Changes in sexual behaviour, pre-exposure prophylaxis use and HIV incidence among gay, bisexual, and other men who have sex with men in England

The identification of longitudinal changes in sexual behaviour over time, pre-exposure prophylaxis (PrEP) use, the incidence of HIV infection among HIV-negative GBMSM, and risk behaviours among HIV-positive GBMSM shortly after diagnosis is needed to improve HIV prevention efforts and is crucial to assess the potential risk of HIV spread in the community. Data from UK prospective studies are lacking. Data from two prospective studies were used in this thesis. The AURAH2 (Attitudes to, and Understanding of, Risk of Acquisition of HIV over time) study recruited GBMSM who were HIV-negative from three large sexual health clinics in England with four-monthly online follow-up (2013 – 2018, 1,162 men completed baseline questionnaire, 622 men completed at least one follow-up questionnaire). The Guy’s and St. Thomas’ study enrolled newly diagnosed people from an HIV clinic in London and followed them up at weeks 12, 24, and 48 (2015 – 2018, 90 GBMSM included in analyses). Among all men enrolled in AURAH2, past three months condomless anal sex with two or more partners (CLS2+, 46% to 47%, p-trend=0.010) increased slightly between 2013 and 2018. PrEP use in the past year also increased from 0% in 2013 to 43% in 2018 (p<0.001). HIV incidence declined from 1.47 per 100 PYs in 2013/2014 to 0.25 per 100 PYs in 2018/2019. Among a subset of men in AURAH2 with at least two consecutive questionnaires during follow-up, men reporting CLS2+ had an overall 78% probability of reporting CLS2+ in the subsequent questionnaires, and of men who reported none or one CLS partner, 88% reported the same in the subsequent period. Among GBMSM newly diagnosed with HIV in the Guy’s and St. Thomas study, the within-individual tendency for reporting CLS was that men reduced their behaviours from baseline (62%) to week 12 (45.2%), then increased again by 48 weeks (62%). The greatest increase at week 48 was seen in the frequency of CLS with serodiscordant partners (CLS-D; 14% at week 12 to 36% at week 48). The proportion of men having CLS-D with the most recent documented plasma viral load (VL) > 200 copies/mL at week 12 was almost 11%. With HIV incidence declining among GBMSM in England and coinciding with a substantial increase in the use of PrEP, there is a clear need to focus prevention efforts on potential transmission risk. HIV providers should emphasize the importance of knowledge of viral suppression in decision making about CLS among newly diagnosed GBMSM

PENERAPAN KONSEP THE VICTIM OF PRONE OCCUPATION DALAM KASUS PEMERKOSAAN TERHADAP PEKERJA SEKS KOMERSIAL DIHUBUNGKAN DENGAN HUKUM PIDANA INDONESIA

Kaum perempuan sebagai penjaja seks komersial selalu menjadi objek dan tudingan sumber permasalahan prostitusi juga muncul karena ada definisi sosial di masyarakat bahwa wanita sebagai objek seks. Pekerja seks komersial pada umumnya adalah pekerjaan yang paling rentan dengan kekerasan dan suatu pekerjaan yang rentan menjadi korban akibat profesinya. profesi ini menjadi alat penekan yang mampu untuk melakukan pemerasan terhadap mereka juga dari beberapa pelanggan mereka yang rentan mengalami kekerasan dalam menjalani pekerjaanya. Adapun permasalahan yang dapat diidentifikasikan adalah sebagai berikut Bagaimana peranan korban kejahatan dalam tindak pidana perkosaan terhadap Pekerja Seks Komersial berdasarkan konsep The Victim Of Prone Occupation, Bagaimana bentuk perlindungan hukum yang diberikan kepada korban kejahatan pemerkosaan pada kasus pemerkosaan terhadap Pekerja Seks Komersial berdasarkan Hukum Pidana Indonesia. Penelitian ini bersifat deskriptif analitis, metode pendekatan yang digunakan adalah yuridis normatif, penelitian ini dilakukan dengan dua tahap yaitu studi kepustakaan dan studi lapangan, metode yang dipergunakan untuk memperoleh data adalah studi liberatur dan wawancara, kemudian data yang diperoleh dalam penelitian ini dianalisis dengan menggunakan metode yuridis kualitatif. Hasil yang diperoleh dari penelitian tersebut diketahui bahwa : Peranan korban sebagai Pekerja Seks Komersial telah memenuhi konsep the victim of prone occupation karena kekerasan yang terjadi berawal dari kesepakatan dan perjanjian-perjanjian yang telah disepakati antara kedua belah pihak yaitu kesepakatan dan perjanjian antara korban dan pelaku sebagai pelanggan dari Pekerja Seks Komersial yang telah mempengaruhi terjadinya kekerasan tersebut. Bentuk-bentuk perlindungan hukum terhadap Pekerja Seks Komersial dalam kejahatan ini yaitu Pekerja Seks Komersial mendapatkan penuntutan ganti rugi dari pelaku dan pemerintah, Pekerja Seks Komersial mendapat hak perlindungan reproduksinya yang dilindungi oleh hukum, Pekerja Seks Komersial mendapat pemberian jaminan hukum dan layanan perlindungan bagi Pekerja Seks Komersial, dan Pekerja Komersial mendapat rehabilitasi sosial dari negara. namun di dalam praktiknya perlindungan hukum ini tidak diberlakukan pada Pekerja Seks Komersial karena di dalam praktiknya Pekerja Seks Komersial bukan dikategorikan sebagai korban melainkan Pekerja Seks Komersial dikategorikan sebagai Pelaku. Kata Kunci : Perkosaan, Pekerja Seks Komersial, The Victim Of Prone Occupatio

