A lottery incentive system to facilitate dialogue and social support for workplace HIV counselling and testing: A qualitative inquiry

Despite South African mid-sized companies’ efforts to offer HIV counselling and testing (HCT) in the workplace, companies report relatively poor uptake rates. An urgent need for a range of different interventions aimed at increasing participation in workplace HCT has been identified. The aim of this study was to explore qualitatively the influence of a lottery incentive system (LIS) as an intervention to influence shop-floor workers’ workplace HIV testing behaviour. A qualitative study was conducted among 17 shop-floor workers via convenience sampling in two mid-sized South African automotive manufacturing companies in which an LIS for HCT was implemented. The in-depth interviews employed a semi-structured interview schedule and thematic analysis was used to analyse the data. The interviews revealed that the LIS created excitement in the companies and renewed employees’ personal interest in HCT. The excitement facilitated social interactions that resulted in a strong group cohesion pertaining to HCT that mitigated the burden of HIV stigma in the workplace. Open discussions allowed for the development of supportive social group pressure to seek HCT as a collective in anticipation of a reward. Lotteries were perceived as a supportive and innovative company approach to workplace HCT. The study identified important aspects for consideration by companies when using an LIS to enhance workplace HIV testing. The significance of inter- and intra-player dialogue in activating supportive social norms for HIV testing in collectivist African contexts was highlighted.Keywords: HCT, company, collectivist, group pressure, norm, South AfricaMalgre´ les efforts que font les petites et moyennes entreprises sud-africaines pour offrir le conseil et de´pistage volontaire du VIH (CDV) en milieu de travail, les entreprises font e´tat de taux de participation relativement bas. Un besoin urgent pour une gamme de diffe´rentes interventions visant a` accroıˆtre la participation au CDV en milieu de travail a e´te´ identifie´e. Le but de cette e´tude e´tait d’e´tudier qualitativement l’influence d’un syste`me d’incitation a` la loterie comme intervention pour influencer le comportement CDV des ouvriers en milieu de travail. Une e´tude qualitative a e´te´ mene´e aupre`s de 17 ouvriers choisis par e´chantillonnage de commodite´ dans 2 entreprises de fabrication automobile en Afrique du Sud. Dans ces 2 entreprises de taille moyenne, un syste`me d’incitation a` la loterie a e´te´ mis en oeuvre pour encourager le CDV en milieu de travail. Un guide d’interviews semistructure ´es a e´te´ employe´ pour mener des entretiens approfondis. L’analyse the´matique a e´te´ utilise´e pour analyser les donne´es. Les entrevues ont re´ve´le´ que les syste`mes d’incitation ont cre´e´ de l’excitation dans les entreprises et ont renouvele´ l’inte´reˆt personnel des employe´s pour le CDV. L’excitation a facilite´ des interactions sociales qui ont abouti a` une forte cohe´sion du groupe d’ouvriers concernant le CDV et atte´nuant ainsi la stigmatisation lie´e au VIH en milieu de travail. Des discussions ouvertes ont permis l’e´laboration de pression sociale de groupe en support a` la participation collective au CDV en pre´vision d’une re´compense. Les loteries ont e´te´ perc¸ues comme une approche soutenante et innovante de la part des entreprises pour le CDV en milieu de travail. L’e´tude a identifie´ des aspects importants a` prendre en compte par les entreprises lors de l’utilisation d’un syste`me d’incitation a` la loterie pour augmenter le taux de de´pistage VIH en milieu de travail. L’importance du dialogue inter- et intra-joueur dans l’activation de normes sociales favorables pour le de´pistage VIH dans les contextes collectivistesafricains a e´te´ souligne´e.Mots cle´s: CDV, entreprise, collectiviste, pression de groupe, norme, Afrique du Su

Prevalence patterns and predictors of alcohol use and abuse among secondary school students in southern KwaZulu-Natal, South Africa: demographic factors and the influence of parents and peers

