Medical and dental students’ willingness to administer treatments and procedures for patients living with AIDS

Background. Nearly three decades after the discovery of the human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS)epidemics continue to pose significant challenges to low-income countries in sub-Saharan Africa.Objective. To assess medical and dental students’ willingness to perform specific techniques and procedures on people living with AIDS (PLWA).Methods. A survey was done among medical and dental students (N=304) at a Nigerian University using a 21-item questionnaire that elicitedresponses on sociodemographic characteristics and willingness to perform specific techniques and procedures. Analysis of variance (ANOVA) andan independent t-test were used to determine the influence of sociodemographic variables. Multiple regression analyses were used to determine the predictors of willingness.Results. The cohort of medical and dental students was willing to care for PLWA. Almost all medical students were either undecided or unwillingto perform mouth-to-mouth resuscitation. A higher proportion of dental students were either undecided or unwilling to assist during surgery, toothextractions and other procedures they considered to be invasive. More medical than dental students were willing to carry out surgical procedures.Previous personal encounters with AIDS patients, religion, and satisfaction with instructions influenced medical and dental students’ willingness tocare for PLWA, while knowing a family member living with AIDS (R2=0.22, p<0.001) was the strongest predictor of willingness to care for PLWA.Conclusion. Extensive use of clinical clerkships and exposure through direct experience are viable strategies necessary for optimising and enhancingmedical and dental students’ dispositions to perform procedures and care for PLWA

Intergovernmental Organisations and Economic Freedom: Wise Technocrats or Black Helicopters?

This article explores the relationship between country membership in major intergovernmental organisations and economic freedom. While it makes no claims to have found any broad theoretically bound, robust causal mechanism, baseline fixed effects models establish relationships amongst economic freedom and membership in the EU, NATO, WTO, UN, OECD, World Bank, and IMF. Though the results are not simple, the strongest findings are negative relationships with the UN, IMF, and WTO, and positive relationships with the World Bank and possibly the EU

Lower diagnostic accuracy of hs-cTnI in patients with prior coronary artery bypass grafting

High-sensitivity cardiac troponin T (hs-cTnT) and the ESC 0/1h-hs-cTnT-algorithm have worse performance in the early diagnosis of myocardial infarction (MI) in patients with prior coronary artery bypass grafting (CABG). It is unknown, whether this concern applies also to hs-cTnI, the most widely used analyte worldwide.; In an international multicenter diagnostic study, two cardiologists centrally adjudicated the final diagnosis in patients presenting to the emergency department with symptoms suggestive of MI according to the Third Universal Definition of MI. The objective was to compare the diagnostic accuracy of hs-cTnI assays and their performance within the ESC hs-cTnI 0/1h-algorithms in patients with versus without prior CABG. Findings were externally validated in an U.S. multicenter diagnostic study.; A total of 392/5'200 patients (8%) had prior coronary artery bypass grafting (CABG). Diagnostic accuracy of hs-cTnI as quantified by the area under the receiver-operating characteristics-curve (AUC) in these patients was high, but lower versus patients without prior CABG (e.g. hs-cTnI-Architect 0.91 versus 0.95; p = 0.016). Sensitivity/specificity of rule-out/in by the European Society of Cardiology (ESC) 0/1h-hs-cTnI-algorithms remained very high [e.g. hs-cTnI-Architect 100% and 93.5%], but efficacy was lower (52% versus 74%, p < 0.01). External validation (n = 2113) confirmed these findings in 192 patients with prior CABG using hs-cTnI-Atellica, with 52% versus 36% (p < 0.001) remaining in the observe zone.; Diagnostic accuracy of hs-cTnI and efficacy of the ESC 0/1h-hs-cTnI-algorithms are lower in patients with prior CABG, but sensitivity/specificity remain very high.; https://clinicaltrials.gov/ct2/show/NCT00470587, number NCT00470587