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Infection Risk (infection + risk)
Selected AbstractsThymoglobulin-Associated Cd4+ T-Cell Depletion and Infection Risk in HIV-Infected Renal Transplant RecipientsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 4 2006J.T. Carter HIV-infected patients are increasingly referred for kidney transplantation, and may be at an increased risk for rejection. Treatment for rejection frequently includes thymoglobulin. We studied thymoglobulin's effect on CD4+ T-cell count, risk of infection and rejection reversal in 20 consecutive HIV-infected kidney recipients. All patients used antiretroviral therapy and opportunistic infection prophylaxis. Maintenance immunosuppression consisted of prednisone, mycophenolate mofetil and cyclosporine. Eleven patients received thymoglobulin (7 for rejection and 4 for delayed/slow graft function) while 9 did not. These two groups were similar in age, gender, race, donor characteristics and immunosuppression. Mean CD4+ T-cell counts remained stable in patients who did not receive thymoglobulin, but became profoundly suppressed in those who did, decreasing from 475 ± 192 to 9 ± 10 cells/,L (p < 0.001). Recovery time ranged from 3 weeks to 2 years despite effective HIV suppression. Although opportunistic infections were successfully suppressed, low CD4+ T-cell count was associated with increased risk of serious infections requiring hospitalization. Rejection reversed in 6 of 7 patients receiving thymoglobulin. We conclude that thymoglobulin reverses acute rejection in HIV-infected kidney recipients, but produces profound and long-lasting suppression of the CD4+ T-cell count associated with increased risk of infections requiring hospitalization. [source] Perioperative Management of Medications for Psoriasis and Psoriatic Arthritis: A Review for the DermasurgeonDERMATOLOGIC SURGERY, Issue 4 2008CLAUDIA HERNANDEZ MD BACKGROUND Psoriasis affects an estimated 3% of the world's population. Many are on chronic immunosuppressive therapy for the cutaneous and joint manifestations of this disorder. The management of these medications in the perioperative period is controversial. Psoriasis and psoriatic arthritis medications can affect wound healing, hemostasis, and infection risk during cutaneous surgery. OBJECTIVES The objective of this article is to provide a critical review of various medications used for care of the psoriatic patient and their potential effect on cutaneous surgical procedures. CONCLUSIONS This review summarizes current understanding of wound healing, hemostatic effects, and infectious risks regarding many psoriasis medications including nonsteroidal anti-inflammatory drugs, cyclooxygenase inhibitors, corticosteroids, various immunosuppressants, and biologic response modifiers. Recommendations vary depending on the agent in question, type of procedure, and comorbid conditions in the patient. Caution is advised when using many of the medications reviewed due to lack of human data of their effects in the perioperative period. [source] Factors driving pathogenicity vs. prevalence of amphibian panzootic chytridiomycosis in IberiaECOLOGY LETTERS, Issue 3 2010Susan F. Walker Ecology Letters (2010) 13: 372,382 Abstract Amphibian chytridiomycosis is a disease caused by the fungus Batrachochytrium dendrobatidis (Bd). Whether Bd is a new emerging pathogen (the novel pathogen hypothesis; NPH) or whether environmental changes are exacerbating the host-pathogen dynamic (the endemic pathogen hypothesis; EPH) is debated. To disentangle these hypotheses we map the distribution of Bd and chytridiomycosis across the Iberian Peninsula centred on the first European outbreak site. We find that the infection-free state is the norm across both sample sites and individuals. To analyse this dataset, we use Bayesian zero-inflated binomial models to test whether environmental variables can account for heterogeneity in both the presence and prevalence of Bd, and heterogeneity in the occurrence of the disease, chytridiomycosis. We also search for signatures of Bd -spread within Iberia using genotyping. We show (1) no evidence for any relationship between the presence of Bd and environmental variables, (2) a weak relationship between environmental variables and the conditional prevalence of infection, (3) stage-dependent heterogeneity in the infection risk, (4) a strong association between altitude and chytridiomycosis, (5) multiple Iberian genotypes and (6) recent introduction and spread of a single genotype of Bd in the Pyrenees. We conclude that the NPH is consistent with the emergence of Bd in Iberia. However, epizootic forcing of infection is tied to location and shaped by both biotic and abiotic variables. Therefore, the population-level consequences of disease introduction are explained by EPH-like processes. This study demonstrates the power of combining surveillance and molecular data to ascertain the drivers of new emerging infections diseases. [source] RESIN COLLECTION AND SOCIAL IMMUNITY IN HONEY BEESEVOLUTION, Issue 11 2009Michael Simone Diverse