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Anxiety and depression continue to be significant comorbidities for people with human immunodeficiency virus (HIV) infection. The aim of this study was to determine the prevalence of anxiety and depression disorder among HIV patients at Conakry, Guinea. In this cross-sectional study, we described socio-demographic, clinical and psychosocial data related to anxiety and depression in 160 HIV patients of the University Teaching Hospital, Conakry, Guinea. The Hospital Anxiety and Depression Scale (HADS) was used for measuring depression and anxiety in the prior month. The HADS score of ⩾8 was used to identify possible cases of depression and anxiety. Multivariate logistic regression analyses were performed to identify factors associated with symptoms of anxiety and depression. The prevalence of comorbid depression and anxiety among HIV patients was 8.1% and the prevalence of anxiety and depressive symptoms among HIV-infected patients was 13.8% and 16.9%, respectively. Multivariate analysis showed that individuals having BMI ⩽ 18 (AOR = 3.62, 95% confidence interval (CI) 1.37–9.57) and who did not receive antiretroviral treatment (AOR = 18.93, 95% CI 1.88–188.81) were significantly more likely to have depressive symptoms. Similarly, having age <40 years (AOR = 2.81, 95% CI 1.04–7.58) was also significantly associated with anxiety. Prevalence of symptoms of anxiety and depression was high in these HIV patients. This suggests a need for training on the screening and management of anxiety and depression among HIV patients.
As part of the international joint projects working towards the control of taeniosis/cysticercosis in Asia Pacific, epidemiological studies on Taenia solium cysticercosis have been carried out in high-incidence populations, such as minority groups in Thailand. To assess the epidemiology of cysticercotic infections in pigs in the hill-tribe minority villages (Karen) in Tak province, Thailand, we conducted serological screening and necropsies. The patterns of antibody response to T. solium antigens were then investigated using immunoblot assays. Of the 188 pig serum samples tested for antibody responses to partially purified low-molecular-weight antigens of T. solium cyst fluid, positive responses were detected in 37 samples (19.7%). Based on these results, 16 pigs (10 seropositive and 6 seronegative) were necropsied for investigation of cysticerci and intestinal parasites. All seropositive pigs were coinfected with both T. solium and Taenia hydatigena cysticerci, except one, which was infected with T. hydatigena alone. Three of the six seronegative pigs were confirmed to be infected with T. hydatigena. Pigs infected with T. solium showed much stronger antibody responses than those infected with T. hydatigena. Our results demonstrate the co-occurrence of two swine cysticercoses due to T. solium and T. hydatigena in the studied areas. This study also reveals the importance of direct confirmation of the presence of cysticerci by necropsy after serological screening. In addition to the prevalence of swine cysticercosis in these endemic areas, our findings also reveal potential implications for the development of serological diagnostic assays for swine cysticercosis.
The Dark Energy Survey is undertaking an observational programme imaging 1/4 of the southern hemisphere sky with unprecedented photometric accuracy. In the process of observing millions of faint stars and galaxies to constrain the parameters of the dark energy equation of state, the Dark Energy Survey will obtain pre-discovery images of the regions surrounding an estimated 100 gamma-ray bursts over 5 yr. Once gamma-ray bursts are detected by, e.g., the Swift satellite, the DES data will be extremely useful for follow-up observations by the transient astronomy community. We describe a recently-commissioned suite of software that listens continuously for automated notices of gamma-ray burst activity, collates information from archival DES data, and disseminates relevant data products back to the community in near-real-time. Of particular importance are the opportunities that non-public DES data provide for relative photometry of the optical counterparts of gamma-ray bursts, as well as for identifying key characteristics (e.g., photometric redshifts) of potential gamma-ray burst host galaxies. We provide the functional details of the DESAlert software, and its data products, and we show sample results from the application of DESAlert to numerous previously detected gamma-ray bursts, including the possible identification of several heretofore unknown gamma-ray burst hosts.
In Russia, both alveolar and cystic echinococcoses are endemic. This study aimed to identify the aetiological agents of the diseases and to investigate the distribution of each Echinococcus species in Russia. A total of 75 Echinococcus specimens were collected from 14 host species from 2010 to 2012. Based on the mitochondrial DNA sequences, they were identified as Echinococcus granulosus sensu stricto (s.s.), E. canadensis and E. multilocularis. E. granulosus s.s. was confirmed in the European Russia and the Altai region. Three genotypes, G6, G8 and G10 of E. canadensis were detected in Yakutia. G6 was also found in the Altai region. Four genotypes of E. multilocularis were confirmed; the Asian genotype in the western Siberia and the European Russia, the Mongolian genotype in an island of Baikal Lake and the Altai Republic, the European genotype from a captive monkey in Moscow Zoo and the North American genotype in Yakutia. The present distributional record will become a basis of public health to control echinococcoses in Russia. The rich genetic diversity demonstrates the importance of Russia in investigating the evolutionary history of the genus Echinococcus.
