-learning models for high school

Directory of Open Access Journals (Sweden)

Gomez Zermeño Marcela Georgina

2011-07-01

Full Text Available Este documento presenta un estudio realizado sobre modelos innovadores de educación a distancia para adolescentes, con el propósito de generar información sobre los factores que permiten lograr que alumnos inscritos en programas a distancia, desarrollen las habilidades necesarias para su aprendizaje. Los alumnos que conforman la muestra de estudio, son adolescentes entre los 15 y 17 años de edad, en condiciones de rezago económico pero con necesidades propias de su edad y deseos de obtener sus estudios de preparatoria, inscritos en la Universidad TecMilenio y apoyados por la Fundación Bécalos, para que participen en el programa SEP Prepárate. Los alumnos cuentan con las herramientas necesarias para lograr sus estudios como son beca escolar, apoyo económico durante sus estudios, equipo de cómputo, conexión a Internet y Modem. Durante los trabajos de campo, se realizaron encuestas a los alumnos y padres de familia, entrevistas personales a los alumnos exitosos y a los alumnos no exitosos. El análisis de la información reveló que el programa SEP Prepárate creado por la Secretaría de Educación Pública y la Universidad Tecmilenio, es una alternativa viable que atiende las necesidades propias de los alumnos que estudian a distancia y como ayudar a los estudiantes a llegar con éxito al final de sus estudios de preparatoria. This document presents a study done about innovative e-learning models for trailed adolescents; it seeks to generate relevant information about the elements that would guarantee that enrolled students into an e-learning program develop the needed abilities for their instruction. The sample students that took part are adolescents between 15 and 17 years old, in poverty conditions but with the desire to graduate high school as any other teenager. The students are enrolled at TecMilenio University with the financial support of Fundación Bécalos, in coordination with the Mexican Ministry of Public Education, within

Clean industrial room for drift tube assembling

International Nuclear Information System (INIS)

Glonti, G.L.; Gongadze, A.L.; Evtukhovich, P.G.

2001-01-01

Description of a clean industrial room for assembly of drift tubes for the muon spectrometer of the ATLAS experiment is presented. High quality specifications on the detectors to be produced demanded creation of a workplace with stable temperature and humidity, as well as minimum quantity of dust in the room. Checking of parameters of intra-room air during long period of continuous work has confirmed correctness of the designed characteristics of the climatic system installed in the clean room. The room large volume (∼ 190 m 3 ), the powerful and flexible climatic system, and simplicity of service allow assembling of detectors with length up to 5 m. Subsequent checking of functionality of the assembled detectors has shown high quality of assembling (the amount of rejected tubes does not exceed 2%). It demonstrates conformity to the assembling quality requirements for mass production of drift chambers for the muon spectrometer. (author)

Clean Industrial Room for Drift Tube Assembling

CERN Document Server

Glonti, GL; Evtoukhovitch, P G; Kroa, G; Manz, A; Potrap, I N; Rihter, P; Stoletov, G D; Tskhadadze, E G; Chepurnov, V F; Chirkov, A V; Shelkov, G A

2001-01-01

Description of a clean industrial room for assembly of drift tubes for the muon spectrometer of the ATLAS experiment is presented. High quality specifications on the detectors to be produced demanded creation of a workplace with stable temperature and humidity, as well as minimum quantity of dust in the room. Checking of parameters of intra-room air during long period of continuous work has been confirmed correctness of the designed characteristics of the climatic system installed in the clean room. The room large volum (\\sim 190 m^3), the powerful and flexible climatic system, and simplicity of service allow assembling of detectors with length up to 5 m. Subsequent checking of functionality of the assembled detectors has shown high quality of assembling (the amount of rejected tubes does not exceed 2 %). It demonstrates conformity to the assembling quality requirements for mass production of drift chambers for the muon spectrometer.

Control room habitability in Spanish Nuclear Power Plants

International Nuclear Information System (INIS)

Mediavilla, F.; Sierra, J. J.

2007-01-01

Since the NRC published in 2003 the Generic Letter 2003-01 Control room Habitability and the Regulatory guide 1.197 Demonstrating Control Room Envelope Integrity at Nuclear Power Reactors, where it is emphasized the importance of verifying the control room habitability by means of alternative methods, Spanish Nuclear Power Plants are undertaking the different necessary activities to fulfill the requirements of the regulatory commission. This paper describes the main mechanisms included in NEI 99-03 Nuclear Energy Institute publication Control room Habitability Assessment guidance, to demonstrate and maintain Control room Habitability. In addition, in this article it Ds shown the theoretical principle of the test used to quantify air in-leakage in a control room envelope by using tracer gas techniques. The necessary activities to perform the initial in leakage testing are also put forward. Since 2006 Tecnatom, S. A. has performed the baseline testing in four Spanish Units, all of them with successful results. The rest of the Plants are scheduled to perform the tests during the second half of this year. Finally, this document summarises the more important aspects to be taken into account in the development of control room Habitability Programs, which are expected to ensure the integral maintenance of the Control room Envelope during the life a plant. (Author)

Architectural Survey of Pence Elementary School, Fort Leonard Wood, Missouri

Science.gov (United States)

2011-09-01

younger students often learned what they needed to know from older students (Graves 1993, 22). During the first half of the 19th century , urban...of class- rooms with an applied Gothic, Greek Revival, or Victorian facade to create a cohesive building (Figure 5). ERDC/CERL TR-11-25 8...with Eliel and Eero Saarinen and con- structed in 1940, this school was the first to separate from the traditional Victorian style of school buildings

Control room and ergonomic design

International Nuclear Information System (INIS)

Hinz, W.

1984-01-01

The important basis for the configuration of the control room of a nuclear power station is the concept for controlling a fault and that for controlling normal operation. The tasks resulting from this for the control room personnel are decided by the control room concept. In this configuration process (from the division of process control tasks between the system components operators and control technology to the configuration of individual means of operation) the characteristics and capabilities of the personnel, which are subject to special requirements as regards their qualifications, are observed. New concepts which are only now technically feasible are therefore being developed for information processing and display, in order to give the personnel a better oversight of the state and trends of the plant. (orig./DG) [de

Indoor radon concentration measurements in Tarqumia Girl Schools at Western Hebron Region, Palestine

International Nuclear Information System (INIS)

Dabyneh, K.M.

2006-01-01

In this study, radon-222 in indoor air was surveyed in 62 rooms located in four governmental schools, for girls, in Tarqumia town that lies in the north western part of Hebron city in Palestine. The annual effective dose equivalents resulting from the inhalation of radon and its daughters by 2318 pupils and 102 staff members occupying the surveyed rooms were also measured. TASTRAK, a solid state nuclear track detector, has been used to measure the indoor radon concentrations at those schools thus, 124 radon detectors were distributed in the four school buildings. The radon detectors stayed for 70 days between February 2006 and April 2006. The results showed that the radon concentration and the annual effective dose equivalent in these schools were varied from 12 to 232.5 Bq/m 3 with an average of 34.1 Bq/m 3 and 0.62 to 12.0 mSv/y with an average of 1.76 mSv/y, respectively. The mean values of radon concentrations in Tarqumia secondary girls school, Al-aqsa elementary girls school, Umsalama elementary girls school and Tarqumia elementary girls school were 35.8, 26.7, 25.9 and 47.8 Bq/m 3 , respectively, and the mean values of the annual effective dose equivalent for the above mentioned were 1.85, 1.38, 1.34 and 2.47 mSv/y, respectively. It has been found from these results that, most of the values were of nominal state values (that is less than the allowed global values) and in few places, the concentration was higher than the allowed global values, therefore, the annual effective dose higher than annual global level values (1.3 mSv/y) was resulted. Poor ventilation and old buildings were, most mobility, the main cause of these high radon concentrations. Improving ventilation of these places will increase air exchange rates with the out side, thereby resulting in reduced concentration. In general, the results showed that protection against radiological hazards would not be necessary for pupils and staff members occupying the rooms of the investigated schools

A survey of acoustic conditions and noise levels in secondary school classrooms in England.

