Suicide in Eastern Europe, the Commonwealth of Independent States, and the Baltic Countries: Social and Public Health Determinants

While suicide is a major public health problem worldwide, the countries of the former Soviet Union, including the Baltic States and the Commonwealth of Independent States (CIS), have some of the highest rates in the world. High suicide rates across Eastern Europe have been correlated with the post-Soviet transitional period and the societal changes associated with that transition. Many scholars have speculated that the sudden collapse of the paternalistic Soviet system and the introduction of a market economy - and the psychosocial distress that ensued.contributed to the suicide mortality crisis that most of the former Soviet republics experienced in the 1990s. It is unclear whether the transitional period has ended or is still ongoing. While suicide mortality rates in many countries have declined since then, they remain alarmingly high. In some countries, such as Belarus, the rates have increased. From September 14 to 15, 2010, suicidologists and other scholars and professionals with expertise in suicide and suicide prevention gathered in Tallinn, Estonia, to discuss the evidence base for social and public health determinants of suicide in the Baltic States, the CIS, and Eastern Europe. The participants identified research and data gaps that, if filled, would strengthen the foundation for developing effective suicide prevention policies and programs. This report summarizes the presentations and discussions that took place during the conference

Investigation of False Positive Results with an Oral Fluid Rapid HIV-1/2 Antibody Test

BACKGROUND: In March 2004, the OraQuick® rapid HIV antibody test became the first rapid HIV test approved by the US Food and Drug Administration for use on oral fluid specimens. Test results are available in 20 minutes, and the oral fluid test is non-invasive. From August 2004–June 2005, we investigated a sudden increase in false-positive results occurring in a performance study of OraQuick® oral-fluid rapid HIV tests in Minnesota. METHODOLOGY/PRINCIPAL FINDINGS: In a field investigation, we reviewed performance study data on oral-fluid and whole-blood OraQuick® rapid HIV test device lots and expiration dates and assessed test performance and interpretation with oral-fluid and whole-blood specimens by operators who reported false-positive results. We used multivariate logistic regression to evaluate client demographic and risk characteristics associated with false-positive results. Next, we conducted an incidence study of false-positive OraQuick rapid HIV tests in nine US cities and tested both oral-fluid and finger-stick whole-blood specimens from clients; reactive tests were confirmed with Western blot. Sixteen (4.1%) false-positive oral-fluid results occurred in the performance study from April 15, 2004 through August 31, 2004 with unexpired devices from six test lots among 388 HIV-uninfected clients (specificity, 95.9%; 95% CI: 93.4–97.6). Three test operators who had reported false-positive results performed and interpreted the test according to package-insert instructions. In multivariate analysis, only older age was significantly associated with false-positive results (adjusted odds ratio = 4.5, 95% CI: 1.2–25.7). In the incidence study, all valid oral-fluid and whole-blood results from 2,268 clients were concordant and no false-positive results occurred (100% specificity). CONCLUSIONS/SIGNIFICANCE: The field investigation did not identify a cause for the increase in false-positive oral-fluid results, and the incidence study detected no false-positive results. The findings suggest this was an isolated cluster; the test's overall performance was as specified by the manufacturer

Enrollment in HIV Care Two Years after HIV Diagnosis in the Kingdom of Swaziland: An Evaluation of a National Program of New Linkage Procedures

To improve early enrollment in HIV care, the Swaziland Ministry of Health implemented new linkage procedures for persons HIV diagnosed during the Soka Uncobe male circumcision campaign (SOKA, 2011–2012) and the Swaziland HIV Incidence Measurement Survey (SHIMS, 2011). Abstraction of clinical records and telephone interviews of a retrospective cohort of HIV-diagnosed SOKA and SHIMS clients were conducted in 2013–2014 to evaluate compliance with new linkage procedures and enrollment in HIV care at 92 facilities throughout Swaziland. Of 1,105 clients evaluated, within 3, 12, and 24 months of diagnosis, an estimated 14.0%, 24.3%, and 37.0% enrolled in HIV care, respectively, after adjusting for lost to follow-up and non-response. Kaplan-Meier functions indicated lower enrollment probability among clients 14–24 (P = 0.0001) and 25–29 (P = 0.001) years of age compared with clients > 35 years of age. At 69 facilities to which clients were referred for HIV care, compliance with new linkage procedures was low: referral forms were located for less than half (46.8%) of the clients, and few (9.6%) were recorded in the appointment register or called either before (0.3%) or after (4.9%) their appointment. Of over one thousand clients newly HIV diagnosed in Swaziland in 2011 and 2012, few received linkage services in accordance with national procedures and most had not enrolled in HIV care two years after their diagnosis. Our findings are a call to action to improve linkage services and early enrollment in HIV care in Swaziland

