Effectiveness of sport-based HIV prevention interventions: a systematic review of the evidence.

Interest in sport as a tool for behavioral HIV prevention has grown substantially in the past decade. With dozens of organisations now using sport-based HIV prevention (SBHP) approaches and upcoming randomized controlled trials in South Africa and Zimbabwe, there is a pressing need to synthesize previous evaluation findings and identify gaps in existing research. A systematic review on the effectiveness of SBHP interventions was carried out, identifying both published and unpublished studies on SBHP interventions that measured effectiveness quantitatively. Study quality was scored using an adapted Newcastle-Ottawa Scale. Random-effects meta-analyses were carried out across studies for effects on six categories of HIV-related outcomes. The review identified 952 publications, 21 of which met inclusion criteria. No randomised controlled trials on SBHP interventions and no studies assessing biological outcomes were identified. Mean study quality score was 5.1 (SD 3.1) out of 20 points. Overall strong evidence was observed for positive effects on HIV-related knowledge (RR = 1.26, 95 % CI = 1.15-1.37), stigma (RR = 1.13, 95 % CI = 1.02-1.24), self-efficacy (RR = 1.22, 95 % CI = 1.02-1.41), reported communication (RR = 1.24, 95 % CI = 1.06-1.41), and reported recent condom use (RR = 1.29, 95 % CI = 1.00-1.59). Generally, the review found encouraging evidence for some short-term effects but relied predominantly on low-quality studies. More rigorous research on SBHP is needed to objectively assess effectiveness. Randomised controlled trials could play an important role in guiding policies, strategies, and funding related to SBHP.

Complications of foldable intraocular lenses requiring explantation or secondary intervention--2000 survey update.

A survey of the complications associated with foldable intraocular lenses (IOLs) that required explantation or secondary intervention was sent to members of the American Society of Cataract and Refractive Surgery and was also available to members of the European Society of Cataract and Refractive Surgeons. Preoperative data about visual acuity, patient signs and symptoms, and complications were assessed, and postoperative results and outcomes were analyzed. Complications and symptoms for each of the major groups of foldable IOLs explanted were tabulated separately: 3-piece monofocal silicone; 3-piece acrylic; 1-piece (plate-type) silicone; and multifocal silicone. A total of 259 surveys returned for evaluation. Accurate IOL power measurements as well as meticulous surgical technique, IOL loading and insertion, and proper patient counseling/selection remain the most important factors in avoiding complications with foldable IOLs.

Postoperative sterile endophthalmitis (TASS) associated with the memorylens.

PURPOSE: To report 10 cases of delayed-onset acute intraocular inflammation following cataract extraction and posterior chamber implantation of the MemoryLens(R) intraocular lens (IOL). SETTING: John A. Moran Eye Center, Department of Ophthalmology, University of Utah, Salt Lake City, Utah, USA. METHODS: This retrospective study evaluated 10 cases of postoperative inflammation that occurred after cataract extraction with placement of the posterior chamber MemoryLens IOL. Protocols of the Intermountain Ocular Research Center used to analyze outbreaks of unexplained postoperative inflammation as well as medical records were reviewed. RESULTS: Nine patients had uneventful cataract extraction and 1 had a small anterior capsule tear with placement of the MemoryLens IOL. All 10 patients presented with increased anterior segment inflammation a mean of 7.8 days (range 1 to 21 days) after surgery. Three cases were tapped and were culture negative, and 7 were presumed noninfectious. The anterior segment inflammation improved in all patients. Treatment of the 7 patients included intensive topical steroids. Careful analysis of the inflammation has not revealed an obvious etiology; however, the MemoryLens was associated with all the cases. CONCLUSIONS: We postulate that these cases of noninfectious postoperative endophthalmitis may be associated with the MemoryLens.

A comparison of in vitro skin-penetration cells.

