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Tietz, Jonathan. "The "Broadest Reasonable Interpretation" and Applying Issue Preclusion to Administrative Patent Claim Construction". Michigan Law Review, nr 117.2 (2018): 349. http://dx.doi.org/10.36644/mlr.117.2.broadest.
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Inventions are tangible. Yet patents comprise words, and words are imprecise. Thus, disputes over patents involve a process known as “claim construction,” which formally clarifies the meaning of a patent claim’s words and, therefore, the scope of the underlying property right. Adversarial claim construction commonly occurs in various Article III and Article I settings, such as district courts or the Patent Trial and Appeal Board (PTAB). When these proceedings ignore each other’s claim constructions, a patent’s scope can become inconsistent and unpredictable. The doctrine of issue preclusion could help with this problem. The Supreme Court recently reemphasized in B & B Hardware v. Hargis Industries that administrative decisions can have issue preclusive effect. But district courts and the PTAB use formally different legal standards in claim construction, where the district court takes a narrower view of a patent’s scope. This Note contends that a claim construction determination made by the PTAB under the “broadest reasonable interpretation” standard should, indeed, be the broadest reasonable interpretation of a claim. To facilitate uniformity and public notice, issue preclusion should be applied such that the PTAB’s “broadest reasonable interpretation” is an outer interpretive bound of a patent’s scope in subsequent district court litigation.
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Morris, Grant. "To Promote or Not to Promote? The Role of the Judiciary in the New Zealand Commercial Mediation Market". Victoria University of Wellington Law Review 53, nr 1 (26.05.2022): 85–104. http://dx.doi.org/10.26686/vuwlr.v53i1.7584.
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Judicial promotion of mediation has been identified as an important way to encourage and increase the amount of commercial mediation in New Zealand. This latest contribution to the New Zealand Commercial Mediation Study (NZCMS) explores the views of District and High Court judges in relation to the use of mediation in their courts. Comparisons are made with earlier NZCMS studies, including the controversial issue of mandatory mediation. While the judiciary is well placed to increase the amount of commercial mediation in New Zealand, this paper concludes that it is unlikely that this potential will be realised under the current civil procedure settings. District and High Court judges possess a good understanding of mediation and its benefits but also prioritise party autonomy in choosing whether to undertake mediation or not.
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Yell, Mitchell L., Antonis Katsiyannis, Chad A. Rose i David E. Houchins. "Bullying and Harassment of Students With Disabilities in Schools". Remedial and Special Education 37, nr 5 (wrzesień 2016): 274–84. http://dx.doi.org/10.1177/0741932515614967.
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Bullying is a common occurrence in U.S.’s schools and is currently at the forefront of national attention. Unfortunately, students with disabilities are frequently the targets of peer-on-peer bullying. The purpose of this article is to examine the legal ramifications when students with disabilities are bullied in school settings. We address court cases, state educational agency decisions, Office of Special Education Programs (OSEP) guidance, and Office of Civil Rights (OCR) rulings that have held that bullying may violate Section 504 of the Rehabilitation Act of 1973 and the Individuals With Disabilities Education Act. School personnel must address the bullying of students with disabilities in a quick and efficient manner. In fact, these decisions show that when bullying is not stopped, school district officials and personnel may be subjecting their school districts to legal risks. We end by proposing how school district officials can develop legally sound policies for identifying, investigating, and responding to incidences of bullying of students with disabilities.
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Taipale, Jaakko. "Judges’ socio-technical review of contested expertise". Social Studies of Science 49, nr 3 (czerwiec 2019): 310–32. http://dx.doi.org/10.1177/0306312719854538.
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This article investigates how civil court judges practice meta-expertise in cases that feature contradictory and inconclusive medical expertise. The empirical case study consists of a sample of eleven Helsinki district court verdicts from 2014–2017, drawn from a larger number of similar traffic insurance compensation cases. The case-type features a medical controversy concerning traumatic brain injury (TBI) diagnostics. I contend that the difficulties judges face in evaluating the medical expertise result from epistemic asymmetries between legal and medical professionals. This study highlights the importance of explaining and understanding how judges overcome uncertainty and discriminate between expert positions. Drawing from earlier studies on meta-expertise and judges’ practice of evaluating expertise in court, I introduce the concept ‘socio-technical review’ to describe judges’ practice of facilitating highly technical and esoteric scientific expertise to needs of judicial decision making. I argue that socio-technical review is a special form of practicing meta-expertise, which effectively allows meta-experts to manage epistemic asymmetries. In examining how meta-expertise is practiced in the TBI case-type, the paper contributes to general sociological understanding of decision-making under uncertainty and suggests further studies in comparable settings.
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Block, Martin E. "Implications of U.S. Federal Law and Court Cases for Physical Education Placement of Students with Disabilities". Adapted Physical Activity Quarterly 13, nr 2 (kwiecień 1996): 127–52. http://dx.doi.org/10.1123/apaq.13.2.127.
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Inclusion, the philosophy of placing all children with disabilities in regular education settings, is easily the most discussed and controversial education reform issue since the 1975 passage of PL 94-142, Education of Handicapped Children Act (EHA). However, inclusion is never mentioned in the original EHA or the updated PL 101-476, Individuals with Disabilities Education Act (IDEA) (e.g., Sherrill, 1994; Stein, 1994). What is discussed in IDEA as well as Section 504 of the Rehabilitation Act of 1973 is the “continuum of least restrictive environments” (LRE). The purpose of this paper is to (a) review United States federal laws regarding inclusion and LRE, most notably IDEA and Section 504 of the Rehabilitation Act of 1973; (b) review recent U.S. court cases regarding inclusion and LRE including three landmark cases: Roncker v. Walter (Ohio) (1983), Daniel R.R. v. State Board of Education (Texas) (1989), and Sacramento Unified School District, Board of Education v. Rachel H. (California) (1994); and (c) apply these federal laws and court decisions to physical education placement.
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Mora, María José. "The Diverse Topography of Restoration Comedy". Restoration and Eighteenth-Century Theatre Research 33, nr 1-2 (1.12.2021): 61–82. http://dx.doi.org/10.5325/rectr.33.1-2.0061.
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Abstract The choice of setting is an important element in dramatic works, one that is often aligned with the definition of character or genre. Restoration comedy has traditionally been associated with London settings, particularly with the fashionable new areas of court and town, frequented by the higher classes: St James's Park, the Mulberry Garden, the Mall, or Covent Garden. Such an assumption, however, rests largely on a view of the comic production of Restoration England which used to foreground the work of a small group of canonical playwrights like Etherege, Wycherley, and Congreve. To revise this notion, the kind of quantitative analysis facilitated by the cataloguing work of the Restoration Comedy Project can prove very useful. This article discusses the difficulties faced in the process of determining the scene of the plays and builds on the data already collected for the period 1660–1682 to trace the topography of Restoration comedy. A review of this information yields a more diverse landscape than is usually taken for granted. Only half of the plays are set in London and barely half of those lay scenes in the genteel areas of the town. Moreover, an examination of the Covent Garden comedies shows that, after the Great Fire, this district is not represented as the exclusive preserve of the gentry, but as the home of a substantial number of citizen characters too.
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Chapman, Thandeka K., i René Antrop-González. "A Critical Look at Choice Options as Solutions to Milwaukee's Schooling Inequities". Teachers College Record: The Voice of Scholarship in Education 113, nr 4 (kwiecień 2011): 787–810. http://dx.doi.org/10.1177/016146811111300401.
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Background/Context The lack of court-ordered support for race-based policies that maintain and create integrated schools has forced communities of color to seek other avenues to obtain equitable education, such as school choice. Individual states and the federal government, as seen in grant provisions through the American Reinvestment and Recovery Act, are encouraging the expansion of choice at the very time that options for increasing student diversity, particularly racial diversity, are being narrowed by the courts. Purpose/Objective/Research Question/Focus of Study The article uses critical race theory to examine the outcomes of specific school reforms, based on market theory models of school choice, that were designed to alleviate schooling inequities in urban districts. Setting The context of Milwaukee, Wisconsin, serves as a microcosm of urban districts that have embraced school choice to create more equitable schooling options. Milwaukee, like most metropolitan areas, has a history of court-ordered desegregation that served as a temporary solution to racially segregated schools. Given the federal and district court turn from supporting race-based desegregation policies in schools, Milwaukee and other metropolitan districts are looking for new models to serve students of color in their districts and cities. Research Design This article is a conceptual paper that incorporates data from a variety of sources to support the authors’ conclusions. Data Collection and Analysis Data for this project were taken from the U.S. Census Bureau, documents from newly created small high schools, such as Web sites and curriculum designs; current newspaper articles discussing issues of small high schools; archival newspaper articles documenting the creation of the 1990 choice and charter programs; professional experiences as a member of the Bill and Melinda Gates institutional selection and small-school team support system; and an empirical study that documents teachers’ attempts to provide curriculum and instruction in newly created small schools. Conclusions/Recommendations In combination, these data sources tell the story of market theory reforms that will continue to struggle to meet reformists’ goals to serve all Milwaukee populations so long as policy makers and the courts continue to deny the irrefutable power that race and class exercise in parental choice in U.S. urban schools.
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Sujayadi, Sujayadi. "INTERACTION BETWEEN THE SETTING ASIDE OF AN AWARD AND LEAVE FOR ENFORCEMENT* An Overview on Karaha Bodas Case Tension between U.S. Court and Indonesian Court". Yuridika 30, nr 2 (23.08.2017): 333. http://dx.doi.org/10.20473/ydk.v30i2.4661.
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Karaha Bodas case is a notorious case which demonstrates how is unpredictable of the Indonesian court’s practice when facing cases related to arbitration. This case shows various aberrations of the principles that have been commonly accepted in international commercial arbitration but distorted in practice, especially in Indonesia, therefore many experts in the field of international commercial arbitration always mention this case as a “pathology” in international commercial arbitration.[1] This article will examine the interaction between the attempt to set aside of the award, while on the other hand the successful party requests for enforcement in other jurisdictions. The discussion will be focused on the standings of the U.S. courts toward the annulment proceeding in and the judgement of the District Court of Central Jakarta. The findings in this article show that the U.S. courts – like any other jurisdictions – disobeyed the judgement of the annulment which was rendered by Indonesian court, because Indonesian courts were the secondary jurisdiction. In addition, the courts in which the enforcement sought may have discretion whether they will or will not enforce an award which has been vacated in the country of origin. The discretion is guaranteed under the New York Convention 1958.
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Putu Ayu Sarina Selsa Oktaviani, Anak Agung Sagung Laksmi Dewi i I Nyoman Gede Sugiartha. "Penerapan Diversi melalui Pendekatan Keadilan Restoratif (Restorative Justice) pada Anak Pelaku Penyalahgunaan Narkotika". Jurnal Preferensi Hukum 2, nr 1 (19.03.2021): 202–6. http://dx.doi.org/10.22225/jph.2.1.3068.202-206.
