Documenting the Oral Narratives of Transient Punks

The uninitiated do not realize the complexity of the punk rock sub-culture. Outsiders may find it hard to distinguish the subtle lines by which differentiation occurs within the so-called subculture. The punk rock subculture is a misnomer; it is not a salient community. The experience of being punk is fractal; what it means to be punk and what classifies one as punk is in constant redefinition and there are various different communities with varying ideologies and identities. The punk subculture has absorbed various epistemologies in its 40+ years of existence, modified them, and made them their own. Within this milieu of experience there is a segment of the punk rock population that takes the anti-authoritarian, do-it-yourself ethos of the subculture to its logical conclusion: they drop out of society and hit the streets relying upon their wits, the good nature of strangers, and a vast interconnected support network of peers for their survival. There is very little documentation of the lives of this unique population and due to the precarious circumstance that they live in (i.e., the far margins of society), the risk of losing their history is a real threat. To understand why these punks became transient, one must ask them about their life history, ideological beliefs, views on life, family history, and personal experiences within the community (i.e., their story). My unit of analysis is the transient punk community. I have created a qualitative analysis of this community by collecting oral narratives of self identifying transients via participant observation. Data was collected by utilizing informal interviews and by snowball sampling

Walt Whitman in Trimming Square

Describes the location of historic "Trimming Square" where Whitman taught in 1839 and 1840 and offers a photograph of the school building

Impact and Cost-Effectiveness of Point-Of-Care CD4 Testing on the HIV Epidemic in South Africa.

Rapid diagnostic tools have been shown to improve linkage of patients to care. In the context of infectious diseases, assessing the impact and cost-effectiveness of such tools at the population level, accounting for both direct and indirect effects, is key to informing adoption of these tools. Point-of-care (POC) CD4 testing has been shown to be highly effective in increasing the proportion of HIV positive patients who initiate ART. We assess the impact and cost-effectiveness of introducing POC CD4 testing at the population level in South Africa in a range of care contexts, using a dynamic compartmental model of HIV transmission, calibrated to the South African HIV epidemic. We performed a meta-analysis to quantify the differences between POC and laboratory CD4 testing on the proportion linking to care following CD4 testing. Cumulative infections averted and incremental cost-effectiveness ratios (ICERs) were estimated over one and three years. We estimated that POC CD4 testing introduced in the current South African care context can prevent 1.7% (95% CI: 0.4% - 4.3%) of new HIV infections over 1 year. In that context, POC CD4 testing was cost-effective 99.8% of the time after 1 year with a median estimated ICER of US$4,468/DALY averted. In healthcare contexts with expanded HIV testing and improved retention in care, POC CD4 testing only became cost-effective after 3 years. The results were similar when, in addition, ART was offered irrespective of CD4 count, and CD4 testing was used for clinical assessment. Our findings suggest that even if ART is expanded to all HIV positive individuals and HIV testing efforts are increased in the near future, POC CD4 testing is a cost-effective tool, even within a short time horizon. Our study also illustrates the importance of evaluating the potential impact of such diagnostic technologies at the population level, so that indirect benefits and costs can be incorporated into estimations of cost-effectiveness

Surgical Infection Society Guidelines for Vaccination after Traumatic Injury

Background: Recommendations for vaccination of injured patients against infection are evolving. Newly-recognized infections, safety considerations, changing epidemiology, and redefinition of patient groups at risk are factors that may influence vaccine development priorities and recommendations for immunization. However, recommendations must often be formulated based on incomplete data, forcing reliance on expert opinion to address some crucial questions. These guidelines provide evidence-based recommendations for the prevention or treatment of infectious morbidity and mortality after traumatic injury, such as soft tissue wounds, human or animal bites, or after splenectomy. Methods: A panel of experts conducted a thorough review of published literature, as well as information posted on the internet at the websites of the U.S. Centers for Disease Control and Prevention, among others. MEDLINE was searched for the period 1966–2004 using relevant terms including anthrax, rabies, tetanus, tetanus toxoid, and splenectomy, in combination with vaccine and immunization. The Cochrane database was searched also. Reference lists were cross-referenced for additional relevant citations. All published reports were analyzed for quality and graded, with the strength of the recommendation proportionate to the quality of the supporting evidence. Results: Recommendations are provided for pre- and post-exposure prophylaxis of rabies and anthrax. For tetanus prophylaxis, recommendations are provided for prophylaxis of acute wounds stratified y age and prior immunization status, and for immunization of persons at high risk. After splenectomy, it is recommended that all persons ages 2–64 years receive 23- valent pneumococcal vaccine and meningococcal vaccine, with Haemophilus influenzae type B vaccine administered to high-risk patients as well (all are Grade D recommendations). Vaccination should be given two weeks before elective splenectomy (Grade C), or two weeks after emergency splenectomy (Grade D). A booster dose of pneumococcal vaccine is recommended after five years (Grade D); no re- vaccination recommendation is made for meningococcal or Haemophilus influenzae type B vaccine. Recommendations for prophylaxis of splenectomized children under the age of five years are also provided. Conclusion: There are limited data on the use of vaccines after injury. This document brings together a disparate literature of variable quality into a discussion of the infectious risks after injury relevant to vaccine administration, a summary of safety and adverse effects of vaccines, and evidence-based recommendations for vaccination

Bibliography of Oyster Research - Survey of the Major Oyster Fishery Reefs and Associated Organisms in Area M-6

A brief bibliography of reports applying to oyster research in the Galveston Bay system

Religion in the recovery journey of individuals with experience of psychosis

This study investigated the role of religion in recovery from psychosis. Semi-structured interviews explored the experiences of ten participants. Data analysis was informed by social constructionist grounded theory. Several processes through which religion may influence recovery were identified: use of scriptures and rituals; a genuine connection with God; the struggle to maintain rituals; guidelines for living; choice and control; relating to others; enhancing psychological well-being; and making sense of experiences. Implications are that services should address religious needs in promoting recovery. This could be achieved through environmental adaptations, collaboration with religious representatives and incorporation of religion into psychotherapeutic approaches