Women, Health and Aging: Building a Statewide Movement

Provides an overview of current policy and program environments that affect the state's most vulnerable elder population, and considers some effective strategies to address the growing needs of older persons in California

Prevalence and Risk Factors for Methicillin-Resistant Staphylococcus aureus in an HIV-Positive Cohort

Background: Persons living with HIV (PLWH) are disproportionately burdened with methicillin-resistant Staphylococcus aureus (MRSA). Our objective was to evaluate prevalence and risks for MRSA colonization in PLWH. Methods: Adults were recruited from Johns Hopkins University AIDS Service in Baltimore, Maryland. A risk questionnaire and specimen collection from anatomic sites with culture susceptibility and genotyping were completed. Generalized estimating equation modeling identified MRSA colonization risk factors. Results: Of 500 participants,mostwere black (69%), on antiretroviral therapy (ART) (87%),with undetectable viral loads (73.4%). Median CD4 count was 487 cells/mm3 (interquartile range, 316-676.5 cells/mm3). MRSA prevalence was 15.4%, predominantly from the nares (59.7%). Forty percent were nares negative but were colonized elsewhere. Lower odds for colonizationwere associatedwith recent sexual activity (adjusted odds ratio [AOR]¼0.84, P$75,000; AOR ¼ 2.68, P \u3c .001), recent hospitalization (AOR ¼ 1.54, P \u3c .001), incarceration (AOR ¼ 1.55,

Prevalence and Risk Factors for Methicillin-Resistant Staphylococcus aureus in an HIV-Positive Cohort

Background: Persons living with HIV (PLWH) are disproportionately burdened with methicillin-resistant Staphylococcus aureus (MRSA). Our objective was to evaluate prevalence and risks for MRSA colonization in PLWH. Methods: Adults were recruited from Johns Hopkins University AIDS Service in Baltimore, Maryland. A risk questionnaire and specimen collection from anatomic sites with culture susceptibility and genotyping were completed. Generalized estimating equation modeling identified MRSA colonization risk factors. Results: Of 500 participants,mostwere black (69%), on antiretroviral therapy (ART) (87%),with undetectable viral loads (73.4%). Median CD4 count was 487 cells/mm3 (interquartile range, 316-676.5 cells/mm3). MRSA prevalence was 15.4%, predominantly from the nares (59.7%). Forty percent were nares negative but were colonized elsewhere. Lower odds for colonizationwere associatedwith recent sexual activity (adjusted odds ratio [AOR]¼0.84, P$75,000; AOR ¼ 2.68, P \u3c .001), recent hospitalization (AOR ¼ 1.54, P \u3c .001), incarceration (AOR ¼ 1.55,

Zika virus preferentially replicates in the female reproductive tract after vaginal inoculation of rhesus macaques.

Zika virus (ZIKV) is a mosquito-transmitted virus that can cause severe defects in an infected fetus. ZIKV is also transmitted by sexual contact, although the relative importance of sexual transmission is unclear. To better understand the role of sexual transmission in ZIKV pathogenesis, a nonhuman primate (NHP) model of vaginal transmission was developed. ZIKV was readily transmitted to mature cycling female rhesus macaque (RM) by vaginal inoculation with 104-106 plaque-forming units (PFU). However, there was variability in susceptibility between the individual RM with 1->8 vaginal inoculations required to establish infection. After treatment with Depoprovera, a widely used contraceptive progestin, two RM that initially resisted 8 vaginal ZIKV inoculations became infected after one ZIKV inoculation. Thus, Depoprovera seemed to enhance susceptibility to vaginal ZIKV transmission. Unexpectedly, the kinetics of virus replication and dissemination after intravaginal ZIKV inoculation were markedly different from RM infected with ZIKV by subcutaneous (SQ) virus inoculation. Several groups have reported that after SQ ZIKV inoculation vRNA is rapidly detected in blood plasma with vRNA less common in urine and saliva and only rarely detected in female reproductive tract (FRT) secretions. In contrast, in vaginally inoculated RM, plasma vRNA is delayed for several days and ZIKV replication in, and vRNA shedding from, the FRT was found in all 6 animals. Further, after intravaginal transmission ZIKV RNA shedding from FRT secretions was detected before or simultaneously with plasma vRNA, and persisted for at least as long. Thus, ZIKV replication in the FRT was independent of, and often preceded virus replication in the tissues contributing to plasma vRNA. These results support the conclusion that ZIKV preferentially replicates in the FRT after vaginal transmission, but not after SQ transmission, and raise the possibility that there is enhanced fetal infection and pathology after vaginal ZIKV transmission compared to a mosquito transmitted ZIKV

