It Takes a Village: Perspectives from a Multidisciplinary Team Addressing the Needs of HIV+ Refugees in Canada

This study explored the perspectives of a multidisciplinary team at an HIV clinic in Canada mandated with addressing the diverse needs experienced by their HIV+ refugee clients. Specifically, the study sought to identify barriers and facilitators to effective service provision for refugee persons living with HIV/AIDS (PHAs) in the context of a multidisciplinary team. Data were acquired using qualitative methods. Individual interviews were conducted with a sample of seven service providers who work directly with HIV+ refugees on a multidisciplinary team at an HIV clinic in Canada. Respondents identified a need for improved community services for HIV+ refugees, specifically legal aid and service from immigration doctors and pharmacies.Cultural and linguistic issues also shaped respondents’ work with refugees; suggestions for addressing these issues included HIV-related and culturally competent training. Implications for policy, practice, and research are included.Cette étude a exploré les points de vue d’une équipe multidisciplinaire dans une clinique du VIH au Canada ayant pour mandat de répondre aux divers besoins de leurs clients séropositifs. Plus précisément, l’étude a cherché à identifier les obstacles et les possibilités à l’égard de la prestation de services efficaces pour les personnes réfugiées vivant avec le VIH/sida (PVVIH) dans le cadre d’une équipe multidisciplinaire. Les données ont été recueillies en utilisant des méthodes qualitatives. Des entretiens individuels ont été menés auprès d’un échantillon de sept intervenants travaillant directement avec des réfugiés séropositifs au sein d’une équipe multidisciplinaire dans une clinique du VIH au Canada. Les répondants ont identifié un besoin d’amélioration des services communautaires pour réfugiés séropositifs, en particulier de l’aide juridique et des services de médecins et de pharmacies à l’immigration. Les questions culturelles et linguistiques agissent aussi sur le travail des répondants avec les réfugiés; une formation culturellement compétente liée au VIH fi gure parmi les suggestions pour traiter de ces questions. Les incidences pour la politique, la pratique et la recherche sont aussi discutées

Ecosystem Studies at Cedar Creek Natural History Area, III: Water Use Studies

Previous articles in this series (Lawrence et al. 1957-58, 1960) have dealt with the nature of ecosystems, history of the ecosystem analysis approach, and some of the objectives and the methods that have been used at the Cedar Creek Natural History Area of the University of Minnesota and the Minnesota Academy of Science. The area, which was acquired in large part through a generous grant from the Fleischmann Foundation, is located in Anoka and Isanti Counties in east central Minnesota. The work has been generously supported by the Hill Family Foundation since the early summer of 1957. One main objective has been to learn what becomes of the solar energy striking the landscape. It has been estimated from studies elsewhere that a rather large portion, probably over half of the energy which strikes a given level area, is expended in evaporation from non-living surfaces of open water and moist soil, and in transpiration from living plant surfaces. The combined vaporization is called evapotranspiration. The Cedar Creek area is especially well suited for studying these water losses, or uses as we shall consider them here, because such a large variety of surfaces occur in close proximity to one another, and because water surface is exposer in ponds and the water table is usually at the surface or within a few inches of the surface in willow, alder, and tamarack swamps

Improved test of Lorentz Invariance in Electrodynamics using Rotating Cryogenic Sapphire Oscillators

We present new results from our test of Lorentz invariance, which compares two orthogonal cryogenic sapphire microwave oscillators rotating in the lab. We have now acquired over 1 year of data, allowing us to avoid the short data set approximation (less than 1 year) that assumes no cancelation occurs between the $\tilde{\kappa}_{e-}$ and $\tilde{\kappa}_{o+}$ parameters from the photon sector of the standard model extension. Thus, we are able to place independent limits on all eight $\tilde{\kappa}_{e-}$ and $\tilde{\kappa}_{o+}$ parameters. Our results represents up to a factor of 10 improvement over previous non rotating measurements (which independently constrained 7 parameters), and is a slight improvement (except for $\tilde{\kappa}_{e-}^{ZZ}$) over results from previous rotating experiments that assumed the short data set approximation. Also, an analysis in the Robertson-Mansouri-Sexl framework allows us to place a new limit on the isotropy parameter $P_{MM}=\delta-\beta+{1/2}$ of $9.4(8.1)\times10^{-11}$, an improvement of a factor of 2.Comment: Accepted for publication in Phys. Rev.

Statistical analysis plan for the Stroke Oxygen Study (SO₂S): a multi-center randomized controlled trial to assess whether routine oxygen supplementation in the first 72 hours after a stroke improves long-term outcome.

