"It's Not Too Aggressive": Key Features of Social Branding Anti-Tobacco Interventions for High-Risk Young Adults.

Purpose. Peer crowd-targeted campaigns are a novel approach to engage high-risk young adults in tobacco use prevention and cessation. We elicited the perspectives of young adult key informants to understand how and why two social branding interventions were effective: (1) "COMMUNE," designed for "Hipsters" as a movement of artists and musicians against Big Tobacco, and (2) "HAVOC," designed for "Partiers" as an exclusive, smoke-free clubbing experience. Design. Qualitative study (27 semistructured qualitative phone interviews). Setting. Intervention events held in bars in multiple U.S. cities. Participants: Twenty-seven key informants involved in COMMUNE or HAVOC as organizers (e.g., musicians, event coordinators) or event attendees. Measures. We conducted semistructured, in-depth interviews. Participants described intervention events and features that worked or did not work well. Analysis. We used an inductive-deductive approach to thematically code interview transcripts, integrating concepts from intervention design literature and emergent themes. Results: Participants emphasized the importance of fun, interactive, social environments that encouraged a sense of belonging. Anti-tobacco messaging was subtle and nonjudgmental and resonated with their interests, values, and aesthetics. Young adults who represented the intervention were admired and influential among peers, and intervention promotional materials encouraged brand recognition and social status. Conclusion. Anti-tobacco interventions for high-risk young adults should encourage fun experiences; resonate with their interests, values, and aesthetics; and use subtle, nonjudgmental messaging

Medico-legal aspects of pathology - current dilemmas regarding confidentiality and disclosure

This article deals with confidentiality and disclosure in the practice of pathology in South Africa. The recent bringing into force of the National Health Act and the proposed implementation of the International Classification of Diseases (ICD 10) codes as well as the furore regarding the accuracy of HIV related mortality statistics emanating from death certificates has focused the spotlight on ethical and legal problems with regard to confidentiality. Medical confidentiality is a duty cast upon a medical practitioner/health care provider (HCP) to keep secret any information, whether relating to a patient's ailment or otherwise, obtained directly or indirectly by the practitioner as a result of the doctor patient relationship. Confidentiality is governed by the ethical rules of the profession and the law. The ethical rules are based on the principles of autonomy and the duty not to harm patients. Rule 20 of the Health Professions Council of South Africa (HPCSA) Ethical Code makes it ethical misconduct to breach confidentiality '…except with the express consent of the patient or, in the case of a minor under the age of 14 years, with the written consent of his or her parent or guardian, or in the case of a deceased patient, with the written consent of his or her next of kin or the executor of his or her estate.' The rule has recently been amplified by Ethical Rules 24 26 of the HPCSA.5 Legally, the confidentiality of patient information is prescribed in the Constitution, statute law and in the common law. Section 14 of the Constitution specifically protects people from unwanted and unnecessary disclosures of information. Section 14 of the new National Health Act1 (NHA) has specific provisions regarding confidentiality, and the common law has recognised an action for invasion of privacy for many years. All these privacy provisions have to be measured against the right of access to information in the Constitution and the Promotion of Access to Information Act

Characterizing Server Compromise: Resilience Models, Instantiations, and Impossibilities

One of the pervasive problems arising in our modern, digital world surrounds data breaches where an adversary, through zero-day exploitations, phishing, or old-fashioned social engineering attacks, gains access to a service’s data stores. Our society increasingly relies on these cloud-based services for everything from our taxes to personal communication. As many of these services, including those run by the government, often store biometric data such as fingerprints and other personally identifiable information, data breaches can cause immeasurable harm to a service’s userbase. Even when a service doesn’t store immediately harmful data on a user, the majority of authentication is mediated by passwords which are commonly recycled between different platforms. In these cases, one service’s breach can lead to breaches across many different services. It may not be immediately clear that we can even protect the server as, first glance, it may seem as if compromising a server’s data stores immediately leaks everything to the attacker. Even if some measure of post-breach security can be afforded, password-based authentication is doubly at risk as passwords come from some human memorable distribution and are considered to be of low complexity. This low complexity implies an inescapable attack where an adversary, who steals a server’s storage, can exhaustively run through a list of password guesses testing each one until it finds which one corresponds to a specific user. Since these so-called post-compromise dictionary attacks exist for all password-based authentication protocols we consider, it is incumbent on us to show that such exhaustive attacks are the best possible attack an adversary has. In this document, we undertake a characterization of party compromise, in the universal composability (UC) framework, in both the specific case of PAKE as well as the case of general secure two-party computation. To this end, we augment known results showing that we can restrict attackers to exhaustive attacks in the PAKE setting and extend these results to consider other PAKE modes such as typo-correcting password authentication. Along the way, we show that our notion of post-compromise security for authentication implies virtual black-box obfuscation. We then show that our strong notion of security is achievable for interactive evaluation of this class of functions; namely, those functions which already have virtual black-box obfuscations in idealized models. In pursuit of this result, we additionally construct a protocol for oblivious evaluation of a keyed group analogous to previous results for oblivious pseudorandom functions. We then show the applicability of our results by constructing efficient protocols achieving our strong notion of post-compromise security and show that previous protocols from the literature can be proven to achieve our definitions. This includes constructing the first pre-computation-resilient PAKE protocol from post-quantum assumptions and the first pre-computation-resilient PAKE protocol for fuzzy matching in the UC framework. As a secondary contribution, we provide the first (as far as we are aware) localized treatment of all UC models for post-compromise security in the PAKE setting, enumerating where previous models diverge and constructing explicit differentiators between them

Muscle Strength, Physical Activity, and Functional Limitations in Older Adults with Central Obesity

