Reasons for non- use of condoms and self-efficacy among female sex workers: A qualitative study in Nepal

Background Heterosexual contact is the most common mode of transmission of sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV) in Nepal and it is largely linked to sex work. We assessed the non-use of condoms in sex work with intimate sex partners by female sex workers (FSWs) and the associated self-efficacy to inform the planning of STI/HIV prevention programmes in the general population. Methods This paper is based on a qualitative study of Female Sex Workers (FSWs) in Nepal. In-depth interviews and extended field observation were conducted with 15 FSWs in order to explore issues of safe sex and risk management in relation to their work place, health and individual behaviours. Results The main risk factor identified for the non-use of condoms with intimate partners and regular clients was low self efficacy. Non-use of condoms with husband and boyfriends placed them at risk of STIs including HIV. In addition to intimidation and violence from the police, clients and intimate partners, clients’ resistance and lack of negotiation capacity were identified as barriers in using condoms by the FSWs. Conclusion This study sheds light on the live and work of FSWs in Nepal. This information is relevant for both the Government of Nepal and Non Governmental Organisations (NGO) to help improve the position of FSWs in the community, their general well-being and to reduce their risks at work

Effect of prophylactic corticosteroids on the incidence of reactions in newly diagnosed multibacillary leprosy patients [5]

To the editor: Leprosy reactions, including reversal re-actions and episodes of neuritis, are known to occur in leprosy patients most frequently in the first few months after starting multidrug therapy (MDT), especially in cases with multibacillary (MB) disease. Such reactions can lead to impairment of nerve function, and subsequent deformity and disability. That this can occur in leprosy patients who present without any nerve function impairment (NFI) at diagnosis is a discouraging phenomenon for both the patient and the doctor or health worker.It is an axiom of modern leprosy controlthat early case detection and treatment with MDT can prevent much NFI by halting the multiplication of the leprosy bacillus, and that this is the single most important activity in the prevention of NFI. [...]<br/

Effect of prophylactic corticosteroids on the incidence of reactions in newly diagnosed multibacillary leprosy patients [5]

To the editor: Leprosy reactions, including reversal re-actions and episodes of neuritis, are known to occur in leprosy patients most frequently in the first few months after starting multidrug therapy (MDT), especially in cases with multibacillary (MB) disease. Such reactions can lead to impairment of nerve function, and subsequent deformity and disability. That this can occur in leprosy patients who present without any nerve function impairment (NFI) at diagnosis is a discouraging phenomenon for both the patient and the doctor or health worker.It is an axiom of modern leprosy controlthat early case detection and treatment with MDT can prevent much NFI by halting the multiplication of the leprosy bacillus, and that this is the single most important activity in the prevention of NFI. [...]<br/

Corticosteroids for treating nerve damage in leprosy. A Cochrane review.

OBJECTIVE: Corticosteroids are commonly used for treating nerve damage in leprosy. We assessed the effectiveness of corticosteroids for treating nerve damage due to leprosy. METHODS: A systematic search was undertaken to identify randomised controlled trials (RCTs) comparing corticosteroids with placebo or with no treatment. Two authors independently assessed quality and extracted data. Where it was not possible to perform a meta-analysis, the data for each trial was summarised. RESULTS: Three RCTs involving 513 people were found. Two trials compared prednisolone with placebo. One trial treated mild sensory impairment of less than 6 months duration and the other trial treated nerve function impairment of 6 to 24 months duration. Both trials examined nerve function improvement 12 months from the start of treatment, but found no significant difference between the two groups. The third trial compared three corticosteroid regimens for severe type 1 reactions. After 12 months, a significantly higher proportion of individuals on a 3 month course required extra corticosteroids compared to the groups with a high-dose and low-dose regimen of 5 months duration. Diabetes and peptic or infected ulcers were not significantly more often reported in the corticosteroid compared to the placebo group. CONCLUSIONS: Evidence from RCTs does not show a significant long-term effect for either long-standing nerve function impairment or mild sensory impairment. A 5 month corticosteroid regimen was significantly more beneficial than a 3 month corticosteroid regimen. Further RCTs are needed to establish the effectiveness and optimal regimens of corticosteroids and to examine new therapies

Comparing health status in Belarus between 2001-10: a novel method using surveys with different response categories

