'Brexit' : Effects and Consequences for Ireland and Northern Ireland

The aim of this study is to analyze the potential implications of the United Kingdom's exit from the European Union on both Northern Ireland and the Republic of Ireland. While, this remains, the UK's only land border and was a source of contention for decades, it has only played a minor role in the debate on EU membership. Yet the region is particularly vulnerable to a more restrictive future partnership, in terms of both its economy and the potential for social conflict. A year after the referendum, there is still much uncertainty on what Brexit will mean for both Irelands.L'objectiu d'aquest estudi és analitzar les implicacions que tindria la sortida del Regne Unit de la Unió Europea, tant a Irlanda del Nord com en la República d'Irlanda. Encara sent l'única frontera terrestre que té el Regne Unit, a més d'un punt de conflicte durant molts anys, solament ha tingut un rol menor al debat sobre la pertinença a la UE. La regió, no obstant això, és particularment vulnerable a una relació futura més restrictiva, tant econòmicament com en el potencial per a conflicte social. Un any després del referèndum, encara hi ha molta incertesa en el que "Brexit" suposarà per a ambdues IrlandesEl objetivo de este estudio es analizar las implicaciones que tendría la salida del Reino Unido de la Unión Europea, tanto en Irlanda del Norte como en la República de Irlanda. Aún siendo la única frontera terrestre que tiene el Reino Unido, además de un punto de conflicto durante muchos años, solamente ha tenido un rol menor al debate sobre la pertenencia a la UE. La región, sin embargo, es particularmente vulnerable a una relación futura más restrictiva, tanto económicamente como en el potencial para conflicto social. Un año después del referéndum, todavía hay mucha incertidumbre en el que "Brexit" supondrá para ambas Irlande

High Accuracy of Common HIV-Related Oral Disease Diagnoses by Non-Oral Health Specialists in the AIDS Clinical Trial Group

Objective: Many studies include oral HIV-related endpoints that may be diagnosed by non-oral-health specialists (non-OHS) like nurses or physicians. Our objective was to assess the accuracy of clinical diagnoses of HIV-related oral lesions made by non-OHS compared to diagnoses made by OHS. Methods: A5254, a cross-sectional study conducted by the Oral HIV/AIDS Research Alliance within the AIDS Clinical Trial Group, enrolled HIV-1-infected adults participants from six clinical trial units (CTU) in the US (San Francisco, New York, Chapel Hill, Cleveland, Atlanta) and Haiti. CTU examiners (non-OHS) received standardized training on how to perform an oral examination and make clinical diagnoses of specific oral disease endpoints. Diagnoses by calibrated non-OHS were compared to those made by calibrated OHS, and sensitivity and specificity computed. Results: Among 324 participants, the majority were black (73%), men (66%), and the median CD4+ cell count 138 cells/mm3. The overall frequency of oral mucosal disease diagnosed by OHS was 43% in US sites, and 90% in Haiti. Oral candidiasis (OC) was detected in 153 (47%) by OHS, with erythematous candidiasis (EC) the most common type (39%) followed by pseudomembranous candidiasis (PC; 26%). The highest prevalence of OC (79%) was among participants in Haiti, and among those with CD4+ cell count ≤ 200 cells/mm3 and HIV-1 RNA > 1000 copies/mL (71%). The sensitivity and specificity of OC diagnoses by non-OHS were 90% and 92% (for EC: 81% and 94%; PC: 82% and 95%). Sensitivity and specificity were also high for KS (87% and 94%, respectively), but sensitivity was < 60% for HL and oral warts in all sites combined. The Candida culture confirmation of OC clinical diagnoses (as defined by ≥ 1 colony forming unit per mL of oral/throat rinse) was ≥ 93% for both PC and EC. Conclusion: Trained non-OHS showed high accuracy of clinical diagnoses of OC in comparison with OHS, suggesting their usefulness in studies in resource-poor settings, but detection of less common lesions may require OHS

‘Brexit’: Effects and Consequences for Ireland and Northern Ireland

The aim of this study is to analyze the potential implications of the United Kingdom’s exit from the European Union on both Northern Ireland and the Republic of Ireland. While, this remains, the UK’s only land border and was a source of contention for decades, it has only played a minor role in the debate on EU membership. Yet the region is particularly vulnerable to a more restrictive future partnership, in terms of both its economy and the potential for social conflict. A year after the referendum, there is still much uncertainty on what Brexit will mean for both Irelands.L'objectiu d'aquest estudi és analitzar les implicacions que tindria la sortida del Regne Unit de la Unió Europea, tant a Irlanda del Nord com en la República d'Irlanda. Encara sent l'única frontera terrestre que té el Regne Unit, a més d'un punt de conflicte durant molts anys, solament ha tingut un rol menor al debat sobre la pertinença a la UE. La regió, no obstant això, és particularment vulnerable a una relació futura més restrictiva, tant econòmicament com en el potencial per a conflicte social. Un any després del referèndum, encara hi ha molta incertesa en el que “Brexit” suposarà per a ambdues IrlandesEl objetivo de este estudio es analizar las implicaciones que tendría la salida del Reino Unido de la Unión Europea, tanto en Irlanda del Norte como en la República de Irlanda. Aún siendo la única frontera terrestre que tiene el Reino Unido, además de un punto de conflicto durante muchos años, solamente ha tenido un rol menor al debate sobre la pertenencia a la UE. La región, sin embargo, es particularmente vulnerable a una relación futura más restrictiva, tanto económicamente como en el potencial para conflicto social. Un año después del referéndum, todavía hay mucha incertidumbre en el que "Brexit" supondrá para ambas Irlande

