HIV/AIDS in Haiti. An Analysis of Demographics, Lifestyle, STD Awareness, HIV Knowledge and Perception that Influence HIV Infection among Haitians.

Introduction Haiti has the highest prevalence of HIV infection in Latina America and the Caribbean. The country faces the worst AIDS epidemic outside Africa and bears the greatest burden of HIV in the western hemisphere. Studies in the past recent years show that HIV/AIDS is most likely to be seen in developed countries. People with low education level and appropriate knowledge about STD’s are more susceptible to get HIV. Lifestyle behaviors represent significant factors in HIV transmission. Understandings these lifestyle factors are therefore critical in reversing the increasing prevalence of HIV/AIDS. The purpose of this investigation is to determine the influence of factors such as demographic, lifestyle, HIV knowledge and misconceptions on HIV transmission. Statistical analysis For this study, we use SPSS (PAWS Statistics 18). The prevalence of HIV-AIDS via HIV status was determined across socio-demographic variables, respondents’ knowledge and misconception regarding HIV/AIDS, STDs awareness and lifestyle. The distribution of categorical variables across levels of dependent variable was analyzed using chi-square tests. All Analyses were stratified across HIV status. The distribution of categorical variables by levels of HIV/AIDS status was determined using one-way analysis of variance. Chi-square analysis was done to determine the distribution of independents across status of dependent variable. Univariate and multivariate logistic regression analyses were used to determine the association between selected life style factors and HIV/AIDS. Odds ratios from the logistic regression analyses were used to estimate the risks of HIV/AIDS that were associated with life style factors. In all analysis, P\u3c .05 was used to determine statistical significance among variables. Stepwise analysis was performed to evaluate the most significant variables that are associated with HIV. Results Among demographic variables, only age was reported having negative significant contribution in HIV status. The other variables, including residence, education, marital status, economic status and gender were not significantly associated with increased odds of HIV transmission. Significant association was observed for HIV status and respondents “who have ever been tested for HIV”. Odd ratio analysis for people who think “avoiding prostitutes” show significant association with HIV status (7%) compared to those who do not; Variables referring to respondents who think “having only one sex partner” and “Limited number of partners” as a way to protect themselves from getting HIV were negatively associated increased risk of HIV. Those who think HIV/AIDS is by witchcraft ware more likely to have positive HIV status. Stepwise analysis for our significant variables from multivariate logistic regression show that only variables referring to young respondents and those who think they can get AIDS by witchcraft are the most significant for a positive HIV status. Discussion Recent epidemiologic data show that the HIV infection in Haiti is mostly concentrated among youth. Young Haitians lack of sexual education and awareness, and misconceptions are the main drivers of HIV risks. To avert the increasing epidemic of HIV/AIDS in Haiti, public health efforts must concentrate in youth education. Such education must emphasize sexual behaviors, lifestyle issues and attitudes. Demystifying the widely held view that HIV is due to witchcraft may also help in reversing the ongoing epidemics of HIV/AIDS in Haiti

: recherches, formations, pratiques

International audienceCet ouvrage présente les actes du colloque « Education à la santé etcomplexité : Recherches, Formations et Pratiques » qui constituait le4ème colloque international d’UNIRéS, Réseau des universités pour l’éducationà la santé (E.S). Cette 4ème édition, qui a réuni près de 200 chercheurs,formateurs et praticiens, a été portée par la Commission Scientifique duRéseau UNIRéS, nouvellement créé en 2012.C’est à partir de la notion de complexité, dans son acception holistique,que nous avons invité les participants à mener une réflexion autour desquestions d’éducation et de santé, en mettant en exergue la complexité desliens qui se tissent entre éducation, santé et formation.Fidèles à la mise en lien de regards pluridisciplinaires pour penser larecherche, la formation et les interventions éducatives dans un contextede profondes mutations sociales, les contributeurs ont mis en évidence lacomplexité des objets investigués dans le champ de l’E.S, et explicité ce quecette notion apporte aux analyses des processus de formation, d’apprentissageet d’enseignement développés par les acteurs.Il ressort de la confrontation de ces regards pluridisciplinaires, de ladiversité des modèles conceptuels convoqués, comme de la variété despratiques observées sur les territoires, un cadre pertinent pour penser, dansune approche globale et multidimensionnelle, la conception, la mise en oeuvreet l’évaluation de dispositifs de formation et d’ES.Les problématiques abordées dans ce colloque ne sont pas seulementdes questions de recherche et de formation. Elles sont également desquestions sociales et politiques qui se posent dans une société en perpétuellemutation. Autant de problématiques, de questions dont les réponses irriguentsuccessivement les politiques publiques éducatives et de santé publique,visant la (re)construction de liens sociaux durables et la réduction desinégalités sociales de santé.En partant de l’idée que le social s’incorpore dans chaque individu enmême temps qu’il le transforme, le prochain colloque d’UNIRéS constitueraune nouvelle opportunité pour poser de façon critique la question des liensentre les concepts d’E.S et de mutations sociales, en esquissant de nouvellesperspectives pour l’intervention éducative, la formation professionnelle et larecherche.Les actes du 4ème Colloque international : « Éducation à la santé et complexité : recherche, formation, pratiques » qui s’est déroulé en octobre 2012 sont disponibles en ligne sur le site d’UNIRéS, réseau national de formateurs et de chercheurs engagé dans le développement de l’éducation à la santé à / hors l’École

A conformação dos ecomuseus: elementos para compreensão e análise

Apresenta uma história dos ecomuseus enraizado nos movimentos de folclore e etnografia regional, do final do século XIX até os dias de hoje, examinando o caso francês. Explora aspectos em geral menos enfatizados neste campo, tal como a natureza e o papel atribuído aos acervos e ao patrimônio cultural e padrões museográticos

Transitions dans le parcours de vie et construction des inégalités

Tout au long de leur existence, les individus suivent des chemins singuliers dont les trajectoires ne sont pas le simple fait de la seule volonté ou du hasard. Ces cheminements se révèlent souvent générateurs d'inégalités entre individus, notamment au cours des transitions des âges de la vie (enfance, adolescence, âge adulte, grand âge), ou lors de différentes étapes (mariage, divorce, deuil, etc). C'est afin de mieux comprendre les modalités et les combinaisons d'influence à l'origine des inégalités dans les parcours de vie, que les éditeurs de cet ouvrage ont réuni des chercheurs issus des sciences psychologiques, sociales et économiques, afin de croiser leurs regards sur la manière dont ces inégalités se creusent ou se réduisent au fil des trajectoires. Cet ouvrage interdisciplinaire met en relief la richesse d'une approche des inégalités dans la perspective dynamique du parcours de vie.Peer reviewe

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030