Background: The prevalence and predictors of alcohol use and abuse among school students were investigated with the aim of gaining insight to guide prevention interventions.Method: A cross-sectional, self-administered survey pertaining to a one-month period was conducted among students in grades 11 and 12 in purposively selected schools with mixed-race groups. Frequencies and ÷2 analyses were conducted and forward stepwise, conditional entry logistic regression models were fitted to determine the significant demographicpredictors and influence of peers and parents on students’ alcohol use and binge drinking.Results: About 54% of students had used alcohol before, while 14.5% had had their first drink before the age of 13. In the relevant month, 41% used alcohol and 32% engaged in binge drinking. Students who were more likely to have used alcohol in the preceding month were older [odds ratio (OR) = 1.44, P = 0.006], male (OR = 2.1, P < 0.001), white (OR = 5.1,P < 0.001), had often seen their fathers drunk (OR = 1.9, P < 0.001) and had friends who frequently use alcohol (OR = 3.5, P < 0.001). Students who were more likely to report binge drinking in the preceding month were older (OR = 1.6, P < 0.001), male (OR = 2.4, P < 0.001), white (OR = 1.6, P = 0.048), had often seen their fathers (OR = 1.5, P = 0.001) and mothers (OR = 1.4, P = 0.05) drunk and had friends who frequently use alcohol (OR = 3.6, P < 0.001).Conclusion: The long-term consequences of hazardous drinking patterns initiated during adolescence may have negative effects on achievement in life, health and general well-being, and therefore these patterns are in need of urgent address. While older, white male students are at particular risk, the significant influence of peer and parental alcohol use is  highlighted and should be considered when developing prevention interventions in schools

Determinants of communication between partners about STD symptoms: implications for partner referral in South Africa

BackgroundSTDs as preventable diseases are a major public health problem in South Africa, both in terms of their effect on quality of life, their economic costs and the fact that STDs as co-factors drive the HIV epidemic. Their widespread occurrence and high prevalence rates are cause for concern. It is argued that the duration of infection increases the probability of harmful sequelae and STD transmission, including HIV, to others. The promotion of seeking health care for STD symptoms at an early stage and partner referral for STD treatment are important strategies in preventing STD transmission to others and re-infection of partners. The cost implications of contact tracing by healthcare workers has resulted in patients being encouraged to refer their partners for STD treatment. This has not always been effective, despite efforts to improve partner referral rates by improved “contact cards” (i.e. a card with a code representing the STD that the patient has been treated for to be given to sexual partners as a way to speed up treatment) and more accessible healthcare services. Other studies have found that the proportion of clients who present with contact cards at STD services ranged from about 2% to 39%, while the proportion of partners who were referred for treatment range from 16% to 30%. Mathews et al. argue that returning contact cards might not be a sensitive enough proxy indicator for partner referral rates.Partner referrals have been found to be seriously compromised by patients' causal explanations for STDs, as well as by the unequal power of the genders in sexual relationships, which impacts on the patients' ability to communicate about sexual matters. Patients often lack an understanding of the importance of referring their asymptomatic partners for treatment. Women's inability to discuss sexual issues due to their unequal status in sexual relationships might impact on partner referral behaviour. Men have been found to blame the STD on the “outside women” (sexual partners outside the primary relationship) and are therefore less likely to refer these partners. The conflict that could arise from informing a partner about an STD was viewed by men as a reason not to communicate about having a STD.While the ability to communicate about STDs with sexual partners is an essential prerequisite for referring them for medical treatment, little attention has been paid to understanding this process. This study is aimed at gaining some understanding of the determinants of communication between partners about STD symptoms. In this study, “talking with a partner about STD symptoms” before seeking medical treatment was viewed as an indication of the likelihood of future partner referral behaviour.Methods A randomly selected sample of 1 477 patients with STD symptoms was interviewed using a structured questionnaire. Logistic regression analysis was used to identify the determinants of talking to a partner about the present STD.ResultsIt was found that patients who had talked with their partner about their current STD symptoms were more likely to be female, be employed, have a tertiary level of education, have had only one sexual partner in the preceding six months, have used condoms, albeit inconsistently during the last six months, and to have thought about abstaining from sex while infected. Those who talked were also more likely to have good knowledge about the effects of STDs and the transmission of STDs in the absence of symptoms, had positive attitudes towards condoms and perceived social support for partner referral.ConclusionImproved partner referral through health education interventions needs to focus specifically on a subgroup of patients, e.g. men and the unemployed, and on the improvement of knowledge regarding the consequences of STDs and asymptomatic transmission. Social and partner support for partner referral and perceived self-efficacy in this regard should be encouraged and maintained. In the absence of skills and counselling services to manage the consequences of STD partner referral, this prevention strategy will remain vulnerable.For full text, click here:SA Fam Pract 2006;48(7):17-17