Controller of fluorine­doped tin oxide thin films deposition via cycles and annealing temperatures by spin coating techniques

Fluorine-doped tin oxide (FTO) thin films have been deposited by the modified spin coating method at 3000 rpm using tin (II) chloride dehydrate (SnCl2×2H2O) as a precursor, ammonium fluoride (NH4F) as a dopant and ethanol as a solvent. The aim of this research is to find out the quality of the thin film based on the number of cycles (3, 4, 5, and 6 cycles) and annealing temperature (300, 400 and 500 °C). The variation of annealing temperature and number of cycles can affect the crystal structure of the FTO thin film, crystal size and grain size. Increasing the number of cycles and annealing temperature can lead to larger crystallite size and lower dislocation density, so that electrons between the grains can move easily. The large grain can reduce the grain boundary, increasing the electron mobility and decreasing the resistivity. XRD analysis shows that the structure of SnO2 polycrystalline with the most dominant crystal plane (110) is formed in this research when compared to the intensity of other structures. The resistivity value decreases with increasing the annealing temperature and number of cycles. In addition, transparency value also decreases along with increasing the annealing temperature and number of cycles. The optimum results of resistivity and transparency values obtained in this research are 1.692´10-2 Ω×cm and 69.232 % at 500 °C and 5 cycles. These results can be used as a reference for further study to optimize the production of fluorine-doped tin oxide (FTO) thin film with spin coating. Therefore, many factors that affect the production of fluorine-doped tin oxide (FTO) thin film, either dissolving stage or deposition process on the substrate surface still need to be studied deeply to obtain the optimum resul

FACTORS AFFECTING THE REJECTION OF EVALUATION RADIOGRAPH BLASS NIER OVERZICHT-INTRAVENOUS PYELOGRAFI

This research due to know the influencing factors of BNO-IVP radiograph rejection and to know the solution of rejection. The researcher using 3 method of data collecting, i.e. observational method which result the check-list of BNO-IVP rejected influencing factors, interview method which use to validate the data, and documentating method which result the data in photograph of BNO-IVP radiograph rejected. Then the data will be analysed with reject film analysis. Based on the method, the reject rate result on September up to 13,04%, on October up to 13,63%, then on November up to 29,26%. The influencing factors of BNO-IVP rejection i.e. un-cover anatomical region, poor of radiograph contrast, patient movement, fecal materials, and un-effectiveness of patient preparation. This research has been did on Department of Radiodiagnostic of RSUD Dr. Soetomo Surabaya using 12 BNO-IVP radiograph rejected of 41 total exams on November and then rated by 1 responden. Un-effectiveness of patient preparation is the result of this research. This factor is the main influencing factor of rejection up to 100%. Based on the researher analysis about the solution, i.e. increasing the communication to the patient about the BNO-IVP exam preparation and do revision to the patinet preparation form guide more simply, so the patient can understand easly

Behaviour changes following HIV diagnosis among men who have sex with men in the era of treatment as prevention: data from a prospective study

We described the longitudinal changes in sexual behaviour and associated factors among newly diagnosed with HIV men who have sex with men participating in a prospective observational study from a London HIV clinic (2015-2018). Participants self-completed questionnaires at baseline, months 3 and 12. Information collected included socio-demographic, sexual behaviour, health, lifestyle and social support. Trends in sexual behaviours over one year following diagnosis and associated factors were assessed using generalized estimating equations with logit link. Condomless sex (CLS) dropped from 62.2% at baseline to 47.6% at month-three but increased again to 61.8% at month-12 (p-trend = 0.790). Serodiscordant-CLS increased between month-three and month-12 (from 13.1% to 35.6%, p-trend < 0.001). The prevalence of serodiscordant-CLS with high risk of transmitting to their partners at month-three was 10.7%. CLS was higher among men who reported recreational drug use (adjusted Odds Ratio (aOR) 3.03, 95%CI 1.47-6.24, p = 0.003), those with undetectable viral load (aOR 2.17, 95%CI 1.22-3.84, p = 0.008) and those who agreed with a statement "condoms are not necessary when HIV viral load is undetectable" (aOR 3.41, 95%CI 1.58-7.38, p = 0.002). MSM continued to engage in CLS after HIV diagnosis, which coincided with U = U publications and increased throughout the study

