Adapting an Evidence-Based Intervention Targeting HIV-Infected Prisoners in Malaysia

HIV-infected prisoners in Malaysia represent a critical target population for secondary HIV risk reduction interventions and care. We report on the process and outcome of our formative research aimed at systematically selecting and adapting an EBI designed to reduce secondary HIV risk and improve adherence to antiretroviral therapy among soon-to-be-released HIV-infected prisoners. Our formative work involved a critical examination of established EBIs and associated published reports complemented by data elicited through structured interviews and focus groups with key stakeholders, members of the target population, and their family members. Based on all information, we adapted the Holistic Health Recovery Program targeting people living with HIV (HHRP+), an EBI, to consist of eight 2-hour sessions that cover a range of specified topics so that participants may individually apply intervention content as needed to accommodate their particular substance abuse, HIV risk, and antiretroviral adherence issues. This study provides a complete example of the process of selecting and adapting an EBI—taking into account both empirical evidence and input from target organization stakeholders and target population members and their families—for use in real world prison settings where high-risk populations are concentrated

Methadone dose at the time of release from prison significantly influences retention in treatment: Implications from a pilot study of HIV-infected prisoners transitioning to the community in Malaysia

Objective: To evaluate the impact of methadone dose on post-release retention in treatment among HIV-infected prisoners initiating methadone maintenance treatment (MMT) within prison. Methods: Thirty HIV-infected prisoners meeting DSM-IV pre-incarceration criteria for opioid dependence were enrolled in a prison-based, pre-release MMT program in Kiang Valley, Malaysia; 3 died before release from prison leaving 27 evaluable participants. Beginning 4 months before release, standardized methadone initiation and dose escalation procedures began with 5 mg daily for the first week and 5 mg/daily increases weekly until 80 mg/day or craving was satisfied. Participants were followed for 12 months post-release at a MMT clinic within 25 kilometers of the prison. Kaplan-Meier survival analysis was used to evaluate the impact of methadone dose on post-release retention in treatment. Findings: Methadone dose >= 80 mg/day at the time of release was significantly associated with retention in treatment. After 12 months of release, only 21.4 of participants on = 80 mg (Log Rank chi(2) = (1,26) 7.6, p < 0.01). Conclusions: Higher doses of MMT at time of release are associated with greater retention on MMT after release to the community. Important attention should be given to monitoring and optimizing MMT doses to address cravings and side effects prior to community re-entry from prisons. (C) 2013 Elsevier Ireland Ltd. All rights reserved

Effect of emulsion fuel on engine emissions-A review

Emulsion fuel is an unconventional fuel for diesel engines, which can be used without modifications in the engine. The benefits of an emulsion fuel include lowering the emissions of nitrogen oxides (NO x ) and particulate matter (PM) which are harmful to health and cause diesel engines to suffer. This paper explains in detail the effect of water in the emulsion fuel on the emissions of NO x, PM, carbon monoxide (CO), hydrocarbon (HC), smoke and exhaust temperature. Experimental results from various researchers show a decrease in the NO x and PM emissions simultaneously. However, the results with the increasing water percentage in emulsion fuel are not consistent for HC and CO emissions. The water content in emulsion fuel affects the combustion and reduces the peak temperature in the combustion chamber. On the other hand, microexplosion phenomenon occurs and causes an increase in the volatility of diesel fuel which improves the combustion efficiency