Science.gov (United States)

Shield, Bridget; Conetta, Robert; Dockrell, Julie; Connolly, Daniel; Cox, Trevor; Mydlarz, Charles

2015-01-01

An acoustic survey of secondary schools in England has been undertaken. Room acoustic parameters and background noise levels were measured in 185 unoccupied spaces in 13 schools to provide information on the typical acoustic environment of secondary schools. The unoccupied acoustic and noise data were correlated with various physical characteristics of the spaces. Room height and the amount of glazing were related to the unoccupied reverberation time and therefore need to be controlled to reduce reverberation to suitable levels for teaching and learning. Further analysis of the unoccupied data showed that the introduction of legislation relating to school acoustics in England and Wales in 2003 approximately doubled the number of school spaces complying with current standards. Noise levels were also measured during 274 lessons to examine typical levels generated during teaching activities in secondary schools and to investigate the influence of acoustic design on working noise levels in the classroom. Comparison of unoccupied and occupied data showed that unoccupied acoustic conditions affect the noise levels occurring during lessons. They were also related to the time spent in disruption to the lessons (e.g., students talking or shouting) and so may also have an impact upon student behavior in the classroom.

Chem-Prep PZT 95/5 for Neutron Generator Applications: Particle Size Distribution Comparison of Development and Production-Scale Powders

International Nuclear Information System (INIS)

SIPOLA, DIANA L.; VOIGT, JAMES A.; LOCKWOOD, STEVEN J.; RODMAN-GONZALES, EMILY D.

2002-01-01

The Materials Chemistry Department 1846 has developed a lab-scale chem-prep process for the synthesis of PNZT 95/5, a ferroelectric material that is used in neutron generator power supplies. This process (Sandia Process, or SP) has been successfully transferred to and scaled by Department 14192 (Ceramics and Glass Department), (Transferred Sandia Process, or TSP), to meet the future supply needs of Sandia for its neutron generator production responsibilities. In going from the development-size SP batch (1.6 kg/batch) to the production-scale TSP powder batch size (10 kg/batch), it was important that it be determined if the scaling process caused any ''performance-critical'' changes in the PNZT 95/5 being produced. One area where a difference was found was in the particle size distributions of the calcined PNZT powders. Documented in this SAND report are the results of an experimental study to determine the origin of the differences in the particle size distribution of the SP and TSP powders

7 Reasons for Accommodating Transgender Students at School

Science.gov (United States)

Arenas, Alberto; Gunckel, Kristin L.; Smith, William L.

2016-01-01

Schools have become ground zero for clashes over transgender rights, and critics are denouncing academic institutions--and more recently, the Obama administration--for supporting transgender students in their right to use restrooms and locker rooms that match their gender identity. This article responds to the seven most common claims made by…

New technologies for control room habitability assessment

International Nuclear Information System (INIS)

Lahti, G.P.; Muraida, J.E.; Perchiazzi, W.T.; Harden, P.A.

1994-01-01

Older nuclear power plants typically considered only a nominal amount of unfiltered inleakage (typically 10 cfm) impacting their postaccident control room habitability. However, recent measurements of unfiltered inleakage show values in excess of the nominal 10 cfm. A reassessment for two of these ''older'' stations has been completed recently to show that the measured inleakage did not jeopardize the safety of the control room occupants. Recent concerns at the Zion Station and the Palisades Station about control room habitability in the event of a loss-of-coolant accident have led to an extensive effort to increase control room habitability margin. The heating, ventilating and air-conditioning (HVAC) system servicing each of the control rooms has the potential for unfiltered in-leakage through many locations. For example, at the Palisades Station, the current limiting control room habitability analysis allows for 25 cfm unfiltered in-leakage through its normal outside air intake louvered isolation dampers during emergency mode into the control room envelope. This leakage value was not thought to be achievable with the existing as-built configuration. Repairing the system was considered a potential solution; however, this would be costly and could negatively affect plant operation. In addition, the system would still be required to meet the low specified unfiltered in-leakage. An alternate approach was to review the analysis and reassess the most important parameters. The key effort was to determine the atmospheric dispersion factors (χ/Qs) through wind tunnel tests using scale models of the stations. The results of the wind tunnel testing could yield more realistic χ/Qs for control room habitability than previously employed methods. The wind tunnel study options were selected based on their ease of implementation, realistic results, and low cost. More importantly, the results of the studies would allow more realistic values of unfiltered inleakage

The radiation dose dilemma in the hybrid operating room

NARCIS (Netherlands)

de Ruiter, QMB

2016-01-01

The of the hybrid Operation room (an operation room combined with advanced radiological X-ray equipment) is gaining popularity, as it is now the preferred room to perform (complex) endovascular aortic procedures. The fixed C-arms equipped in these rooms make it possible to gain very high image

Nuclear reactor control room construction

International Nuclear Information System (INIS)

Lamuro, R.C.; Orr, R.

1993-01-01

A control room for a nuclear plant is disclosed. In the control room, objects labelled 12, 20, 22, 26, 30 in the drawing are no less than four inches from walls labelled 10.2. A ceiling contains cooling fins that extend downwards toward the floor from metal plates. A concrete slab is poured over the plates. Studs are welded to the plates and are encased in the concrete. 6 figures

Human-Like Room Segmentation for Domestic Cleaning Robots

Directory of Open Access Journals (Sweden)

David Fleer

2017-11-01

Full Text Available Autonomous mobile robots have recently become a popular solution for automating cleaning tasks. In one application, the robot cleans a floor space by traversing and covering it completely. While fulfilling its task, such a robot may create a map of its surroundings. For domestic indoor environments, these maps often consist of rooms connected by passageways. Segmenting the map into these rooms has several uses, such as hierarchical planning of cleaning runs by the robot, or the definition of cleaning plans by the user. Especially in the latter application, the robot-generated room segmentation should match the human understanding of rooms. Here, we present a novel method that solves this problem for the graph of a topo-metric map: first, a classifier identifies those graph edges that cross a border between rooms. This classifier utilizes data from multiple robot sensors, such as obstacle measurements and camera images. Next, we attempt to segment the map at these room–border edges using graph clustering. By training the classifier on user-annotated data, this produces a human-like room segmentation. We optimize and test our method on numerous realistic maps generated by our cleaning-robot prototype and its simulated version. Overall, we find that our method produces more human-like room segmentations compared to mere graph clustering. However, unusual room borders that differ from the training data remain a challenge.

Room temperature creep in metals and alloys

Energy Technology Data Exchange (ETDEWEB)

Deibler, Lisa Anne [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Materials Characterization and Performance

2014-09-01

Time dependent deformation in the form of creep and stress relaxation is not often considered a factor when designing structural alloy parts for use at room temperature. However, creep and stress relaxation do occur at room temperature (0.09-0.21 T_m for alloys in this report) in structural alloys. This report will summarize the available literature on room temperature creep, present creep data collected on various structural alloys, and finally compare the acquired data to equations used in the literature to model creep behavior. Based on evidence from the literature and fitting of various equations, the mechanism which causes room temperature creep is found to include dislocation generation as well as exhaustion.

The Virtual Dressing Room

DEFF Research Database (Denmark)

Holte, Michael Boelstoft

2013-01-01

This paper presents a review of recent developments and future perspectives, addressing the problem of creating a virtual dressing room. First, we review the current state-of-the-art of exiting solutions and discuss their applicability and limitations. We categorize the exiting solutions into three...... kinds: (1) virtual real-time 2D image/video techniques, where the consumer gets to superimpose the clothes on their real-time video to visualize themselves wearing the clothes. (2) 2D and 3D mannequins, where a web-application uses the body measurements provided by the customer, to superimpose...... and their demands to a virtual dressing room....

Quality of emergency rooms and urgent care services: user satisfaction.

Science.gov (United States)

Lima, Cássio de Almeida; Santos, Bruna Tatiane Prates dos; Andrade, Dina Luciana Batista; Barbosa, Francielle Alves; Costa, Fernanda Marques da; Carneiro, Jair Almeida

2015-01-01

To evaluate the quality of emergency rooms and urgent care services according to the satisfaction of their users. A cross-sectional descriptive study with a quantitative approach. The sample comprised 136 users and was drawn at random. Data collection took place between October and November 2012 using a structured questionnaire. Participants were mostly male (64.7%) aged less than 30 years (55.8%), and the predominant level of education was high school (54.4%). Among the items evaluated, those that were statistically associated with levels of satisfaction with care were waiting time, confidence in the service, model of care, and the reason for seeking care related to acute complaints, cleanliness, and comfortable environment. Accessibility, hospitality, and infrastructure were considered more relevant factors for patient satisfaction than the cure itself.