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This research aims to find out how implementation of the diversion of the perpetrators of the abuse of narcotic drugs by using the method of the approach of restorative justice by involving the perpetrator, the victim, the family of the offender or the victim, community counselors and professionals. The research method used is the normative legal research with approach of legislation, articles as well as the doctrine or the views from experts associated with the diversion and narcotic in children. With regard to the handling of child abuse of narcotic drugs, the problems in this thesis is the arrangement of diversion by law about the criminal justice system of the child and the application of diversion through approach restorative justice in the criminal offence of child perpetrator of abuse of narcotic. The settings regarding diversion here is actually a settling criminal acts with children outside of the criminal justice process. Where the diversion can be carried out against the perpetrator of the crime that the threat of punishment of less than 7 (seven) years and is not a repetition of the crime. Against the application of the abuse of narcotics diversion for children conducted through deliberation in accordance whit the provisions of article 8 of law about the criminal justice system so that children can make a deal with diversion consider the child’s interests, in this case intended to avoid and keep children from the judicial process. In terms of the results of the diversion agreement already agreed upon with the parties where the implementation of the outcome of the diversion agreement would of course also have to be monitored both from the elderly, the environment, and investigators also rehabilitation center to ascertain if the result of the diversion deal was already done by the child and reported to the Chairman of the District Court where the implementation of such diversion is implemented.
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Aronson, Ori. "Inferiorizing Judicial Review: Popular Constitutionalism in Trial Courts". University of Michigan Journal of Law Reform, nr 43.4 (2010): 971. http://dx.doi.org/10.36646/mjlr.43.4.inferiorizing.
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The ongoing debates over the legitimacy of judicial review-the power of courts to strike down unconstitutional statutes-as well as the evolving school of thought called "popular constitutionalism, " are characterized by a preoccupation with the Supreme Court as the embodiment of judicial power This is a striking shortcoming in prevailing constitutional theory, given the fact that in the United States, inferior courts engage in constitutional adjudication and in acts of judicial review on a daily basis, in ways that are importantly different from the familiar practices of the Supreme Court. The Article breaks down this monolithic concept of "the courts" by shifting the focus to the lower levels of the judicial system. Trial court adjudication is revealed to hold a unique transformative potential for constitutionalism: the possible enhancement of civic participation, public deliberation, and value pluralism in the process of creating constitutional meanings. The Article presents an argument for "inferiorizing" judicial review, i.e., relegating the power of judicial review to the federal district courts, and removing the Supreme Court from this practice. The inferiorizing model-a procedurally simple, though conceptually radical, jurisdictional shift-is shown to have a redeeming potential for judicial review as a democratically legitimate means of enforcing constitutional rights; while at the same time providing a robust institutional setting for the exercise of popular constitutionalism. Although it would be very difficult to bring about a full inferiorizing shift in constitutional adjudication, the Article exposes the possibilities for democracy-enhancing institutional innovation; these possibilities become available to constitutional actors once the institutional diversity of courts is recognized.
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SCHABAS, WILLIAM. "The Contribution of the Eichmann Trial to International Law". Leiden Journal of International Law 26, nr 3 (31.07.2013): 667–99. http://dx.doi.org/10.1017/s0922156513000290.
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AbstractThe trial of Adolf Eichmann was poorly received by many contemporary observers, who felt that it bent the law beyond recognition in several key areas. With the renaissance of international criminal law in recent decades, the handling of difficult issues by the District Court of Jerusalem and the Supreme Court has been shown to fare rather well. The understanding of the relationship between crimes against humanity and genocide by the Israeli courts, and their response to the charge of retroactive criminality, to the consequences of the kidnapping, and to claims that the tribunal lacked impartiality, have also stood the test of time. Perhaps most important of all, the Eichmann decisions actually moved the law forward on the question of universal jurisdiction, effectively setting aside the narrow jurisdictional frame set by the 1948 Genocide Convention. Critics at the time of the judgments, possibly influenced by the famous but harsh commentary of Hannah Arendt, were much too negative in their assessments.
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Smith, Stephen Samuel, Karen M. Kedrowski, Joseph M. Ellis i Judy Longshaw. "“Your Father Works for My Father”: Race, Class, and the Politics of Voluntarily Mandated Desegregation". Teachers College Record: The Voice of Scholarship in Education 110, nr 5 (maj 2008): 986–1032. http://dx.doi.org/10.1177/016146810811000501.
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Background/Context Unlike the situation nationally where desegregation progress is faltering, the school district in Rock Hill, South Carolina, has recently undertaken measures to increase balance in pupil assignment despite considerable local opposition to these measures and the absence of a court order requiring the district to do so. Moreover, while other districts that are also pursuing desegregation increasingly rely on voluntary strategies such as magnets, the Rock Hill school district has relied more on adjusting the boundaries of mandatory attendance zones. This article investigates the conditions and developments that facilitated the school district's voluntarily increasing its desegregation efforts through the use of mandatory strategies. In so doing, the article expands upon our previous work that raises the possibility of a new politics of school desegregation. Purpose/Objective/Research Question/Focus of Study The purpose of this essay is to clarify the meaning of voluntary desegregation; to understand the political, demographic, and other conditions that affected desegregation efforts in Rock Hill; and to relate these conditions to broader issues such as the changed (since the civil rights era) relationship between the federal government and local school districts on issues involving desegregation, the relative merits of race- versus class-based public policy, citizen participation in desegregation planning, and the Supreme Court's consideration of voluntary desegregation. Setting Rock Hill, South Carolina Research Design Case study Conclusions/Recommendations We find that Rock Hill's school desegregation efforts were facilitated by a change in school board elections, the current relatively loose coupling of policy venues on issues involving desegregation, the overlap between the interests of Blacks and working-class Whites in the development of a high school reassignment plan, citizen participation in desegregation planning, and effective leadership from the district's administration. The findings from this case study suggest that in some situations class-based public policy is more effective than race-based public policy, but they also caution equally strongly against making any sweeping claims for the generic effectiveness of class-based public policy. The findings also suggest why and how, contrary to the situation in the civil rights era, the workings of local politics in southern school districts may currently be consistent with the pursuit of school desegregation, not antithetical to it. Because of this consistency, a Supreme Court ruling against voluntary desegregation may be viewed as undermining not only the pursuit of equality of opportunity, but also the democratic ideal of popular sovereignty.
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Parsons, Gerald M. "A Cautionary Legal Tale: The Bose v. Consumers Union Case". Journal of Technical Writing and Communication 22, nr 4 (październik 1992): 377–86. http://dx.doi.org/10.2190/e077-tam0-bbry-l6tc.
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This article describes the facts of the Bose v. Consumer's Union of U.S., Inc. case, a precedent-setting libel case that involved a technical review of a product, which was litigated over a fifteen-year period, from District Court to the Supreme Court. The litigation centered on interpretation of technical phraseology. The basic facts of the case are described, central legal issues are identified and some speculation about the relevancy of the final decision to other similar future situations is suggested.
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Wasserman, Lewis M., i John P. Connolly. "The Garcetti Effect and the Erosion of Free Speech Rights of K–12 Public Education Employees: Trends and Implications". Teachers College Record: The Voice of Scholarship in Education 119, nr 6 (czerwiec 2017): 1–28. http://dx.doi.org/10.1177/016146811711900607.
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Background/Context Pickering v. Board of Education, decided by the U.S. Supreme Court in 1968, is considered the high-water mark in the constitutional protection of public employee free speech. Two significant decisions issued by that Court since Pickering have limited public employees’ expressive rights: Connick v. Myers and Garcetti v. Ceballos. Purpose/Objective The principal research questions which were the focus of this study are: is the adverse effect on free speech presumed by legal analysts following Connick and Garcetti having real effects in terms of judicial voting behavior and, if so, how has this occurred? Research Design We set up legal precedent and the judge's ideology as predictors of judicial voting behavior. The legal precedent variable delineates three intervals, namely the Pickering era [1968–1983], the Connick era [1983–2006) and the Garcetti era [2006–2014]. Two different measures of ideology are considered: party affiliation and the judge's DW-NOMINATE score. The dependent variable is the judge's individual vote in each case. Votes are categorized as pro-employer or pro-employee. Data Collection and Analysis Because our interest is specific to K–12 settings we analyze 507 judicial votes drawn from the 169 U.S. Courts of Appeals employer-employee free speech cases brought by school employees between the issuance of Pickering in 1968 and the post-Garcetti period into 2014. Since our dependent variable is dichotomous the statistical estimates are obtained via logistic regression. Conclusions/Recommendations We find that employee-plaintiffs are prevailing at lower rates at the U.S. Courts of Appeals in free speech claims against public school districts following the Garcetti decision. Since Garcetti, Courts of Appeals judges—those appointed by both Republican and Democratic presidents—have voted in an increasingly pro-employer direction. We contend this results from “doctrinal signaling,” here, the progressive curtailment in the Supreme Court of public employees’ free speech rights from Connick v. Myers in 1983 to Garcetti. We suggest this “signaling” is used by Courts of Appeals judges as an interpretive tool to give meaning to apparently ambiguous decisions such as Garcetti. Finally, the impact and implications of this negative trend for K–12 employees, as well as possible solutions, are considered.
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Kasaro, M. P., O. N. Chilyabanyama, N. S. Shah, B. Muluka, N. Kapata, A. Krüüner, I. Mwaba i in. "Performance of Xpert® MTB/RIF and Determine™ TB-LAM Ag in HIV-infected adults in peri-urban sites in Zambia". Public Health Action 10, nr 4 (21.12.2020): 134–40. http://dx.doi.org/10.5588/pha.20.0010.
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Setting: Peri-urban health facilities providing HIV and TB care in Zambia.Objective: To evaluate 1) the impact of Xpert® MTB/RIF on time-to-diagnosis, treatment initiation, and outcomes among adult people living with HIV (PLHIV) on antiretroviral therapy (ART); and 2) the diagnostic performance of Xpert and Determine™ TB-LAM Ag assays.Design: Quasi-experimental study design with the first cohort evaluated per standard-of-care (SOC; first sputum tested using smear microscopy) and the second cohort per an algorithm using Xpert as initial test (intervention phase; IP). Xpert testing was provided onsite in Chongwe District, while samples were transported 5–10 km in Kafue District. TB was confirmed using mycobacterial culture.Results: Among 1350 PLHIV enrolled, 156 (15.4%) had confirmed TB. Time from TB evaluation to diagnosis (P = 0.018), and from evaluation to treatment initiation (P = 0.03) was significantly shorter for IP than for SOC. There was no difference in all-cause mortality (7.0% vs. 8.6%). TB-LAM Ag showed higher sensitivity with lower CD4 cell count: 81.8% at CD4 < 50 cells/mm3 vs. 31.7% overall.Conclusion: Xpert improved time to diagnosis and treatment initiation, but there was no difference in all-cause mortality. High sensitivity of Determine TB-LAM Ag at lower CD4 count supports increased use in settings providing care to PLHIV, particularly with advanced HIV disease.
