If someone cares about you, you are more apt to come around: improving HIV care engagement by strengthening the patient-provider relationship.

Purpose:The patient-provider relationship is a central factor that can promote or hinder long-term engagement in care among people living with chronic illnesses. In this paper, we explore characteristics of the patient-provider relationship that facilitated or hindered engagement in care among patients receiving care at HIV specialty clinics. Patients and methods:We conducted 6 focus group discussions with a total of 43 well-retained and less well-retained HIV+ patients in San Francisco, Seattle, and Birmingham, to elicit a wide range of perspectives on engagement in HIV care. Borrowing from the field of psychotherapy, we examined patient-provider relationship characteristics through the lens of the therapeutic alliance, and with regard to their therapeutic efficacy and impact on patient engagement. Results:The majority of participants emphasized how a strong patient-provider relationship defined by trust, intimacy, and collaboration promoted engagement, while a weak patient-provider relationship impeded engagement. Conclusion:We discuss practical strategies and therapeutic techniques that may be helpful to providers in building strong patient-provider relationship and contend that a strong patient-provider relationship is crucial for patients to feel cared for during clinical encounters, which can promote long-term and sustained engagement in HIV care

Ad Hoc Committee on CD-ROM Collections Report

Report of the Ad Hoc Committee on CD-ROM Collections of the University of Rhode Island Libraries. Presents recommendations for handling the acquisition, storage, circulation, cataloging, and processing of CD-ROM materials

The governance of personal data for COVID-19 response: perspective from the access to COVID-19 tools accelerator

COVID-19 is the world’s first digital pandemic. Digital tools and technologies have been developed to track and trace the spread of the virus, screen for infection, and the pandemic has accelerated the use of digital technology in the delivery of healthcare. The continued development of these tools and technologies, the monitoring of the virus and the development of new tests, treatments and vaccines are dependent on the collection of and access to vast amounts of personal data. This includes clinical data, epidemiological data and public health data that may be collected from laboratories, medical records, wearables and smartphone apps. Previous public health emergencies (PHEs) have demonstrated the importance in making this data available, and early in the COVID-19 pandemic, there were calls for making all kinds of data, including clinical trial data, routine surveillance data, genetic sequencing, and data on the ongoing monitoring of disease control programmes, openly and rapidly available. As part of this, personal data on age, race, sex, health, ethnic group, and socioeconomic factors have been shared. This has helped led to the rapid development of COVID-19 interventions. It has also enabled the better understanding of factors contributing to difference in infection rates and effectiveness of tests, treatments, and vaccines. However, the use of this particularly sensitive data can infringe upon individual and group privacy, increase the risks of individual and group stigma and discrimination, and it may negatively impact already vulnerable, marginalised or minority populations. [...

Electrical performance and reliability characterization of a SiC MOSFET power module with embedded decoupling capacitors

Integration of decoupling capacitors in SiC MOSFET modules is an advanced solution to mitigate the effect of parasitic inductance induced by module assembly interconnects. In this paper, the switching transient behavior is reported for a 1.2kV SiC MOSFET module with embedded DC-link capacitors. It shows faster switching transition and less overshoot voltage compared to a module using an identical package but without capacitors. Active power cycling and passive temperature cycling are carried out for package reliability characterization and comparisons are made with commercial Si and SiC power modules. Scanning acoustic microscopy images and thermal structure functions are presented to quantify the effects of package degradation. The results demonstrate that the SiC modules with embedded capacitors have similar reliability performance to commercial modules and that the reliability is not adversely affected by the presence of the decoupling capacitors

Cellulose crystallinity index: measurement techniques and their impact on interpreting cellulase performance