Low frequency sound field control in rectangular listening rooms using CABS (Controlled Acoustic Bass System) will also reduce sound transmission to neighbor rooms

DEFF Research Database (Denmark)

Nielsen, Sofus Birkedal; Celestinos, Adrian

2011-01-01

Sound reproduction is often taking place in small and medium sized rectangular rooms. As rectangular rooms have 3 pairs of parallel walls the reflections at especially low frequencies will cause up to 30 dB spatial variations of the sound pressure level in the room. This will take place not only...... at resonance frequencies, but more or less at all frequencies. A time based room correction system named CABS (Controlled Acoustic Bass System) has been developed and is able to create a homogeneous sound field in the whole room at low frequencies by proper placement of multiple loudspeakers. A normal setup...... from the rear wall, and thereby leaving only the plane wave in the room. With a room size of (7.8 x 4.1 x 2.8) m. it is possible to prevent modal frequencies up to 100 Hz. An investigation has shown that the sound transmitted to a neighbour room also will be reduced if CABS is used. The principle...

7 CFR 58.620 - Freezing and packaging rooms.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Freezing and packaging rooms. 58.620 Section 58.620 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....620 Freezing and packaging rooms. The rooms used for freezing and packaging frozen desserts shall be...

HAMMLAB 1999 experimental control room: design - design rationale - experiences

International Nuclear Information System (INIS)

Foerdestroemmen, N. T.; Meyer, B. D.; Saarni, R.

1999-01-01

A presentation of HAMMLAB 1999 experimental control room, and the accumulated experiences gathered in the areas of design and design rationale as well as user experiences. It is concluded that HAMMLAB 1999 experimental control room is a realistic, compact and efficient control room well suited as an Advanced NPP Control Room (ml)

SurePath Specimens Versus ThinPrep Specimen Types on the COBAS 4800 Platform: High-Risk HPV Status and Cytology Correlation in an Ethnically Diverse Bronx Population.

Science.gov (United States)

Naeem, R C; Goldstein, D Y; Einstein, Mark H; Ramos Rivera, G; Schlesinger, K; Khader, S N; Suhrland, M; Fox, A S

2017-08-01

To compare the cytologic preparations of 130 cervical specimens (from women of various ethnicities at high risk for human papillomavirus [HPV] infection) using the SurePath (SP) collection system with specimens gathered using the ThinPrep (TP) system, as processed on the Cobas 4800 analyzer, to determine which collection method more accurately identifies HPV infection. In our prospective study, specimens were collected from 130 women of various ethnicities residing in or near Bronx County, NY. The SP-collected specimen was first processed for cytologic findings; if clinical HPV testing was requested on that specimen, it was tested using Hybrid Capture II (HC2) methodology. We tested the remnant SP-collected cell concentrate using the Cobas analyzer. Then, the TP-collected and SP-collected specimens were tested in the same run on that analyzer, and the results were compared. We also compared the results with the concurrent cytologic findings. The results were concordant for overall HR-HPV status in 93.8% of cases. Also, a statistically significant lower cycle threshold value was observed with Cobas testing of specimen concentrates tested via the BD SurePath Pap Test (P = .001), suggesting higher sensitivity compared with specimens tested via the ThinPrep Pap Test. Cobas 4800 HPV testing of SP-collected specimen concentrates yields comparable results to TP-collected specimen concentrates. Based on the limited data that we derived, SP collection may be a more favorable methodology than TP collection for HPV testing of individuals at high risk in our ethnically diverse, urban patient population. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Fast rendering of scanned room geometries

DEFF Research Database (Denmark)

Olesen, Søren Krarup; Markovic, Milos; Hammershøi, Dorte

2014-01-01

Room acoustics are rendered in Virtual Realities based on models of the real world. These are typically rather coarse representations of the true geometry resulting in room impulse responses with a lack of natural detail. This problem can be overcome by using data scanned by sensors, such as e...

Room climate in large historical rooms. Raumklima in grossen historischen Raeumen; Heizungsart, Heizungsweise, Schadensentwicklung, Schadensverhinderung

Energy Technology Data Exchange (ETDEWEB)

Arendt, C

1993-01-01

The effects of different types of heating systems in large historical rooms on the room climate, the building and (to some extent) on humans are investigated. Starting from a theoretical analysis and available experimental reports, suitable objects (churches, theatres, festival and assembly halls) were selected in which a number of parameters were measured. From the results criteria were established for judging the different types of heating systems. (BWI). 181 figs.

Air pressure distribution and radon entry processes in east Tennessee schools

International Nuclear Information System (INIS)

Sinclair, L.D.; Dudney, C.S.; Wilson, D.L.; Saultz, R.J.

1990-01-01

Many building characteristics have been found to influence radon entry, including building size and configuration, substructure, location of utility supply lines, and design and operation of the heating, ventilation, and air conditioning (HVAC) system. One of the most significant factors is room depressurization resulting from the HVAC system exhausting more than it supplies. This paper represents a preliminary assessment of HVAC characteristics and how they may relate to radon entry. During the summer of 1989, a limited survey was made of air pressure and radon levels in four schools in eastern Tennessee. Short-term samples of radon and pressure were made in all rooms in contact with the soil using alpha scintillation cells and an electronic microanometer, respectively. The pressure difference and radon concentration changes induced by operation of the building ventilation system varied among sites within individual schools

Determination of radon in housing rooms

International Nuclear Information System (INIS)

Steger, F.; Sorantin, H.; Kozuh-Schneeberger, J.; Lovranich, E.; Khademi, B.

1988-03-01

Radon concentration in 171 apartments with 503 rooms in and around Vienna was measured by a passive measuring system. Polycarbonate foils were exposed during 3 months; the nuclear tracks were visualized by electro-chemical method and evaluated. In housing- and sleeping rooms the mean concentration was 1,03 pCi/l, in cellars 2,15 pCi/l. The equivalent dosis, with 1,03 pCi/l was estimated to 90 mrem/a. At the same time the external radiation dose in the same rooms was measured by TL dosimeters and the dose estimated is again 90 mrem/a. 34 refs., 16 figs., 4 tabs. (qui)

Guidelines for control room systems design. Working material. Report

International Nuclear Information System (INIS)

1993-01-01

This report contains comprehensive technical and methodological information and recommendations for the benefit of Member States for advice and assistance in ''NPP control room systems'' design backfitting existing nuclear power plants and design for future stations. The term ''Control Room Systems'' refers to the entire human/machine interface for the nuclear stations - including the main control room, back-ups control room and the emergency control rooms, local panels, technical support centres, operating staff, operating procedures, operating training programs, communications, etc. Refs, figs and tabs

New heuristics for planning operating rooms.

NARCIS (Netherlands)

Molina-Pariente, J.M.; Hans, Elias W.; Framinan, J.M.; Gomez-Cia, T.

2015-01-01

We tackle the operating room planning problem of the Plastic Surgery and Major Burns Specialty of the University Hospital “Virgen del Rocio” in Seville (Spain). The decision problem is to assign an intervention date and an operating room to a set of surgeries on the waiting list, minimizing access

The Contemporary School and Knowledge management

Directory of Open Access Journals (Sweden)

Mulej Majtaž

2008-03-01

Full Text Available The school of today faces circumstances that differ very much from the ones in which the current educators have been educated as students, especially in the countries that are new members of the European Union as EU-27. Therefore, in order to manage knowledge in their school of today, one must understand the socio-economic development trends and their impact over the school as a subsystem of the emerging innovative society in which the innovative business leaves little or no room for the routine-loving behaviour of previous decades, centuries, and millennia. This contribution summarizes a dialectical system of this development trends and the resulting newly required attributes of the contemporary schools and teachers, but it does so on the level of provocation for readers’ creative and innovative thinking and action rather than on the level of any final answers. The Bologna Process seems to be an underused opportunity for innovation of higher education in Europe.

Clean room actuators

Energy Technology Data Exchange (ETDEWEB)

Higuchi, Toshiro

1987-06-01

This report explains on the present status of the clean room actuators including the author's research results. In a clean room, there exists a possibility of dust generation, even when a direct human work is eliminated by the use of robots or automatic machines, from the machines themselves. For this, it is important to develop such clean robots and transfer/positioning mechanism that do not generate dusts, and to develop an actuator and its control technique. Topics described in the report are as follows: 1. Prevention of dust diffusion by means of sealing. 2. Elimination of mechanical contact (Linear induction motor and pneumatic float, linear motor and magnetic attraction float, linear motor and air bearing, and magnetic bearing). 3. Contactless actuator having a positioning mechanism (Use of linear step motor and rotary contactless actuator). (15 figs, 11 refs)

Control room habitability study - findings and recommendations

International Nuclear Information System (INIS)

Driscoll, J.W.