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Zheng, Mo. "THE EFFECTS OF REDLINING IN SINGAPORE’S RED-LIGHT DISTRICT". International Journal of Strategic Property Management 22, nr 4 (7.09.2018): 337–47. http://dx.doi.org/10.3846/ijspm.2018.5368.
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There are cities or regions with legal red-light districts in both developed and developing countries, but there are also regions or countries with no clear rules regarding prostitution. Financing issues in red-light districts represent another aspect rarely examined in the academic world. Most research studies about redlining are focused on racial or poverty levels, but this paper investigates it in relation to moral issues concerning vice activities. The objectives of this paper are to firstly analyse the red-light phenomenon in relation to sales prices and rent prices, secondly to test the redlining effect on property markets. This paper contributes to the current academic literature. The research setting of this paper is Geylang, Singapore, a place known for its centralized location, 24/7 stores, historic locales and prostitution-related business. The results indicate that the existence of Singapore’s red-light district has a negative effect on both residential purchase prices and rent levels. The results also indicate that there exists a redlining effect since the home prices have a much higher dis-count than rents.
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Cavendish, Roberta, i Cynthia Salomone. "Bullying and Sexual Harassment in the School Setting". Journal of School Nursing 17, nr 1 (luty 2001): 25–31. http://dx.doi.org/10.1177/105984050101700104.
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This article defines bullying and sexual harassment, identifies associated characteristics of the aggressor and the victim, and describes implications for school nurses. The background of federal laws with a focus on the most current 1999 Supreme Court decision, holding a school district liable for damages under federal law (Title IX), is addressed with a case study. Health promotion issues and prevention concepts are outlined in a 10-Point Action Plan to facilitate the prevention and management of bullying and sexual harassment in schools. A survey tool to assess bullying and teaching plans for parents of victims and aggressors are provided. Suggested linkage among approved nursing languages, North American Nursing Diagnosis Association (NANDA) nursing diagnoses (NANDA, 1998), Nursing Interventions Classification interventions ( Iowa Intervention Project, 2000 ), and Nursing Outcomes Classification outcomes ( Iowa Outcomes Project, 2000 ) are included for use in developing nursing care plans for both aggressors and victims of harassment.
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Mtapuri-Zinyowera, Sekesai, Edward T. Chiyaka, Wellington Mushayi, Godfrey Musuka, Florence Naluyinda-Kitabire, Angella Mushavi i Vasco Chikwasha. "PIMA Point of Care CD4+ Cell Count Machines in Remote MNCH Settings: Lessons Learned from Seven Districts in Zimbabwe". Infectious Diseases: Research and Treatment 6 (styczeń 2013): IDRT.S12801. http://dx.doi.org/10.4137/idrt.s12801.
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An evaluation was commissioned to generate evidence on the impact of PIMA point-of-care CD4+ count machines in maternal and new-born child health settings in Zimbabwe; document best practices, lessons learned, challenges, and recommendations related to scale up of this new technology. A mixed methodology approach that included 31 in-depth interviews with stakeholders involved in procurement, distribution, and use of the POC machines was employed. Additionally, data was also abstracted from 207 patient records from 35 sites with the PIMA POC CD4+ count machines and 10 other comparative sites without the machine. A clearer training strategy was found to be necessary. The average time taken to initiate clients on antiretroviral treatment (ART) was substantially less, 15 days (IQR-1-149) for sites with a PIMA POC machine as compared to 32.7 days (IQR-1-192) at sites with no PIMA POC machine. There was general satisfaction because of the presence of the PIMA POC CD4+ count machine at sites that also initiated ART.
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Altalib, Omar. "Al-Mughtaribun". American Journal of Islam and Society 14, nr 1 (1.04.1997): 116–18. http://dx.doi.org/10.35632/ajis.v14i1.2258.
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The focus of this book is on "the gradual transformation of American Muslims'perceptions and self-identification, coaxed by the ways American civillaw has penetrated and come to dominate their daily lives" (p. vii). Hence, thebook attempts to show the link between law and society by using Muslims inthe United States as a case study. It is of interest to sociologists, legal historians,political scientists, and scholars of religion and touches on the themes ofcivil rights, freedom of religion, social change, the status of minorities, andassimilation.Moore shows how Muslims in the United States have been affected byAmerican immigration law (chapters 2 and 3), religious liberty laws affectingMuslims in prison (chapter 4), hate crime legislation affecting mosques (chapter5), and zoning laws that affect mosques (chapter 6). The sources Mooreuses are historical: court records, interviews, magazine articles, and newspaperstories. She points out that there has been a great transformation in theAmerican legal system's attitude toward Islam. In 1811, the New YorkSupreme Court ruled (in People vs. Ruggles) that the "religion of Mohammed"is an impostor religion, a superstition, and is equally false and unknown(p. x). ln 1962, on the other hand, the District of Columbia U.S. District Courtruled (in Fulwood vs. Clemmer) that Muslims believe in Allah as a supremebeing and as the one true god. It follows, therefore, that the Muslim faith is areligion {p. 82).Have American legal institutions been responsive to the Muslim community?Has the American legal setting transformed the Muslim community? Theanswer to the first question, according to Moore, is that in the 1800s, "No"; butgradually the courts have become more responsive and continue to be moreresponsive as time passes and as Muslims become more politically active. Theanswer to the second question is "Yes."How has the American legal setting transformed the Muslim community?It has limited the numbers of Muslims in the United States (through immigrationrestrictions). It has increasingly allowed Muslims in prison to pray jum'ah,wear kufis on their heads, eat nonpork foods, and obtain copies of the Qur'an.It has protected Muslim mosques from vandalism through stiffer penalties forpeople committing such a crime. It has also restricted the establishment of ...
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Firmansyah, Rahmadany, Sihabudin Sihabudin i M. Sudirman. "Pengaturan Klausul Pilihan Hukum dan Pilihan Forum dalam Perjanjian Asuransi Kapal di Indonesia". Jurnal Ilmiah Pendidikan Pancasila dan Kewarganegaraan 7, nr 1 (30.03.2022): 77. http://dx.doi.org/10.17977/um019v7i1p77-86.
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The ship insurance agreement was prone to causing problems because the parties were in different jurisdictions, such as in the dispute over the PT. Purna Arthanugraha Insurance (PT. ASPAN) with PT. Indonesian Maritime Business Development (PT. Bumi Shipmanagement). The insurance policy agreement, in this case, was subject to and complied with English law, but the settlement of the case was filed in a court in Indonesia. This case became a legal problem in determining the choice of law arrangement and forum for resolving disputes. Based on these problems, this study aimed to analyze the regulation over the choice of law clause and the choice of forum in the ship insurance agreement. The approach used in this study was a case study approach and a statutory approach. The type of research used in this study was normative juridical, the data analysis technique used descriptive, interpretation, evaluation and argumentation techniques. The study results showed that the choice of law clause in the ship insurance agreement based on the agreement of the two parties referred to the applicable law in England, namely the Marine Insurance Act 1906. The setting of the forum choice clause in the ship insurance agreement was not regulated strictly and explicitly, so the dispute was submitted by one of the parties to the district court based on civil procedural law. Settlement of ship insurance agreement disputes through a lawsuit to the district court was not ideal because the district court's scope was limited to civil cases of a general nature.
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., Tashwir, Eni Kamal, Deni Sarianto, Yulia Fitri, Harminto . i Adnal Yeka. "ANALISIS FAKTOR PRODUKSI NELAYAN ALAT TANGKAP PAYANG DI KABUPATEN PADANG PARIAMAN PROVINSI SUMATERA BARAT". Jurnal Harpodon Borneo 14, nr 1 (2.07.2021): 29–38. http://dx.doi.org/10.35334/harpodon.v14i1.1877.
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It is hoped that the use of payang fishing gear can help increase the catch of fishermen who will help improve the welfare of the fishing community. The purpose of this study was to analyze the factors of production of payang fishing gear fishermen in Sungai Limau District, Padang Pariaman Regency. The research was conducted in Padang Pariaman District, namely in Sungai Limau District, the respondents in this study were full fishermen who had payang fishing gear as many as 21 fishermen and ABK sampling of 2 people each. When the study was conducted for 2 (two) months early November to the end of December 2019. This type of research used in this research is quantitative descriptive method research. The results of the analysis show that overall the factors of production, namely the trip trip factor, the amount of fuel, the number of crew members, the length of the wings, the size of the ship's engine, the setting and the institutional and policy influence on production with an F count of 28,352 2.83 on the successful production of payang fishermen's catches. In Sungai Limau District, Padang Pariaman Regency. 90.5% of payang fishermen's catch production can be explained by these factors, while 9.5% is influenced by other tractors not included in the analysis. The factor of the amount of fuel with a t count of 4.523 1.761 and the number of ABK with a t count of 3.246 1.76131 are two main factors that have a significant positive effect on the production of Payang fishermen's catches in Sungai Limau District, Padang Pariaman Regency.
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Mubaroq, Husni, i Yulia Nurul Hidayati. "ANALISIS KUALITAS PELAYANAN DAN KINERJA PEGAWAI KANTOR DESA AMBULU KECAMATAN SUMBERASIH KABUPATEN PROBOLINGGO TERHADAP KEPUASAN MASYARAKAT". Publik: Jurnal Manajemen Sumber Daya Manusia, Administrasi dan Pelayanan Publik 9, nr 4 (4.11.2022): 655–67. http://dx.doi.org/10.37606/publik.v9i4.398.
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This study aims to determine and describe the quality of service and employee performance on community satisfaction in Ambulu Village, Sumberasih District, Probolinggo Regency. This study uses descriptive quantitative methods by setting a sample of 100 people with the aim of explaining the relationship between variables through the submission of formulated hypotheses. The data analysis technique applied is multiple regression analysis. The results of the analysis answered that the quality of service and employee performance to the community there was a significant relationship. The level of significance of service quality and employee performance on employee performance can be seen through the results of the F test, it is found that service quality and employee performance simultaneously affect community satisfaction. This is evidenced by the statement, if F count F table or significant value <0.05. Then, the result of F Count is greater than F table which is 35.957 > 2.75 then Ha is accepted, which means that service quality and employee performance simultaneously have an effect on community satisfaction in Ambulu village, Sumberasih sub-district, Probolinggo district.
