The Perceptions on Male Circumcision as a Preventive Measure Against HIV Infection and Considerations in Scaling up of the Services: A Qualitative Study Among Police Officers in Dar es Salaam, Tanzania.

\ud In recent randomized controlled trials, male circumcision has been proven to complement the available biomedical interventions in decreasing HIV transmission from infected women to uninfected men. Consequently, Tanzania is striving to scale-up safe medical male circumcision to reduce HIV transmission. However, there is a need to investigate the perceptions of male circumcision in Tanzania using specific populations. The purpose of the present study was to assess the perceptions of male circumcision in a cohort of police officers that also served as a source of volunteers for a phase I/II HIV vaccine (HIVIS-03) trial in Dar es Salaam, Tanzania. In-depth interviews with 24 men and 10 women were conducted. Content analysis informed by the socio-ecological model was used to analyze the data. Informants perceived male circumcision as a health-promoting practice that may prevent HIV transmission and other sexually transmitted infections. They reported male circumcision promotes sexual pleasure, confidence and hygiene or sexual cleanliness. They added that it is a religious ritual and a cultural practice that enhances the recognition of manhood in the community. However, informants were concerned about the cost involved in male circumcision and cleanliness of instruments used in medical and traditional male circumcision. They also expressed confusion about the shame of undergoing circumcision at an advanced age and pain that could emanate after circumcision. The participants advocated for health policies that promote medical male circumcision at childhood, specifically along with the vaccination program. The perceived benefit of male circumcision as a preventive strategy to HIV and other sexually transmitted infections is important. However, there is a need to ensure that male circumcision is conducted under hygienic conditions. Integrating male circumcision service in the routine childhood vaccination program may increase its coverage at early childhood. The findings from this investigation provide contextual understanding that may assist in scaling-up male circumcision in Tanzania.\u

Libbie Hyman

66 p. : ill. ; 26 cm.Study of invertebrates at the American Museum of Natural History / Neil H. Landman and Judith E. Winston -- Libbie Hyman and the American Museum of Natural History / Judith E. Winston -- Libbie Hyman at the University of Chicago / Jane Maienschein -- Libbie Hyman and comparative vertebrate anatomy / Marvalee H. Wake -- Contributions of Libbie H. Hyman to knowledge of land planarians: relating personal experiences (Tricladida: Terricola) / Robert E. Ogren -- Libbie Henrietta Hyman: her influence on teaching and research in invertebrate zoology / M. Patricia Morse -- Systematics of the flatworms- Libbie Hyman's influence on current views of the Platyhelminthes / Seth Tyler.Includes bibliographical references."This issue of Novitates consists of papers presented at a symposium on the life and work of American zoologist Dr. Libbie Henrietta Hyman, 1888-1969, held at the annual meeting of the American Society of Zoologists in Atlanta, Georgia, December 1991. Judith E. Winston provides an introduction to Libbie Hyman's early years. Growing up in Fort Dodge, Iowa, young Libbie demonstrated a love of nature and a drive for learning that eventually led to a scholarship at the University of Chicago, where she majored in zoology. Jane Maienschein covers Libbie Hyman's Chicago period. During that period Libbie gained experience in experimental biology by participation in Charles Manning Child's research program on metabolic gradients, which applied the "Chicago style" of biology. The lack of good manuals for the comparative anatomy and zoology labs she taught as a graduate student led Libbie to develop her own laboratory manuals, published by the University of Chicago Press. Marvalee Wake discusses Libbie Hyman's interactions with the press about these guides. Hyman's correspondence with press officials revealed her growing frustration as she desired more time to work on invertebrates, but was persuaded to revise vertebrate anatomy texts instead. Despite her protests, her seminal ideas and approaches to learning vetebrate anatomy were profoundly important. Judith Winston discusses Libbie's productive career at the American Museum of Natural History. In 1930, Dr. Hyman left Chicago to pursue the invertebrate work that interested her most-and found a welcome in G. K. Noble's Department of Experimental Biology at the AMNH. With his help she obtained an unpaid position as a research associate, office space, and use of the AMNH library, vital to her project, a treatise on invertebrate zoology. Her 6 volume treatise, The Invertebrates, was published between 1940 and 1967 by McGraw-Hill. In 1943 she transferred to the AMNH Department of Invertebrates. Neil Landman outlines the history of that Department in the Museum, and Libbie's connection with it. M. Patricia Morse discusses Dr. Hyman's influence on invertebrate zoology in general. Her treatise set the tone for invertebrate zoology courses and the publication of books on the subject. Each volume was eagerly received by zoologists, not only for thorough coverage of the literature (including non-English language literature), but also for uniformity of approach, comprehensive illustrations, and thoughtful synthesis of phylogenetic relationships for each group covered. Robert Ogren discusses Libbie Hyman's contributions to land planarian taxonomy. Hyman was the first American zoologist recognized as an authority on Turbellaria, Tricladida, and Terricola. Contributions began after her 1937 appointment as research associate at the American Museum of Natural History and continued for 25 years, resulting in 11 taxonomic papers, the last published in 1962. Seth Tyler discusses Libbie Hyman's overall influence on the systematics of turbellarian flatworms, especially through the comprehensive review of flatworms published in Volume II of The Invertebrates. The system of classification she adopted for the phylum Platyhelminthes was that of Bresslau, dating to 1933. Modern systematists have clarified the phylogenetic relationships of flatworm groups, in particular by using characters discerned with electron microscopy; and application of principles of cladistic systematics has been important in grouping turbellarians and the major groups of parasitic flatworms into supraordinal taxa. A number of competing systems for these higher-level groupings have been proposed, and these are being tested with molecular techniques comparing nucleic-acid sequences. Still, the current best-accepted system clearly bears Hyman's stamp; her views of evolution in the phylum and its taxonomy are still relevant"--P. 2