1987-01-01

The Advisory Committee on Reactor Safeguards (ACRS) has raised a number of concerns related to control room habitability and has recommended actions which they believe could alleviate these concerns. As a result of the ACRS's concerns, the US Nuclear Regulatory Commission's (NRC) Office of Nuclear Reactor Regulation (NRR) in conjunction with the Offices of Research and Inspection and Enforcement, and the NRC regional offices, embarked upon a program to reevaluate Control Room Habitability. Argonne National Laboratory was contracted by the NRC to perform a Control Room Habitability Study on twelve licensed power reactors. The plants selected for the study were chosen based upon architect engineer, nuclear steam system supplier, utility, and plant location. The major findings of this study are included in this report along with generic recommendations of the review team that apply to control room HVAC systems. Although the study is not complete, at the time of publication of this report, the results obtained to date should be useful to persons responsible for Control Room Habitability in evaluating their own systems

Solar Car, Solar Boat: Model Classroom Projects. Seattle Tech Prep.

Science.gov (United States)

Seattle Community Coll. District, Washington.

This booklet shows how teachers at Ingraham High School and Madison Middle School in Seattle (Washington) challenged their students to tackle demanding technical projects. It also shows how well the students responded to that challenge. The booklet begins with the background of the project, the framework for which would be a university-sponsored…

Control room human engineering influences on operator performance

International Nuclear Information System (INIS)

Finlayson, F.C.

1977-01-01

Three general groups of factors influence operator performance in fulfilling their responsibilities in the control room: (1) control room and control system design, informational data displays (operator inputs) as well as control board design (for operator output); (2) operator characteristics, including those skills, mental, physical, and emotional qualities which are functions of operator selection, training, and motivation; (3) job performance guides, the prescribed operating procedures for normal and emergency operations. This paper presents some of the major results of an evaluation of the effect of human engineering on operator performance in the control room. Primary attention is given to discussion of control room and control system design influence on the operator. Brief observations on the influences of operator characteristics and job performance guides (operating procedures) on performance in the control room are also given. Under the objectives of the study, special emphasis was placed on the evaluation of the control room-operator relationships for severe emergency conditions in the power plant. Consequently, this presentation is restricted largely to material related to emergency conditions in the control room, though it is recognized that human engineering of control systems is of equal (or greater) importance for many other aspects of plant operation

7 CFR 58.212 - Hopper or dump room.

Science.gov (United States)

2010-01-01

....212 Hopper or dump room. A separate room shall be provided for the transfer of bulk dry dairy products to the hoppers and conveyors which lead to the fillers. This room shall meet the same requirements... transfer of dry dairy products from portable bulk bins will be accepted if gasketed surfaces or direct...

7 CFR 58.413 - Cutting and packaging rooms.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Cutting and packaging rooms. 58.413 Section 58.413....413 Cutting and packaging rooms. When small packages of cheese are cut and wrapped, separate rooms shall be provided for the cleaning and preparation of the bulk cheese and for the cutting and wrapping...

Calculation of Appropriate Minimum Size of Isolation Rooms based on Questionnaire Survey of Experts and Analysis on Conditions of Isolation Room Use

Science.gov (United States)

Won, An-Na; Song, Hae-Eun; Yang, Young-Kwon; Park, Jin-Chul; Hwang, Jung-Ha

2017-07-01

After the outbreak of the MERS (Middle East Respiratory Syndrome) epidemic, issues were raised regarding response capabilities of medical institutions, including the lack of isolation rooms at hospitals. Since then, the government of Korea has been revising regulations to enforce medical laws in order to expand the operation of isolation rooms and to strengthen standards regarding their mandatory installation at hospitals. Among general and tertiary hospitals in Korea, a total of 159 are estimated to be required to install isolation rooms to meet minimum standards. For the purpose of contributing to hospital construction plans in the future, this study conducted a questionnaire survey of experts and analysed the environment and devices necessary in isolation rooms, to determine their appropriate minimum size to treat patients. The result of the analysis is as follows: First, isolation rooms at hospitals are required to have a minimum 3,300mm minor axis and a minimum 5,000mm major axis for the isolation room itself, and a minimum 1,800mm minor axis for the antechamber where personal protective equipment is donned and removed. Second, the 15 ㎡-or-larger standard for the floor area of isolation rooms will have to be reviewed and standards for the minimum width of isolation rooms will have to be established.

Clinic exam room design: present and future.

Science.gov (United States)

Freihoefer, Kara; Nyberg, Gary; Vickery, Christine

2013-01-01

This article aims to deconstruct various design qualities and strategies of clinic exam rooms, and discuss how they influence users' interaction and behavior in the space. Relevant literature supports the advantages and disadvantages of different design strategies. Annotated exam room prototypes illustrate the design qualities and strategies discussed. Advancements in technology and medicine, along with new legislative policies, are influencing the way care providers deliver care and ultimately clinic exam room designs. The patient-centered medical home model has encouraged primary care providers to make patients more active leaders of their health plan which will influence the overall functionality and configuration of clinic exam rooms. Specific design qualities discussed include overall size, location of doors and privacy curtains, positioning of exam tables, influence of technology in the consultation area, types of seating, and placement of sink and hand sanitizing dispensers. In addition, future trends of exam room prototypes are presented. There is a general lack of published evidence to support design professionals' design solutions for outpatient exam rooms. Future research should investigate such topics as the location of exam tables and privacy curtains as they relate to patient privacy; typical size and location of consultation table as it relates to patient connection and communication; and placement of sinks and sanitization dispensers as they relate to frequency and patterns of usage. Literature review, outpatient, technology, visual privacy.

Measurement of potential alpha energy concentration in some schools in Shillong city

International Nuclear Information System (INIS)

Maibam, Deveshwori; Sharma, Yubaraj; Saxena, Atul; Walia, Devesh; Diengdoh, Evamary; Rapmai, Aibora K.

2011-01-01

Radon and its progeny account for more than 50% of total natural radiation exposure to humans and are considered to an important cause of lung cancer (UNSCEAR, 2008). Indoor radon levels are much higher than outdoor levels hence the importance of assessing radon levels in indoor environments, particularly schools which serve as a significant source of radon exposure both for children and the staffs. Children have smaller lung volumes and higher breathing rates therefore an augmented radon concentration results to a higher radiation dose in children. In our study, potential alpha energy concentration (PAEC) of 20 schools in Shillong region has been measured using the SSNTD method with LR-115 type 2 detectors. The detectors in bare mode were placed in class rooms at different floors of each school during winter and summer season. The detectors in bare mode were placed in class rooms at diff rent floors of each school during winter and summer season. The PAEC (mWL) at each of the selected schools are calculated and it ranges from 2.56 - 58.2 mWL (Arithmetic mean) and 2.34 - 58.18 mWL (Geometric mean). And the annual effective dose equivalent (AEDE) ranges from 0.74 - 17.85 mSv.y -1 . This preliminary study shows that the AEDE values of the schools under study are below the prescribed action limit by AERB i.e. 30 mSv.y -1 . (author)

Operating Room Utilization at Frederick Memorial Hospital

National Research Council Canada - National Science Library

Edwards, Jonathan A

2007-01-01

.... A logistical regression analysis was used to identify the impact of variables on operating room utilization rates and therefore help explain how or why some operating rooms incurred higher utilization rates than others...

Control room habitability study: findings and recommendations

International Nuclear Information System (INIS)

Driscoll, J.W.

1986-01-01

The Advisory Committee on Reactor Safeguards (ACRS) has raised a number of concerns related to control room habitability and has recommended actions which they believe could alleviate these concerns. As a result of the ACRS's concerns, the US Nuclear Regulatory Commission's (NRC) Office of Nuclear Reactor Regulation (NRR) in conjunction with the Offices of Research and Inspection and Enforcement, and the NRC regional offices, embarked upon a program to reevaluate Control Room Habitability. Argonne National Laboratory was contracted by the NRC to perform a Control Room Habitability Study on twelve licensed power reactors. The plants selected for the study were chosen based upon architect engineer, nuclear steam system supplier, utility, and plant location. Participants in the study review the plant design as contained in the Updated Safety Analysis Report, Technical Specifications, Three Mile Island action item III.D.3.4 submittal on Control Room Habitability, NRC staff evaluation of the III.D.3.4 submittal, appropriate plant operating procedures, system drawings, and significant Licensee Event Reports on Loss of Cooling to the Control Room Envelope. A two-day visit is then made to the plant to determine if the as-built systems are built, operated, and surveillance performed as described in the documentation reviewed prior to the visit. The major findings of this study are included in this report along with generic recommendations of the review team that apply to control room HVAC systems. Although the study is not complete, at the time of publication of this report, the results obtained to date should be useful to persons responsible for Control Room Habitability in evaluating their own systems

An inhibitory switch derepressed by pbx, hox, and Meis/Prep1 partners regulates DNA-binding by pbx1 and E2a-pbx1 and is dispensable for myeloid immortalization by E2a-pbx1.