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Desyanti, Desyanti, Sudarsono Sudarsono, Muchamad Ali Safa’at i Tunggul Anshari Setia Negara. "Legal Implications of Regulating Judicial Review of District/City Regulations in Indonesia". International Journal of Social Science Research and Review 5, nr 1 (3.01.2022): 45–55. http://dx.doi.org/10.47814/ijssrr.v5i1.148.
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This article aims to analyze the legal implications of regulating the judicial review of district/city regulations in Indonesia. The author sees that there is incomplete regulation in the examination of statutory regulations under the law against the law, namely the incomplete set of the regional regulations touchstone, the incomplete set of the scope of the material and formal examination, the incompleteness of the legal standing arrangement, and the incomplete setting of the nature of the trial examination open to the court. This study uses a normative juridical research method with a statutory approach and a conceptual approach to provide answers to problems. The existence of incomplete regulation in the examination of legislation under the law against the law has legal implications as follows: legal uncertainty scope of material and formal testing, the absence of legal order, violation of the hierarchy of legislation, the loss of the central government's legal position in testing local regulation, and weak supervision of regional regulations by the central government.
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Reynolds, Craig J. "Rural male leadership, religion and the environment in Thailand's mid-south, 1920s–1960s". Journal of Southeast Asian Studies 42, nr 1 (14.01.2011): 39–57. http://dx.doi.org/10.1017/s0022463410000536.
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By considering the historical significance of a southern Thai policeman, Khun Phantharakratchadet (1898–2006), I aim to shift historical writing away from the court, the aristocracy and the capital even though the social setting is not merely ‘local’ or ‘peripheral’ but an amalgam of elements found throughout the country. I also want to give credit to local historians often dismissed for being parochial, untheoretical and disposed to myth-making, and to show how tantric practices (saiyasat), the arts of self-defence, policing, banditry and masculinity intersect in the career of this policeman, a native of the unique environment in the Songkhla lakes district.
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Grant, Morgan, Jaimie Remines, Pramit Nadpara i Jean-Venable Goode. "Impact of Live Training on Medication Errors in a Community-Based Pharmacy Setting". INNOVATIONS in pharmacy 11, nr 3 (28.08.2020): 11. http://dx.doi.org/10.24926/iip.v11i3.3291.
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Objective: To compare community-based pharmacy medication errors before and after a one-hour live interactive training session for both pharmacists and technicians.
Methods: A one group pre-post intervention design study was conducted in 20 community-based pharmacies in a district of a large national community pharmacy chain. A one-hour live, interactive session was developed based on incident reports and medication error trends including medication error definition, ways in which medication errors occur, strategies for mitigating errors, information about human error, and methods and habits to improve patient safety. At least 50% of full-time staff for each of the 20 pharmacies were required to attend a training session between December 1, 2017-January 15, 2018. Participants completed a demographics survey documenting gender, age, credentials, number of years of experience, and years of service with the company. Pharmacies were categorized as low, medium or high volume based on prescription count. Medication errors were compared six months pre- and post-live education session. Data were analyzed using SAS version 9.4.
Results: One hundred and thirty- five errors and 111 errors were reported pre-and post-live training (mean 6.85 and 5.55, p < 0.301), respectively. Nine pharmacies were low, eight medium, and three high volume with the mean number of medication errors reported pre- and post-live training; low 4.33 vs 4.11 p<0.478, medium 9.37 vs 6.87 p<0.443, and high 7.66 vs 6.33 p<0.593, respectively. Sixty pharmacy staff (34 pharmacists, 26 technicians) attended one of the live training sessions; 73% female; most frequently reported age range 35-50 years; 23 Doctor of Pharmacy, 11 Bachelor of Science in Pharmacy, and 26 Certified Technician; and average number of years’ experience was 13.6 and average service with the company was 8.6 years.
Conclusions: A live training session for both pharmacists and technicians did not significantly decrease medication errors, but could be incorporated as an element of a medication safety program. It should be considered for implementation in other districts of this large national pharmacy chain as a part of an improved patient safety effort.
Article Type: Original Research
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Javaria Malik, Maha Batool, Tahira Yasmeen, Shehzad Manzoor, Hamza Waqar Bhatti i Shumaila Mumtaz. "Correlation of serological markers and thombocytopenia in Dengue infection - a cross sectional study from 2019 epidemic in Rawalpindi, Pakistan." Professional Medical Journal 29, nr 06 (31.05.2022): 764–69. http://dx.doi.org/10.29309/tpmj/2022.29.06.6342.
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ABSTRACT… Objective: To recognize the spectrum of serological markers found in dengue cases and to associate them with the platelet count. Study Design: Cross Sectional Study. Setting: Department of Medicine, District Head Quarter Hospital, and Rawalpindi, Pakistan. Period: August to November 2019. Material & Methods: Serum was analyzed to detect markers of NS1 antigen, IgM and IgG using the ELSIA technique. The platelet count was likewise noted in all of the samples. Data was analyzed by SPSS v25.0. Results: 226 patients with dengue fever were enrolled in the study samples. Among 226 examples 63(27.9%) were positive for isolated NS1 antigen and 10 (4.4%) were positive for isolated IgM. Out of 134 positive primary infection cases, 108(80.5%) had thrombocytopenia while out of 92 secondary infection cases, 74(80.4%) had thromobocyte count ˂100,000/mm3. Overall, thrombocytopenia was recorded in 182(80.5%) out of 226 dengue positive cases. Conclusion: In the present research work, the relationship of low platelet count in dengue-parameters positive cases was seen as exceptionally critical. The thrombocyte count, in addition to dengue-specific parameters, is the main available diagnostic test in less developed areas that may be used to confirm the diagnosis of dengue infection.
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Alvarez-Uria, Gerardo, Manoranjan Midde, Raghavakalyan Pakam, Shanmugamari Kannan, Lakshminarayana Bachu i Praveen Kumar Naik. "Factors Associated with Late Presentation of HIV and Estimation of Antiretroviral Treatment Need according to CD4 Lymphocyte Count in a Resource-Limited Setting: Data from an HIV Cohort Study in India". Interdisciplinary Perspectives on Infectious Diseases 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/293795.
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We describe the CD4 lymphocyte count at HIV presentation in an HIV cohort from a rural district of India. The majority of patients were diagnosed for their HIV-related symptoms, although a sizeable proportion of women were diagnosed because of antenatal screening or for having an HIV-positive partner. Patients diagnosed of HIV for antenatal screening or having an HIV-positive sexual partner had higher CD4 lymphocyte count than patients having tuberculosis or HIV-related symptoms. The proportion of patients diagnosed with CD4 count <200 and <350 cells/mm3were 46% and 68.7%, respectively, and these figures did not change during the five years of the study. Factors associated with late presentations were male sex, older age, not having a permanent house, and, in women, lower education and being a widow or separated. With the implementation of 2010 WHO guidelines, the number of newly diagnosed patients who will require HIV treatment will increase 13.8%. If the CD4 count threshold for initiating HIV treatment is increased from 350 to 500 cells/mm3, the number of patients in need of treatment would increase 15.7%. Therefore, new strategies for avoiding HIV late presentation are urgently needed in developing countries.
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FUKUMOTO, KENTARO, i YUSAKU HORIUCHI. "Making Outsiders' Votes Count: Detecting Electoral Fraud through a Natural Experiment". American Political Science Review 105, nr 3 (sierpień 2011): 586–603. http://dx.doi.org/10.1017/s0003055411000268.
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Weak electoral registration requirements are commonly thought to encourage electoral participation, but may also promote electoral fraud. As one possibility, candidates and their supporters can more easily mobilize voters who do not reside within the district to register there fraudulently and vote for that district's candidates. We statistically detect this classic type of electoral fraud for the first time, by taking advantage of a natural experimental setting in Japanese municipal elections. We argue that whether or not a municipal election was held in April 2003 can be regarded as an “as-if” randomly assigned treatment. A differences-in-differences analysis of municipality–month panel data shows that the increase in the new population just prior to April 2003 is significantly larger in treatment municipalities (with an election) than in control ones (without an election). The estimated effects are decisive enough to change the electoral results when the election is competitive. We argue that our approach—“election timing as treatment”—can be applied to investigate not only this type of electoral fraud but also electoral connections in other countries.
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Mabuza, Langalibalele H., i Daniel F. Sarpong. "Indicators of Adrenal Insufficiency in TB-suspect Patients Presenting with Signs and Symptoms of Adrenal Insufficiency at Three South African Hospitals in Pretoria". Open Public Health Journal 13, nr 1 (23.05.2020): 178–87. http://dx.doi.org/10.2174/1874944502013010178.
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Background: Primary adrenal insufficiency occurs when the function of the adrenal cortex to produce cortisol is impaired. Infections, such as disseminated Tuberculosis (TB) and malignancies, are the major causes of Adrenal Insufficiency (AI) in developing countries. AI is characterized by specific symptoms, signs, and laboratory findings. Objective: To determine indicators of AI in TB-suspect patients presenting with signs and symptoms of AI. Methods: A cross-sectional study was conducted at the primary health care ward of Dr. George Mukhari Academic Hospital, Jubilee District Hospital, and Odi District Hospital. The population comprised all TB-suspects, from whom a sample of 75respondents was obtained. A researcher administered questionnaire was used to collect data related to their signs, symptoms, and laboratory findings. Results: Of the 75 respondents, 47 (62.37) and 28 (37.3%) were classified as Adrenal Sufficiency (AS) and AI, respectively. The most occurring symptoms were craving for salt, dry, itchy skin, and vomiting (prevalence: 79.7%, 68.1%, and 69.0%, respectively). Signs or symptoms by themselves did not discriminate persons with a high likelihood of AI. However, a fasting serum glucose (≤ 5.25 mmol/L), a positive GeneXpect, a low CD4 count (≤ 274.5 cells/ml), with a combination of signs and symptoms (9.5) constituted a discriminator for AI in TB-suspect patients (87.5% likelihood). Conclusion: A low fasting serum glucose, a positive GeneXpect, a low CD4 count with a minimum of ten signs and symptoms constitute a discriminator for AI in TB-suspect patients, necessitating treatment initiation to save patient lives in laboratory resource-limited settings.
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Akom, Antwi. "Eco-Apartheid: Linking Environmental Health to Educational Outcomes". Teachers College Record: The Voice of Scholarship in Education 113, nr 4 (kwiecień 2011): 831–59. http://dx.doi.org/10.1177/016146811111300404.
