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

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 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

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

Drug Facilitated Sexual Assault: Detection and Stability of Benzodiazepines in Spiked Drinks Using Gas Chromatography-Mass Spectrometry

Benzodiazepines are detected in a significant number of drug facilitated sexual assaults (DFSA). Whilst blood and urine from the victim are routinely analysed, due to the delay in reporting DFSA cases and the short half lives of most of these drugs in blood and urine, drug detection in such samples is problematic. Consideration of the drinks involved and analysis for drugs may start to address this. Here we have reconstructed the ‘spiking’ of three benzodiazepines (diazepam, flunitrazepam and temazepam) into five drinks, an alcopop (flavoured alcoholic drink), a beer, a white wine, a spirit, and a fruit based non-alcoholic drink (J2O) chosen as representative of those drinks commonly used by women in 16–24 year old age group. Using a validated GC-MS method for the simultaneous detection of these drugs in the drinks we have studied the storage stability of the benzodiazepines under two different storage conditions, uncontrolled room temperature and refrigerator (4°C) over a 25 day period. All drugs could be detected in all beverages over this time period. Diazepam was found to be stable in all of the beverages, except the J2O, under both storage conditions. Flunitrazepam and temazepam were found not to be stable but were detectable (97% loss of temazepam and 39% loss of flunitrazepam from J2O). The recommendations from this study are that there should be a policy change and that drinks thought to be involved in DFSA cases should be collected and analysed wherever possible to support other evidence types

Application of Vector Spherical Harmonics and Kernel Regression to the computations of OMM Parameters

The high quality of Hipparcos data in position, proper motion, and parallax has allowed for studies about stellar kinematics with the aim of achieving a better physical understanding of our galaxy, based on accurate calculus of the Ogorodnikov-Milne model (OMM) parameters. The use of discrete least squares is the most common adjustment method, but it may lead to errors mainly because of the inhomogeneous spatial distribution of the data. We present an example of the instability of this method using the case of a function given by a linear combination of Legendre polynomials. These polynomials are basic in the use of vector spherical harmonics, which have been used to compute the OMM parameters by several authors, such as Makarov & Murphy, Mignard & Klioner, and Vityazev & Tsvetkov. To overcome the former problem, we propose the use of a mixed method (see Marco et al.) that includes the extension of the functions of residuals to any point on the celestial sphere. The goal is to be able to work with continuous variables in the calculation of the coefficients of the vector spherical harmonic developments with stability and efficiency. We apply this mixed procedure to the study of the kinematics of the stars in our Galaxy, employing the Hipparcos velocity field data to obtain the OMM parameters. Previously, we tested the method by perturbing the Vectorial Spherical Harmonics model as well as the velocity vector field.Part of this work was supported by a grant P1-1B2012-47 from UJI.Marco Castillo, FJ.; Martínez Uso, MJ.; Lopez, J. (2015). Application of Vector Spherical Harmonics and Kernel Regression to the computations of OMM Parameters. Astronomical Journal. 149(4):1-11. https://doi.org/10.1088/0004-6256/149/4/129S111149