National HIV surveillance in South Africa - 1993 - 1995

Objective. To determine the point prevalence of HIV infection by serological examination which, performed consistently over several years, serves to monitor the distribution and trend of the HIV epidemic in South Africa.Design. Annual cross-sectional surveys conducted nationally in October/November.Setting. South Africa, including areas that used to be known as self-governing and independent national states.Subjects. Pregnant women in the age group 15 - 49 years who attend antenatal clinic services provided by the public health services.Outcome measures. HIV positivity as determined serologically.Results. The rising trend found previously continues: HIV positivity in South Africa was found to be 4.25% in 1993, 7.57% in 1994 and 10.44% in 1995. In 1995 the highest rate was recorded in KwaZulu-Natal (18.23%) and the lowest in the Western Cape (1.66%).On the basis of certain assumptions it is estimated that these rates are indicative of 1.7 million sexually active adults having been infected with HIV by October/ November 1995, plus a cumulative total of 40 000 infants. Women in their 20s had the highest age-specific prevalence rates, viz. 13.12% (20 - 24 years) and 11.03% (25 - 29 years). HIV positivity in pregnant teenagers was 9.5%.Conclusions. The HIV epidemic is firmly established in South Africa with a wide variation in provincial prevalence rates. Of particular public health significance is the finding of a high and rising prevalence rate in pregnant teenagers. The observed prevalence rate for 1995 is lower than expected, giving rise to guarded hope that provinces with the highest recorded rates are moving away from the exponential growth found hitherto

The South African HIV epidemic, reflected by nine provincial epidemics, 1990 -1996

Objectives. To determine by serological examination the annual point prevalence rates of infection with the human immunodeficiency virus (HIV) in representative samples of subjects in the nine provinces of South Africa, 1990 - 1996.Design. Annual cross-sectional point prevalence surveys conducted in October/November of each year.Setting. South Africa, induding areas that used to be known as self-governing and independent ational States.Subjects. Pregnant women in the age group 15 - 49 years who attend antenatal clinic services provided by the public health services, and who act as an indicator group of the HIV epidemic among the heterosexually active population.Outcome measures. HIV positivity as determined serologically; done consistently over several years, this serves to monitor the distribution and trend of the HIV epidemic in each of the nine provinces of South Africa,Results. Empirical data gained from seven annual, consecutive countrywide surveys demonstrate a wide geographical variation in the point prevalence rates of HIV infection. In October/November 1996 the point prevalence rates (%) were as follows: Western Cape 3.09, Northern Cape 657, Northern Province 7.96, Eastern Cape 8.10, Gauteng 15.49, Mpurnalanga 15.77, Free State 17.49, KwaZulu-Natal 19.90 and orth West 25.13. The weighted national average was 14.17%. There are indications that some of the provinces (KwaZulu-Natal and possibly Mpumalanga) might have passed a point of inflection suggesting deceleration in their specific rates of increase. These results are, however, counterbalanced by the exponential growth still being experienced in provinces with large populations such as Gauteng and the Eastern Cape. It is concluded that the net effect of these divergent trends currently affects the national figure only marginally. A major deflection from the exponential growth patterns seen hitherto can be anticipated only once all or most of the highly populated provinces have traversed their respective points of inflection.The exponential model significantly explains the HIV epidemics in the provinces. The combination of these provincial epidemics describes the initial exponential phase of the epidemic

Textbook on Scar Management

This text book is open access under a CC BY 4.0 license. Written by a group of international experts in the field and the result of over ten years of collaboration, it allows students and readers to gain to gain a detailed understanding of scar and wound treatment – a topic still dispersed among various disciplines. The content is divided into three parts for easy reference. The first part focuses on the fundamentals of scar management, including assessment and evaluation procedures, classification, tools for accurate measurement of all scar-related elements (volume density, color, vascularization), descriptions of the different evaluation scales. It also features chapters on the best practices in electronic-file storage for clinical reevaluation and telemedicine procedures for safe remote evaluation. The second section offers a comprehensive review of treatment and evidence-based technologies, presenting a consensus of the various available guidelines (silicone, surgery, chemical injections, mechanical tools for scar stabilization, lasers). The third part evaluates the full range of emerging technologies offered to physicians as alternative or complementary solutions for wound healing (mechanical, chemical, anti-proliferation). Textbook on Scar Management will appeal to trainees, fellows, residents and physicians dealing with scar management in plastic surgery, dermatology, surgery and oncology, as well as to nurses and general practitioners ; Comprehensive reference covering the complete field of wounds and scar management: semiology, classifications and scoring Highly educational contents for trainees as well as professionals in plastic surgery, dermatology, surgery, oncology as well as nurses and general practitioners Fast access to information through key points, take home messages, highlights, and a wealth of clinical cases Book didactic contents enhanced by supplementary material and video