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Background/Context The issue of how to achieve a racially diverse student population has become increasingly challenging since a 2007 U.S. Supreme Court split decision endorsed the importance of creating diverse schools, while simultaneously limiting the assignment to public schools based on an individual student's race or ethnicity. The article examines innovative efforts at achieving racial integration in Berkeley, California, as well as other district efforts in New York City, to curtail the dangers associated with polychlorinated biphenyls (PCBs) in school building materials and develop plans to remediate contaminated school buildings. Purpose/Objective/Research Question/Focus of Study In this article, the author draws on the disciplines of environmental sociology, critical race theory, and social epidemiology to examine the relationship between school desegregation, environmental inequality, structural racialization, and health and educational outcomes. The author proposes a conceptual framework for linking environmental health to educational outcomes that considers the dynamic social processes through which social and environmental inequalities—and associated health and educational disparities—are produced, reproduced, and transformed. Setting Berkeley Unified School District has achieved substantial integration in a city where neighborhoods are polarized by racial-ethnic, socioeconomic status, and environmental inequality. Moreover, the Berkeley integration plan was upheld in 2009 by the state appellate court, a decision that the California Supreme Court allowed to stand. As a result, the Berkeley Unified School District's plan to maintain diversity could serve as a national model for other public schools that are seeking constitutionally sound desegregation programs. Research Design Using empirical evidence from the published literature, as well as the author's own practical experience conducting community-based participatory research in Berkeley, the author applies the eco-apartheid conceptual framework to the city of Berkeley. Conclusions/Recommendations The eco-apartheid framework provides a useful model for theory building in the study of environmental health and educational equity. Moreover, the author recommends that theories of racial and educational inequality in general would benefit from a more serious consideration of the role that environmental inequalities play in structuring the relationship between health and educational inequality. Additionally, the author highlights the ways in which existing research on desegregation remains in need of theoretical strength and methodological rigor with respect to environmental inequality.
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Wester, James R., Lesley E. Jackson, Kathryn Mokgosi, Tomer Barak i Mahmoud Abu Hazeem. "Bullous Scabies in an Immunocompromised Host". Case Reports in Infectious Diseases 2022 (28.03.2022): 1–4. http://dx.doi.org/10.1155/2022/3797745.
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A 40-year-old woman with a history of poorly controlled HIV presented to a district referral hospital in rural Botswana for a generalized skin rash of several months duration. The highly pruritic rash predominantly involved her hands and feet and was associated with bullae that were present for days at a time before rupturing without drainage or discharge. The patient endorsed night sweats, periodic fevers, occasional cough productive of blood-tinged sputum, fatigue, and weight loss. On admission, CD4 count was 46 cells/mm3 and viral load was >750000 copies/mL. Pulmonary tuberculosis testing via sputum was negative twice. A blood count demonstrated eosinophilia. Oral acyclovir was started empirically for disseminated herpes virus infection, with topical beclomethasone and intravenous antibiotics for possible superinfected bullous dermatosis. With inadequate response to treatment, a skin biopsy was obtained and microscopic examination demonstrated scabies mites. The absence of skin burrows, the presence of bullae, and working in a low-resource setting without direct access to microscopic examination delayed diagnosis. The patient was initiated on topical permethrin. Oral ivermectin was not available in country and was obtained from overseas shipment, delaying treatment initiation. Drastic improvement was seen after the patient initiated ivermectin. A local nurse in the patient’s village visited her community and found multiple individuals with active scabies infection. The patient’s discharge was delayed until these community members were treated successfully with topical permethrin. This case describes an atypical presentation of scabies in an under-resourced setting, demonstrating unique diagnostic, therapeutic, and public health challenges.
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Handayani, Umi, Sri Utaminingsih i Slamet Utomo. "SOFT SKILLS MODEL BASED SCHOOL CULTURE TO DEVELOPMENT STUDENT CHARACTER FOR ELEMENTARY SCHOOL STUDENTS". Refleksi Edukatika : Jurnal Ilmiah Kependidikan 11, nr 1 (9.12.2020): 1–7. http://dx.doi.org/10.24176/re.v11i1.3996.
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This study aims to develop a soft skills model based school culture for character education for elementary school students.This study is a Research and Development study with a modified Sugiyono model. This research was conducted in 3 elementary schools in the target area of III, Jekulo District, Kudus Regency. Data collection techniques using test techniques and non-test techniques. Data analysis in this study was carried out descriptively quantitative and statistical tests using t-test.The results of the research were in the form of a soft skills model design product based on school culture which had components of goal setting, soft skill values, school culture and character education. The soft skills model based on school culture is suitable for use as a learning model in elementary schools. The results of the t test show that t count t table, so that the soft skills model based on school culture is effectively applied in learning.
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Hemmy Asamsama, Octaviana, Leah Squires, Alpha Tessema, Ephrem Rae, Karen Hall, Rush Williams i Debra Benator. "HIV Nurse Navigation: Charting the Course to Improve Engagement in Care and HIV Virologic Suppression". Journal of the International Association of Providers of AIDS Care (JIAPAC) 16, nr 6 (11.10.2017): 603–7. http://dx.doi.org/10.1177/2325957417732835.
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This study represents one of the few exploring the effectiveness of an integrated HIV nurse navigation program on engagement and virologic outcomes. A navigator provided individualized care management (eg, pillbox renewals), intensive outreach, and collaboration with existing support systems (eg, families, community programs). Clinical data from the Veterans Affairs (VA) Medical Center site of a longitudinal, observational study of HIV in the District of Columbia (DC) cohort were used for comparison (N = 706). Navigation patients (n = 84) were less likely to have permanent housing, and more likely to be disabled, have detectable viral load, comorbid depressive, and substance use disorders. Navigation patients showed improvements in clinic visits (doubled), rate of medication renewal (40.91% to 80.61%), CD4 count and CD4%, and viral rates of Veterans with <200 copies/mL increased from 47.6% to 69.0% after one year. Integration of nurse navigation into a HIV primary care setting shows promise in improving engagement and virologic suppression in a high-risk population.
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Baldovin, Tatjana, Irene Amoruso, Fabrizio Caldara, Alessandra Buja, Vincenzo Baldo, Silvia Cocchio i Chiara Bertoncello. "Microbiological Hygiene Quality of Thermal Muds: A Pilot Study in Pelotherapy Facilities of the Euganean Thermal District (NE Italy)". International Journal of Environmental Research and Public Health 17, nr 14 (13.07.2020): 5040. http://dx.doi.org/10.3390/ijerph17145040.
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Evaluation of hygienic aspects of thermal mud microbiology is still neglected. This study evaluates the microbiological hygiene quality of thermal muds, providing a comprehensive assessment of the whole mud cultivation chain. Maturing mud, peloid and used mud samples were collected twice in a year from 30 SPAs of the Euganean Thermal District, NE Italy. Samples were processed with an ad hoc laboratory method. The following indicator parameters were assessed: Total Count at 22, 37 and 55 °C; total coliforms; Escherichia coli; enterococci; Staphylococcus aureus; Pseudomonas aeruginosa; sulfite-reducing clostridia; dermatophytes. Statistical significance of differences between the two sampling campaigns and correlation between temperature and indicator parameters were evaluated. One-hundred eighty samples were analyzed. Widespread presence of environmental species was found, as well as hints of possible microorganism transfer from the patient’s skin to the mud. Proper setting of thermal water temperature resulted critical, in terms of hygienic quality. Although optimal maturation should be granted (thermal water at 30–42 °C), a pasteurization step at 60–65 °C is strongly recommended to sanitize peloids before pelotherapy. Facilities re-using thermal muds should also implement a regeneration step at ≥65 °C. Core evaluation of thermal mud hygienic quality could encompass the following guidelines: absence (i.e., 0 colony forming units (CFU)/g) of E. coli, P. aeruginosa, S. aureus and dermatophytes.
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Kunutsor, Setor, John Walley, Elly Katabira, Simon Muchuro, Hudson Balidawa, Elizabeth Namagala i Eric Ikoona. "Clinic Attendance for Medication Refills and Medication Adherence amongst an Antiretroviral Treatment Cohort in Uganda: A Prospective Study". AIDS Research and Treatment 2010 (2010): 1–8. http://dx.doi.org/10.1155/2010/872396.
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Background. Regular clinic attendance for antiretroviral (ARV) drug refills is important for successful clinical outcomes in HIV management.Methods. Clinic attendance for ARV drug refills and medication adherence using a clinic-based pill count in 392 adult patients receiving antiretroviral therapy (ART) in a district hospital in Uganda were prospectively monitored over a 28-week period.Results. Of the 2267 total scheduled clinic visits, 40 (1.8%) were missed visits. Among the 392 clients, 361 (92%) attended all appointments for their refills (regular attendance). Clinic attendance for refills was statistically significantly associated with medication adherence with regular attendant clients having about fourfold greater odds of achieving optimal (≥95%) medication adherence [odds ratio(OR)=3.89, 95% CI: 1.48 to 10.25, exactP=.013]. In multivariate analysis, clients in age category 35 years and below were less likely to achieve regular clinic attendance.Conclusion. Monitoring of clinic attendance may be an objective and effective measure and could be a useful adjunct to an adherence measure such as pill counting in resource-constrained settings. Where human resource constraints do not allow pill counts or other time-consuming measures, then monitoring clinic attendance and acting on missed appointments may be an effective proxy measure.
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Box-Steffensmeier, Janet M., Charles P. Campisano, Matthew P. Hitt i Kevin M. Scott. "Advising, Consenting, Delaying, and Expediting: Senator Influences on Presidential Appointments". Studies in American Political Development 30, nr 1 (9.02.2016): 19–37. http://dx.doi.org/10.1017/s0898588x15000140.
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When, how, and under what conditions can individual legislators affect presidential appointments? Since the early 1900s, the senatorial norm of the blue slip has played a key role in the confirmation process of federal district and appeals court judges, and it is an important aspect of the individual prerogative that characterizes senatorial behavior more broadly. We analyze newly available blue slips, covering the historical period 1933–1960. We show that the blue slip functioned in this era most often to support and expedite nominations, indicating that senators used this device to shape the nominations agenda in this period. Additionally, we analyze the factors that contributed to an individual senator's decision to support or oppose a nominee, or return a blue slip at all, finding that senators were more likely to return positive blue slips when the Judiciary Committee chair was not a coalition ally. We argue that while blue slips did at times provide an early warning for poor nominees, they more often offered a means by which senators ensured that their desired nominees were confirmed swiftly. The positive role of the blue slip demonstrates that this device protected the individual prerogatives of senators, allowing them a degree of agenda-setting authority with regard to nominees in the weak parties era.
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Lifson, Alan Raymond, Sale Workneh, Abera Hailemichael, Richard Fleming MacLehose, Keith Joseph Horvath, Rose Hilk, Anne Redmond Sites i Tibebe Shenie. "Advanced HIV Disease among Males and Females Initiating HIV Care in Rural Ethiopia". Journal of the International Association of Providers of AIDS Care (JIAPAC) 18 (1.01.2019): 232595821984719. http://dx.doi.org/10.1177/2325958219847199.