animals have evolved an ability to collect antimicrobial compounds from the environment as a means of reducing infection risk. Honey bees battle an extensive assemblage of pathogens with both individual and "social" defenses. We determined if the collection of resins, complex plant secretions with diverse antimicrobial properties, acts as a colony-level immune defense by honey bees. Exposure to extracts from two sources of honey bee propolis (a mixture of resins and wax) led to a significantly lowered expression of two honey bee immune-related genes (hymenoptaecin and AmEater in Brazilian and Minnesota propolis, respectively) and to lowered bacterial loads in the Minnesota (MN) propolis treated colonies. Differences in immune expression were also found across age groups (third-instar larvae, 1-day-old and 7-day-old adults) irrespective of resin treatment. The finding that resins within the nest decrease investment in immune function of 7-day-old bees may have implications for colony health and productivity. This is the first direct evidence that the honey bee nest environment affects immune-gene expression. [source] Hepatitis A and B immunization for individuals with inherited bleeding disordersHAEMOPHILIA, Issue 2 2009M. STEELE Summary., Hepatitis A and B vaccines are highly effective tools that can greatly reduce infection risk in the bleeding disorder population. Although hepatitis A and B immunization for individuals with bleeding disorders is universally recommended, various advisory bodies often differ with respect to many practical aspects of vaccination. To review the published literature and guidelines and form a practical, comprehensive and consistent approach to hepatitis A and B immunization for individuals with bleeding disorders. We reviewed published immunization guidelines from North American immunization advisory bodies and published statements from North American and international haemophilia advisory bodies. A search of the MEDLINE database was performed to find original published literature pertaining to hepatitis A or B immunization of patients with haemophilia or bleeding disorder patients that provided supporting or refuting evidence for advisory body guidelines. Various advisory bodies' immunization guidelines regarding individuals with bleeding disorders have contradictory statements and often did not clarify issues (e.g. post vaccination surveillance). Published literature addressing immunization in bleeding disorder patients is sparse and mostly examines route of vaccine administration, complications and corresponding antibody response. Although the risk of hepatitis A and B infection is low, the use of simple measures such as vaccination is reasonable and advocated by haemophilia advisory bodies. Following our review of the available literature and North American guidelines, we have developed comprehensive and practical recommendations addressing hepatitis A and B immunization for the bleeding disorder population that may be applicable in Bleeding Disorder clinics. [source] Safety of nevirapine in pregnancyHIV MEDICINE, Issue 1 2007U Natarajan Background Nevirapine has been widely used in pregnancy for its efficacy, low pill burden, bioavailability and rapid transplacental transfer. Concern about nevirapine toxicity during pregnancy has emerged over recent years. Objectives The aims of the study were to document the frequency of cutaneous and hepatic toxicity secondary to nevirapine use during pregnancy and to compare rates in women starting nevirapine during the current pregnancy with those in women who had commenced nevirapine prior to the current pregnancy. Design This was a retrospective, comparative, five-centre study carried out in London, UK, in 1997,2003. Methods All HIV-1-infected women who received nevirapine as part of combination antiretroviral therapy (ART) during pregnancy were included in the study. Data on demographics, HIV infection risk, Centers for Disease Control and Prevention (CDC) status, surrogate markers at initiation of therapy, other medications hepatitis B and C virus coinfection and clinical data relating to potential toxicity were collated and analysed. Results Fifteen of 235 eligible women (6.4%) developed rash and eight (3.4%) developed hepatotoxicity, including four with coexistent rash, giving a combined incidence of 19 potential cases of nevirapine toxicity during pregnancy (8.1%). Alternative causes of rash/hepatotoxicity were suspected in seven cases and only 10 mothers (5.8%) discontinued nevirapine. Of the 170 women who commenced nevirapine during this pregnancy, 13 (7.6%) developed rash and eight (4.7%) hepatotoxicity, a combined incidence of 10%. Only two of 65 women with nevirapine exposure prior to this pregnancy developed rash (3.1%). Conclusions Nevirapine-containing ART was well tolerated in this cohort of pregnant women. Although pregnancy did not appear to increase the risk of nevirapine-associated toxicity compared to published adult data, CD4 count may be less predictive of toxicity in pregnancy. [source] Cowpox virus infection in natural field vole Microtus agrestis populations: delayed density dependence and individual riskJOURNAL OF ANIMAL ECOLOGY, Issue 6 2006SARAH BURTHE Summary 1Little is known about the dynamics of pathogen (microparasite) infection in wildlife populations, and less still about sources of variation in the risk of infection. Here we present the first detailed analysis of such variation. 