PERAN EWOM DALAM MEMBENTUK BRAND ATTITUDE DAN PURCHASE INTENTION PADA BRAND ROLLOVER REACTION

ABSTRACT The purpose of this paper is to examine how user-generated positive social electronic word-of-mouth (eWOM) via Instagram affects brand attitude and, consequently, influences purchase intention of Rollover Reaction Lip Cream. The spending patterns of consumers, particularly decision-makers, have been affected to a substantial degree by the strong presence of brands on the web. eWOM, one among the shape of net product reviews, exercises extensive influence not only on the consumers’ attitude towards the brand but also impacts their buying intentions. A survey-based empirical study was conducted to examine the influence of social eWOM on brand attitude and purchase intention of consumers. Structural equation modeling (SEM) was applied using data collected from 120 respondents comprising users of Instagram. The research established that user-generated positive eWOM on social networking site, Instagram has an influence on Brand attitude and Purchase intention, and Brand attitude was found to be the biggest influence on purchase intention. Keywords:&nbsp; Brand attitude, Purchase intention, Instagram, Online Shop, Social eWOM &nbsp; &nbsp; &nbsp; ABSTRAK Electronic Word Of Mouth adalah salah satu pendekatan pemasaran yang digunakan pada era media sosial saat ini. Cepatnya arus informasi membuat konsumen melakukan transaksi informasi mengenai brand yang mereka gunakan atau mereka sukai dengan bentuk interaksi online.Tujuan penelitian ini untuk melihat interaksi Electronic Word Of Mouth yang positif dari pengguna sosial media Instagram berdampak pada brand attitude dan juga purchase intention terhadap brand Lipcream Rollover Reaction. EWOM tidak hanya mempengaruhi sikap pengguna terhadap merek lipstik lokal ini tetapi juga mempengaruhi keinginan membeli para konsumen. Penelitian yang berdasarkan survei ini dilakukan untuk melihat dampak dari social eWOM terhadap brand attitude dan purchase intention Lip Cream merek Rollover Reaction. Structural Equation Modelling (SEM) digunakan untuk mengoleksi data 120 responden yang merupakan pengguna Instagram. Riset ini menemukan bahwa sosial eWOM positif dari pengguna instagram memiliki pengaruh terhadap brand attitude. Social eWOM positif&nbsp; juga memengaruhi&nbsp; purchase decision dari produk Lip Cream Rollover Reaction. Dari hasil temuan kami, ternyata brand attitude memiliki pengaruh terbesar terhadap purchase decision. Kata Kunci: Instagram, eWOM, Brand attitude, Purchase intention, Social eWO

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Nanotechnology in cosmetics: the legal challenges in Malaysia/ Siti Hanum Mohmad Sah, Masturina Mohamad Rodzi and Puteri NorNadia Mohamed Iqbal

This project paper on nanotechnology in cosmetic is written to observe the legal challenges arising from the development of the technology. The issue of nanotechnology arises due to the reason that despite the vast development of nanotechnology there is yet a complete research done on nanotechnology, on whether the technology is safe. Scientist worldwide has often expressed their concerns that nano-particles in cosmetic would have its own potential harm towards users. One of the major developments of nanotechnology is in the cosmetic industries where smaller particles work better. Our market search confirms that nano-cosmetic products are available on the market shelf despite the lacking in the legislation and research done. Our major research strategy is by a quantitative analysis and references are mainly obtained from the internet and scientific journals. Data have been collected from surveys conducted and published reports on nanotechnology in cosmetic and people's awareness on this matter. Response from the survey shows that 82% of respondents are unaware of any potential harm of nanocosmetic and the lack of law thereof. These situations confirm the low level of awareness among Malaysian on this issue and therefore boost the necessity for us to target on the legal challenges of nano-cosmetic

Predictive Modelling of Mobile Marketing Usage among Generation Y: A Preliminary Survey

This preliminary analysis examines mobile marketing usage among Generation Y. This study investigates the level of mobile marketing usage among Gen Y and to identify the relationships between attitude, subjective norm, perceived behavioural control, perceived risk, behavioural intention and actual usage. This study utilizes self-administered survey questionnaires by using 115 students from University Malaysia Kelantan. Overall, the results provides verification of a positive relationship between the constructs of attitude, subjective norm, perceived behavioural control and perceived risk on intention to use mobile marketing services