Safety in home care: A research protocol for studying medication management

<p>Abstract</p> <p>Background</p> <p>Patient safety is an ongoing global priority, with medication safety considered a prevalent, high-risk area of concern. Yet, we have little understanding of the supports and barriers to safe medication management in the Canadian home care environment. There is a clear need to engage the providers and recipients of care in studying and improving medication safety with collaborative approaches to exploring the nature and safety of medication management in home care.</p> <p>Methods</p> <p>A socio-ecological perspective on health and health systems drives our iterative qualitative study on medication safety with elderly home care clients, family members and other informal caregivers, and home care providers. As we purposively sample across four Canadian provinces: Alberta (AB), Ontario (ON), Quebec (QC) and Nova Scotia (NS), we will collect textual and visual data through home-based interviews, participant-led photo walkabouts of the home, and photo elicitation sessions at clients' kitchen tables. Using successive rounds of interpretive description and human factors engineering analyses, we will generate robust descriptions of managing medication at home within each provincial sample and across the four-province group. We will validate our initial interpretations through photo elicitation focus groups with home care providers in each province to develop a refined description of the phenomenon that can inform future decision-making, quality improvement efforts, and research.</p> <p>Discussion</p> <p>The application of interpretive and human factors lenses to the visual and textual data is expected to yield findings that advance our understanding of the issues, challenges, and risk-mitigating strategies related to medication safety in home care. The images are powerful knowledge translation tools for sharing what we learn with participants, decision makers, other healthcare audiences, and the public. In addition, participants engage in knowledge exchange throughout the study with the use of participatory data collection methods.</p

Dead or alive: animal sampling during Ebola hemorrhagic fever outbreaks in humans

There are currently no widely accepted animal surveillance guidelines for human Ebola hemorrhagic fever (EHF) outbreak investigations to identify potential sources of Ebolavirus (EBOV) spillover into humans and other animals. Animal field surveillance during and following an outbreak has several purposes, from helping identify the specific animal source of a human case to guiding control activities by describing the spatial and temporal distribution of wild circulating EBOV, informing public health efforts, and contributing to broader EHF research questions. Since 1976, researchers have sampled over 10,000 individual vertebrates from areas associated with human EHF outbreaks and tested for EBOV or antibodies. Using field surveillance data associated with EHF outbreaks, this review provides guidance on animal sampling for resource-limited outbreak situations, target species, and in some cases which diagnostics should be prioritized to rapidly assess the presence of EBOV in animal reservoirs. In brief, EBOV detection was 32.7% (18/55) for carcasses (animals found dead) and 0.2% (13/5309) for live captured animals. Our review indicates that for the purposes of identifying potential sources of transmission from animals to humans and isolating suspected virus in an animal in outbreak situations, (1) surveillance of free-ranging non-human primate mortality and morbidity should be a priority, (2) any wildlife morbidity or mortality events should be investigated and may hold the most promise for locating virus or viral genome sequences, (3) surveillance of some bat species is worthwhile to isolate and detect evidence of exposure, and (4) morbidity, mortality, and serology studies of domestic animals should prioritize dogs and pigs and include testing for virus and previous exposure

Understanding and Measuring the Wellbeing of Carers of People With Dementia

Background and Objectives  To determine how the wellbeing of carers of people with dementia is understood and measured in contemporary health research.  Research Design and Methods  A systematic review of reviews was designed, registered with PROSPERO, and then conducted. This focused on systematic reviews of research literature published from 2010 onwards; with the wellbeing of carers of people with dementia being a primary focus. N = 19 studies met the inclusion criteria. Quality appraisal was conducted using the AMSTAR tool (2015). A narrative synthesis was conducted to explore how wellbeing is currently being understood and measured.  Results  Contemporary health research most frequently conceptualizes wellbeing in the context of a loss–deficit model. Current healthcare research has not kept pace with wider discussions surrounding wellbeing which have become both more complex and more sophisticated. Relying on the loss–deficit model limits current research in understanding and measuring the lived experience of carers of people with dementia. There remains need for a clear and consistent measurement of wellbeing.  Discussion and Implications  Without clear consensus, health professionals must be careful when using the term “wellbeing”. To help inform healthcare policy and practice, we offer a starting point for a richer concept of wellbeing in the context of dementia that is multi-faceted to include positive dimensions of caregiving in addition to recognized aspects of burden. Standardized and robust measurements are needed to enhance research and there may be benefit from developing a more mixed, blended approach to measurement

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure