Sustainability of an HIV PEP Program for Sexual Assault Survivors: “Lessons Learned” from Health Care Providers

This study explored challenges to continuing an HIV post-exposure prophylaxis (PEP) program of care provided to sexual assault survivors in the province of Ontario, Canada. Data were collected as part of an implementation and evaluation of a universal offering of HIV PEP (known as the HIV PEP Program) at 24 of 34 provincial hospital-based sexual assault treatment centres. Experienced health care providers were surveyed (n = 132) and interviewed in four focus groups (n = 26) about their perceptions of what, if any, factors threatened their ability to maintain the HIV PEP Program. All focus groups were audio-recorded and the recordings transcribed. The transcriptions and open-ended survey responses were analyzed using content analysis. Administrator, nurse, physician, social worker, and pharmacist respondents perceived important barriers to sustainability of the HIV PEP Program. Eight constructs were identified within four broad themes: resources (inadequate funds, overworked and unacknowledged staff), expertise (insufficient external supports, insufficiently trained and knowledgeable staff), commitment (lack of institutional support, physician resistance to offering HIV PEP), and accommodation (lack of flexibility in addressing specific client and community needs, inaccessibility and lack of clarity of tools). We discuss the implications of these findings and the actions that were taken to address the challenges

Recommendations to Improve Services and Supports for Domestically Sex Trafficked Persons Derived from the Insights of Health Care Providers

Janice Du Mont,1,2 Frances Montemurro,1 Rhonelle Bruder,1,2 C Emma Kelly,1 Frances Recknor,1 Robin Mason1,2 1Women’s College Research Institute, Women’s College Hospital, Toronto, ON, M5S 1B2, Canada; 2Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, CanadaCorrespondence: Janice Du Mont, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St, Toronto, ON, M5S 1B2, Canada, Email [email protected]: Health care providers are highly likely to encounter persons who have been domestically sex trafficked and, therefore, possess valuable insights that could be useful in understanding and improving existing services and supports. In-depth interviews were conducted with 31 health care providers residing and working in Canada’s largest province, Ontario. Results were analyzed using Braun and Clarke’s analytical framework. Across providers, a key theme was identified: “Facilitators to improve care”, which was comprised of two sub-themes, “Address needs in service provision” and “Center unique needs of survivors”. From these results, eight wide-ranging recommendations to improve services and supports were developed (eg, Jointly mobilize an intersectoral, collaborative, and coordinated approach to sex trafficking service provision; Employ a survivor-driven approach to designing and delivering sex trafficking services). These recommendations hold the potential to enhance services in Canada and beyond by reducing barriers to access and care, facilitating disclosure, aiding in recovery, and empowering those who have been domestically sex trafficked.Keywords: domestic, human trafficking, health care, recommendations, sex trafficking, social service

ORNL Liquid Low-Level Waste Solidification

The solidification of LLLW at ORNL has developed two basic strategies, a near-term or backup flowsheet is planned to alleviate the immediate capacity problem for storage of concentrated LLLW and a long-term or reference flowsheet is planned to incorporate filtration of the settleable TRU and cesium and strontium decontamination of the LLLW. Presently a feasibility study is evaluating the process alternatives for segregating LLLW from remote-handled transuranic (RH-TRU) sludges, decontamination of the LLLW for beta-gamma radionuclides such as cesium and strontium, and the handling and storage of the RH-TRU sludges and decontamination media. 14 refs

Kinematic Control of the Inertiality of the System of Tycho-2 and UCAC2 Stellar Proper Motions

Based on the Ogorodnikov-Milne model, we analyze the proper motions of Tycho-2 and UCAC2 stars. We have established that the model component that describes the rotation of all stars under consideration around the Galactic y axis differs significantly from zero at various magnitudes. We interpret this rotation found using the most distant stars as a residual rotation of the ICRS/Tycho-2 system relative to the inertial reference frame. For the most distant ($d\approx900$ pc) Tycho-2 and UCAC2 stars, the mean rotation around the Galactic y axis has been found to be $M_{13}=-0.37\pm0.04$ mas yr$^{-1}$. The proper motions of UCAC2 stars with magnitudes in the range $12-15^m$ are shown to be distorted appreciably by the magnitude equation in $\mu_\alpha\cos\delta$, which has the strongest effect for northern-sky stars with a coefficient of $-0.60\pm0.05$ mas yr$^{-1}$ mag$^{-1}$. We have detected no significant effect of the magnitude equation in the proper motions of UCAC2 stars brighter than $\approx11^m$.Comment: 15 pages, 6 figure

Kinematic Control of the Inertiality of ICRS Catalogs

We perform a kinematic analysis of the Hipparcos and TRC proper motions of stars by using a linear Ogorodnikov-Milne model. All of the distant (r more than 0.2 kpc) stars of the Hipparcos catalog have been found to rotate around the Galactic y axis with an angular velocity of -0.36 +/- 0.09 mas/year. One of the causes of this rotation may be an uncertainty in the lunisolar precession constant adopted when constructing the ICRS. In this case? the correction to the IAU (1976) lunisolar precession constant in longitude is shown to be -3.26 +/- 0.10 mas/yr. Based on the TRC catalog, we have determined the main Oort constants: A = 14.9 +/- 1.0 and B = -10.8 +/- 0.3 km/s/kpc. The component of the model that describes the rotation of all TRC stars around the Galactic y axis is nonzero for all magnitudes, My= -0.86 +/- 0.11 mas/yr.Comment: 10 pages, 4 figures, 2 table

Lower Rate of Restenosis and Reinterventions With Covered vs Bare Metal Stents Following Innominate Artery Stenting

PURPOSE: To determine any difference between bare metal stents (BMS) and balloon-expandable covered stents in the treatment of innominate artery atheromatous lesions. MATERIALS AND METHODS: A multicenter retrospective study involving 13 university hospitals in France collected 93 patients (mean age 63.2±11.1 years; 57 men) treated over a 10-year period. All patients had systolic blood pressure asymmetry >15 mm Hg and were either asymptomatic (39, 42%) or had carotid (20, 22%), vertebrobasilar (24, 26%), and/or brachial (20, 22%) symptoms. Innominate artery stenosis ranged from 50% to 70% in 4 (4%) symptomatic cases and between 70% and 90% in 52 (56%) cases; 28 (30%) lesions were preocclusive and 8 (9%) were occluded. One (1%) severely symptomatic patient had a <50% stenosis. Demographic characteristics, operative indications, and procedure details were compared between the covered (36, 39%) and BMS (57, 61%) groups. Multivariate analysis was performed to determine relative risks of restenosis and reinterventions [reported with 95% confidence intervals (CI)]. RESULTS: The endovascular procedures were performed mainly via retrograde carotid access (75, 81%). Perioperative strokes occurred in 4 (4.3%) patients. During the mean 34.5±31.2-month follow-up, 30 (32%) restenoses were detected and 13 (20%) reinterventions were performed. Relative risks were 6.9 (95% CI 2.2 to 22.2, p=0.001) for restenosis and 14.6 (95% CI 1.8 to 120.8, p=0.004) for reinterventions between BMS and covered stents. The severity of the treated lesions had no influence on the results. CONCLUSION: Patients treated with BMS for innominate artery stenosis have more frequent restenoses and reinterventions than patients treated with covered stents

Medico-Legal Findings, Legal Case Progression, and Outcomes in South African Rape Cases: Retrospective Review

Rachel Jewkes and colleagues examine the processing of rape cases by South African police and courts and show an association between documentation of ano-genital injuries, trials commencing, and convictions in rape cases

Kinematic Peculiarities of Gould Belt Stars

We analyzed the space velocities of Gould Belt stars younger than 125 Myr located at heliocentric distances <650 pc. We determined the rotation and expansion parameters of the Gould Belt by assuming the existence of a single kinematic center whose direction was found to be the following: $l_\circ=128^\circ$ and $R_\circ=150$ pc. The linear velocities reach their maximum at a distance of $\approx300$ pc from the center and are -6 km s$^{-1}$ for the rotation (whose direction coincides with the Galactic rotation) and +4 km s$^{-1}$ for the expansion. The stellar rotation model used here is shown to give a more faithful description of the observed velocity field than the linear model based on the Oort constants $A_G$ and $B_G$. We present evidence that the young clusters $\beta$ Pic, Tuc/HorA, and TWA belong to the Gould Belt structure.Comment: 17 pages, 5 figure

A review of information flow diagrammatic models for product-service systems

A product-service system (PSS) is a combination of products and services to create value for both customers and manufacturers. Modelling a PSS based on function orientation offers a useful way to distinguish system inputs and outputs with regards to how data are consumed and information is used, i.e. information flow. This article presents a review of diagrammatic information flow tools, which are designed to describe a system through its functions. The origin, concept and applications of these tools are investigated, followed by an analysis of information flow modelling with regards to key PSS properties. A case study of selection laser melting technology implemented as PSS will then be used to show the application of information flow modelling for PSS design. A discussion based on the usefulness of the tools in modelling the key elements of PSS and possible future research directions are also presented