A case of cystic echinococcosis (CE) in a domestic cat is described from Saint Petersburg, Russia. Ultrasonography showed numerous cysts with hyperechoic walls and anechoic contents within the cat's abdominal cavity. Molecular identification based on mitochondrial DNA genes indicated that the causative agent was Echinococcus granulosus sensu stricto (G1 strain). This is the first report of CE in a cat caused by E. granulosus sensu stricto with molecular confirmation.
To describe the Emergency Management Plan for H1N1 Major Epidemic Event to reduce the impact of the patients in a general emergency department.
Einstein hospital has a catastrophe management program which is regularly tested for several scenarios: accidents, fire, and biological attack among others. Special concern is given for pandemics since we need to keep employees' fit to keep the hospital running as usual.
On April 24, WHO issued an alert about the rising cases of influenza virus H1N1. Immediately we provided a plan of care for suspected or confirmed cases based on WHO and CDC guidelines. On April 29 increased level of alert to Phase 5 (pandemic imminent). The crisis management group created a multidisciplinary team with actions directed to Einstein's doctors and staff, 6,000 registered professionals, engineering, emergency care, laboratory, occupational medicine, hygiene, waste disposal, among others. Communication was maintained with government to update the official guidelines. Two specific drills were performed to train staff and support teams. Debriefings were made to all participants and lessons learnt were incorporated.
Official figures showed that in São Paulo until August 2 have been reported 6,383 cases, 11.8% (756 cases) of these were reported by HIAE. From 5 May 2009 to 05 December 2009, 1,324 cases were reported. There were only four deaths of patients with influenza A H1N1 and two acquired in hospital and the daily business were not compromised by the epidemic showing the importance of a crises management plan.
The methodology of realistic simulations has showed effectiveness in the planning of how to manage Major Epidemic Events and improvement actions from this exercise has been showing best results for the patient flow and safety whenever this kind of situation happens at Hospital Albert Eisntein.
The terms catastrophe and disaster have been frequently heard worldwide due to situations like earthquakes, floods and events provoked by man as the September 11th and Anthrax attack. Catastrophe means all situations where material and human resources available in a healthcare facility are not enough to assist a large number of victims admitted at the same time. Accreditation requires having a plan to manage effectively those situations, assessing safely as much victims as possible.
To describe the catastrophe plan and its management in a private hospital.
Hospital Albert Einstein is located close to a huge soccer game stadium and near to the State Government Hall. This was the reason to have a plan focusing on casualties with a large number of victims. The literature was revised to choose the triage methodology. Triage to identify the priority of patients' assessment based on their condition, possibility of treatment and determining discharge for those without visible risk. Simulation was implemented, followed by debriefing to register lessons learned.
An algorithm was developed with a crisis center and defining care and support areas in the organizations to manage the victims at Emergency Room and triage field. The plan was effectively deflagrated twice: 47 victims from a bus accident and 25 from a policeman strike. Debriefing was done in all opportunities and communication is the main issue; 15 simulations have been done for training purpose, with specific goals.
Hospital is a high risk environment itself for an internal or external incident depending on its localization. A disaster plan is necessary to improve everyone safety, to organize resources, to respond effectively to such situations and take the organization back to regular operation as soon as possible. Simulations are essential to guarantee staff competency and organization support and response to adverse situations.
Staff education and qualification is a safety issue to maintain employees ready to act whenever the catastrophe plan is deflagrated especially since it only happens once in a while. Considering that catastrophe is an unexpected event and most of the time an unusual scenario, the risk of inefficient patient care and unsafe situations for employees and for the environment is high.
To describe the e-learning as a continuous training methodology to keep staff prepared to manage victims from a catastrophic situation whenever it happens.
E-learning is a methodology for distance learning with focused content, pedagogy, technology and instructional system design aimed to deliver education. E-learning has advantages such as: a rapid update, customization of content, access flexibility, continued availability, reduced time for learning, training of a large number of employees with access control and release reporting. The development of e-learning is based on the following phases: analysis of topic relevance, evaluation by expert professional, relevance and applicability as educational strategy, planning and content construction with related areas, development of the storyboard and formatting with an instructional designer. The content of the e-learning Catastrophe Plan include definition of catastrophe, STAR screening method, roles and responsibilities, attendance flows, tests. Its duration was 30 minutes.
During 03 months the e-learning of Catastrophe Plan was available in the intranet to Albert Einstein employees. A total of 3104 employees were trained representing 56% of target public (n = 5541). After this period, the e-learning became constantly available and part of the new employees admission process.
E-learning is an innovative educational methodology that contributes to the retention and generation of knowledge. The care and support team during the simulations in 2010 showed better performance when compared to 2009 due to the capability of this tool to spread the knowledge.