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Despite recommendations for rapidly initiating HIV treatment, many persons in sub-Saharan Africa present to care with advanced HIV disease. Baseline survey and clinical data were collected on 1799 adults newly enrolling at 32 district hospitals and local health HIV clinics in rural Ethiopia. Among those with complete HIV disease information, advanced HIV disease (defined as CD4 count <200 cells/mm3 or World Health Organization [WHO] HIV clinical stage III or IV disease) was present in 66% of males and 56% of females ( P < .001). Males (compared to females) had lower CD4 counts (287 cells/mm3 versus 345 cells/mm3), lower body mass index (19.3 kg/m2 versus 20.2 kg/m2), and more WHO stage III or IV disease (46% versus 37%), ( P < .001). Men reported more chronic diarrhea, fevers, cough, pain, fatigue, and weight loss ( P < .05). Most initiating care in this resource-limited setting had advanced HIV disease. Men had poorer health status, supporting the importance of earlier diagnosis, linkage to care, and initiation of antiretroviral therapy.
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Orishaba, Philip, Joan N. Kalyango, Pauline Byakika-Kibwika, Emmanuel Arinaitwe, Bonnie Wandera, Thomas Katairo, Wani Muzeyi i in. "Increased malaria parasitaemia among adults living with HIV who have discontinued cotrimoxazole prophylaxis in Kitgum district, Uganda". PLOS ONE 15, nr 11 (11.11.2020): e0240838. http://dx.doi.org/10.1371/journal.pone.0240838.
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Background Although WHO recommends cotrimoxazole (CTX) discontinuation among HIV patients who have undergone immune recovery and are living in areas of low prevalence of malaria, some countries including Uganda recommend CTX discontinuation despite having a high malaria burden. We estimated the prevalence and factors associated with malaria parasitaemia among adults living with HIV attending hospital outpatient clinic before and after discontinuation of CTX prophylaxis. Methods Between March and April 2019, 599 participants aged 18 years and above, and attending Kitgum hospital HIV clinic in Uganda were enrolled in a cross study. A standardized questionnaire was administered and physical examination conducted. A finger-prick blood sample was collected for identification of malaria parasites by microscopy. The prevalence of parasitaemia was estimated and compared among participants on and those who had discontinued CTX prophylaxis, and factors associated with malaria parasitaemia assessed. Results Of the enrolled participants, 27 (4.5%) had malaria parasites and 452 (75.5%) had stopped CTX prophylaxis. Prevalence of malaria parasitaemia was significantly higher in participants who had stopped CTX prophylaxis (5.5% versus 1.4% p = 0.03) and increased with increasing duration since the discontinuation of prophylaxis. Compared to participants taking CTX, those who discontinued prophylaxis for 3–5 months and >5 months were more likely to have malaria parasites (adjusted prevalence ratio (aPR) = 1.64, 95% CI 0.37–7.29, p = 0.51, and aPR = 6.06, 95% CI 1.34–27.3, P = 0.02). Low CD4 count (< 250cells/mm3) was also associated with increased risk of having parasites (aPR = 4.31, 95% CI 2.13–8.73, p <0.001). Conclusion People from malaria endemic settings living with HIV have a higher prevalence of malaria parasitaemia following discontinuation of CTX compared to those still on prophylaxis. The risk increased with increasing duration since discontinuation of the prophylaxis. HIV patients should not discontinue CTX prophylaxis in areas of Uganda where the burden of malaria remains high. Other proven malaria control interventions may also be encouraged in HIV patients following discontinuation of CTX prophylaxis.
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Pear, Veronica A., Julia P. Schleimer, Elizabeth Tomsich, Rocco Pallin, Amanda Charbonneau, Garen J. Wintemute i Christopher E. Knoepke. "Implementation and perceived effectiveness of gun violence restraining orders in California: A qualitative evaluation". PLOS ONE 16, nr 10 (19.10.2021): e0258547. http://dx.doi.org/10.1371/journal.pone.0258547.
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Background Uptake of gun violence restraining orders (GVROs), which temporarily prohibit the possession and purchase of firearms and ammunition from individuals at particularly high risk of harming themselves or others with a firearm, has been slow and heterogenous across California. Insights into the implementation process and perceived effectiveness of the law could guide implementation in California and the many states that have enacted or are considering enacting such a law. Methods We conducted 21 semi-structured interviews with 27 key informants, including judges, law enforcement officers, city and district attorneys, policy experts, and firearm violence researchers. Analysis of transcripts was guided by grounded theory and the Consolidated Framework for Implementation Research (CFIR). Findings The following constructs emerged within 4 CFIR domains as salient features of implementation: 1) implementation characteristics: risk of violence, cost, and adaptability; 2) outer setting: interagency coordination and local firearm ideology; 3) inner setting: readiness for implementation and law enforcement firearm culture; and 4) implementation process: planning and engaging with those involved in implementation. Key informants perceived the law to be effective, particularly for preventing firearm suicide, but agreed that more research was needed. While most indicated that the law resulted in positive outcomes, concerns about the potential for class- and race-based inequities were also raised. Conclusions Implementation of the GVRO law in California was hampered by a lack of funding to support local proactive implementation efforts. This resulted in ad hoc policies and procedures, leading to inconsistent practices and widespread confusion among those responsible for implementation. In states that have not begun implementation, we recommend dedicating funding for implementation and creating local procedures statewide prior to the law’s rollout. In California, recommendations include providing training on the GVRO law—including an explication of agency-specific roles, responsibilities, and procedures—to officers, city attorneys, and civil court judges.
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Yusuf, Lydia, Srivasavi Dukka i Etienne Ciantar. "Hermansky–Pudlak syndrome in pregnancy: A case report". Obstetric Medicine 9, nr 4 (19.08.2016): 171–73. http://dx.doi.org/10.1177/1753495x16662580.
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Hermansky–Pudlak syndrome is a rare autosomal recessive disorder estimated to affect 1 in 500,000 to 1,000,000 individuals worldwide. Clinically, it presents as oculocutaneous albinism combined with bleeding diathesis. This is due to the absence of dense bodies in platelets causing a delayed secondary response resulting in prolonged bleeding time despite normal platelet count and coagulation factors. This has consequences for major bleeding, the risk of which is high at delivery. In the longer term, the condition is also associated with the development of pulmonary fibrosis, inflammatory bowel disorders caused by granulomatous colitis and renal failure. We present a case of a patient with Hermansky–Pudlak syndrome diagnosed and managed through her second pregnancy by the Obstetric Haematology team in a Tertiary Unit. During her previous pregnancy at a District Hospital, they had not been aware of the diagnosis; she then had a forceps delivery and her haemoglobin dropped to 69 g/L. During this pregnancy, she was managed in a multidisciplinary setting involving obstetrics, haematology, anaesthesia and neonatology. She was induced at 39 weeks and had human leukocyte antigen-matched platelets prepared for her delivery. Her platelet count was normal throughout the pregnancy. She had a normal vaginal delivery under platelet cover and also received tranexamic acid at the time of cord clamping. Her blood loss was moderate and her haemoglobin dropped from 115 to 97 g/L. She recovered well. We discuss the diagnosis, pathology and management of this very rare condition in pregnancy and thereafter.
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Withanage, Gayan P., Sameera D. Viswakula, Yasanthi Silva Gunawardene i Menaka D. Hapugoda. "Use of Novaluron-Based Autocidal Gravid Ovitraps to Control Aedes Dengue Vector Mosquitoes in the District of Gampaha, Sri Lanka". BioMed Research International 2020 (2.03.2020): 1–9. http://dx.doi.org/10.1155/2020/9567019.
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Dengue is the most important mosquito-borne viral infection in Sri Lanka causing an enormous social and economic burden in the country. In the absence of therapeutic drugs and the developed vaccines are under investigation, vector control is the best strategy to reduce the disease transmission. Therefore, the development of novel tools to control dengue vector mosquitoes has become the need of the hour. Novaluron is a recently developed Insect Growth Regulator (IGR) which inhibits chitin synthesis in immature stages of insects. The aim of the study was to identify the efficacy of a simple and cost-effective Autocidal Gravid Ovitrap (AGO) developed using Novaluron to control dengue outbreaks in the District of Gampaha, Sri Lanka. Laboratory and semifield experiments were performed to identify the activity range, optimum field dosage, and residual effects of Novaluron following the World Health Organization guidelines, and field experiments were performed in the Ragama Medical Officer of Health (MOH) area. Two study areas 800 m apart were selected and assigned as treated and control areas randomly. In each study area, 30 households were selected randomly. Each household was given two ovitraps, one placed indoors and the other placed outdoors. Mortality and survival counts were recorded separately for one-year time period and data were analyzed using a two-way repeated measures analysis of variance model. During the laboratory experiments, the adult emerging inhibition was 100% in all tested concentrations. The optimum field dosage was 2 ppm and the residual effect was 28 days. In the field experiments, significantly higher mortality counts were recorded in treated areas both indoor- and outdoor-placed AGOs. Two-factor repeated measures ANOVA followed by Tukey’s test confirmed that the mean mortality count is high for the developed AGOs both indoor and outdoor settings. The developed AGO can be deployed to control both indoor and outdoor dengue vector mosquito populations, and in dengue-risk areas, the ovitrap will be supportive to local health authorities to enhance the efficiency of future vector control programs.
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Klotz, Stephen A., Hao Cong Nguyen, Tam Van Pham, Liem Thanh Nguyen, Dong Thi Anh Ngo i Son Nhoc Vu. "Clinical features of HIV/AIDS patients presenting to an inner city clinic in Ho Chi Minh City, Vietnam". International Journal of STD & AIDS 18, nr 7 (1.07.2007): 482–85. http://dx.doi.org/10.1258/095646207781147265.
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An outpatient HIV clinic was opened in March 2005 in Binh Thanh District, a poor section of Ho Chi Minh City, Vietnam. Over 1500 patients were seen in the first year. The average age of patients was 27 years. Men represented 77% of the clinic population, women, 23% and children under the age of 16 years of age, 5% of the population. The most common risk factor among men was being an injecting drug user (IDU), 76%, and among women, being married to an IDU HIV-positive man, 35%. Physical signs of disease were uncommon: lymphadenopathy in 24% and hepatomegaly and splenomegaly in 4% and 3%, respectively. Men and women were anaemic at presentation, with a mean haemoglobin of 11.9 g/dL and 11.1 g/dL, respectively. An overwhelming majority of patients had profound immunodeficiency. The mean CD4+ cell count was 164 cells/mL and the median was 69 cells/mL. No correlation was found between the World Health Organization's stage of disease and the CD4+ cell count. Thus, the former is a poor predictor of immunity in this population. Data regarding opportunistic infections diagnosed at the first visit were studied. Candidiasis of the oral pharynx, oesophagus or vagina was found in 34.5% of the patients, and pulmonary and extrapulmonary tuberculosis was found in 32% of the patients. Pneumocystis carinii pneumonia (PCP) was diagnosed in only 3% of the patients. Cotrimoxazole prophylaxis is advocated for HIV-infected Vietnamese, but the incidence of PCP is negligible and resources could be spent elsewhere. The various opportunistic infections seen in this resource-poor clinic setting is likely to be a pattern of presentation of HIV-infected Vietnamese for some time to come.
