Patterns Of Drug Use And Correlates Of Active Amphetamine-Type Substance Use Among Sex Workers In Kuala Lumpur, Malaysia

Objective: To describe the female and transgender sex worker population in Kuala Lumpur, Malaysia, understand their patterns of substance use, and examine the correlates of active amphetamine-type substance (ATS) use. Methods: We administered a cross-sectional survey and performed biological testing on 492 sex workers to assess lifetime and active substance use history and frequency, criminal justice involvement, alcohol and substance abuse disorders, sexual risk behaviors, experience of childhood and adulthood physical and sexual abuse, depression, and prevalence of HIV, syphilis, chlamydia, and gonorrhea. We performed descriptive statistics to describe demographics and lifetime and active drug use patterns and employed bivariate and multivariate logistic regression to examine correlates of active ATS use. Results: Of 492 participants 299 (60.8%) were female and 193 (39.2%) were transgender. Prevalence of substance abuse disorders (29.7%) were high. ATS (32.3%) was the substance with highest reported use in the 30 days prior; smoking was the main route of administration. Of the sample, 11.7% was HIV-infected and 11.9% tested positive for syphilis. The majority of participants were unaware of their infections. History of childhood and adulthood physical and sexual abuse, depression (57.1%), and previous incarceration was also high (57.5%). Location, history of incarceration, history of self-harm, polysubstance use, and testing positive for syphilis were significantly associated with active ATS use even after controlling for all other variables. Conclusion: Our findings suggest there is a high need for evidence-based interventions for HIV prevention tailored specifically towards female and transgender women who dually engage in drug use and sex work

The false consensus effect in estimates of safe and unsafe sexual practices

The purpose of this study was three fold: 1) to determine if false consensus effects would be found for estimates of sexual behaviors, 2) to determine the directional accuracy of consensus estimates for subscribers and nonsubscribers and 3) to determine if the degree of accuracy of those estimates was influenced by self-esteem, sexual esteem, collective self-esteem, and religiosity. A questionnaire was administered to a sample of 821 university students to gather consensus estimates for twelve sexual behavior items. False consensus effects were found for all twelve behavioral items and further analysis was done to determine the directional accuracy of the estimates as well as to determine what motivational factors might influence the degree of accuracy of the consensus estimates. The specific motivational factors examined were self-esteem, sexual esteem, collective self-esteem, and religiosity. These four factors were measured using the following scales: 1) the Self-Esteem Scale (SES) (Rosenberg, 1965), 2) the Sexuality Scale (SS) (Snell & Papini, 1989; Wiederman & Allgeier, 1993), 3) the Collective Self-Esteem Scale Revised (CSES-R) (Luhtanen & Crocker, 1992) and 4) the Scale of Attitude Towards Christianity (Francis & Stubbs, 1987; Francis, 1989). Results of the study indicated that although significant false consensus effects were found for all twelve behavioral items, the directional accuracy of subscriber's estimates of consensus was not consistently or predictably different from the directional accuracy of nonsubscriber's estimates of consensus. A motivation theory for false consensus effects as measured by the self-esteem scale, sexuality scale, collective self-esteem scale, and religiosity scale used in this study was not supported

PBL Student Projects and Sustainable Development Goals: A Case Study

Working with the Sustainable Development Goals can be a highly motivating factor in Problem Based Learning, especially if the solutions produced can be used afterwards and have an actual impact on people and communities. This paper describes how three engineering students from Aalborg University, Denmark, collaborated with the South African Organisation Green Shoots on bringing IT-supported Math education out to some of the most disadvantaged learners from townships and rural areas of the Western Cape. The project provided the Danish students with a unique learning experience and have a lasting impact on the communities involved. While the content of the project focused on bringing IT-supported Math education to learners in previously disadvantaged areas around the Western Cape, the project also provided valuable insight into how such students’ projects, where the outcomes benefit people and communities suffering from socio-economic challenges e.g. poverty, can be carried out. In addition to demonstrate that such projects are actually possible, we studied three critical aspects: How to ensure a good fit between learning objectives and project outcome, how to ensure that the project creates value for the partner organisation and communities, and how to ensure that the projects can be conducted without overloading the university supervisors. We believe that student projects focusing on SDGs have a big potential in terms of providing highly motivating student projects yet at the same time contribute to a better world through solutions that are being used even afterwards. However, our study was just a single case with one group of three students. We hope it will serve as inspiration for larger studies, where more quantitative data could be gathered in terms of how to establish a good framework around such projects, and in order to demonstrate the value for students and societies

Early goal-directed nutrition in icU patients (EAT-ICU):protocol for a randomised trial