'Brexit' : Effects and Consequences for Ireland and Northern Ireland

The aim of this study is to analyze the potential implications of the United Kingdom's exit from the European Union on both Northern Ireland and the Republic of Ireland. While, this remains, the UK's only land border and was a source of contention for decades, it has only played a minor role in the debate on EU membership. Yet the region is particularly vulnerable to a more restrictive future partnership, in terms of both its economy and the potential for social conflict. A year after the referendum, there is still much uncertainty on what Brexit will mean for both Irelands.L'objectiu d'aquest estudi és analitzar les implicacions que tindria la sortida del Regne Unit de la Unió Europea, tant a Irlanda del Nord com en la República d'Irlanda. Encara sent l'única frontera terrestre que té el Regne Unit, a més d'un punt de conflicte durant molts anys, solament ha tingut un rol menor al debat sobre la pertinença a la UE. La regió, no obstant això, és particularment vulnerable a una relació futura més restrictiva, tant econòmicament com en el potencial per a conflicte social. Un any després del referèndum, encara hi ha molta incertesa en el que "Brexit" suposarà per a ambdues IrlandesEl objetivo de este estudio es analizar las implicaciones que tendría la salida del Reino Unido de la Unión Europea, tanto en Irlanda del Norte como en la República de Irlanda. Aún siendo la única frontera terrestre que tiene el Reino Unido, además de un punto de conflicto durante muchos años, solamente ha tenido un rol menor al debate sobre la pertenencia a la UE. La región, sin embargo, es particularmente vulnerable a una relación futura más restrictiva, tanto económicamente como en el potencial para conflicto social. Un año después del referéndum, todavía hay mucha incertidumbre en el que "Brexit" supondrá para ambas Irlande

High Accuracy of Common HIV-Related Oral Disease Diagnoses by Non-Oral Health Specialists in the AIDS Clinical Trial Group

AbstractObjectiveMany studies include oral HIV-related endpoints that may be diagnosed by non-oral-healthspecialists (non-OHS) like nurses or physicians. Our objective was to assess the accuracyof clinical diagnoses of HIV-related oral lesions made by non-OHS compared to diagnosesmade by OHS.MethodsA5254, a cross-sectional study conducted by the Oral HIV/AIDS Research Alliance withinthe AIDS Clinical Trial Group, enrolled HIV-1-infected adults participants from six clinicaltrial units (CTU) in the US (San Francisco, New York, Chapel Hill, Cleveland, Atlanta) andHaiti. CTU examiners (non-OHS) received standardized training on how to perform an oralexamination and make clinical diagnoses of specific oral disease endpoints. Diagnoses bycalibrated non-OHS were compared to those made by calibrated OHS, and sensitivity andspecificity computed.ResultsAmong 324 participants, the majority were black (73%), men (66%), and the median CD4+cell count 138 cells/mm3. The overall frequency of oral mucosal disease diagnosed by OHSwas 43% in US sites, and 90% in Haiti. Oral candidiasis (OC) was detected in 153 (47%) byOHS, with erythematous candidiasis (EC) the most common type (39%) followed by pseudomembranouscandidiasis (PC; 26%). The highest prevalence of OC (79%) was amongparticipants in Haiti, and among those with CD4+ cell count 200 cells/mm3 and HIV-1RNA > 1000 copies/mL (71%). The sensitivity and specificity of OC diagnoses by non-OHSwere 90% and 92% (for EC: 81% and 94%; PC: 82% and 95%). Sensitivity and specificitywere also high for KS (87% and 94%, respectively), but sensitivity was < 60% for HL andoral warts in all sites combined. The Candida culture confirmation of OC clinical diagnoses(as defined by 1 colony forming unit per mL of oral/throat rinse) was 93% for both PCand EC.ConclusionTrained non-OHS showed high accuracy of clinical diagnoses of OC in comparison withOHS, suggesting their usefulness in studies in resource-poor settings, but detection of lesscommon lesions may require OHS

Proportion of participants with a positive oral rinse culture among 153 participants¹ with a clinical diagnosis of oral candidiasis in ACTG/OHARA² protocol 5254.

<p>¹ All participants in the study had an oral rinse culture, however we only report the proportion of positive cultures, defined as ≥ 1 CFU/mL, among those who had clinical features of oral candidiasis, as potential confirmation of the clinical diagnosis</p><p>² The Oral HIV/AIDS Research Alliance (OHARA) is a Collaborative Science Group within the AIDS Clinical Trial Group (ACTG)</p><p>³ Number of clinical diagnoses. Note: participants may have more than one type of oral candidiasis, so counts do not add up to 153</p><p>Proportion of participants with a positive oral rinse culture among 153 participants<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0131001#t005fn001" target="_blank">¹</a> with a clinical diagnosis of oral candidiasis in ACTG/OHARA<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0131001#t005fn002" target="_blank">²</a> protocol 5254.</p

Socio-demographic characteristics and CD4+ cell count at enrollment, by recruitment site among 324 participants in ACTG/OHARA¹ protocol 5254.

<p>¹ The Oral HIV/AIDS Research Alliance (OHARA) is a Collaborative Science Group within the AIDS Clinical Trial Group (ACTG)</p><p>²<b>US sites</b>: Case Western Reserve University (Cleveland); Emory University (Atlanta); New York University (New York City); University of California San Francisco (San Francisco); University of North Carolina at Chapel Hill (Chapel Hill). <b>Non-US site</b>: Centre GHESKIO (Port au Prince, Haiti)</p><p>Socio-demographic characteristics and CD4+ cell count at enrollment, by recruitment site among 324 participants in ACTG/OHARA<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0131001#t001fn001" target="_blank">¹</a> protocol 5254.</p