A new low-volume flow-through diffusion cell (LVFC) was designed to provide accurate determinations of penetrant flux across skin while minimizing the dilution of penetrant in receptor fluid and eliminating the need for magnetic stirring. The performance of the 0.3-mL LVFC was compared to a magnetically stirred, 4.3-mL high-volume flow cell (HVFC) and to a magnetically stirred, manually sampled 7.5-mL static cell (SC) with hydrophilic and lipophilic penetrants. The clearance of 14C-labeled benzoic acid from the LVFC and HVFC followed an exponential profile expected for complete mixing when the LVFC and HVFC were run at flow rates of 0.4-0.9 and 4.0-5.2 mL/h, respectively. The in vitro dispositions of 14C-labeled benzoic acid and estradiol were determined in the LVFC and HVFC by applying the compounds to split-thickness pig skin at a 4 micrograms/cm2 dose. Additionally, the effects of receptor fluid flow rate (1.2 vs 3.5 cell volumes/h) and method of skin attachment (O-ring vs compression) were determined on disposition in the HVFC. The percutaneous penetration of benzoic acid and the residue of estradiol within skin did not differ between the LVFC and HVFC. However, the percutaneous penetration of benzoic acid increased significantly (p < 0.05) using the O-ring attachment as compared to compression at a flow rate of 1.2 cell volumes/h. The in vitro permeation of benzoic acid-saturated water and 17 beta-estradiol-saturated propylene glycol monolaurate through human epidermis was compared between the LVFC, HVFC, and SC. The LVFC and HVFC had flow rates of 0.9-1.0 mL/h.(ABSTRACT TRUNCATED AT 250 WORDS)

Contracting for helicopter emergency transport services.

A hospital considering the lease of a helicopter for use in a medical emergency evacuation program will need to consider many issues, from the type and availability of the aircraft needed to the experience and qualifications required of the pilot and mechanic. Also to be considered are the liability of the hospital for negligence or misconduct of the helicopter service, and the particulars of reimbursement for helicopter service under Medicare as a capital-related cost.

What are the vendor's responsibilities in the purchase agreement?

Often, when buying computer software, computer hardware, or communications equipment, the vendor develops the contractual agreement concerning purchase, licensing, and maintenance. And often, this agreement falls short of the buyer's expectations. Therefore, it is important to understand what responsibilities should be required of the vendor, so as to negotiate a purchase contract that fits the buyer's needs and assures the purchase of equipment in good working condition.

A study of mouse strains susceptibility to Bacillus piliformis (Tyzzer's disease): the association of B-cell function and resistance.

Tests were conducted on 11 inbred strains of mice and an NIH outbred stock. It was found that only the CBA/N and C3. CBA/N mice (strains deficient in IgM production) were highly susceptible to Bacillus piliformis infection. Susceptibility to infection was determined by induction of typical surface liver lesions and the ability to maintain serial passage without concurrent administration of cortisone. Mice deficient in T-cell function (Nu/Nu/++) were as resistant to Bacillus piliformis infection as intact immunologically competent mice. The data suggested that resistance to Tyzzer's disease was, at least in part, a B-cell function.

Evaporation of diethyltoluamide from human skin in vivo and in vitro.

Relative evaporation and penetration of the insect repellent, N,N-diethyl-m-toluamide, has been measured by 3 methods, 2 in vivo and 1 in vitro. The evaporation rate 30 min after application was found to be similar by all 3 methods. At an applied dose of 0.25 microgram/cm2, 9.6% in vivo and 9.7% in vitro evaporated from the skin in the first hour after application. Although the techniques used produced similar results in vivo and in vitro for diethyltoluamide, studies are being conducted to further elucidate kinetics of loss by evaporation.

Correlation between mosquito repellent protection time and insensible water loss from the skin.

Insensible water loss and mosquito repellent protection time have been found to be relatively characteristic of any given individual. In a population having a biologic distribution of repellent protection period against mosquitoes, an inverse linear correlation was observed between repellent duration and insensible water loss. Doubling of insensible water loss was associated with a 20% decrease in repellent duration. Repellent penetration or evaporation but not attractiveness to mosquitoes are explanations for the observed relationship.

Temperature dependence of water content of stratum corneum.

The water content of human stratum corneum has been measured gravimetrically in vitro in relation to relative humidity (RH) and temperature. Water content increased with increasing RH. Stratum corneum water content increased 50% when the temperature was raised from 20 to 35 degrees C at RH below 60%. Temperature dependence decreased with increasing RH until there was essentially no temperature dependence at 90% RH. The conclusion is that temperature changes could significantly affect water content in vivo and pliability of skin at RH below 60%.