An exploratory study on the social and genotypic clustering of HIV infection in men having sex with men

OBJECTIVE: To explore the clustering of HIV infected men having sex with men (MSM) using social network approach in conjunction with the phylogenetic relationship of the virus strains. DESIGN: An exploratory study incorporating social network and phylogenetic analysis. METHODS: Recently diagnosed HIV-infected MSM attending one major HIV specialist clinic in Hong Kong were recruited in the study involving the administration of a self-administered questionnaire on behaviours and partnership patterns using a Likert Scale, the results of which were assessed using social network analysis and in context of the phylogenetic analysis from sequencing the HIV-1 pol gene, as part of the clinical investigation for genotypic resistance. Clusters were defined using social and molecular methods. RESULTS: An 'Internet-centred' cluster and 'Sauna-centred' cluster could be delineated using correspondence analysis and network diagrams. The main distinguishing features of MSM in the 'Internet-centred' social cluster were: younger age, higher education level, and multiple partner types. Three genetic clusters could be identified in the phylogenetic tree, two of which associated with Internet use and one with sauna for sex partnership. There were partial overlaps between social and genetic clusters. Characteristically, the virus strains in sauna users were more disperse compared with the closely knit configuration of those using Internet. CONCLUSION: The principle of the duality of place and person can be strategically applied in epidemiologic investigation. The characterization of MSM cluster using anonymized network data provides a potentially powerful tool for informing public health intervention. © 2009 Lippincott Williams & Wilkins, Inc.postprin

Identification, disclosure and education support of domestic violence and sexual abuse (DVSA) victims

Aim: Supporting Domestic violence and sexual abuse (DVSA) victims at education paradigm. Objective: To find practical methods of disclosing, identifying, and supporting DVSA victims in the education paradigm. Methodology: A phenomenological descriptive literature review study explores what is known from different authors about identification, influence, disclosure tools and support of DVSA victims to clarify the phenomenon, approaches of disclosure tools and victims’ support at education paradigm. Conclusion: Improving factual knowledge and awareness among students and teachers. National policies are mandating the teaching of violence prevention in the national curricula, allocation of budgets, and resources. The need for more comprehensive studies on this subject, educating educators about this paradigm, structuring effective practical disclosure aids, and raising funds and professionals for highly flexible individualised methods of victim’s support. Recommendations Tools chosen should consider the target population, screeners’ skills and experience, and the evaluation’s objective and context. Educators and healthcare providers must ensure that adequate referral and follow-up are provided to those identified through screening to ensure the efficacy of DVSA interventions. Teacher’s lack of confidence, conviction, and expertise could jeopardise the intended message; educator’s training is recommended. To establish DVSA forum at educational institutes, starting with the “digital generation” at tertiary education or secondary and lower educational levels. Students can write, discuss, share, and disclose at this forum anonymously. The details are accessed by a specialised individual who can implement policies and communicate with students who disclosed the information or are suspected of DVSA

Patients’ impact on the hidden curriculum of medical students a qualitative study on undergraduate medical students

Aim: To explore and understand professional practice development through medical students’ observation of patient’s responses towards the medical students, illness, and hospital staff. Methodology: Semi-structured focused group discussions were conducted between 3rd September 2019 and 3rd May 2020 using non-probability purposive sampling. Three focused groups were conducted with fourth year medical students (n=19) to discuss about their third-year clinical placement experience. The focused group discussions were audio-recorded and transcribed verbatim. Data were analysed using Interpretative Phenomenological Analysis framework to label the concepts, attached code to the data, and the codes were subsequently grouped into similar themes. Themes that emerged from the interpretation of the coded data were identified. Results: Four main themes emerged from the focus groups: (1) Student’s observation on patient’s responses towards students, illness, and staff; (2) Patient’s perspectives towards students; (3) Students were affected by the experience; and (4) Factors influencing patient’s responses to students, illness, and staff. The impact of patient’s behaviour has influenced students’ professional practice in two ways. The first impact is collaboration of students’ observation during clinical placement with what has been learned through the written curriculum. The second impact is through a hidden curriculum. Conclusions: The hidden curriculum has influenced our students’ learning through observation of new aspects and implementation of the learned written curriculum. Students can aspire medical educators, doctors, and medical staff to adopt approaches and attitudes that have a positive impact on students’ professional practice and to acknowledge that they are the role models for the new generation’s learning through the hidden curriculum