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Wells, Amy Stuart, Jacquelyn Duran i Terrenda White. "Refusing to Leave Desegregation Behind: From Graduates of Racially Diverse Schools to the Supreme Court". Teachers College Record: The Voice of Scholarship in Education 110, nr 12 (grudzień 2008): 2532–70. http://dx.doi.org/10.1177/016146810811001204.
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Background/Context In light of the June 2007 U.S. Supreme Court decision in the Louisville and Seattle voluntary school desegregation cases, making it more difficult for district officials to racially balance their schools, this article presents an analysis of prior research on the long-term effects of attending racially diverse schools on their adult graduates as well as new data from interviews with graduates of desegregated schools in Louisville and Seattle. Although the bulk of research on school desegregation examines what is happening to students while they are still in school and their immediate academic outcomes, the growing body of research on the long-term effects of attending racially diverse schools on adult graduates is powerful and significant and, thus, should play a central role in public debates about the future of racial integration in American schools following the Court's ruling in these cases, referred to as Parents Involved. Taken together, findings from this research on the long-term effects of school desegregation speak to both of the central themes to emerge from the larger body of research on racial integration within public schools or universities: 1. the “legacies of structural inequality” theme, which addresses the need for race-conscious policies to overcome decades of perpetuated racial inequality and 2 the “diversity rationale,” which focuses on preparing young people for a diverse society. The new interview data from Louisville and Seattle confirm these prior findings and add new insights. Purpose Knowing that prior research on the long-term effects of school desegregation spoke to the central legal issue in the cases before the Supreme Court in the Parents Involved cases, we wanted to explore the two prominent themes from that literature — “structural inequality” and the “diversity rationale” — as they related to the life experiences of Louisville and Seattle graduates of racially diverse schools. Participants We interviewed 42 graduates—classes of 1985 and 1986—of six high schools: Central, Fern Creek, and Louisville Male high schools in Louisville, and Franklin, Garfield, and Ingraham high schools in Seattle. These six schools were selected because in each city, they represented a wide range of student experiences given their different geographic locations within their districts, their curricular programs, and the social class and racial make-up of their student bodies by the mid-1980s. Still, in each of these schools, no one ethnic group made up more than 75% of the student body at the time these graduates attended them. Research Design Qualitative, in-depth interviews with a random sample of adult graduates (graduating classes of 1985 and 86) from six racially diverse high schools, which were purposively sampled to reflect the different experiences of student who went to public high schools in Louisville and Seattle at that time. Data Collection and Analysis Using a semi-structured, open-ended interview protocol, the authors interviewed a total of 19 graduates from the three Louisville high schools and 23 graduates from the Seattle high schools. In terms of the racial/ethnic identities of these 42 graduates from the six high schools across the two cities, 22 identified themselves as White, 14 as African Americans, 4 as Asian/Pacific Islanders, and 2 as mixed race, including one who was half Latino and half White. Each interview lasted approximately 45 minutes—although they varied in length from 20 minutes to more than an hour—and was tape-recorded and transcribed verbatim. The transcripts were coded for themes that emerged from the interviewees’ responses across schools and context, and the following findings emerged as the most salient experiences of graduates across the six schools. Findings/Results 1. Graduates of racially mixed schools in Louisville and Seattle said they learned to be more accepting of and comfortable with people of other racial backgrounds. Like their counterparts in the six cities of the Wells et al. (in press) study, the Louisville and Seattle graduates we interviewed said they believe that their day-to-day experiences attending diverse public schools as children and adolescents did indeed change them, making them more open-minded and thus more accepting of people who differ from them racially and in terms of their background and culture. 2. Louisville and Seattle graduates and the diversity rationale: Desegregated public schools prepared them for a global economy and society. Preparation for working in a diverse setting—the “diversity rationale”—was, for these graduates, by far the most obvious and pragmatic outcome of their experiences in desegregated public schools. The vast majority of graduates we interviewed in Louisville and Seattle said that at work in particular, they draw on the skills they learned in their desegregated public schools, skills of getting along and feeling comfortable with people of divergent backgrounds and cultures. 3. Overcoming structural inequality: Without diverse public schools, most graduates would have grown up in race isolation. In a society in which housing patterns, places of worship, and social circles are often segregated by race, diverse public schools have been, for many students, the only institutions in which cross-racial interaction and understanding can occur. They have also too often been historically the only institutions in our society in which students of color can gain access to predominantly White and prestigious institutions—in K–12 schooling or higher education. Conclusions/Recommendations We argue, based on our research and that of many others, that in an era when technology and free trade are breaking down physical and economic barriers across cultures and traditions, to not prepare our children to embrace and accept differences to the extent possible—the diversity rationale—is shortsighted and irresponsible. But even more important, we need to question how we can maintain a healthy democracy in a society so strongly divided by race, social class, and ideology now that the Supreme Court's decision has made it increasingly difficult to challenge such structural inequality, in spite of a compelling rationale for greater school-level diversity.
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Alvarez-Uria, Gerardo, Manoranjan Midde, Raghavakalyan Pakam, Lakshminarayana Bachu i Praveen Kumar Naik. "Effect of Formula Feeding and Breastfeeding on Child Growth, Infant Mortality, and HIV Transmission in Children Born to HIV-Infected Pregnant Women Who Received Triple Antiretroviral Therapy in a Resource-Limited Setting: Data from an HIV Cohort Study in India". ISRN Pediatrics 2012 (3.06.2012): 1–9. http://dx.doi.org/10.5402/2012/763591.
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We describe a programme for the prevention of mother-to-child transmission (PMTCT) of HIV that provided universal antiretroviral therapy (ART) to all pregnant women regardless of the CD4 lymphocyte count and formula feeding for children with high risk of HIV transmission through breastfeeding in a district of India. The overall rate of HIV transmission was 3.7%. Although breastfeeding added a 3.1% additional risk of HIV acquisition, formula-fed infants had significantly higher risk of death compared to breastfed infants. The cumulative 12-month mortality was 9.6% for formula-fed infants versus 0.68% for breastfed infants. Anthropometric markers (weight, length/height, weight for length/height, body mass index, head circumference, mid-upper arm circumference, triceps skinfold, and subscapular skinfold) showed that formula-fed infants experience severe malnutrition during the first two months of life. We did not observe any death after rapid weaning at 5-6 months in breastfed infants. The higher-free-of HIV survival in breastfed infants and the low rate of HIV transmission found in this study support the implementation of PMTCT programmes with universal ART to all HIV-infected pregnant women and breastfeeding in order to reduce HIV transmission without increasing infant mortality in developing countries.
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Mabokela, Reitumetse Obakeng, i Jean A. Madsen. "African American Teachers in Suburban Desegregated Schools: Intergroup Differences and the Impact of Performance Pressures". Teachers College Record: The Voice of Scholarship in Education 109, nr 5 (maj 2007): 1171–206. http://dx.doi.org/10.1177/016146810710900503.
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Background/Context There is much research that examines how desegregation literature has implications for majority teachers and its impact on students of color. However, little has been written about the experiences of teachers of color working in suburban desegregated majority schools. Focus of Study This article examines how intergroup differences created performance pressures for African American teachers and how this affected their ability to contribute optimally in these environments. Setting The study took place in four predominantly European American districts that surround a large midwestern metropolitan area. When the desegregation program was implemented in these districts, it was court mandated; however, now the program operates on a volunteer basis whereby students can elect to participate and withdraw as necessary. The district accepted less than 25% of their minority students from a court-mandated desegregation program. Participants A total of 7 male and 7 female African American teachers were interviewed. These male and female participants differed in grade-level positions. There were 4 female African American teachers at the elementary level, and 1 female and 3 male African American teachers at the middle school level. At the secondary level, there were 2 female and 4 male teachers who taught English, math, and history. There were some similarities between the male and female African American teachers. Research Design For this study, a case study is defined as a single entity, a unit of similar groups of people within the bounded context of suburban desegregated schools surrounding a midsized midwestern city. Case studies are differentiated from other types of qualitative research in that they are intense descriptions and analysis of a single unit or bounded system. Data Collection and Analysis In our sample of 14 participants, we had an equal representation of males and females (7 each). We were specifically interested in the perceptions and experiences of the African American teachers in their interactions with school administrators, parents, and students. A qualitative thematic strategy of data analysis was employed to categorize and make judgments about the interpretation of the data. This analytical procedure allowed important themes and categories to emerge inductively from the data across schools and districts. The researchers used the prior-research-driven approach to identify themes and to develop a coding process. In establishing the reliability for this study, the data were analyzed using what Glaser and Strauss called a constant comparative method. Conclusions and Recommendations Our findings, based on the experiences of 14 self-reported accounts of African American teachers in these school environments, illuminated patterns of experiences for teachers of color. Regarding the first subtheme, automatic notice, teachers developed strategies that assisted them in their transitions to inhospitable environments in the suburban schools. The female teachers reported the need for a strong reference-group orientation that would enable them to retain their cultural identity within the school. Whereas the female teachers viewed automatic notice negatively, the male participants recognized their high visibility as way to compete with their peers. Dealing with symbolic consequences, the second emergent subtheme, underrepresented individuals often bear the burden of dispelling myths and representing their race in their exchanges with coworkers. The African American teachers also became resistant to representing their race. In many ways, these teachers expressed the notion that their European American colleagues expected them to take ownership for issues that affected only the African American children. These teachers were compromised by this narrow definition of their expertise and disliked their limited role as the “minority representative.” In fighting discrepant stereotypes, the third subtheme, the underrepresented African American teachers had to defend their status to have their accomplishments recognized. The teachers reported that their individuality was often overshadowed by their colleagues’ stereotypical beliefs about African Americans. The male teachers constantly had to refute negative male African American stereotypes, and the women had to deal with proving their worth as “qualified” teachers. The final pressure, what we call cultural switching, became apparent as the African American female teachers expressed the heaviness of being in an environment where they were often one of few people of color, or the only person of color, in the school. The female teachers struggled with the cultural incongruity that occurred between them and their European American peers. In many ways, these performance pressures resulted in the feeling constrained and unable to use social cues to navigate their school's culture. Recommendations from this study may provide insights on how suburban desegregated schools may improve workplace relationships to recruit and retain teachers of color in these contexts.