Muscle strengthening intervention for boys with haemophilia: Developing and evaluating a best-practice exercise programme with boys, families and health-care professionals

Background: Muscle strengthening exercises have the potential to improve outcomes for boys with haemophilia, but it is unclear what types of exercise might be of benefit. We elicited the views of health-care professionals, boys and their families to create and assess a home-based muscle strengthening programme. Objective: To design and develop a muscle strengthening programme with health-care professionals aimed at improving musculoskeletal health, and refine the intervention by engaging boys with haemophilia and their families (Study 1). Following delivery, qualitatively evaluate the feasibility and acceptability of the exercise programme with the boys and the study's physiotherapists (Study 2). Design: A person-based approach was used for planning and designing the exercise programme, and evaluating it post-delivery. The following methods were utilized: modified nominal group technique (NGT) with health-care professionals; focus group with families; exit interviews with boys; and interviews with the study's physiotherapists. Results: Themes identified to design and develop the intervention included exercises to lower limb and foot, dosage, age accommodating, location, supervision and monitoring and incentivization. Programme refinements were carried out following engagement with the boys and families who commented on: dosage, location, supervision and incentivization. Following delivery, the boys and physiotherapists commented on progression and adaptation, physiotherapist contact, goal-setting, creating routines and identifying suitable timeframes, and a repeated theme of incentivization. Conclusions: An exercise intervention was designed and refined through engagement with boys and their families. Boys and physiotherapists involved in the intervention's delivery were consulted who found the exercises to be generally acceptable with some minor refinements necessary

Development of a haemophilia physiotherapy intervention for optimum musculoskeletal health (Dolphin trial)

Introduction: Haemophilic arthropathy is associated with muscle weakness and may be reduced prior to the onset of clinical arthropathy.Muscle weakness is strongly correlated to reduced walking distances, slower ascent and descent of stairs, and altered joint motion and forces during weight bearing activities. Our aim was to develop a muscle strengthening exercise intervention for children that could be tested in a randomised clinical trial. Methods: We conducted modified Nominal Group Technique focus groups with academic experts and specialist physiotherapists, and most importantly in consultation with patients. The exercise programme was demonstrated to five boys with haemophilia and their parents. Children and parents were asked; what they thought about the exercises and whether they could undertake them on a regular basis, where they thought the best place was for undertaking them, and how they would like to receive information on the exercise programme. They were also asked questions about how they would feel about taking part in a study testing the benefits of the exercises, issues around being allocated randomly into study groups, and what would encourage the children to continue on the exercise programme. Results: Strong consensus from physiotherapists indicated the exercise programme should include exercises focused on strength, balance, proprioception, flexibility and mobility, and a motor learning component. Families noted the best place for the intervention being carried out was at home and that twice per week would be achievable. Parents felt that in order to sustain interest and motivation, it was important to build in an incentive that would be valued by the child. They also said that in order to find out whether or not the exercise programme worked, they would not have a problem with their child being allocated into an intervention or usual care groups. Discussion/Conclusion: Engaging clinicians and patients in partnership as part of the research process enhanced the design of an exercise intervention ensuring it is acceptable and potentially beneficial for children with chronic disorders. The efficacy of a 24-session progressive exercise programme of stretching, strengthening, balance, proprioceptive and mobility using functional movement patterns is currently being tested in a randomised controlled trial

Double quantum dot with tunable coupling in an enhancement-mode silicon metal-oxide semiconductor device with lateral geometry

We present transport measurements of a tunable silicon metal-oxide-semiconductor double quantum dot device with lateral geometry. Experimentally extracted gate-to-dot capacitances show that the device is largely symmetric under the gate voltages applied. Intriguingly, these gate voltages themselves are not symmetric. Comparison with numerical simulations indicates that the applied gate voltages serve to offset an intrinsic asymmetry in the physical device. We also show a transition from a large single dot to two well isolated coupled dots, where the central gate of the device is used to controllably tune the interdot coupling.Comment: 4 pages, 3 figures, to be published in Applied Physics Letter