Stenting in Zone II Stab Wounds of Carotid Arteries

AbstractWe present three cases of endovascular treatment of a cervical Zone II carotid artery pseudoaneurysm and arteriovenous fistulae following stab wounds using covered Wall-graft stents in three male patients. All three were clinically stable with no other associated aerodigestive injuries or neurological deficit. Angiography revealed pseudoaneurysms and arteriovenous fistulae. Under local anaesthesia, using Seldinger technique and femoral approach, a covered Wall graft stent (Boston Scientific) was inserted using the standard endovascular technique. No cerebral protective devices were used in our patients. Patients received aspirin before the procedure. Patients were discharged on aspirin 24 hours later. Patients were followed up with duplex ultra sound at 3, 6 and 9 months intervals, with good patency

Evolution of the chemical composition of Sn thin films heated during x-ray photoelectron spectroscopy

High-vacuum XPS have been used to analyse the surface modification of a 3 nm-thick Sn thin film on Si (100) before and after annealing up to 450 °C. Increasing the XPS stage temperature led to a reduction in the amount of surface Sn and increasing amounts of O and Si. High-resolution XPS scans revealed the presence of mostly pure Sn and SnO2 for the as-deposited Sn thin film. Increasing the XPS stage temperature to > 232 °C led to the conversion of SnO2 to SnO and an enhancing pure Sn signal. The Si2p and SiO2 peaks become prominent at temperatures > 350 °C, which in combination with scanning electron microscope images, signals the dewetting of the Sn film and subsequent exposure of the underlying Si (100) substrate. XPS depth profiles revealed the presence of a pure Sn metallic core encapsulated by a Sn-oxide shell. Electron microscope images shows a densely packed particulate surface features for the as-deposited Sn thin film. However, these particulate regions increase in size and are more isolated at XPS stage temperatures > 350 °C.National Metrology Institute of South Africa and the National Research Foundation (GUN: 93212, 92520, 103621)

A traumatic means of diagnosing gastrointestinal stromal tumour: A case report

Blunt abdominal trauma (BAT) is known to cause intra-abdominal organ damage and haemorrhage, especially after severe impact to the body. We present a case in which a gastrointestinal stromal tumour became symptomatic after BAT

Penetrating trauma in rural areas – a public health disease: A report of 2 cases

It has been recommended that all penetrating trauma to the head, neck and torso, and to the extremities proximal to the elbow and knee, should be managed in specialised trauma centres. We present two cases of penetrating trauma that presented to Pietersburg Hospital, part of the Limpopo Academic Complex. Both of them were the result of interpersonal violence

A checklist of the spiders (Arachnida, Araneae) of the Polokwane Nature Reserve, Limpopo Province, South Africa

As part of the South African National Survey of Arachnida (SANSA), spiders were collected from all the field layers in the Polokwane Nature Reserve (Limpopo Province, South Africa) over a period of a year (2005–2006) using four collecting methods. Six habitat types were sampled: Acacia tortillis open savanna; A. rehmanniana woodland, false grassland, riverine and sweet thorn thicket, granite outcrop; and Aloe marlothii thicket. A total of 13 821 spiders were collected (using sweep netting, tree beating, active searching and pitfall trapping) represented by 39 families, 156 determined genera and 275 species. The most diverse families are the Thomisidae (42 spp.), Araneidae (39 spp.) and Salticidae (29 spp.). A total of 84 spp. (30.5%) were web builders and 191 spp. (69.5%) wanderers. In the Polokwane Nature Reserve, 13.75% of South African species are presently protected

Health Diplomacy the Adaptation of Global Health Interventions to Local Needs in sub-Saharan Africa and Thailand: Evaluating Findings from Project Accept (HPTN 043).

Study-based global health interventions, especially those that are conducted on an international or multi-site basis, frequently require site-specific adaptations in order to (1) respond to socio-cultural differences in risk determinants, (2) to make interventions more relevant to target population needs, and (3) in recognition of 'global health diplomacy' issues. We report on the adaptations development, approval and implementation process from the Project Accept voluntary counseling and testing, community mobilization and post-test support services intervention. We reviewed all relevant documentation collected during the study intervention period (e.g. monthly progress reports; bi-annual steering committee presentations) and conducted a series of semi-structured interviews with project directors and between 12 and 23 field staff at each study site in South Africa, Zimbabwe, Thailand and Tanzania during 2009. Respondents were asked to describe (1) the adaptations development and approval process and (2) the most successful site-specific adaptations from the perspective of facilitating intervention implementation. Across sites, proposed adaptations were identified by field staff and submitted to project directors for review on a formally planned basis. The cross-site intervention sub-committee then ensured fidelity to the study protocol before approval. Successfully-implemented adaptations included: intervention delivery adaptations (e.g. development of tailored counseling messages for immigrant labour groups in South Africa) political, environmental and infrastructural adaptations (e.g. use of local community centers as VCT venues in Zimbabwe); religious adaptations (e.g. dividing clients by gender in Muslim areas of Tanzania); economic adaptations (e.g. co-provision of income generating skills classes in Zimbabwe); epidemiological adaptations (e.g. provision of 'youth-friendly' services in South Africa, Zimbabwe and Tanzania), and social adaptations (e.g. modification of terminology to local dialects in Thailand: and adjustment of service delivery schedules to suit seasonal and daily work schedules across sites). Adaptation selection, development and approval during multi-site global health research studies should be a planned process that maintains fidelity to the study protocol. The successful implementation of appropriate site-specific adaptations may have important implications for intervention implementation, from both a service uptake and a global health diplomacy perspective

A comparison of HIV/AIDS-related stigma in four countries: Negative attitudes and perceived acts of discrimination towards people living with HIV/AIDS