Although measurements of crystallinity index (CI) have a long history, it has been found that CI varies significantly depending on the choice of measurement method. In this study, four different techniques incorporating X-ray diffraction and solid-state 13C nuclear magnetic resonance (NMR) were compared using eight different cellulose preparations. We found that the simplest method, which is also the most widely used, and which involves measurement of just two heights in the X-ray diffractogram, produced significantly higher crystallinity values than did the other methods. Data in the literature for the cellulose preparation used (Avicel PH-101) support this observation. We believe that the alternative X-ray diffraction (XRD) and NMR methods presented here, which consider the contributions from amorphous and crystalline cellulose to the entire XRD and NMR spectra, provide a more accurate measure of the crystallinity of cellulose. Although celluloses having a high amorphous content are usually more easily digested by enzymes, it is unclear, based on studies published in the literature, whether CI actually provides a clear indication of the digestibility of a cellulose sample. Cellulose accessibility should be affected by crystallinity, but is also likely to be affected by several other parameters, such as lignin/hemicellulose contents and distribution, porosity, and particle size. Given the methodological dependency of cellulose CI values and the complex nature of cellulase interactions with amorphous and crystalline celluloses, we caution against trying to correlate relatively small changes in CI with changes in cellulose digestibility. In addition, the prediction of cellulase performance based on low levels of cellulose conversion may not include sufficient digestion of the crystalline component to be meaningful

Malaria treatment-seeking behaviour and recovery from malaria in a highland area of Kenya

<p>Abstract</p> <p>Background</p> <p>Malaria epidemics in highland areas of Kenya cause significant morbidity and mortality.</p> <p>Methods</p> <p>To assess treatment-seeking behaviour for malaria in these areas, a questionnaire was administered to 117 randomly selected households in the highland area of Kipsamoite, Kenya. Self-reported episodes of malaria occurred in 100 adults and 66 children.</p> <p>Results</p> <p>The most frequent initial sources of treatment for malaria in adults and children were medical facilities (66.0% and 66.7%) and local shops (19.0% and 30.3%). Adults and children who initially visited a medical facility for treatment were significantly more likely to recover and require no further treatment than those who initially went to a local shop (adults, 84.9% v. 36.8%, <it>P </it>< 0.0001, and children, 79.6% v. 40.0%, <it>P </it>= 0.002, respectively). Individuals who attended medical facilities recalled receiving anti-malarial medication significantly more frequently than those who visited shops (adults, 100% vs. 29.4%, and children, 100% v. 5.0%, respectively, both <it>P </it>< 0.0001).</p> <p>Conclusion</p> <p>A significant proportion of this highland population chooses local shops for initial malaria treatment and receives inappropriate medication at these localshops, reslting in delay of effective treatment. Shopkeeper education has the potential to be a component of prevention or containment strategies for malaria epidemics in highland areas.</p

Detection of efflux pump activity among clinical isolates of Staphylococcus and Micrococcus species

Purpose: To detect efflux pump activity (EPA) and screening a suspected efflux pump inhibitor (EPI) [1- (3-(trifluoromethyl)benzyl]-piperazine (TFMBP)], which could help in reducing multi-drug resistance (MDR).Methods: Eighteen isolates, viz, 14 S. aureus, 2 S. lentus, 1 S. xylosus and 1 Micrococcus species from various hospital infections of admitted patients were screened for antibiotics susceptibility to 11 classes of antibiotics including oxacillin and β-lactamase production. Efflux pump activity (EPA) was determined by minimum inhibitory concentration (MIC) technique in the presence and absence of TFMBP, the isolates were also screened for MDR genes.Results: All the isolates were resistant to ampicillin (10 μg) and penicillin (10 μg), but sensitive to bacitracin (10 μg). Majority of the isolates were MDR 12/18 (66.7 %), 10 (55.6 %) were inducible β- lactamase producers and 3 (16.7 %) were intrinsic β-lactamase producers. Seven (38.9 %) were resistant to oxacillin and also produced carbapenemase enzyme. Eight (66.7 %) of the 12 MDR isolates gave evidence of EPA with TFMBP. However, no MDR genes were detected.Conclusion: Staphylococcus and Micrococcus species exhibit EPA in antibiotic resistance while a suitable EPI such as TFMBP when combined with specific antibiotics could help combat this menace.Keywords: [1-(3-(Trifluoromethyl)benzyl]-piperazine, Efflux pump activity, Oxacillin resistant S. aureus, Multidrug resistant, Carbapenemas