Infant HIV infection: acceptability of preventive strategies in central Tanzania.

Safe, cost-effective interventions are being developed to reduce HIV transmission to children, suitable for lower income countries such as Tanzania. The interventions include Nevirapine treatment, replacement feeding, exclusive breast-feeding and heat-treating breast milk. This article reports on research to explore factors, which may influence the acceptability of these interventions. Data collection methods used were qualitative in-depth interviews with 12 health workers and focus group discussions with five community groups. Findings are presented with reference to the theory of diffusion of innovation, which seeks to explain how new ideas and products are disseminated through a community. Respondents describe the factors that may help and hinder this process. They propose ways to maximize this diffusion, such as integrating HIV and antenatal services, encouraging male participation, community-wide education, offering free HIV testing, and training health workers as change agents.

The effect of chiropractic manipulation on salivary cortisol levels.

BACKGROUND: The stress response in humans is a healthy response and is necessary for life. The effects of chiropractic manipulation (CM), if any, on stress are ill-defined. Cortisol has been used as an accurate measure of the stress response system in humans. Salivary cortisol is a noninvasive technique to accurately quantify biologically active cortisol. OBJECTIVE: To determine whether basal salivary cortisol levels can be properly detected and whether CM has any direct effect on basal salivary cortisol levels in humans. METHODS: Subjects were adult male students attending a chiropractic college. Salivary samples were collected for 5 weeks. During Week 1, samples were collected by the students at home upon waking. During Weeks 2 through 5, home samples were collected upon waking and were followed by an additional time course of samples collected in a laboratory setting before and after CM. Salivary cortisol was measured by enzyme-linked immunoassay. RESULTS: Chiropractic manipulative therapy did not significantly change basal salivary cortisol levels. The time course of acute changes to cortisol levels was independent of testing week and group. A decrease in salivary cortisol was detected over time on each trial testing day. Overall, cortisol levels significantly decreased from the time of the home samples until the pretreatment laboratory measurement (P <.05). Cortisol levels subsequently decreased from pretreatment to 15 minutes after treatment (P <.05). After treatment, there were progressive decreases in cortisol levels from the 15- and 30-minute time points to the 60-minute time point (P <.05). CONCLUSION: The results of this pilot study suggest that there is no effect of CM on salivary cortisol levels in asymptomatic subjects. As such, we conclude that neither the anticipation of CM nor the spinal manipulative procedure itself induces a state of stress or anxiety.

Carbohydrates and physical/mental performance during intermittent exercise to fatigue.

PURPOSE: This study was designed to examine the effects of carbohydrate-electrolyte ingestion on physical and mental function associated with the performance of intermittent high-intensity (IHI) exercise similar to many common competitive sporting events. METHODS: Physically active men (N = 5) and women (N = 5), experienced in competitive soccer or basketball, completed three practice sessions and two experimental trials of an IHI shuttle running protocol designed to closely stimulate the demands of an actual competitive sporting event such as basketball. The experimental trials consisted of four 15-min quarters (QTR) of intermittent shuttle running at various percentages of .VO(2max) (walking, jogging, running, sprinting and jumping), separated by a 20-min halftime rest period (HALF) and followed by a shuttle run to fatigue. Various tests of physical and mental function (shuttle run to fatigue, 20-m maximal sprint, 10-repetition maximal vertical jumping, whole body motor skill test (MS-Test), profile of mood states (POMS), and Stroop Color-Word Test) were performed throughout the experimental trial. Carbohydrate-electrolyte (CHO) or placebo (P) drinks were consumed before exercise (5 mL.kg(-1); 6% solution) and at halftime (5 mL.kg(-1); 18% solution). Smaller volumes (3 mL.kg(-1); 6% solution) were given after QTR-1, HALF, QTR-3, and QTR-4. RESULTS: CHO ingestion resulted in a 37% longer run time to fatigue and faster 20-m sprint time during QTR-4 (P < 0.05). MS-Test performance was also improved during the latter stages of exercise along with self-reported perceptions of fatigue (subscale of POMS) (P < 0.05) in CHO versus P. CONCLUSION: These results suggest a beneficial role of carbohydrate-electrolyte ingestion on physical and mental function during intermittent exercise similar to that of many competitive team sports.