BACKGROUND: The Stroke Oxygen Study (SO₂S) is a multi-center randomized controlled trial of oxygen supplementation in patients with acute stroke. The main hypothesis for the trial is that fixed-dose oxygen treatment during the first 3 days after an acute stroke improves outcome. The secondary hypothesis is that restricting oxygen supplementation to night time only is more effective than continuous supplementation. This paper describes the statistical analysis plan for the study. METHODS AND DESIGN: Patients (n = 8000) are randomized to three groups: (1) continuous oxygen supplementation for 72 hours; (2) nocturnal oxygen supplementation for three nights; and (3) no routine oxygen supplementation. Outcomes are recorded at 7 days, 90 days, 6 months, and 12 months. The primary outcome measure is the modified Rankin scale at 90 days. Data will be analyzed according to the intention-to-treat principle. Methods of statistical analysis are described, including the handling of missing data, the covariates used in adjusted analyses, planned subgroups analyses, and planned sensitivity analyses. TRIAL REGISTRATION: This trial is registered with the ISRCTN register, number ISRCTN52416964 (30 September 2005)

Febuxostat, an Inhibitor of Xanthine Oxidase, Suppresses Lipopolysaccharide-Induced MCP-1 Production via MAPK Phosphatase-1-Mediated Inactivation of JNK.

Excess reactive oxygen species (ROS) formation can trigger various pathological conditions such as inflammation, in which xanthine oxidase (XO) is one major enzymatic source of ROS. Although XO has been reported to play essential roles in inflammatory conditions, the molecular mechanisms underlying the involvement of XO in inflammatory pathways remain unclear. Febuxostat, a selective and potent inhibitor of XO, effectively inhibits not only the generation of uric acid but also the formation of ROS. In this study, therefore, we examined the effects of febuxostat on lipopolysaccharide (LPS)-mediated inflammatory responses. Here we show that febuxostat suppresses LPS-induced MCP-1 production and mRNA expression via activating MAPK phosphatase-1 (MKP-1) which, in turn, leads to dephosphorylation and inactivation of JNK in macrophages. Moreover, these effects of febuxostat are mediated by inhibiting XO-mediated intracellular ROS production. Taken together, our data suggest that XO mediates LPS-induced phosphorylation of JNK through ROS production and MKP-1 inactivation, leading to MCP-1 production in macrophages. These studies may bring new insights into the novel role of XO in regulating inflammatory process through MAPK phosphatase, and demonstrate the potential use of XO inhibitor in modulating the inflammatory processes

Coding accuracy for Parkinson's disease hospital admissions:implications for healthcare planning in the UK

ObjectivesHospital Episode Statistics data are used for healthcare planning and hospital reimbursements. Reliability of these data is dependent on the accuracy of individual hospitals reporting Secondary Uses Service (SUS) which includes hospitalisation. The number and coding accuracy for Parkinson's disease hospital admissions at a tertiary centre in Birmingham was assessed.Study designRetrospective, routine-data–based study.MethodsA retrospective electronic database search for all Parkinson's disease patients admitted to the tertiary hospital over a 4-year period (2009–2013) was performed on the SUS database using International Classification of Disease codes, and on the local inpatient electronic prescription database, Prescription and Information Communications System, using medication prescriptions. Capture-recapture methods were used to estimate the number of patients and admissions missed by both databases.ResultsFrom the two databases, between July 2009 and June 2013, 1068 patients with Parkinson's disease accounted for 1999 admissions. During these admissions, the Parkinson's disease was coded as a primary or secondary diagnosis. Ninety-one percent of these admissions were recorded on the SUS database. Capture-recapture methods estimated that the number of Parkinson's disease patients admitted during this period was 1127 patients (95% confidence interval: 1107–1146). A supplementary search of both SUS and Prescription and Information Communications System was undertaken using the hospital numbers of these 1068 patients. This identified another 479 admissions. SUS database under-estimated Parkinson's disease admissions by 27% during the study period.ConclusionThe accuracy of disease coding is critical for healthcare policy planning and must be improved. If the under-reporting of Parkinson's disease admissions on the SUS database is repeated nationally, expenditure on Parkinson's disease admissions in England is under-estimated by approximately £61 million per year

Creating the cultures of the future: cultural strategy, policy and institutions in Gramsci. Part three: Is there a theory of cultural policy in Gramsci’s prison notebooks?

In this article, I argue that Gramsci’s prison notes on questions of cultural strategy, policy and institutions, which have so far been largely overlooked by scholars, provide further analytical insights to those offered by his more general concepts. Together they enrich the theoretical underpinnings for critical frameworks of analysis as well as for radical practices of cultural strategy, cultural policy-making and cultural organisation. On the basis of a detailed analysis of these notes, I then answer the question of whether they amount to a theory of cultural policy

Test of Lorentz Invariance in Electrodynamics Using Rotating Cryogenic Sapphire Microwave Oscillators

We present the first results from a rotating Michelson-Morley experiment that uses two orthogonally orientated cryogenic sapphire resonator-oscillators operating in whispering gallery modes near 10 GHz. The experiment is used to test for violations of Lorentz Invariance in the frame-work of the photon sector of the Standard Model Extension (SME), as well as the isotropy term of the Robertson-Mansouri-Sexl (RMS) framework. In the SME we set a new bound on the previously unmeasured $\tilde{\kappa}_{e-}^{ZZ}$ component of $2.1(5.7)\times10^{-14}$, and set more stringent bounds by up to a factor of 7 on seven other components. In the RMS a more stringent bound of $-0.9(2.0)\times 10^{-10}$ on the isotropy parameter, $P_{MM}=\delta - \beta + {1/2}$ is set, which is more than a factor of 7 improvement. More detailed description of the experiment and calculations can be found in: hep-ph/0506200Comment: Final published version, 4 pages, references adde