HIV/AIDS-related stigma and discrimination have a substantial impact on people living with HIV/AIDS (PLHA). The objectives of this study were: (1) to determine the associations of two constructs of HIV/AIDS-related stigma and discrimination (negative attitudes towards PLHA and perceived acts of discrimination towards PLHA) with previous history of HIV testing, knowledge of antiretroviral therapies (ARVs) and communication regarding HIV/AIDS and (2) to compare these two constructs across the five research sites with respect to differing levels of HIV prevalence and ARV coverage, using data presented from the baseline survey of U.S. National Institute of Mental Health (NIMH) Project Accept, a four-country HIV prevention trial in Sub-Saharan Africa (Tanzania, Zimbabwe and South Africa) and northern Thailand. A household probability sample of 14,203 participants completed a survey including a scale measuring HIV/AIDS-related stigma and discrimination. Logistic regression models determined the associations between negative attitudes and perceived discrimination with individual history of HIV testing, knowledge of ARVs and communication regarding HIV/AIDS. Spearman's correlation coefficients determined the relationships between negative attitudes and perceived discrimination and HIV prevalence and ARV coverage at the site-level. Negative attitudes were related to never having tested for HIV, lacking knowledge of ARVs, and never having discussed HIV/AIDS. More negative attitudes were found in sites with the lowest HIV prevalence (i.e., Tanzania and Thailand) and more perceived discrimination against PLHA was found in sites with the lowest ARV coverage (i.e., Tanzania and Zimbabwe). Programs that promote widespread HIV testing and discussion of HIV/AIDS, as well as education regarding and universal access to ARVs, may reduce HIV/AIDS-related stigma and discrimination

'I believe that the staff have reduced their closeness to patients': an exploratory study on the impact of HIV/AIDS on staff in four rural hospitals in Uganda

<p>Abstract</p> <p>Background</p> <p>Staff shortages could harm the provision and quality of health care in Uganda, so staff retention and motivation are crucial. Understanding the impact of HIV/AIDS on staff contributes to designing appropriate retention and motivation strategies. This research aimed 'to identify the influence of HIV/AIDS on staff working in general hospitals at district level in rural areas and to explore support required and offered to deal with HIV/AIDS in the workplace'. Its results were to inform strategies to mitigate the impact of HIV/AIDS on hospital staff.</p> <p>Methods</p> <p>A cross-sectional study with qualitative and quantitative components was implemented during two weeks in September 2005. Data were collected in two government and two faith-based private not-for-profit hospitals purposively selected in rural districts in Uganda's Central Region. Researchers interviewed 237 people using a structured questionnaire and held four focus group discussions and 44 in-depth interviews.</p> <p>Results</p> <p>HIV/AIDS places both physical and, to some extent, emotional demands on health workers. Eighty-six per cent of respondents reported an increased workload, with 48 per cent regularly working overtime, while 83 per cent feared infection at work, and 36 per cent reported suffering an injury in the previous year. HIV-positive staff remained in hiding, and most staff did not want to get tested as they feared stigmatization. Organizational responses were implemented haphazardly and were limited to providing protective materials and the HIV/AIDS-related services offered to patients. Although most staff felt motivated to work, not being motivated was associated with a lack of daily supervision, a lack of awareness on the availability of HIV/AIDS counselling, using antiretrovirals and working overtime. The specific hospital context influenced staff perceptions and experiences.</p> <p>Conclusion</p> <p>HIV/AIDS is a crucially important contextual factor, impacting on working conditions in various ways. Therefore, organizational responses should be integrated into responses to other problematic working conditions and adapted to the local context. Opportunities already exist, such as better use of supervision, educational sessions and staff meetings. However, exchanges on interventions to improve staff motivation and address HIV/AIDS in the health sector are urgently required, including information on results and details of the context and implementation process.</p

Age-Related Differences in Socio-demographic and Behavioral Determinants of HIV Testing and Counseling in HPTN 043/NIMH Project Accept

Youth represent a large proportion of new HIV infections worldwide, yet their utilization of HIV testing and counseling (HTC) remains low. Using the post-intervention, cross-sectional, population-based household survey done in 2011 as part of HPTN 043/NIMH Project Accept, a cluster-randomized trial of community mobilization and mobile HTC in South Africa (Soweto and KwaZulu Natal), Zimbabwe, Tanzania and Thailand, we evaluated age-related differences among socio-demographic and behavioral determinants of HTC in study participants by study arm, site, and gender. A multivariate logistic regression model was developed using complete individual data from 13,755 participants with recent HIV testing (prior 12 months) as the outcome. Youth (18–24 years) was not predictive of recent HTC, except for high-risk youth with multiple concurrent partners, who were less likely (aOR 0.75; 95% CI 0.61–0.92) to have recently been tested than youth reporting a single partner. Importantly, the intervention was successful in reaching men with site specific success ranging from aOR 1.27 (95% CI 1.05–1.53) in South Africa to aOR 2.30 in Thailand (95% CI 1.85–2.84). Finally, across a diverse range of settings, higher education (aOR 1.67; 95% CI 1.42, 1.96), higher socio-economic status (aOR 1.21; 95% CI 1.08–1.36), and marriage (aOR 1.55; 95% CI 1.37–1.75) were all predictive of recent HTC, which did not significantly vary across study arm, site, gender or age category (18–24 vs. 25–32 years)

The experiences of mothers who lost a baby during pregnancy

The purpose of this study was to explore and describe the experiences of mothers who lost a baby during pregnancy and care given by doctors and midwives during this period. Opsomming Die doel van die studie was om die ervaring van moeders met betrekking tot die dood van ‘n baba tydens swangerskap te verken en te beskryf, asook die versorging wat hulle van vroedvroue en dokters gedurende die periode ontvang het. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text