Background: Two population surveys were conducted in Belarus: The Living Conditions, Lifestyle and Health (LLH) in 2001 (n=2000) and The Health in Times of Transition (HITT) in 2010 (n=1800). Each survey included a question on health status. The LLH questionnaire provided a 4-point Verbal Response Scale, but the HITT questionnaire used a 5-point scale. When translated into Russian, only two response categories of these scales had identical wording. These differences made a direct comparison of self-reported health status between 2001 and 2010 difficult. Methods: We conducted a Health Category Response Scale (HCRS) survey in 2010 (n=570) using a 100ths graduated Visual Analogue Scale (VAS) to understand how the response categories of different scales are perceived by Russian speakers. We implemented the HCRS survey’s data to calculate the weighted health status (WHS) for each of the original surveys and to compare health status in Belarus between 2001 and 2010. Results: The WHS in Belarus showed a small, but statistically significant, improvement of 2.9 points on a 0–100 scale between 2001 and 2010 (56.2 vs. 59.1). Identical response categories were perceived differently on a 4-point and 5-point VAS. The category ‘good’ (‘Umomwee’) measured ~12 points higher, and the category ‘bad/poor’ (‘Ojmtme’) measured ~16 points lower, on the 4-point compared with the 5-point VAS. Conclusion: Our HCRS survey and novel method enabled a direct comparison of questions with different response options. When applied to the LLH and HITT projects, we concluded that health status in Belarus has improved between 2001 and 2010

Systematic review of exercise and the long-term outcomes of the treatment for obesity.

We systematically reviewed randomised controlled trials (RCTs) of obesity treatments in adults and assessed long term effects on weight and risk factors for disease

Collection Development Policies in Public Libraries in Australia: A Qualitative Content Analysis

The role that public library collection development polices play inguiding selectors and informing users has been promoted as a pillar of good professional practice. While these policies purport to open up the methods and the criteria used in selection so as to promote transparency and a sense of professional objectivity, how they actually are developed and put into practice has remained largely implicit in the research literature. This analysis revealedthat policies tended to focus on local issues and remained heavily materials focused. How collections are developed to support user’s information needs and substantive issues associated with topicality are largely unarticulated

Leprosy post-exposure prophylaxis with single-dose rifampicin (LPEP): an international feasibility programme

Background Innovative approaches are required for leprosy control to reduce cases and curb transmission of Mycobacterium leprae. Early case detection, contact screening, and chemoprophylaxis are the most promising tools. We aimed to generate evidence on the feasibility of integrating contact tracing and administration of single-dose rifampicin (SDR) into routine leprosy control activities. Methods The leprosy post-exposure prophylaxis (LPEP) programme was an international, multicentre feasibility study implemented within the leprosy control programmes of Brazil, India, Indonesia, Myanmar, Nepal, Sri Lanka, and Tanzania. LPEP explored the feasibility of combining three key interventions: systematically tracing contacts of individuals newly diagnosed with leprosy; screening the traced contacts for leprosy; and administering SDR to eligible contacts. Outcomes were assessed in terms of number of contacts traced, screened, and SDR administration rates. Findings Between Jan 1, 2015, and Aug 1, 2019, LPEP enrolled 9170 index patients and listed 179 769 contacts, of whom 174782 (97·2%) were successfully traced and screened. Of those screened, 22 854 (13·1%) were excluded from SDR mainly because of health reasons and age. Among those excluded, 810 were confirmed as new patients (46 per 10 000 contacts screened). Among the eligible screened contacts, 1182 (0·7%) refused prophylactic treatment with SDR. Overall, SDR was administered to 151 928 (86·9%) screened contacts. No serious adverse events were reported. Interpretation Post-exposure prophylaxis with SDR is safe; can be integrated into different leprosy control programmes with minimal additional efforts once contact tracing has been established; and is generally well accepted by index patients, their contacts, and health-care workers. The programme has also invigorated local leprosy control through the availability of a prophylactic intervention; therefore,

An epidemiological study of coronary heart disease and its risk factors in Scotland The Scottish Heart Health Study

SIGLEAvailable from British Library Document Supply Centre- DSC:D179719 / BLDSC - British Library Document Supply CentreGBUnited Kingdo