Experiences of social exclusion among young deaf adults influencing their beliefs and perceptions of HIV/AIDS

This paper reports on a Master's study whose aim was to capture the beliefs and perceptions of young deaf adults about HIV/AIDS in the Cape Metropole and surrounding areas. The study utilised the explorative, contextual and qualitative descriptive study design. Purposive sampling was implemented and data were collected through focus groups and in-depth interviews. Data were analysed using content analysis. Ethical considerations were adhered to. The main findings of the study indicate that numerous myths and misperceptions about HIV/AIDS prevail among deaf people. This paper advocates for policymakers to include deaf people, particularly sign language users, in HIV-prevention programmes

Tenant and resident militancy for housing justice: An exchange between Amanda Huron and Neil Gray

In this conversation, RHJ editors have asked Amanda Huron and Neil Gray to reflect on their approach to strategies and histories of tenant and resident militancy and what lessons can be learnt from the past to shed light on contemporary housing struggles

Tenant and resident militancy for housing justice: An exchange between Amanda Huron and Neil Gray

In this conversation, RHJ editors have asked Amanda Huron and Neil Gray to reflect on their approach to strategies and histories of tenant and resident militancy and what lessons can be learnt from the past to shed light on contemporary housing struggles

Economic issues in a trial of the controlled provision of heroin

Executive Summary: This paper discusses some economic issues that may be investigated as part of a proposed trial of the controlled provision of heroin in the Australian Capital Territory. Such a trial would provide an opportunity to gather empirical evidence on some aspects of the operation of the market for heroin. Specifically, it would enable the investigation of the extent to which purity, rather than price, is the equilibrating mechanism in this market. If purity is an important equilibrating mechanism, then provision of heroin of constant purity to trial participants would yield important health benefits to those participants. However, if purity on the black market is increased in economic retaliation against a trial, there may be unintended adverse effects on the health of black market users in the short run. In the long run, stabilisation of purity on the black market may be associated with an improvement in the health status of non-trial users. An important issue that cannot be addressed in the context of the proposed trial is the price elasticity of demand for heroin, that is, the responsiveness of demand for heroin to a change in its price. The use of pre–specified criteria to determine eligibility for participation in a trial will preclude any estimation of the increase in demand for heroin attributable to a fall in its price

The New Zealand workforce survey II: occupational risk factors for asthma.

INTRODUCTION: We conducted a cross-sectional population-based survey in New Zealand that collected information on work history, current workplace exposures, and selected health outcomes. We report here the findings on occupational risk factors for asthma symptoms. METHODS: A random sample of men and women aged 20-64 years were selected from the New Zealand Electoral Roll and invited to take part in a telephone survey. Current asthma was defined as: (i) woken up by shortness of breath in the past 12 months; or (ii) an attack of asthma in the past 12 months; or (iii) currently taking asthma medication. Adult-onset asthma was defined as first attack of asthma at age 18 or over. Prevalence odds ratios (ORs) for all occupations were calculated using logistic regression adjusting for sex, age, smoking, and deprivation. RESULTS: Totally, 2903 participants were included in the analyses. The prevalence of current asthma was 17% and the prevalence of adult-onset asthma was 9%. Prevalence ORs for current asthma were elevated for ever working as a printer [OR = 2.26; 95% confidence interval (CI) = 1.09-4.66], baker (OR = 1.98; 95% CI = 1.02-3.85), sawmill labourer (OR = 3.26; 95% CI = 1.05-10.16), metal processing plant operator (OR = 2.48; 95% CI = 1.22-5.05), and cleaner (OR = 1.60; 95% CI = 1.09-2.35). Excess risks of adult-onset asthma were also found for ever working as a printer, baker, and sawmill labourer as well as ever-working as a market-oriented animal producer (OR = 1.66; 95% CI = 1.14-2.41), and other agricultural worker (OR = 2.08; 95% CI = 1.03-4.20). A number of occupations not previously considered at high risk for asthma were also identified, including teachers and certain sales professionals. CONCLUSION: This population-based study has confirmed findings of previous international studies showing elevated risks in a number of high-risk occupations. The strongest risks were consistently observed for printers, bakers, and sawmill labourers. Several occupations were also identified that have not been previously associated with asthma, suggesting that the risk of occupational asthma may be more widely spread across the workforce than previously assumed

A crossover study to evaluate the diversion of malaria vectors in a community with incomplete coverage of spatial repellents in the Kilombero Valley, Tanzania