Science.gov (United States)

Calvo, K R; Knoepfler, P; McGrath, S; Kamps, M P

1999-12-23

The Pbx/Exd family of homeodomain (HD) proteins contribute to the transcriptional and developmental roles of other Hox and Meis/Prep1/Hth HD proteins through heterodimer formation. E2a-Pbx1 is an oncogenic derrivative of Pbx1 produced by the t(1;19) translocation in pediatric pre-B cell acute lymphoblastic leukemia. E2a-Pbx1 heterodimerizes with Hox but not with Meis/Prep1 proteins, produces acute myeloid leukemia in mice, and blocks differentiation of cultured murine myeloid progenitors. Here, we characterize negative and positive regulatory sequences that flank the Pbx1 HD and determine their importance for myeloid immortalization by E2a-Pbx1. A 25 residue predicted alpha helix preceding the Pbx1 HD bound the HD and prevented both its binding to DNA and its ability to heterodimerize with Hox proteins. Addition of 39 residues N-terminal to this inhibitory helix exposed a Pbx dimerization interface that orchestrated cooperative DNA-binding of E2a-Pbx1 and all Pbx proteins as homodimers and heterdimers. Sequences inhibiting DNA-binding and mediating Pbx dimerization coincided with those reported to have nuclear export function. An additional 103 residues N-terminal to the Pbx dimerization interface restored heterodimerization with Hox and Meis1/Prep1 proteins. This negative switch domain - comprised of the inhibitory helix and N-terminal regions required for its partner-mediated derepression - was dispensable for myeloid immortalization by E2a-Pbx1. While stabilizing the heterodimer, the 310 helix C-terminal to the Pbx1 HD was also dispensable for the ability of E2a-Pbx1 to heterodimerize with Hox proteins and immortalize myeloblasts. Retention of myeloid immortalization by E2a-Pbx1 proteins lacking all Pbx1 sequences N- or C-terminal to the HD indicates that Hox proteins, or a yet undefined factor that binds the Pbx1 HD and derepresses DNA-binding by the HD, cooperate with E2a-Pbx1 in myeloid immortalization.

Multi-bed patient room architectural evaluation

Directory of Open Access Journals (Sweden)

Evangelia Sklavou

2016-12-01

Full Text Available Introduction: Leveraging the physical environment’s merits is crucial in healthcare settings towards fostering sustainable healing conditions. In the future, the need to retrofit hospitals already appears more probable than to build new facilities. In Greece, holistic healthcare architecture has significant potential and room to develop. Aim: The architectural research of multi-bed patient room environment. Method: A sample of multi-bed patient rooms of a Greek hospital was studied per architectural documentation and user evaluation survey. Beyond recording the existing situation and user experience, user group differences and the influence of window proximity were studied. The survey sample was based on convenience and comprised 160 patients and 136 visitors. Statistical analysis was performed in SPSS 20, using chi-square exact tests of independence. The chosen level of significance was p < 0.05. Results: Architectural documentation showed that the building morphology had a positive impact in patient rooms, with regard to sunlight penetration and view. Further solar daylight control was deemed necessary, to facilitate overall environmental comfort conditions. High spatial density and considerable disadvantages of the middle patient bed, compared to the one bedside the window and the one further in the back of the room, were also ascertained. User groups did not evaluate their surroundings significantly different, with the exception of ease of access to the view. Window proximity influenced both patients and visitors in evaluating ease of access to the view and visual discomfort. Patients were further affected on window size evaluation and visitors on view related aspects. Conclusions: Synergy between building form and function contributes in creating holistic sustainable healing environments. User evaluation can deviate from objective documentation. Patients and visitors experienced the patient room in a similar manner. The middle bed was

VRML Programs for Room Ventilation Applications

DEFF Research Database (Denmark)

Nielsen, Anker

Cheap 3D models for visualization of room ventilation applications are now available. VRML (Virtu~l Reality Modelling Language) is found to be a good format to describe buildings, rooms and furniture. A 3D model in VRML can be placed on a World Wide Web (www) page and others can see the model...

Mathematical Models for Room Air Distribution - Addendum

DEFF Research Database (Denmark)

Nielsen, Peter V.

1982-01-01

A number of different models on the air distribution in rooms are introduced. This includes the throw model, a model on penetration length of a cold wall jet and a model for maximum velocity in the dimensioning of an air distribution system in highly loaded rooms and shows that the amount of heat...... removed from the room at constant penetration length is proportional to the cube of the velocities in the occupied zone. It is also shown that a large number of diffusers increases the amount of heat which may be removed without affecting the thermal conditions. Control strategies for dual duct and single...... duct systems are given and the paper is concluded by mentioning a computer-based prediction method which gives the velocity and temperature distribution in the whole room....

Single room control for user-optimised room air conditions; Einzelraumregelung fuer nutzungsoptimiertes Raumklima

Energy Technology Data Exchange (ETDEWEB)

Lezius, A. [Staefa Control System GmbH, Leinfelden-Echterdingen (Germany)

1995-12-31

In chapter 14 of the anthology about building control the single room control for achieving user-optimised room air conditions is described. The following aspects are discussed: What is comfort? What is economic efficiency? Systems for secondary air treatment, adapted functions of the measurement and control technique, management functions, orientation of the demand at the use, investment and amortisation. (BWI) [Deutsch] Kapitel 14 des Sammelbandes ueber Building control ist dem Thema der Einzelraumregelung zur Erzielung eines nutzungsoptimierten Raumklimas gewidmet. In diesem Zusammenhang werden folgende Themenbereiche angesprochen: Was ist Komfort? Was ist Wirtschaftlichkeit? Systeme fuer sekundaere Luftbehandlung; Angepasste Funktionen der MSR-Technik; Managementfunktionen; Bedarfsorientierung an der Nutzung; Investition und Amortisation. (BWI)

Recovery room nurses' knowledge regarding postoperative airway ...

African Journals Online (AJOL)

Adele

room nurses in private hospitals in Northern Gauteng, South Af- rica, regarding ... room nurse' is used. The same principle applies when reference is made to the terms ... Ethical considerations. Written consent ..... Principles of CPR in theatre.

DSS / Press Room

Science.gov (United States)

Defense Security Service, U.S. Department of Defense Site Map | A-Z Index | Facebook | Twitter Locations Press Room Organizational Structure Careers at DSS Doing Business with DSS Frequently Asked Classification System (NCCS) National Industrial Security System (NISS) ODAA Business Management System (OBMS

Analysis of room acoustics in Danish Hospitals

DEFF Research Database (Denmark)

Hoffmann, Ida Ørduk; Zapata Rodriguez, Valentina; Jeong, Cheol-Ho

2018-01-01

time (EDT) and T20, and the sound pressure level metrics, namely the equivalent level and peak level. In addition, the staff at the hospitals is asked about their personal perception of the acoustic and noise conditions and the correlation between their subjective disturbances......This project aims to compare room acoustic parameters and noise levels in various Danish hospitals: Odense, Gentofte, Bispebjerg, Hillerød and Aarhus Hospitals. Room acoustic conditions are measured in audiometric rooms at Odense, Gentofte, Bispebjerg and Aarhus hospitals. The noise levels...

Creators Room

DEFF Research Database (Denmark)

Iversholt, Lene; Iversholt Toft, Karina

2012-01-01

Creators Room er et koncept til daginsitutioner, der indrammer og giver bud på en forståelse mellem inkluderende pædagogik og fysiske rammer. Konceptet er udviklet i et tværfagligt procesforløb, hvor formålet har været at skabe stadig bedre indendørsmiljøer for børn ved at forene pædagogiske...

Human factors methods for nuclear control room design. Volume 2. Human factors survey of control room design practices

International Nuclear Information System (INIS)

Seminara, J.L.; Parsons, S.O.