Multiple light scattering in anisotropic random media

In the last decade Diffusing Wave Spectroscopy (DWS) has emerged as a powerful tool to study turbid media. In this article we develop the formalism to describe light diffusion in general anisotropic turbid media. We give explicit formulas to calculate the diffusion tensor and the dynamic absorption coefficient, measured in DWS experiments. We apply our theory to uniaxial systems, namely nematic liquid crystals, where light is scattered from thermal fluctuations of the local optical axis, called director. We perform a detailed analysis of the two essential diffusion constants, parallel and perpendicular to the director, in terms of Frank elastic constants, dielectric anisotropy, and applied magnetic field. We also point out the relevance of our results to different liquid crystalline systems, such as discotic nematics, smectic-A phases, and polymer liquid crystals. Finally, we show that the dynamic absorption coefficient is the angular average over the inverse viscosity, which governs the dynamics of director fluctuations.Comment: 23 pages, 12 ps figures, to be published in Phys. Rev.

Denitrification and nitrous oxide emissions from riparian forests soils exposed to prolonged nitrogen runoff

Compared to upland forests, riparian forest soils have greater potential to remove nitrate (NO3) from agricultural run-off through denitrification. It is unclear, however, whether prolonged exposure of riparian soils to nitrogen (N) loading will affect the rate of denitrification and its end products. This research assesses the rate of denitrification and nitrous oxide (N2O) emissions from riparian forest soils exposed to prolonged nutrient run-off from plant nurseries and compares these to similar forest soils not exposed to nutrient run-off. Nursery run-off also contains high levels of phosphate (PO4). Since there are conflicting reports on the impact of PO4 on the activity of denitrifying microbes, the impact of PO4 on such activity was also investigated. Bulk and intact soil cores were collected from N-exposed and non-exposed forests to determine denitrification and N2O emission rates, whereas denitrification potential was determined using soil slurries. Compared to the non-amended treatment, denitrification rate increased 2.7- and 3.4-fold when soil cores collected from both N-exposed and non-exposed sites were amended with 30 and 60 μg NO3-N g-1 soil, respectively. Net N2O emissions were 1.5 and 1.7 times higher from the N-exposed sites compared to the non-exposed sites at 30 and 60 μg NO3-N g-1 soil amendment rates, respectively. Similarly, denitrification potential increased 17 times in response to addition of 15 μg NO3-N g-1 in soil slurries. The addition of PO4 (5 μg PO4–P g-1) to soil slurries and intact cores did not affect denitrification rates. These observations suggest that prolonged N loading did not affect the denitrification potential of the riparian forest soils; however, it did result in higher N2O emissions compared to emission rates from non-exposed forests

Knowledge, perceived stigma, and care-seeking experiences for sexually transmitted infections: a qualitative study from the perspective of public clinic attendees in Rio de Janeiro, Brazil