Malaria elimination is unlikely to occur if vector control efforts focus entirely on transmission occurring indoors without addressing vectors that bite outdoors and outside sleeping hours. Additional control tools such as spatial repellents may provide the personal protection required to fill this gap. However, since repellents do not kill mosquitoes it is unclear if vectors will be diverted from households that use spatial repellents to those that do not.; A crossover study was performed over 24 weeks in Kilombero, Tanzania. The density of resting and blood-engorged mosquitoes and human blood index (HBI) of malaria vector species per household was measured among 90 households using or not using 0.03 % transfluthrin coils burned outdoors under three coverage scenarios: (i) no coverage (blank coils); (ii) complete coverage of repellent coils; and (iii) incomplete coverage of repellent and blank coils. Mosquitoes were collected three days a week for 24 weeks from the inside and outside of all participating households using mosquito aspirators. Paired indoor and outdoor human landing collections were performed in three random households for six consecutive nights to confirm repellent efficacy of the coils and local vector biting times.; The main vectors were Anopheles arabiensis and Anopheles funestus (sensu stricto), which fed outdoors, outside sleeping hours, on humans as well as animals. Anopheles arabiensis landings were reduced by 80 % by the spatial repellent although household densities were not reduced. The HBI for An. arabiensis was significantly higher among households without repellents in the incomplete coverage scenario compared to houses in the no coverage scenario (Odds ratio 1.71; 95 % CI: 1.04-2.83; P = 0.03). This indicated that An. arabiensis mosquitoes seeking a human blood meal were diverted from repellent users to non-users. The repellent coils did not affect An. funestus densities or HBI.; Substantial malaria vector activity is occurring outside sleeping hours in the Kilombero valley. Repellent coils provided some protection against local An. arabiensis but did not protect against local (and potentially pyrethroid-resistant) An. funestus. Pyrethroid-based spatial repellents may offer a degree of personal protection, however the overall public health benefit is doubtful and potentially iniquitous as their use may divert malaria vectors to those who do not use them

Ubiquitin plays an atypical role in GPCR-induced p38 MAP kinase activation on endosomes.

Protease-activated receptor 1 (PAR1) is a G protein-coupled receptor (GPCR) for thrombin and promotes inflammatory responses through multiple pathways including p38 mitogen-activated protein kinase signaling. The mechanisms that govern PAR1-induced p38 activation remain unclear. Here, we define an atypical ubiquitin-dependent pathway for p38 activation used by PAR1 that regulates endothelial barrier permeability. Activated PAR1 K63-linked ubiquitination is mediated by the NEDD4-2 E3 ubiquitin ligase and initiated recruitment of transforming growth factor-β-activated protein kinase-1 binding protein-2 (TAB2). The ubiquitin-binding domain of TAB2 was essential for recruitment to PAR1-containing endosomes. TAB2 associated with TAB1, which induced p38 activation independent of MKK3 and MKK6. The P2Y1 purinergic GPCR also stimulated p38 activation via NEDD4-2-mediated ubiquitination and TAB1-TAB2. TAB1-TAB2-dependent p38 activation was critical for PAR1-promoted endothelial barrier permeability in vitro, and p38 signaling was required for PAR1-induced vascular leakage in vivo. These studies define an atypical ubiquitin-mediated signaling pathway used by a subset of GPCRs that regulates endosomal p38 signaling and endothelial barrier disruption

Minimising bias in an un-masked, pragmatic rct comparing two treatment pathways for glaucoma by the use of decision support software - the light trial experience

ragmatic trials of treatment pathways can require patient awareness of treatment allocation in order to better represent clinical reality, for example when concordance with a treatment has an important effect on outcome. Conversely, masking of treating clinicians to allocation group can be impossible when full clinical assessment requires knowledge of the current treatments, resources do not permit separate teams for treatment and assessment or when such duplication of clinician contact might affect an outcome such as patient experience. The LiGHT trial is a 718 subject multi-centre 6-year NIHR-funded study of two treatment pathways for glaucoma with outcome measures of health related quality of life and cost effectiveness. We aimed to minimise variation in aspects of clinical behaviour that might introduce bias by affecting either of these outcomes

Phase 2 trial of montelukast for prevention of pain in sickle cell disease.

Cysteinyl leukotrienes (CysLTs) are lipid mediators of inflammation. In patients with sickle cell disease (SCD), levels of CysLTs are increased compared with controls and associated with a higher rate of hospitalization for pain. We tested the hypothesis that administration of the CysLT receptor antagonist montelukast would improve SCD-related comorbidities, including pain, in adolescents and adults with SCD. In a phase 2 randomized trial, we administered montelukast or placebo for 8 weeks. The primary outcome measure was a >30% reduction in soluble vascular cell adhesion molecule 1 (sVCAM), a marker of vascular injury. Secondary outcome measures were reduction in daily pain, improvement in pulmonary function, and improvement in microvascular blood flow, as measured by laser Doppler velocimetry. Forty-two participants with SCD were randomized to receive montelukast or placebo for 8 weeks. We found no difference between the montelukast and placebo groups with regard to the levels of sVCAM, reported pain, pulmonary function, or microvascular blood flow. Although montelukast is an effective treatment for asthma, we did not find benefit for SCD-related outcomes. This clinical trial was registered at www.clinicaltrials.gov as #NCT01960413