1979-11-01

An earlier review of the control rooms of operating nuclear power plants identified many design problems having potential for degrading operator performance. As a result, the formal application of human factors principles was found to be needed. This report demonstrates the use of human factors in the design of power plant control rooms. The approaches shown in the report can be applied to operating power plants, as well as to those in the design stage. This study documents human factors techniques required to provide a sustained concern for the man-machine interface from control room concept definition to system implementation

Screening Criteria for Loss of Room Cooling Failure

Energy Technology Data Exchange (ETDEWEB)

Hwang, Mee Jeong; Yang, Joon Eon; Yoon, Churl

2007-01-15

In this report, we estimated the temperature of the pump rooms and reviewed the operability of the components under the loss of the HVAC (Heating, Ventilation, and Air Condition) system. The issues relevant to the HVAC system in the PSA (Probabilistic Safety Assessment) FT (Fault Tree) model are as follows: (1) Does the loss of the HVAC system bring about a function failure of other components? (2) Can the operator take action to reduce the temperature of the room in case of a HVAC function failure? At present, we do not know whether a component will lose its function or not under the loss of the HVAC. ASME Standard describes that a recovery action can be credited if the related recovery action is included in the procedure or there are similar recovery experiences in the plant. However, there is no description about the recovery action of the HVAC in the EOP (Emergency Operation Procedure) of the UCN3, 4 under the situation of a loss of the HVAC. Even though we consider this assumption positively, it would be limited to the rooms such as the Switchgear Room, Inverter Room, and Main Control Room etc. where a real recovery action can be performed easily. However, if we consider the HVAC failure in the PSA FT model according to the above background, the problem is that the unavailability induced from the loss of a HVAC is highly unrealistically. From a viewpoint of the PSA, it is not true that the related system always fails even though the HVAC system fails. Therefore, we reviewed the necessity of the HVAC model through the identification of the operable temperature of the components' within the pump room and the change of the temperature of the pump room under the situation of a loss of the HVAC system. In this paper, we performed a heat up calculation for the Auxiliary Feedwater Motor Operated Pump (AFW MDP) room, PAB-077-11A with CFX 10 and RATT when the HVAC system is failed. We also reviewed the operability of the components under a loss of the HVAC. Room

Screening Criteria for Loss of Room Cooling Failure

International Nuclear Information System (INIS)

Hwang, Mee Jeong; Yang, Joon Eon; Yoon, Churl

2007-01-01

In this report, we estimated the temperature of the pump rooms and reviewed the operability of the components under the loss of the HVAC (Heating, Ventilation, and Air Condition) system. The issues relevant to the HVAC system in the PSA (Probabilistic Safety Assessment) FT (Fault Tree) model are as follows: (1) Does the loss of the HVAC system bring about a function failure of other components? (2) Can the operator take action to reduce the temperature of the room in case of a HVAC function failure? At present, we do not know whether a component will lose its function or not under the loss of the HVAC. ASME Standard describes that a recovery action can be credited if the related recovery action is included in the procedure or there are similar recovery experiences in the plant. However, there is no description about the recovery action of the HVAC in the EOP (Emergency Operation Procedure) of the UCN3, 4 under the situation of a loss of the HVAC. Even though we consider this assumption positively, it would be limited to the rooms such as the Switchgear Room, Inverter Room, and Main Control Room etc. where a real recovery action can be performed easily. However, if we consider the HVAC failure in the PSA FT model according to the above background, the problem is that the unavailability induced from the loss of a HVAC is highly unrealistically. From a viewpoint of the PSA, it is not true that the related system always fails even though the HVAC system fails. Therefore, we reviewed the necessity of the HVAC model through the identification of the operable temperature of the components' within the pump room and the change of the temperature of the pump room under the situation of a loss of the HVAC system. In this paper, we performed a heat up calculation for the Auxiliary Feedwater Motor Operated Pump (AFW MDP) room, PAB-077-11A with CFX 10 and RATT when the HVAC system is failed. We also reviewed the operability of the components under a loss of the HVAC. Room

Current status of managing food allergies in schools in Seoul, Korea.

Science.gov (United States)

Kim, Soyoung; Yoon, Jihyun; Kwon, Sooyoun; Kim, Jihyun; Han, Youngshin

2012-12-01

Recently the need to manage food allergies in schools has been growing. This study aimed to examine the current status of managing food allergies in schools in Seoul, Korea. A questionnaire survey was conducted in cooperation with the School Dietician Association during April 2009. Among the participating 154 schools, a total of 109 (71%) were determining students' food allergy status through parental surveys based on self-reported food allergies. A total of 72 (47%) had experienced student visits to a school health room due to food allergies within one year before the survey. Over 80 percent of the schools relied on self-care only without any school-wide measures for food allergies in place. Among the 890 menu items most frequently served in school lunch programs, a total of 664 (75%) were found to contain more than one food allergen. It is highly suggested that preventive plans and treatment measures should be established to manage food allergies in schools.

School Students and Computer Games with Screen Violence

Science.gov (United States)

Fedorov, A. V.

2005-01-01

In this article, the author states how these days, school students from low-income strata of the population in Russia spend hours sitting in computer rooms and Internet clubs, where, for a relatively small fee, they can play interactive video games. And to determine what games they prefer the author conducted a content analysis of eighty-seven…

PREP-CHEM-SRC – 1.0: a preprocessor of trace gas and aerosol emission fields for regional and global atmospheric chemistry models

Directory of Open Access Journals (Sweden)

S. R. Freitas

2011-05-01

Full Text Available The preprocessor PREP-CHEM-SRC presented in the paper is a comprehensive tool aiming at preparing emission fields of trace gases and aerosols for use in atmospheric-chemistry transport models. The considered emissions are from the most recent databases of urban/industrial, biogenic, biomass burning, volcanic, biofuel use and burning from agricultural waste sources. For biomass burning, emissions can be also estimated directly from satellite fire detections using a fire emission model included in the tool. The preprocessor provides emission fields interpolated onto the transport model grid. Several map projections can be chosen. The inclusion of these emissions in transport models is also presented. The preprocessor is coded using Fortran90 and C and is driven by a namelist allowing the user to choose the type of emissions and the databases.

Photographic art in exam rooms may reduce white coat hypertension.

Science.gov (United States)

Harper, Michael B; Kanayama-Trivedi, Stacy; Caldito, Gloria; Montgomery, David; Mayeaux, E J; DelRosso, Lourdes M

2015-12-01

Blood pressure (BP) elevation in medical office settings in patients who are normotensive in nonmedical settings is an effect known as 'white coat hypertension'. This phenomenon is thought to be due to situational anxiety caused by the experience of visiting a doctor and the anxiety-inducing nature of the medical office. Our study was designed to determine if carefully selected photographic art could counter the anxiety that causes white coat hypertension and lead to lower BP recordings in some patients. 117 adults, non-pregnant patients from the Louisiana State University Health Sciences Center Family Medicine Resident Clinic participated in this study. After the triage nurse measured the BP, the patients were randomly placed in either an exam room with standard medical posters (control room) or in an exam room with photographic art (photo room). The BP was measured in the exam room. After the medical visit, the patients switched rooms and the BP was measured a third time. The patients were asked to fill out a questionnaire to identify room preference. On average, the BP obtained in the control rooms was higher than that obtained in the photo rooms. There was a statistically significant difference between the mean arterial pressure, systolic BP and diastolic BP between the control room and the photo room. Landscape photographic art may have the beneficial effect of reducing BP in medical office examination rooms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Managing specific learning disability in schools in India.

Science.gov (United States)

Karande, Sunil; Sholapurwala, Rukhshana; Kulkarni, Madhuri

2011-07-01

Specific learning disability (dyslexia, dysgraphia, and dyscalculia) afflicts 5-15% of school-going children. Over the last decade; awareness about this invisible handicap has grown in India. However, much needs to be done to ensure that each afflicted child gets an opportunity to achieve his or her full academic potential in regular mainstream schools. In order to achieve this ideal scenario, all regular classroom teachers should be sensitized to suspect, and trained to screen for this disability when the child is in primary school. School managements should become proactive to set up resource rooms and employ special educators to ensure that these children receive regular and affordable remedial education; and be diligent in ensuring that these children get the mandatory provisions both during school and board examinations. Once specific learning disability is recognized as a disability by the Government of India, these children with the backing of the Right to Education Act, would be able to benefit significantly.

Prepare to protect: Operating and maintaining a tornado safe room.

Science.gov (United States)

Herseth, Andrew; Goldsmith-Grinspoon, Jennifer; Scott, Pataya

2017-06-01

Operating and maintaining a tornado safe room can be critical to the effective continuity of business operations because a firm's most valuable asset is its people. This paper describes aspects of operations and maintenance (O&M) for existing tornado safe rooms as well as a few planning and design aspects that affect the ultimate operation of a safe room for situations where a safe room is planned, but not yet constructed. The information is based on several Federal Emergency Management Agency safe room publications that provide guidance on emergency management and operations, as well as the design and construction of tornado safe rooms.

Slow progress in changing the school food environment: nationally representative results from public and private elementary schools.