2Cowpox virus is an endemic sublethal pathogen circulating in populations of wild rodents. Cowpox prevalence was monitored longitudinally for 2 years, in populations of field voles exhibiting multiannual cycles of density in Kielder Forest, UK. 3The probability that available susceptible animals seroconverted in a given trap session was significantly positively related to host density with a 3-month time lag. 4Males were significantly more likely to seroconvert than females. 5Despite most infection being found in young animals (because transmission rates were generally high) mature individuals were more likely to seroconvert than immature ones, suggesting that behavioural or physiological changes associated with maturity contribute to variation in infection risk. 6Hence, these analyses confirm that there is a delayed numerical response of cowpox infection to vole density, supporting the hypothesis that endemic pathogens may play some part in shaping vole cycles. [source] Male and female Silene latifolia plants differ in per-contact risk of infection by a sexually transmitted diseaseJOURNAL OF ECOLOGY, Issue 1 2001Oliver Kaltz Summary 1,Behavioural, physiological or immunological constraints often render one sex more susceptible to parasites, thereby potentially generating sex-specific trade-offs between traits associated with infection risk and other life-history characters. 2,The fungal pathogen Microbotryum violaceum systemically infects the dioecious plant Silene latifolia when pollinators deposit fungal spores on the flowers of healthy plants. Male plants produce many short-lived flowers, whereas females produce few flowers that remain connected with the plant after fertilization. We investigated how variation in flower production and flower longevity affects the infection risk for males and females. 3,In glasshouse experiments, we varied the number of flowers inoculated (4 vs. 16 per plant) with spores and the time until these flowers were removed (1 or 2 days for both sexes, 14 days for females only). We also measured the longevity of male flowers receiving simulated visits, with or without spores, to test for an abscission response to visitation and/or contamination. In a field survey, we measured male and female disease prevalence in 17 natural populations. 4,Varying the number of inoculated flowers did not affect infection probability, but females retaining inoculated flowers for 14 days became diseased more often (20.0%) than did plants with flowers removed within 2 days (7.3%). 5,Males that had dropped more inoculated flowers prematurely were more likely to remain uninfected. Spore-bearing visits shortened male flower longevity (38.4 ± 2.8 h) relative to non-spore visits (47.9 ± 5.2 h). 6,Female field disease prevalence (19.7 ± 3.5%) was higher than that of males (14.3 ± 2.6%), especially in populations with a high disease incidence. 7,Continuing physical connection during fruit ripening appears to increase invasion time and thus the per-contact infection risk in females. This is consistent with higher female field prevalences, although other explanations, unrelated to disease transmission, are possible. These results illustrate how interactions between plant reproductive behaviour and pollinator activity may affect disease spread. Female mating behaviour may evolve towards lower attractiveness to pollinators to minimize infectious contacts, while males can afford to be more promiscuous with an attractive, but disposable, floral display. [source] Costly carotenoids: a trade-off between predation and infection risk?JOURNAL OF EVOLUTIONARY BIOLOGY, Issue 4 2005I. T. VAN DER VEEN Abstract Carotenoid reserves in copepods seem costly in terms of predation risk because they make individuals conspicuous. However, carotenoids also seem to play an important role in immune defence as free radical scavengers. To test whether predation risk influences carotenoid levels and whether changes in carotenoid levels are related to changes in immune defence, I examined individual changes in large carotenoid and other lipid droplets upon exposure to predation risk and subsequent exposure to parasites in the copepod Macrocyclops albidus. Copepods reduced carotenoid reserves upon exposure to predators, through which they potentially avoided the costs of being conspicuous under predation risk. Thus, the size of carotenoid reserves is a plastic trait. Such a decrease in carotenoid reserves may also have a negative impact on the copepods' immune system as individuals that decreased their reserves suffered higher parasite prevalence upon exposure to the cestode Schistocephalus solidus. These results suggest that carotenoid reserves may be individually optimized to