National HIV surveillance - South Africa, 1990 - 1992

The findings of three annual surveys of women attending antenatal clinics (at the end of 1990,1991 and 1992) are presented here. These surveys form part of the National HIV Surveillance Programme. This programme is probably the most usefulmeans of monitoring the trend and distribution of the epidemic. In all strata, a consistent rise in the HIV prevalence rate was found; it doubled almost every 12 months. The point prevalence rate in antenatal clinic attenders in South Africa increased from 0,76% in 1990 to 1,49% in 1991 and 1,49% in 1992. The prevalence rate was found to vary widely geographically: Natal/KwaZulu formed the spearhead of the epidemic with a 4,77% rate of HIV infection in 1992. Venda and the Capeappeared to be the least affected with rates of 0,64% and 0,66% respectively

The Effect of a Reduction in Phosphate Application on Soil Phosphate Pools

Excessive use of manure and fertilisers in western Europe has led to high phosphorus (P) contents in many agricultural soils leading to environmental P losses by overland flow, subsurface drainage and leaching to groundwater. To stop phosphate build up in the soil and leaching to surface and ground waters, the Dutch government is gradually reducing allowable phosphate application on grassland from 130 kg/ha per year in 2005 to 90 kg/ha per year in 2015. This will lead to a reduction of the phosphate surplus from 40 in 2005 to 0 kg/ha per year. To investigate the impact of reductions in application rates on soil phosphate, leaching and grass production, a field experiment was started in 1997 on four dairy farms on two sandy soils, a peat and a clay soil

Коментарі Валерія Шевчука в літописі Самійла Величка як позатекстова інтерпретація давньоукраїнської пам'ятки

У статті розглядаються різновиди коментарів як позатекстової інтерпретації Валерієм Шевчуком барокової пам’ятки – Літопису Самійла Величка.The article deals with Valery Shevchuk’s way of varieties of the commentaries as out-of-text interpretation of Baroque remembrance of Chronicle of Samiylo Velitchko

Participatory scenario development for integrated assessment of nutrient flows in a Catalan river catchment

Rivers in developed regions are under significant stress due to nutrient enrichment generated mainly by human activities. Excess nitrogen and phosphorus emissions are the product of complex dynamic systems influenced by various factors such as demographic, socio-economic and technological development. Using a Catalan river catchment, La Tordera (North-East of Spain), as a case study of an integrated and interdisciplinary environmental assessment of nutrient flows, we present and discuss the development of narrative socio-economic scenarios through a participatory process for the sustainable management of the anthropogenic sources of nutrients, nitrogen and phosphorus. In this context, scenarios are an appropriate tool to assist nutrient emissions modelling, and to assess impacts, possible pathways for socio-economic development and associated uncertainties. Evaluated against the 1993–2003 baseline period, scenarios target the 2030 horizon, i.e. through the implementation process of the Water Framework Directive (Directive 2000/60/EC). After a critical examination of the methodology used in the participatory development of socio-economic scenarios, we present four possible futures (or perspectives) for the Catalan river catchment conceived by stakeholders invited to a workshop. Keys to the success of such a participatory process were trust, which enhanced openness, and disagreements, which fostered the group's creativity for scenario development. The translation of narrative socio-economic scenarios into meaningful nutrient emission scenarios is also discussed. By integrating findings of natural sciences and socio-economic analysis, we aim to assist decision makers and stakeholders in evaluating optimal management strategies for the anthropogenic sources of nitrogen and phosphorus

Carbohydrate metabolism in twin pregnancy

Carbohydrate metabolism was evaluated in 26 women with a twin pregnancy and 26 women with a singleton pregnancy. The groups were similar in respect of age, parity and gestational age. Each woman had an oral glucose tolerance test. Nosignificant differences in venous blood sugar values or insulin responses were found between singleton and twin pregnancies