INTRODUCTION: Extensive weight loss has been documented in intensive care unit (ICU) survivors, primarily as the result of muscle loss, leading to impaired physical function and reduced quality of life. The aim of the EAT-ICU trial is to test the effect of early goal-directed protein-energy nutrition based on measured requirements on short-term clinical outcomes and long-term physical quality of life in ICU patients. METHODS: The EAT-ICU trial is a single-centre, randomised, parallel-group trial with concealed allocation and blinded outcome assessment. A total of 200 consecutive, acutely admitted, mechanically ventilated intensive care patients will be randomised 1: 1 to early goal-directed nutrition versus standard of care to show a potential 15% relative risk reduction in the primary outcome measure (physical function) at six months (two-sided significance level alpha = 0.05; power beta = 80%). Secondary outcomes include energy-and protein balances, metabolic control, new organ failure, use of life support, nosocomial infections, ICU- and hospital length of stay, mortality and cost analyses. CONCLUSION : The optimal nutrition strategy for ICU patients remains unsettled. The EAT-ICU trial will provide important data on the effects of early goal-directed proteinenergy nutrition based on measured requirements in these patients.Copenhagen University Hospital; Rigshospitalet; Fresenius Kabi A/S; European Society for Clinical Nutrition and Metabolism (ESPEN)SCI(E)[email protected]

Adult nutrient intakes from current dietary surveys of European populations

The World Health Organisation (WHO) encourages countries to undertake national dietary survey (NDS), but implementation and reporting is inconsistent. This paper provides an up-to-date review of adult macro and micronutrient intakes in European populations as reported by national diet surveys (NDS). It uses WHO Recommended Nutrient Intakes (RNIs) to assess intake adequacy and highlight areas of concern. NDS information was gathered primarily by internet searches and contacting survey authors and nutrition experts. Survey characteristics and adult intakes by gender/age group were extracted for selected nutrients and weighted means calculated by region. Of the 53 WHO Europe countries, over a third (n=19), mainly Central & Eastern European countries (CEEC), had no identifiable NDS. Energy and nutrient intakes were extracted for 21 (40%) countries, but differences in age group, methodology, under-reporting and nutrient composition databases hindered inter-country comparisons. No country met more than 39% WHO RNIs in all age/gender groups; macronutrient RNI achievement was poorer than micronutrient. Overall RNI attainment was slightly worse in CEEC, and lower in women and female elderly. Only 40% countries provided adult energy and nutrient intakes. The main gaps lie in CEEC, where unknown nutrient deficiencies may occur. WHO RNI attainment was universally poor for macronutrients, especially for women, the female elderly and CEEC. All countries could be encouraged to report a uniform nutrient set and sub-analyses of nationally representative nutrient intakes

How Noise and Coupling Induce Bursting Action Potentials in Pancreatic beta-cells

Unlike isolated beta-cells, which usually produce continuous spikes or fast and irregular bursts, electrically coupled beta-cells are apt to exhibit robust bursting action potentials. We consider the noise induced by thermal fluctuations as well as that by channel gating stochasticity and examine its effects on the action potential behavior of the beta-cell model. It is observed numerically that such noise in general helps single cells to produce a variety of electrical activities. In addition, we also probe coupling via gap junctions between neighboring cells,with heterogeneity induced by noise, to find that it enhances regular bursts.Comment: 40 pages, 10 figure

Brucellosis remains a neglected disease inthe developing world: a call forinterdisciplinary action

Brucellosis places significant burdens on the human healthcare system and limits the economic growth of individuals, communities, and nations where such development is especially important to diminish the prevalence of poverty. The implementation of public policy focused on mitigating the socioeconomic effects of brucellosis in human and animal populations is desperately needed. When developing a plan to mitigate the associated consequences, it is vital to consider both the abstract and quantifiable effects. This requires an interdisciplinary and collaborative, or One Health, approach that consists of public education, the development of an infrastructure for disease surveillance and reporting in both veterinary and medical fields, and campaigns for control in livestock and wildlife species

"Now he walks and walks, as if he didn't have a home where he could eat": food, healing, and hunger in Quechua narratives of madness

In the Quechua-speaking peasant communities of southern Peru, mental disorder is understood less as individualized pathology and more as a disturbance in family and social relationships. For many Andeans, food and feeding are ontologically fundamental to such relationships. This paper uses data from interviews and participant observation in a rural province of Cuzco to explore the significance of food and hunger in local discussions of madness. Carers’ narratives, explanatory models, and theories of healing all draw heavily from idioms of food sharing and consumption in making sense of affliction, and these concepts structure understandings of madness that differ significantly from those assumed by formal mental health services. Greater awareness of the salience of these themes could strengthen the input of psychiatric and psychological care with this population and enhance knowledge of the alternative treatments that they use. Moreover, this case provides lessons for the global mental health movement on the importance of openness to the ways in which indigenous cultures may construct health, madness, and sociality. Such local meanings should be considered by mental health workers delivering services in order to provide care that can adjust to the alternative ontologies of sufferers and carers