Science.gov (United States)

Turner, Lindsey; Chaloupka, Frank J

2012-09-01

Children spend much of their day in school, and authorities have called for improvements in the school food environment. However, it is not known whether changes have occurred since the federal wellness policy mandate took effect in 2006-2007. We examined whether the school food environment in public and private elementary schools changed over time and examined variations by school type and geographic division. Survey data were gathered from respondents at nationally representative samples of elementary schools during the 2006-2007 and 2009-2010 school years (respectively, 578 and 680 public schools, and 259 and 313 private schools). Topics assessed included competitive foods, school meals, and other food-related practices (eg, school gardens and nutrition education). A 16-item food environment summary score was computed, with possible scores ranging from 0 (least healthy) to 100 (healthiest). Multivariate regression models were used to examine changes over time in the total school food environment score and component items, and variations by US census division. Many practices improved, such as participation in school gardens or farm-to-school programs, and availability of whole grains and only lower-fat milks in lunches. Although the school food environment score increased significantly, the magnitude of change was small; as of 2009-2010 the average score was 53.5 for public schools (vs 50.1 in 2006-2007) and 42.2 for private schools (vs 37.2 in 2006-2007). Scores were higher in public schools than in private schools (Pschool size. For public schools, scores were higher in the Pacific and West South Central divisions compared with the national average. Changes in the school food environment have been minimal, with much room remaining for improvement. Additional policy changes may be needed to speed the pace of improvement. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

ATLAS Virtual Visits: Bringing the World into the ATLAS Control Room

International Nuclear Information System (INIS)

Goldfarb, S

2012-01-01

The newfound ability of Social Media to transform public communication back to a conversational nature provides HEP with a powerful tool for Outreach and Communication. By far, the most effective component of nearly any visit or public event is that fact that the students, teachers, media, and members of the public have a chance to meet and converse with real scientists. While more than 30,000 visitors passed through the ATLAS Visitor Centre in 2011, nearly 7 billion did not have a chance to make the trip. Clearly this is not for lack of interest. Rather, the costs of travel, in terms of time and money, and limited parking, put that number somewhat out of reach. On the other hand, during the LHC “First Physics” event of 2010, more than 2 million visitors joined the experiment control rooms via webcast for the celebration. This document presents a project developed for the ATLAS Experiment's Outreach and Education program that complements the webcast infrastructure with video conferencing and wireless sound systems, allowing the public to interact with hosts in the control room with minimal disturbance to the shifters. These “Virtual Visits” have included high school classes, LHC Masterclasses, conferences, expositions and other events in Europe, USA, Japan and Australia, to name a few. We discuss the technology used, potential pitfalls (and ways to avoid them), and our plans for the future.

RLA room 20 cleanout and stabilization

International Nuclear Information System (INIS)

Ham, J.E.

1997-01-01

This engineering report documents the decontamination and stabilization of the Rupture Loop Annex located in room 20 of the 309 building's Plutonium Recycle Test Reactor. Low level, mixed, and recyclable waste was removed from the room. Smearable contamination was removed and/or fixed in place with paint. The RLA was cleaned out and stabilized to meet the Environmental Restoration Contractor's turnover criteria

Perception of tomorrow's nuclear power plant control rooms

International Nuclear Information System (INIS)

Meyer, O.R.

1986-01-01

Major development programs are upgrading today's light water reactor nuclear power plant (NPP) control rooms. These programs involve displays, control panel architecture, procedures, staffing, and training, and are supported by analytical efforts to refine the definitions of the dynamics and the functional requirements of NPP operation. These programs demonstrate that the NPP control room is the visible command/control/communications center of the complex man/machine system that operates the plant. These development programs are primarily plant specific, although the owners' groups and the Institute of Nuclear Power Operations (INPO) do provide some standardization. The Idaho National Engineering Laboratory recently completed a project to categorize control room changes and estimate the degree of change. That project, plus related studies, provides the basis for this image of the next generation of NPP control rooms. The next generation of NPP control rooms is envisioned as being dominated by three current trends: (1) application of state-of-the-art computer hardware and software; (2) use of NPP dynamic analyses to provide the basis for the control room man/machine system design; and (3) application of empirical principles of human performance

Active low frequency sound field control in a listening room using CABS (Controlled Acoustic Bass System) will also reduce the sound transmitted to neighbour rooms

DEFF Research Database (Denmark)

Nielsen, Sofus Birkedal; Celestinos, Adrian

2012-01-01

Sound in rooms and transmission of sound between rooms gives the biggest problems at low frequencies. Rooms with rectangular boundaries have strong resonance frequencies and will give big spatial variations in sound pressure level (SPL) in the source room, and an increase in SPL of 20 dB at a wall...... Bass System) is a time based room correction system for reproduced sound using loudspeakers. The system can remove room modes at low frequencies, by active cancelling the reflection from at the rear wall to a normal stereo setup. Measurements in a source room using CABS and in two neighbour rooms have...... shown a reduction in sound transmission of up to 10 dB at resonance frequencies and a reduction at broadband noise of 3 – 5 dB at frequencies up to 100 Hz. The ideas and understanding of the CABS system will also be given....

School on Laser Physics & Technology

CERN Document Server

Khare, Rajeev

2015-01-01

The book, ‘Laser Physics and Technology’, addresses fundamentals of laser physics, representative laser systems and techniques, and some important applications of lasers. The present volume is a collection of articles based on some of the lectures delivered at the School on ‘Laser Physics and Technology’ organized at Raja Ramanna Centre for Advanced Technology during March, 12-30, 2012. The objective of the School was to provide an in-depth knowledge of the important aspects of laser physics and technology to doctoral students and young researchers and motivate them for further work in this area. In keeping with this objective, the fourteen chapters, written by leading Indian experts, based on the lectures delivered by them at the School, provide along with class room type coverage of the fundamentals of the field, a brief review of the current status of the field. The book will be useful for doctoral students and young scientists who are embarking on a research in this area as well as to professional...

Reasonable Adjustments in Learning Programs: Teaching Length, Mass and Capacity to Students with Intellectual Disability

Science.gov (United States)

Du Plessis, Jelene; Ewing, Bronwyn

2017-01-01

Developed in concert with twelve special schools (Prep to Year 12) in Queensland, this paper regarding reasonable adjustments that promote quality differentiated teaching practice in special education math classrooms represents the knowledge and expertise of fifty teachers in special education. Survey responses and empirical evidence suggest that…

Room-temperature antiferromagnetic memory resistor.

Science.gov (United States)

Marti, X; Fina, I; Frontera, C; Liu, Jian; Wadley, P; He, Q; Paull, R J; Clarkson, J D; Kudrnovský, J; Turek, I; Kuneš, J; Yi, D; Chu, J-H; Nelson, C T; You, L; Arenholz, E; Salahuddin, S; Fontcuberta, J; Jungwirth, T; Ramesh, R

2014-04-01

The bistability of ordered spin states in ferromagnets provides the basis for magnetic memory functionality. The latest generation of magnetic random access memories rely on an efficient approach in which magnetic fields are replaced by electrical means for writing and reading the information in ferromagnets. This concept may eventually reduce the sensitivity of ferromagnets to magnetic field perturbations to being a weakness for data retention and the ferromagnetic stray fields to an obstacle for high-density memory integration. Here we report a room-temperature bistable antiferromagnetic (AFM) memory that produces negligible stray fields and is insensitive to strong magnetic fields. We use a resistor made of a FeRh AFM, which orders ferromagnetically roughly 100 K above room temperature, and therefore allows us to set different collective directions for the Fe moments by applied magnetic field. On cooling to room temperature, AFM order sets in with the direction of the AFM moments predetermined by the field and moment direction in the high-temperature ferromagnetic state. For electrical reading, we use an AFM analogue of the anisotropic magnetoresistance. Our microscopic theory modelling confirms that this archetypical spintronic effect, discovered more than 150 years ago in ferromagnets, is also present in AFMs. Our work demonstrates the feasibility of fabricating room-temperature spintronic memories with AFMs, which in turn expands the base of available magnetic materials for devices with properties that cannot be achieved with ferromagnets.

The Operating Room of the Future Versus the Future of the Operating Room.

Science.gov (United States)

Kassam, Amin B; Rovin, Richard A; Walia, Sarika; Chakravarthi, Srikant; Celix, Juanita; Jennings, Jonathan; Khalili, Sammy; Gonen, Lior; Monroy-Sosa, Alejandro; Fukui, Melanie B

2017-06-01

Technological advancement in the operating room is evolving into a dynamic system mirroring that of the aeronautics industry. Through data visualization, information is continuously being captured, collected, and stored on a scalable informatics platform for rapid, intuitive, iterative learning. The authors believe this philosophy (paradigm) will feed into an intelligent informatics domain fully accessible to all and geared toward precision, cell-based therapy in which tissue can be targeted and interrogated in situ. In the future, the operating room will be a venue that facilitates this real-time tissue interrogation, which will guide in situ therapeutics to restore the state of health. Copyright © 2017 Elsevier Inc. All rights reserved.

The Ethics of the Collegiate Locker Room

Science.gov (United States)

Roper, Larry D.

2017-01-01

Locker rooms are a fixture in the athletic culture of colleges and universities. Given the important roles those spaces play in the learning, growth, and development of student-athletes, collegiate leaders should consider how to influence locker room environments in positive ways.

The investigation of the design of hybrid operating room

International Nuclear Information System (INIS)

Jiang Weihao; Li Jun

2011-01-01

Objective: To investigate the design of the interventional operating room that can meet the needs of modern DSA operation, and the overall arrangement of the hybrid operating room should be reasonable, practical and perspective. Methods: The experience and understanding obtained from the designing and planning of the new Building of Radiology and Surgery in authors' hospital were summarized. In order to meet the requirements of aseptic surgical practices and a full-featured hybrid operating room the following factors should be carefully and synthetically taken into account: the room size, the functional sub-areas, the operational procedures, the aseptic specification, etc. Results: The sufficient verification and scientific design were the important link for building a hybrid operating room. It could provide the surgeons and interventional physicians with more alternative operating methods and it could represent the development trend of medical technology. Conclusion: When planning and designing a new DSA operating room, various factors related to the interventional procedures, such as the room size, the functional sub-areas, the operational procedures and the aseptic specification, should be carefully and synthetically taken into account. The standard of aseptic procedure must be strictly complied with and the various functional sub-areas need to be rationally distributed. The design of hybrid operating room, which joins the functions of both open surgery and interventional management together, should be scientific, practical and perspective. (authors)

Experiencing the use of a chat room in EFL teaching in a public school

Directory of Open Access Journals (Sweden)

Hélvio Frank de Oliveira

2013-03-01

Full Text Available The technological aids available in public schools may be used during teaching experiences through methods and methodologies which provide the student an extensive network of opportunities to (reconfigure their way of building knowledge in a foreign language, in order to reflect on their own learning approach. From this perspective, beyond the reflection and desire to use these tools, an autonomous and active attitude by the student is essential in order to use significant environments with on-line activities. An experience was conducted with high school first graders at a public school in a country town of the State of Goiás, aiming at identifying and analyzing the possibilities for the use of the foreign language (English by employing Omegle.com chat tool. This is  a free random chat that allows people from all over the world to interact in several languages, Twenty-one participants used the chat to interact in English with several people from different places in of the world. The data include chat dialogues as well as others collected by means of questionnaires, a researcher journal and classroom observation notes. Results show that the experience, which was inedited in this context of investigation, was developed with enthusiasm by the participants who, through the chat, improved their communication in an independent way.

Acoustic design of open plan schools and comparison of requirements

DEFF Research Database (Denmark)

Møller Petersen, Claus; Rasmussen, Birgit

2012-01-01

between groups and satisfac¬tory speech intelligibility internally in groups. This paper describes the newest Danish requirements and recommendations for such open plan areas and presents the design, measurements and subjective evaluation of two newer Danish schools. According to the users, the general...... conditions at both schools are satisfactory due to both optimized acoustical conditions and teaching methods adapted to the special open environment. The results from room acoustical modelling, verification measurements and questionnaire survey are presented and evaluated in relation to the newest Danish...

School environment and sanitation in rural India

Directory of Open Access Journals (Sweden)

J P Majra

2010-01-01

Full Text Available Context : A school child educated about the benefits of sanitation and good hygiene behavior is a conduit for carrying those messages far beyond the school walls, bringing lasting improvement to community hygienic practices. Aims : To study the status of school environment and sanitation in rural India. Settings and Design: Government schools in rural Karnataka, cross sectional study. Materials and Methods: Twenty schools were randomly selected for the study. Informed consent was taken from the Heads of the schools. A pre tested close ended questionnaire was used to get the information. The minimum standards for sanitation of the school and its environment in India were used as the guiding principles to evaluate the appropriateness/ adequacy of the various attributes. Statistical analysis used: Percentages and proportions. Results : Out of 20 schools selected, one fourth of the schools were located/ sited at inappropriate places. Only half of the schools had appropriate/ adequate structure. Eighteen (90% of the schools were overcrowded. Ventilation and day light was adequate for 12(60% and 14(70% of the schools respectively. Cleanliness of school compound/classrooms was adequate in 80% of the schools. There were no separate rooms for serving the midday meals in any of the schools under study. Eighteen (90% of the schools were having drinking water points. Liquid and solid waste disposal was insanitary in six (30% and eight (40% of the schools respectively. Only half of the schools had adequate latrines for boys and 60% for girls. Only two (10% of the schools had adequate hand washing points with soap. Conclusions : Environment and sanitation facilities at many of the schools are not fully satisfactory.

Gaining control room habitability margin at the Palisades Plant

International Nuclear Information System (INIS)

Harden, P.A.

1993-01-01

The bounding design-basis accident for control room habitability is the loss-of-coolant accident (LOCA). At Palisades, very little margin existed between the calculated control room operator thyroid dose and the 0.3-Sv (30-rem) limit of Standard Review Plan (SRP) 6.4. Also, a low rate of unfiltered air leakage into the control room during the emergency mode of operation, 5.5 x 10 -3 m 3 /s (11.6 ft 3 /min), was accounted for in the control room habitability analysis. The control room heating, ventilating and air-conditioning system at Palisades has louvered isolation dampers for the normal air intake that are exposed to a negative pressure. Considering the small margin to the thyroid dose limits and the leakage characteristics of louvered dampers, a low allowable rate of unfiltered air in-leakage raised some concern. A significant effort has been initiated to alleviate control room habitability concerns at Palisades. The first step in this effort was to evaluate the calculational models for control room habitability and gain margin through updated analytical methods. To accomplish this, a new radiological consequence analysis for the LOCA was completed

Air change. Ventilation requirements of closed rooms

Energy Technology Data Exchange (ETDEWEB)

Cords, W

1988-04-01

Closed rooms have to be ventilated in order to compensate influences changing the composition and quality of air. Details are given on the conditions and factors determining the required change of air as well as the design of ventilation systems. Reference is made to the respiratory consumption of oxygen, the increase of hazardous carbon dioxide contents causing headaches and indispositions, water vapor exhalations, body heat, odors, cold air coming in from outside, bodily heat losses, carbon dioxide limiting values, air speeds, and air pressures inside rooms. The humidity and temperatures of frequented rooms should keep within the maximum values. (HWJ).

Assessment of daylight quality in simple rooms

DEFF Research Database (Denmark)

Johnsen, Kjeld; Dubois, Marie-Claude; Sørensen, Karl Grau

The present report documents the results of a study on daylight conditions in simple rooms of residential buildings. The overall objective of the study was to develop a basis for a method for the assessment of daylight quality in a room with simple geometry and window configurations. As a tool...... in daylighting conditions for a number of lighting parameters. The results gave clear indications of, for instance, which room would be the brightest, under which conditions might glare be a problem and which type of window would yield the greatest luminous variation (or visual interest), etc....

Local control room

CERN Multimedia

CERN PhotoLab

1972-01-01

Local control room in the ejection building : all electronics pertaining to proton distribution and concomitants such as beam gymnastics and diagnostics at high energies will eventually be gathered here. Shown is the first of two rows of fast ejection electronic racks. It includes only what is necessary for operation.

Atmospheric diffusion model for control room habitability assessments

International Nuclear Information System (INIS)

Ramsdell, J.V.; Lee, J.Y.

1993-01-01

General Design Criterion 19 for nuclear power plants (Appendix A to 10CFR50) requires control room radiation protection adequate to limit radiation exposures to control room personnel. Murphy and Campe proposed the procedure currently used in evaluating control room habitability. However, data from building-wake diffusion experiments at nuclear power plants indicate that the Murphy-Campe procedure tends to overestimate concentrations, particularly during low wind speeds. This paper describes an alternative procedure developed by the Pacific Northwest Laboratory that is acceptable to U.S. Nuclear Regulatory Commission (NRC) staff. The procedure estimates control room air intake concentrations that are generally lower than those estimated by the Murphy-Campe procedure, yet are still conservative

Control room inleakage testing using tracer gases at Zion Generating station

International Nuclear Information System (INIS)