Background: Obesity and muscle weakness are independently associated with increased risk of physical and functional impairment in older adults. It is unknown whether physical activity (PA) and muscle strength combined provide added protection against functional impairment. This study examines the association between muscle strength, PA, and functional outcomes in older adults with central obesity. Methods: Prevalence and odds of physical (PL), ADL, and IADL limitation were calculated for 6,388 community dwelling adults aged ≥ 60 with central obesity. Individuals were stratified by sex-specific hand grip tertiles and PA. Logistic models were adjusted for age, education, comorbidities, and body-mass index and weighted. Results: Overall prevalence of PL and ADL and IADL limitations were progressively lower by grip category. Within grip categories, prevalence was lower for individuals who were active than those who were inactive. Adjusted models showed significantly lower odds of PL OR 0.42 [0.31, 0.56]; ADL OR 0.60 [0.43, 0.84], and IADL OR 0.46 0.35, 0.61] for those in the highest grip strength category as compared to those in the lowest grip category. Conclusion: Improving grip strength in obese elders who are not able to engage in traditional exercise is important for reducing odds of physical and functional impairment

Assessment of utilization of provider-initiated HIV testing and counseling as an intervention for prevention of mother to child transmission of HIV and associated factors among pregnant women in Gondar town, North West Ethiopia

<p>Abstract</p> <p>Background</p> <p>Detection of maternal HIV infection early in pregnancy is critical for prevention of mother to child transmission of HIV/AIDS. Most efforts have focused on VCT as the primary means of encouraging people to become aware of their HIV status. However, its uptake is low in many parts of sub-Saharan Africa including Ethiopia. Provider-initiated HIV testing and counseling provides a critical opportunity to diagnose HIV infection, to begin chronic care, and to prevent mother to child transmission. However, little is known about its acceptance and associated factors among pregnant women in the country and particularly in the present study area.</p> <p>Methods</p> <p>Health institution based cross-sectional quantitative study was conducted in Gondar town from July 22-August 18, 2010. A total of 400 pregnant women were involved in the study using stratified sampling technique and multiple logistic regression analysis was employed using SPSS version 16.</p> <p>Results</p> <p>A total of 400 pregnant women actively participated in this study and 330 (82.5%) of them accepted provider-initiated HIV testing and counseling to be tested for HIV and 70(17.5%) of them refused. Acceptance of provider-initiated HIV testing and counseling was positively associated with greater number of antenatal care visits [Adj. OR (95%CI)=2.64(1.17, 5.95)], residing in the urban areas[Adj. OR (95%CI)=2.85(1.10, 7.41)], having comprehensive knowledge on HIV [Adj. OR (95%CI)=4.30(1.72, 10.73)], positive partners reaction for HIV positive result [Adj. OR (95%CI)=8.19(3.57, 18.80)] and having knowledge on prevention of mother to child transmission of HIV[Adj. OR (95%CI)=3.27(1.34, 7.94)], but negatively associated with increased maternal age and education level.</p> <p>Conclusion</p> <p>Utilization of provider-initiated HIV testing and counseling during antenatal care was relatively high among pregnant women in Gondar town. Couple counseling and HIV testing should be strengthened to promote provider-initiated HIV testing and counseling among male partners and to reduce HIV related violence of women from their partner and access to and consistent use of antenatal care should be improved to increase the uptake of provider-initiated HIV testing and counseling service.</p

Compound-specific radiocarbon dating of the varved Holocene sedimentary record of Saanich Inlet, Canada

Author Posting. © American Geophysical Union, 2004. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Paleoceanography 19 (2004): PA2012, doi:10.1029/2003PA000927.The radiocarbon contents of various biomarkers extracted from the varve-counted sediments of Saanich Inlet, Canada, were determined to assess their applicability for dating purposes. Calibrated ages obtained from the marine planktonic archaeal biomarker crenarchaeol compared favorably with varve-count ages. The same conclusion could be drawn for a more general archaeal biomarker (GDGT-0), although this biomarker proved to be less reliable due to its less-specific origin. The results also lend support to earlier indications that marine crenarchaeota use dissolved inorganic carbon (DIC) as their carbon source. The average reservoir age offset ΔR of 430 years, determined using the crenarchaeol radiocarbon ages, varied by ±110 years. This may be caused by natural variations in ocean-atmosphere mixing or upwelling at the NE Pacific coast but variability may also be due to an inconsistency in the marine calibration curve when used at sites with high reservoir ages.This work was supported by the Netherlands Organization for Scientific Research (NWO) and NSF grants OCE-9907129 and OCE-0137005 (Eglinton)

Ubiquitous healthy diatoms in the deep sea confirm deep carbon injection by the biological pump

The role of the ocean as a sink for CO2 is partially dependent on the downward transport of phytoplankton cells packaged within fast-sinking particles. However, whether such fast-sinking mechanisms deliver fresh organic carbon down to the deep bathypelagic sea and whether this mechanism is prevalent across the ocean requires confirmation. Here we report the ubiquitous presence of healthy photosynthetic cells, dominated by diatoms, down to 4,000 m in the deep dark ocean. Decay experiments with surface phytoplankton suggested that the large proportion (18%) of healthy photosynthetic cells observed, on average, in the dark ocean, requires transport times from a few days to a few weeks, corresponding to sinking rates (124–732 m d−1) comparable to those of fast-sinking aggregates and faecal pellets. These results confirm the expectation that fast-sinking mechanisms inject fresh organic carbon into the deep sea and that this is a prevalent process operating across the global oligotrophic ocean

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P &lt; 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P &lt; 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk