Stigma, social reciprocity and exclusion of HIV/AIDS patients with illicit drug histories: A study of Thai nurses' attitudes

Background: Stigma is a key barrier for the delivery of care to patients living with HIV/AIDS (PLWHA). In the Asia region, the HIV/AIDS epidemic has disproportionately affected socially marginalised groups, in particular, injecting drug users. The effect of the stigmatising attitudes towards injecting drug users on perceptions of PLWHA within the health care contexts has not been thoroughly explored, and typically neglected in terms of stigma intervention. Methods: Semi-structured interviews were conducted with a group of twenty Thai trainee and qualified nurses. Drawing upon the idea of 'social reciprocity', this paper examines the constructions of injecting drug users and PLWHA by a group of Thai nurses. Narratives were explored with a focus on how participants' views concerning the high-risk behaviour of injecting drug use might influence their attitudes towards PLWHA. Results: The analysis shows that active efforts were made by participants to separate their views of patients living with HIV/AIDS from injecting drug users. While the former were depicted as patients worthy of social support and inclusion, the latter were excluded on the basis that they were perceived as irresponsible 'social cheaters' who pose severe social and economic harm to the community. Absent in the narratives were references to wider socio-political and epidemiological factors related to drug use and needle sharing that expose injecting drug users to risk; these behaviours were constructed as individual choices, allowing HIV positive drug users to be blamed for their seropositive status. These attitudes could potentially have indirect negative implications on the nurses' opinions of patients living with HIV/AIDS more generally. Conclusion: Decreasing the stigma associated with illicit drugs might play crucial role in improving attitudes towards patients living with HIV/AIDS. Providing health workers with a broader understanding of risk behaviours and redirecting government injecting drug policy to harm reduction are discussed as some of the ways for stigma intervention to move forward

Cultivation of mushroom (Volvariella volvacea) on banana leaves

Following the solid state fermentation of banana leaves (Musa sapientum lina) by lignin degrading mushroom (Volvariella volvacea), yield of fruiting bodies and compositional changes of the substrate were evaluated using a student parametric “T” test model. The biological efficiency was 5.21 while the total weight of fruit yield was 2.5 kg. The percentage biomass loss was 18.20%. The banana leaves treated with V. volvacea exhibited losses primarily in the polysaccharide components and with a greater percentage of the fibre components being degraded. The crude protein content was enhanced by theincubation of the mushroom due probably to the addition of microbial protein. The acid detergent lignin (ADL) was significantly reduced in the fungus treated sample. The acid detergent fibre (ADF) and neutral detergent fibre (NDF) followed similar trend but, the cellulose and hemicellulose increased. Thedevelopment of this simple technology is expected to improve the yield of mushroom as well as provide sustainable feed (spent substrate) for ruminant animals

Deformations of Topological Open Strings

Deformations of topological open string theories are described, with an emphasis on their algebraic structure. They are encoded in the mixed bulk-boundary correlators. They constitute the Hochschild complex of the open string algebra -- the complex of multilinear maps on the boundary Hilbert space. This complex is known to have the structure of a Gerstenhaber algebra (Deligne theorem), which is also found in closed string theory. Generalising the case of function algebras with a B-field, we identify the algebraic operations of the bulk sector, in terms of the mixed correlators. This gives a physical realisation of the Deligne theorem. We translate to the language of certain operads (spaces of d-discs with gluing) and d-algebras, and comment on generalisations, notably to the AdS/CFT correspondence. The formalism is applied to the topological A- and B-models on the disc.Comment: LaTeX 30 pages, corrected typo

抗Di(a)抗體引起新生兒嚴重溶血症的病例

Red cell allo-antibodies directed against the Diego (Di) blood group antigen have rarely been reported to cause a haemolytic reaction against transfusion or haemolytic disease of the newborn. The frequency of the Di(a+) phenotype among the Hong Kong Chinese population is estimated to be 4.4%. We report on a case of severe haemolytic disease of the newborn due to anti-Di(a) antibody--the first local case to the best of our knowledge. Rare but clinically significant antibodies targeting red blood cells have to be considered in the investigation of haemolytic disease of the newborn when common underlying factors have been eliminated.published_or_final_versio

Effects of Trichoderma-treated cassava waste in the diets of West African dwarf goat on blood, reproductive and urinary parameters

A study was conducted to evaluate effects of Trichoderma-treated cassava waste on the haemotology, reproductive and urinary parameters of West African dwarf (WAD) does. Twenty mature WAD does were allotted randomly to one four treatments using a completely randomized design arrangement. Does were individually fed the experimental diets containing 0, 20, 30 and 40% fungus treated cassava waste based diets (A, B, C and D, respectively) during the 56 days experiment. The blood parameters (PCV, Hb, RBC and WBC) of animals fed the tested diet compared with those fed the control diet are similar (p>0.05). Likewise, the pH, urea concentration of the urine were comparable (P>0.05) in does fed the experimental and control diets while the urobilinogen was normal across the diets. Fertility, fecundityand prolificacy rates showed better reproductive performance with diet D compared to that of diets A, B and C. These data indicate that addition of Trichoderma-treated cassava waste in the diet of goats hadno detrimental effect on the haematological, urinary and reproductive performances of lactating WAD does

Effect of biological and chemical preservatives on the shelf life of West African soft cheese

The effect of biological extracts on the storage qualities of West African soft cheese was evaluated in a completely randomized design model within a 15-day period. The control and the treated cheeses were stored under ambient temperature and assessed for the pH, titrable acidity, moisture content and crude protein. The pH and titrable acidity rose (P<0.05) with ginger extract preservant. The crude protein and moisture content were increased (P<0.05) by preservation. The ginger extract was found to be the most effective method of reducing microbial load, followed closely by the garlic extract. The ginger extract treatment extended the shelf life of cheese for 15 days. Treatment of West African soft cheese with ginger extract may not markedly alter the nutritional quality but appeared promising as it has a preservative property

Implementation of case management to reduce cardiovascular disease risk in the Stanford and San Mateo Heart to Heart randomized controlled trial: study protocol and baseline characteristics

BACKGROUND: Case management has emerged as a promising alternative approach to supplement traditional one-on-one sessions between patients and doctors for improving the quality of care in chronic diseases such as coronary heart disease (CHD). However, data are lacking in terms of its efficacy and cost-effectiveness when implemented in ethnic and low-income populations. METHODS: The Stanford and San Mateo Heart to Heart (HTH) project is a randomized controlled clinical trial designed to rigorously evaluate the efficacy and cost-effectiveness of a multi-risk cardiovascular case management program in low-income, primarily ethnic minority patients served by a local county health care system in California. Randomization occurred at the patient level. The primary outcome measure is the absolute CHD risk over 10 years. Secondary outcome measures include adherence to guidelines on CHD prevention practice. We documented the study design, methodology, and baseline sociodemographic, clinical and lifestyle characteristics of 419 participants. RESULTS: We achieved equal distributions of the sociodemographic, biophysical and lifestyle characteristics between the two randomization groups. HTH participants had a mean age of 56 years, 63% were Latinos/Hispanics, 65% female, 61% less educated, and 62% were not employed. Twenty percent of participants reported having a prior cardiovascular event. 10-year CHD risk averaged 18% in men and 13% in women despite a modest low-density lipoprotein cholesterol level and a high on-treatment percentage at baseline. Sixty-three percent of participants were diagnosed with diabetes and an additional 22% had metabolic syndrome. In addition, many participants had depressed high-density lipoprotein (HDL) cholesterol levels and elevated values of total cholesterol-to-HDL ratio, triglycerides, triglyceride-to-HDL ratio, and blood pressure. Furthermore, nearly 70% of participants were obese, 45% had a family history of CHD or stroke, and 16% were current smokers. CONCLUSION: We have recruited an ethnically diverse, low-income cohort in which to implement a case management approach and test its efficacy and cost-effectiveness. HTH will advance the scientific understanding of better strategies for CHD prevention among these priority subpopulations and aid in guiding future practice that will reduce health disparities