In the last decades social mixing programs have become a key ingredient of urban policy throughout Europe. There are important political motives for paying attention to ‘the neighborhood’: neighborhoods of poverty in cities in Western Europe and North America have been the stage of riots and unrest for more than three decades now and recent examples in Leeds/Bradford and the French urban banlieues are fresh in many people's memories. Consequently, many politicians in France, the Netherlands, Germany, and the UK have become convinced that rigorous transformations of the so-called ‘problematic neighborhoods’ is unavoidable. The aim of the resulting area-based programs is not only to address the day-to-day problems of neighborhood disorder and crime in areas of concentrated poverty (Uitermark & Duyvendak 2005a) but also to address the limited social mobility of residents (Atkinson & Kintrea 2001). Many researchers, however, have expressed doubts whether area-based programs of social mixing can actually provide a solution to the problems of social exclusion and anti-social behavior, such as dropping out of school, youth delinquency and deviant work ethics, in disadvantaged urban areas (for a discussion on this point, see Andersson & Musterd 2005). This depends on whether the problems that manifest themselves at the neighborhood level also originate there, a question which is central to the study of neighborhood effects.
Until recently, empirical evidence from the European context for negative neighborhood effects with respect to aspects of social mobility, such as labor market participation and level of income, was scarce. The general assumption was that neighborhood effects are smaller in the European than the American context due to the substantial differences in welfare state interventions aimed at reducing inequalities between people and between neighborhoods (Musterd et al. 2003). However, several recent large-scale quantitative studies from the Dutch and the Swedish context show that even in comprehensive welfare states the neighborhood context plays a role in shaping the socio-economic opportunities and behavior of those who are part of the neighborhood. At the same time, neighborhood does not affect everyone in the same way and there are few European studies that can help explain the way in which living in a low-income neighborhood context impacts residents’ socio-economic opportunities.
The Microlensing Observations in Astrophysics (MOA) is a microlensing survey conducted at Mt. John Observatory in New Zealand. We searched transiting planet candidates from the MOA-I Galactic bulge data, which have been obtained with a 61cm B&C telescope from 2000 to 2005 for a microlensing search. Although this survey data were dedicated to microlensing, they are also quite useful for searching transiting objects because of the large number of stars monitored (~7 million) and the long span of the survey (~6 years). From our analysis, we found 58 transiting planet candidates. We are planning to follow up these candidates with high-precision spectroscopic and photometric observations for further selection, toward the detection of planets by radial velocity observations.
We have developped a software of Star-Image-Extractor (SIE) which works as the on-board real-time image processor. It detects and extracts only the object data from raw image data. SIE has two functions: reducing image data and providing data for the satellite's high accuracy attitude control system.
Nano-JASMINE is a nano-size astrometry satellite that will carry out astrometry measurements of nearby bright stars for more than one year. This will enable us to detect annual parallaxes of stars within 300 pc from the Sun. We expect the satellite to be launched as a piggy-back system as early as in 2009 into a Sun synchronized orbit at the altitude between 500 and 800 km. Being equipped with a beam combiner, the satellite has a capability to observe two different fields simultaneously and will be able to carry out HIPPARCOS-type observations along great circles. A 5 cm all aluminum made reflecting telescope with a aluminum beam combiner is developed. Using the on-board CCD controller, experiments with a real star have been executed. A communication band width is insufficient to transfer all imaging data, hence, we developed an onboard data processing system that extracts stellar image data from vast amount of imaging data. A newly developed 2K × 1K fully-depleted CCD will be used for the mission. It will work in the time delayed integration(TDI) mode. The bus system has been designed with special consideration of the following two points. Those are the thermal stabilization of the telescope and the accuracy of the altitude control. The former is essential to achieve high astrometric accuracies, on the order of 1 mas. Therefore relative angle of the beam combiner must be stable within 1 mas. A 3-axes control of the satellite will be realized by using fiber gyro and triaxial reaction wheel system and careful treatment of various disturbing forces.