Analysing interactions in a teacher network forum: a sociometric approach

This article presents the sociometric analysis of the interactions in a forum of a social network created for the professional development of Portuguese-speaking teachers. The main goal of the forum, which was titled Stricto Sensu, was to discuss the educational value of programmes that joined the distance learning model in Brazil. The empirical study focused on the sociometrie analysis of the social interactions that take place in asynchronous online environments. This approach, according to literature, allows for new means to observe, analyse, and interpret the reality of a new social paradigm. This type of analysis tries to understand the relationship established between the different actors, seeking to verify if the roles they play in both the access to information and the construction of shared knowledge. The data collected allow the researchers to deduce that the indicators used in the analysis are important for understanding and intervening in the dynamics and functioning of the network to propose improvements in its structure and organisation. In the specific case of the aforementioned discussion forum, the results of the sociometrie analysis of the perceived interactions were not surprising, considering that the nature of the topic did not demand deep reflection to contribute to the debate.This work is funded by Portuguese Foundation for Science and Technology under the doctoral grant SFRH/BD/60677/2009

Scaling Consultative Selling with Virtual Reality: Design and Evaluation of Digitally Enhanced Services

Virtual, augmented, and mixed reality technologies allow creation of powerful customer experiences and illustrative demonstrations especially in use cases that benefit from spatial visualizations. Our study focuses on the natural resource management sector and digitalizing of consultative selling process. More specifically, we look at how to improve customer engagement with the use of virtual reality (VR) and thus digitally scale consultative selling. In this process, a VR application is used to demonstrate various management operations and their economic results. Design research methodology is applied to a pre-development phase and three application development iterations between 2016 and 2018. Data consists of user interviews and video observations (N = 129) during various development iterations and three application development plans. The results show that VR offers an emotionally engaging and illustrative tool in consultative selling. Further, it opens a novel way for interaction between the salesperson and customer and possibilities to scale consultative selling digitally, emphasizing the role of trust.Peer reviewe

Spatial autocorrelation analysis of health care hotspots in Taiwan in 2006

<p>Abstract</p> <p>Background</p> <p>Spatial analytical techniques and models are often used in epidemiology to identify spatial anomalies (hotspots) in disease regions. These analytical approaches can be used to not only identify the location of such hotspots, but also their spatial patterns.</p> <p>Methods</p> <p>In this study, we utilize spatial autocorrelation methodologies, including Global Moran's I and Local Getis-Ord statistics, to describe and map spatial clusters, and areas in which these are situated, for the 20 leading causes of death in Taiwan. In addition, we use the fit to a logistic regression model to test the characteristics of similarity and dissimilarity by gender.</p> <p>Results</p> <p>Gender is compared in efforts to formulate the common spatial risk. The mean found by local spatial autocorrelation analysis is utilized to identify spatial cluster patterns. There is naturally great interest in discovering the relationship between the leading causes of death and well-documented spatial risk factors. For example, in Taiwan, we found the geographical distribution of clusters where there is a prevalence of tuberculosis to closely correspond to the location of aboriginal townships.</p> <p>Conclusions</p> <p>Cluster mapping helps to clarify issues such as the spatial aspects of both internal and external correlations for leading health care events. This is of great aid in assessing spatial risk factors, which in turn facilitates the planning of the most advantageous types of health care policies and implementation of effective health care services.</p

Factors Associated with Refusal of Rapid HIV Testing in an Emergency Department

HIV screening studies in the emergency department (ED) have demonstrated rates of HIV test refusal ranging from 40–67%. This study aimed to determine the factors associated with refusal to undergo routine rapid HIV testing in an academic ED in Boston. HIV counselors offered routine testing to 1,959 patients; almost one-third of patients (29%) refused. Data from a self-administered survey were used to determine independent correlates of HIV testing refusal. In multivariate analysis, women and patients with annual household incomes of $50,000 or more were more likely to refuse testing, as were those who reported not engaging in HIV risk behaviors, those previously HIV tested and those who did not perceive a need for testing. Enrollment during morning hours was also associated with an increased risk of refusal. Increased educational efforts to convey the rationale and benefits of universal screening may improve testing uptake among these groups

The Leverage of Demographic Dynamics on Carbon Dioxide Emissions: Does Age Structure Matter?

This article provides a methodological contribution to the study of the effect of changes in population age structure on carbon dioxide (CO2) emissions. First, I propose a generalization of the IPAT equation to a multisector economy with an age-structured population and discuss the insights that can be obtained in the context of stable population theory. Second, I suggest a statistical model of household consumption as a function of household size and age structure to quantitatively evaluate the extent of economies of scale in consumption of energy-intensive goods, and to estimate age-specific profiles of consumption of energy-intensive goods and of CO2 emissions. Third, I offer an illustration of the methodologies using data for the United States. The analysis shows that per-capita CO2 emissions increase with age until the individual is in his or her 60s, and then emissions tend to decrease. Holding everything else constant, the expected change in U.S. population age distribution during the next four decades is likely to have a small, but noticeable, positive impact on CO2 emissions

Shaping the Future of Research: a perspective from junior scientists

The landscape of scientific research and funding is in flux as a result of tight budgets, evolving models of both publishing and evaluation, and questions about training and workforce stability. As future leaders, junior scientists are uniquely poised to shape the culture and practice of science in response to these challenges. A group of postdocs in the Boston area who are invested in improving the scientific endeavor, planned a symposium held on October 2 nd and 3 rd, 2014, as a way to join the discussion about the future of US biomedical research. Here we present a report of the proceedings of participant-driven workshops and the organizers’ synthesis of the outcomes