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Mukherjee, S., B. Quilty, H. Burstow i K. Hennessy. "AB0808 IMPLEMENTING IPad-BASED ASSESSMENTS TO IMPROVE PERFORMANCE IN A PSORIATIC ARTHRITIS CLINIC AT A DISTRICT GENERAL HOSPITAL". Annals of the Rheumatic Diseases 79, Suppl 1 (czerwiec 2020): 1705.1–1706. http://dx.doi.org/10.1136/annrheumdis-2020-eular.1111.
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Background:Psoriatic Arthritis (PsA) is a complex disease with profound physical and psychosocial effects. The core domain set for this condition was updated by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)-Outcome Measures in Rheumatology (OMERACT) PsA working group in 20161and the TICOPA (TIght COntrol of Psoriatic Arthritis) study suggested that adopting a ‘treat-to-target’ approach aiming for Minimal Disease Activity (MDA) could result in better clinical outcomes2.Objectives:To improve assessment of all the core domains of PsA during clinic appointments and aim to treat these patients using a ‘treat-to-target’ approach to improve clinical outcomes.Methods:We were able to confirm through a retrospective baseline audit that all core domains of PsA were not being fully addressed in our general rheumatology clinics. A dedicated weekly PsA clinic was then set up at our district general hospital. Subsequently, iPads incorporated with GRAPPA App were implemented in these clinics to facilitate multi-domain assessments aiming for MDA. This was supported by a Health Education England (Wessex) Quality Improvement Fellowship that involved rheumatology and dermatology team members working in close collaboration. We then carried out a re-audit to assess our performance. Additionally we set up quarterly combined Rheumatology and Dermatology clinics for patients with severe joint and skin involvement. We also conducted a baseline survey by asking patients for their opinion about the ‘setting up of the dedicated PsA service’, the ‘quarterly combined clinics’ and the ‘use of iPad-based assessments’. We asked them to score each of these on a scale of 0 to 10, with 0 being ‘very negative’ and 10 ‘very positive’.Results:We had pragmatically set a standard of 75% for our baseline audit but we found an overall compliance of only 27.4%. There was also a wide variation between different domains with a compliance of even 0% for some. Domains that are not assessed are unlikely to be fully taken into account when deciding about treatment. The re-audit following the implementation of iPad-based assessments in dedicated PsA clinics showed a significant improvement in each of the domains and the overall compliance went up to 97.9% (Table 1). The patient survey findings were also excellent with mean scores of 9.5, 9.0 and 9.5 respectively for the three items (Figure 1).Table. 1Audit(n = 25)Re-audit(n = 29)ComplianceQ1. Documented evidence of joint count being performed?84.0%100.0%Q2. If yes, then was it a 66/68 count for swollen and tender joints?4.7%100.0%Q3. Documented evidence of dactylitis being assessed?8.0%100.0%Q4. Documented evidence of enthesitis being assessed?4.0%100%Q5. Documented evidence of assessment of spinal involvement?8.0%100.0%Q6. Documented evidence of assessment of skin involvement?36.0%100.0%Q7. Documented evidence of assessment of nail involvement?4.0%93.1%Q8. Documented evidence of assessment of fatigue?8.0%96.6%Q9. Documented evidence of assessment of degree of pain?60.0%100.0%Q10. Documented evidence of patient’s global assessment?68.0%96.6%Q11. Documented evidence of assessment of physical function?0.0%96.6%Q12. Documented evidence of assessment of health-related quality of life?0.0%93.1%Q13. Documented evidence of assessment of systemic inflammation?72.0%96.6%Overall Compliance27.4%97.9%Conclusion:Dedicated PsA clinics using the GRAPPA App on iPads could facilitate comprehensive multi-domain assessments of patients with PsA and potentially lead to better outcomes as well as greater patient satisfaction.References:[1]Orbai AMet al., (2017) Updating the psoriatic arthritis (PsA) core domain set: a report from the PsA workshop at OMERACT 2016. J Rheumatol 44(10):1522–1528[2]Coates LCet al., Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial. Lancet. 2015; 386(10012):2489–2498AcknowledgmentsDisclosure of Interests:None declared
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I Made Suarja, Simon Nahak i I Ketut Widia. "Perlindungan Hukum terhadap Kreditur Pemegang Jaminan Fidusia yang Dipindah Tangankan". Jurnal Konstruksi Hukum 1, nr 2 (28.10.2020): 431–35. http://dx.doi.org/10.22225/jkh.2.1.2628.431-435.
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This research was conducted based on fiduciary guarantee of execution provided for in Article 29 of Act No. 42 of the year 1999 about Fiduciary Guarantee stating that the fiduciary guarantee execution can be carried out by means of the execution of the title eksekutorial, the distribution of sale through the society, or sale under the hand with the consent of both parties. However, in practice when it will do the execution of fiduciary guarantee, guarantee that turned out to be transferable and controlled by third parties without the consent of the borrower. Formulation of the problem in this study was 1. The requirements are to be met by the lender in order to have the power of doing execution in granting credit Guarantee Chattels? 2. How is the legal protection for the lender that guarantees Fiduciary transferable? The purpose of the research to know the procedure of obtaining legal protection for holders of a Fiduciary which is transferable. The theory is a theory of legal certainty and the protection of the law. This type of research approach with normative approach legislation and the approach to the case. The first discussion about the terms of execution of fiduciary guarantee and second set of laws regarding a lender to Fiduciary redirected. The result of the research showed that if not created by notariil and registered office at Fiduciary, then their execution procedures can only be done with the setting of the ruling of the District Court. Procedures and procedures binding guarantee of fiduciary fiduciary registration procedures on Fiduciary Office, are not set or are not found in detail in the Law Number 42 Year 1999.
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Biswas, S., i P. Pradnya. "GDPR and its Impact on Indian IT Firms". CARDIOMETRY, nr 23 (20.08.2022): 606–18. http://dx.doi.org/10.18137/cardiometry.2022.23.606618.
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The development has been seen as’security interference,’ and few researchers feel that advances drive us into a period of ‘zero information assurance.’ This paper analyses the new GDPR rule in EU Law, fitting all the affiliations controlling or getting ready individual data surprisingly with the EU region. Moreover, it will cover the challenges to executing the proportional in India. Any affiliation taking care of data relating to a perceived or unmistakable individual, an implied data subject, needs to adjust to GDPR. The results of not doing so can be liberal. Fines can show up at 4% of the affiliation’s overall turnover, or as much as 20 million Euros, whichever is higher. Simultaneously, this looks empowering for the EU district; executing the equal in India would speak to another plan of troubles. With India moving towards a serious economy with the allotment of Aadhaar and an ever-expanding dependence on information, the concerns over advanced security, data confirmation, and security are upheld. A Data Protection law is the need vital. Further, in the wake of the Supreme Court concluding that security is a significant right, there is a creating want to move rapidly in India to have set up a definitive fitting framework to address the concerns over computerized security, data protection, and insurance. In an Indian setting, various components, such as Nuclear families and social viewpoints, have covered the necessity for singular space and security for quite a while. Regardless, urbanization, digitization, and changing lifestyles have created enthusiasm among Indians for Privacy and confirmation of the information they share, unequivocally on cutting-edge stages.
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Yue, Zhi, Ying Zhong i Zhouxiao Cui. "Respondent Dynamic Attention to Streetscape Composition in Nanjing, China". Sustainability 14, nr 22 (16.11.2022): 15209. http://dx.doi.org/10.3390/su142215209.
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Scholars are interested in understanding human responses and perceptions concerning the configuration of streetscape environments that serve multiple functions. However, drivers’ visual attention to the streetscape has seldom been studied dynamically in multi-modal settings. By employing eye-tracking and semantic segmentation, visual attention partitions and objects and patterns are inspected in a per-second count along three typical roadways in Nanjing, China. In our study of 28 participants, it was found that people are likely to focus on the frame center (p-value < 0.005) in all methods of transportation. Roads and buildings are constantly observed along the roadway (p-value < 0.005), while smaller transportation objects across multi-modal conditions are noticed more in per-area counts (p-value < 0.025). Besides, vehicles are focused on more in a higher-speed driving lane (p-values < 0.005), while greenery and humans attract more attention in a slower lane (p-values < 0.005). The results indicate that the previous visual engagement results should be reconsidered on several points, and that the risk of distractions from non-traffic-related elements could be overestimated. The potential of the road surface in integrating safety and information-providing has been ignored in current studies. This study showed that greenery and other functional elements will not distract users in driving lanes; decreasing the calculation burden to two-ninth is possible in smart driving. These results could be helpful in future sustainable cities.
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Goudar, Vikram R., Gautam Mohan Kabbin, Suhas N. Joshi, Vinod P. Chavan i Shriharsha L. Badiger. "A study of bacterial sepsis and its relation to thrombocytopenia in neonates". International Journal of Contemporary Pediatrics 4, nr 3 (25.04.2017): 1032. http://dx.doi.org/10.18203/2349-3291.ijcp20171722.
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Background: In developing countries like India, the culture facilities are non-existent in most of the district hospitals, so the burden of identification of sepsis lies on hematological investigations like platelet count and white blood cells and very few indian studies have been done to show the association. Objectives: 1) To know the incidence of thrombocytopenia in babies with proven bacterial sepsis. 2) To find, if any, species specific differences in severity and incidence of thrombocytopenia. 3) Clinical outcomes in thrombocytopenic and nonthrombocytopenic septic babies.Methods: It is a prospective observational hospital based study. All the neonates admitted to our NICU with probable sepsis were screened for sepsis and neonates with birth weight of 1000 grams and above with blood and/or Cerebrospinal Fluid (CSF) culture positivity for bacterial growth were recruited during the study period from November 2011 to October 2012. A total of 100 neonates with blood and/or CSF culture positivity for bacterial growth were considered convenient for the study.Results: During the present study period of 1 year we had a total of 960 Neonates admitted to our NICU. 475 neonates were screened for sepsis. A total of 100 neonates with blood and/or CSF culture positivity for bacterial growth were considered for the study. Klebsiella pneumoniae sepsis was the highest contributor to the severe thrombocytopenia category (15 out of 29cases). Out of the 100 cases, 41 had normal platelet count and 59 had thrombocytopenia. Klebsiella positivity was more significantly associated with severe thrombocytopenia than MRCONS positivity or rest of the cultures combined together (p value <0.01). Although there was no significant association between thrombocytopenia and mortality (p=0.176), the proportion of children with severe thrombocytopenia was significantly higher in babies who expired (25% vs 9%) when compared to babies who survived.Conclusions: Our study shows that in our setting bacterial sepsis is significantly complicated by thrombocytopenia. Severe thrombocytopenia in a suspected case of bacterial sepsis might predict Klebsiella species sepsis and hence it may be prudent to start empirical antibiotics covering the Klebsiella species.