We observed embedded super-star clusters (SSCs) in blue compact dwarf galaxies (BCDs) IIZw40 and He2-10 with N-band and Q-band imaging and spectroscopy using the Cooled Mid-Infrared Camera and Spectrometer (COMICS) on board the 8m Subaru Telescope. Our infrared images of Henize 2–10 resolve the radio knots (knots I-V; Kobulnicky & Johnson 1999) and the N- and Q-band spectra show the strong [NeII] 12.8 μm and the [SIII] 18.71 μm together with relatively weak [SIV] 10.51 μm and [ArIII] 8.99 μm as well as the distinct unidentified infrared (UIR) bands at 8.6, 11.2 and 12.7 μm. We find the typical stellar spectral type of the members in the SSCs is O9 using the CoStar model (Stasinska & Schaerer 1997) and that the ionization environment in the most deeply embedded SSC(POS/#D) is the softest among those SSCs. The UIR bands exhibit a flat distribution over the galaxy and do not show a correlation with the MIR continuum, suggesting that polycyclic aromatic hydrocarbons (PAHs) are not strongly associated with the SSCs. We also find a possible decrease in the UIR 12.7 μm/11.2 μm ratio inside the embedded SSCs, suggesting that smooth-edged large PAHs are dominant (Hony et al. 2001) there. The small UIR to continuum ratio inside the embedded SSCs also suggests that the size distribution of the carbonaceous dust is skewed to the larger ones inside the embedded SSCs. Possible destruction of smaller species by harsh radiation field in the vicinity of massive stars due to the smaller heat capacity and/or the coagulation process that have been undertaken in dense dusty embedded SSCs would explain our results consistently. From the mid-infrared spectroscopy of IIZw40, the UIR bands are detected only in the south-western border of the mid-infrared peaks, suggesting the uneven distribution of PAHs within 4×106yr (Vanzi et al. 1996) after the nuclear starburst triggered in the merging of two small original galaxies.
Serology (ELISA and immunoblot) using native glycoproteins, affinity purified glycoproteins, and a recombinant antigen is known to be highly specific to Taenia solium cysticercosis in humans and pigs. These techniques were applied for dogs in the highly endemic area of cysticercosis in Papua (Irian Jaya), Indonesia. Analysis of dog sera by both ELISA and immunoblot revealed 7 of 64 dogs were highly positive. Examination of two sero-positive dogs revealed cysticerci of T. solium in the brain and heart of these dogs. Mitochondrial DNA analysis confirmed that they were the same as T. solium previously confirmed from pigs and biopsies from local people from Irian Jaya. It is suggested that the life cycle of T. solium may be completed not only between humans and pigs but also between humans and dogs.
Genetic polymorphism was determined among 13 isolates of Taenia solium from various regions using PCR-amplified sequences of 2 mitochondrial genes: cytochrome c oxidase subunit 1 and cytochrome b. The 2 phylogenies obtained were similar to each other regardless of the genes examined. The isolates from Asia (China, Thailand, Irian Jaya and India) formed a single cluster, whereas the isolates from Latin America (Mexico, Peru, Ecuador, Bolivia and Brazil) combined with those from Africa (Tanzania, Mozambique and Cameroon) to form an additional cluster. These results and historical data of swine domestication, distribution of pigs and colonization suggest that T. solium was introduced recently into Latin America and Africa from different regions of Europe during the colonial age, which started 500 years ago, and that the tapeworm of another origin independently spread in Asian countries.
Rats are known to be relatively resistant to infection with Echinococcus multilocularis. However, when rats are inoculated with the parasite tissues, E. multilocularis proliferates slowly at first but after 6 months the cysts increase in size considerably and contain large numbers of protoscoleces. As rats survive for 18 months or longer, approximately 100 ml of packed protoscoleces can be produced from each rat. A comparison of the antigenicity of the protoscoleces and microvesicles by immunoblot methods showed that both Em18 and Em16 are shared components between both protoscoleces and microvesicles, although the latter have some additional antigenic components. In antigens prepared from protoscoleces, the banding patterns around Em18 were much simpler than those from microvesicles. Therefore, for serodiagnosis of E. multilocularis, antigens should be carefully prepared from protoscoleces rather than microvesicles from the rat.
The Collaboration of Australia and Nippon for a GAmma Ray Observatory in the Outback operates two large telescopes at Woomera (South Australia), which detect the Čerenkov light images produced in the atmosphere by electronpositron cascades initiated by very high energy (~1 TeV or 1012 eV) gamma rays. These gamma rays arise from a different mechanism than at EGRET energies: inverse Compton (IC) emission from relativistic electrons.
The spoke-like images are recorded by a multi-pixel camera which facilitates the rejection of the large numbers of oblique and ragged cosmic ray images. A field of view ~3.5° is required. The Australian team operates a triple 4 m diameter mirror telescope, BIGRAT, with a 37 photomultiplier tube camera and energy threshold 600 GeV. The Japanese operate a single, highly accurate 3.8 m diameter f/1 telescope and high resolution 256 photomultipler tube camera. In 1998 a new 7 m telescope is planned for Woomera with a design threshold ~;200GeV.
The effects of apomorphine, a stimulant of dopamine autoreceptors, were studied in 12 chronic schizophrenics on neuroleptic treatment; both subcutaneous and intravenous administration were used. Apomorphine has been reported to have therapeutic effects in previous studies but, we were not able to confirm any significant and specific differences in psychotic symptoms or tardive dyskinesia scores with apomorphine administration, compared with placebo. These results do not support the importance of dopamine autoreceptors in the regulation of schizophrenic and dyskinetic symptoms in chronic neuroleptic-treated patients.
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