BACKGROUND: An estimated 12 million sexually transmitted infections (STIs) are documented in Brazil per year. Given the scope of this public health challenge and the importance of prompt treatment and follow-up counseling to reduce future STI/HIV-related risk behavior, we sought to qualitatively explore STI clinic experiences among individuals diagnosed with STIs via public clinics in Rio de Janeiro, Brazil. The study focused on eliciting the perspective of clinic users with regard to those factors influencing their STI care-seeking decisions and the health education and counseling which they received during their clinic visit. METHODS: Thirty semi-structured interviews were conducted with heterosexual men and women and men who have sex with men presenting with STIs at two public clinics. Content analysis was conducted by coding transcripts of audio-taped interviews for key domains of interest and comparing and synthesizing code output across participants and sub-groups. Thematic narratives were then developed per each of the study sub-groups. RESULTS: Salient themes that emerged from participant narratives included the importance of low STI-related knowledge and high perceived stigma, both STI-related and other types of social stigma, on STI care-seeking delays. However, there are indications in the data that the level of STI-related knowledge and the amount and types of stigma experienced vary across the study sub-groups suggesting the need for further research on the significance and program relevance of these potential differences. Interview findings also suggest that such barriers to care seeking are not adequately addressed through ongoing health education and counseling efforts at public STI clinics and in turn critical opportunities for STI/HIV prevention are currently being missed. CONCLUSION: Information, communication and education regarding early recognition and prompt care-seeking for STIs should be developed, with consideration given to the possibility of tailoring messages tailored to specific sub-groups. To promote prompt treatment-seeking, interventions must also address both STI-specific and other forms of social stigma which may limit access to care. Efforts to further assess and respond to barriers related to the delivery of quality health education and counseling within the context of public STI clinics are also needed

Theory of Light Hydrogenlike Atoms

The present status and recent developments in the theory of light hydrogenic atoms, electronic and muonic, are extensively reviewed. The discussion is based on the quantum field theoretical approach to loosely bound composite systems. The basics of the quantum field theoretical approach, which provide the framework needed for a systematic derivation of all higher order corrections to the energy levels, are briefly discussed. The main physical ideas behind the derivation of all binding, recoil, radiative, radiative-recoil, and nonelectromagnetic spin-dependent and spin-independent corrections to energy levels of hydrogenic atoms are discussed and, wherever possible, the fundamental elements of the derivations of these corrections are provided. The emphasis is on new theoretical results which were not available in earlier reviews. An up-to-date set of all theoretical contributions to the energy levels is contained in the paper. The status of modern theory is tested by comparing the theoretical results for the energy levels with the most precise experimental results for the Lamb shifts and gross structure intervals in hydrogen, deuterium, and helium ion $He^+$, and with the experimental data on the hyperfine splitting in muonium, hydrogen and deuterium.Comment: 230 pages, 106 figures, 24 tables. Discussion of muonic hydrogen is added, list of references expanded, some minor corrections and amendment

Calmodulin Interaction with hEAG1 Visualized by FRET Microscopy

BACKGROUND: Ca(2+)-mediated regulation of ion channels provides a link between intracellular signaling pathways and membrane electrical activity. Intracellular Ca(2+) inhibits the voltage-gated potassium channel EAG1 through the direct binding of calmodulin (CaM). Three CaM binding sites (BD-C1: 674-683, BD-C2: 711-721, BD-N: 151-165) have been identified in a peptide screen and were proposed to mediate binding. The participation of the three sites in CaM binding to the native channel, however, remains unclear. METHODOLOGY/PRINCIPAL FINDINGS: Here we studied the binding of Ca(2+)/CaM to the EAG channel by visualizing the interaction between YFP-labeled CaM and Cerulean-labeled hEAG1 in mammalian cells by FRET. The results of our cellular approach substantiate that two CaM binding sites are predominantly involved; the high-affinity 1-8-14 based CaM binding domain in the N-terminus and the second C-terminal binding domain BD-C2. Mutations at these sites completely abolished CaM binding to hEAG1. CONCLUSIONS/SIGNIFICANCE: We demonstrated that the BD-N and BD-C2 binding domains are sufficient for CaM binding to the native channel, and, therefore, that BD-C1 is unable to bind CaM independently

Defect symmetry influence on electronic transport of zigzag nanoribbons

The electronic transport of zigzag-edged graphene nanoribbon (ZGNR) with local Stone-Wales (SW) defects is systematically investigated by first principles calculations. While both symmetric and asymmetric SW defects give rise to complete electron backscattering region, the well-defined parity of the wave functions in symmetric SW defects configuration is preserved. Its signs are changed for the highest-occupied electronic states, leading to the absence of the first conducting plateau. The wave function of asymmetric SW configuration is very similar to that of the pristine GNR, except for the defective regions. Unexpectedly, calculations predict that the asymmetric SW defects are more favorable to electronic transport than the symmetric defects configuration. These distinct transport behaviors are caused by the different couplings between the conducting subbands influenced by wave function alterations around the charge neutrality point