trade-off each individual's unique costs (predation risk) and benefits (immune defence) of having these reserves. [source] Nurses' and physicians' viewpoints regarding children visiting/not visiting adult ICUsNURSING IN CRITICAL CARE, Issue 2 2007Susanne Knutsson Abstract Allowing children to visit adult intensive care units (ICUs) has been an area of controversy. There is a lack of recent research dealing with visits by children and physicians' views and whether differences exist between the views held by nurses and physicians regarding visits by children. The aim of this study was to describe and compare reasons given by nurses and physicians for restricting visits by children to a relative hospitalized in an adult ICU. This was a quantitative, descriptive multicentre study. Nurses and physicians (n= 291) at 72 general adult ICUs participated, each completing a questionnaire. A majority of the nurses and physicians were positive to children visiting patients in ICU, but they also imposed restrictions. The most common reasons were: severity of the patient's injury (50%); the environment was frightening for the child (50%); the infection risk for the child (36%) and the patient (56%). Children <7 years were restricted more than those >7 years. Nurses were more positive than physicians to visits by younger children. Physicians were more positive to visits if the patient was tired and critically ill/injured or was a friend/cousin. More physicians refused visits due to the fact that children are too noisy for the staff. Risks of negative effects on the children's health by visiting patients were also stated. Nurses and physicians still restrict children's visits to adult ICUs for a number of reasons, and nurses' and physicians' views on children visiting differ and so also the views within each professional group. The differences in views show that the dynamics are complicated and this could be attributed to a lack of a common view of care, which prevents family-centred care that includes children from being practised. [source] Immunonutrition support for athletesNUTRITION REVIEWS, Issue 6 2008David C Nieman Multiple components of the immune systems in athletes exhibit transient dysfunction after prolonged, heavy exertion. During this "open window" of impaired immunity, pathogens may gain a foothold, increasing infection risk. Nutritional supplements have been studied as countermeasures to exercise-induced immune changes and infection risk. This review focuses on findings from recent exercise-based studies with macro- and micronutrient supplements, and "advanced" immunonutrition supplements including ,-glucan, curcumin, and quercetin. Results from these studies indicate that immunonutrition supplements have the potential to lessen the magnitude of exercise-induced perturbations in immune function and to reduce the risk of upper respiratory tract infections. [source] Introduction of Infection Control Measures to Reduce Infection Associated With Implantable Pain Therapy DevicesPAIN PRACTICE, Issue 3 2007Abram H. Burgher MD Abstract Introduction: Implantable pain therapy devices for chronic pain include spinal cord stimulators (SCS) and intrathecal drug delivery systems (IDDS). A number of different complications can occur after implantation of these devices, but among the most serious is infection. Based on Centers for Disease Control and Prevention guidelines for prevention of surgical site infection, published literature on infection risk with implantable pain therapy devices, and recommendations from groups within our own our institution, we introduced infection control measures for all patients receiving either SCS or IDDS. Methods: After approval from the Institutional Review Board, we performed a retrospective review of patients undergoing primary implantation of SCS or IDDS before and after introduction at our institution of safety measures designed to reduce device-related infection. We compared infection incidence and compliance to infection precautions before and after introduction of these measures. Results: Thirty-four SCS or IDDS were implanted before implementation of the infection control measures and 58 were placed after. Five device-related infections occurred. Adherence to most infection precautions improved during the study period, but 100% compliance was seen only with venue used for implantation. Infection incidence declined after introduction of the safety measures, but the reduction was not statistically significant. Conclusions: Introduction of infection control measures for implantable pain therapy devices improved adherence to most infection precautions in our practice. Lack of specific documentation could have hindered practice surveillance within our group. A tool to document performance of infection control measures would be useful not only as a marker of compliance but could also serve as a reminder to perform certain safety measures. [source] Granulocyte-macrophage colony stimulating factor and immunosuppression in the treatment of pediatric acquired severe aplastic anemiaPEDIATRIC BLOOD & CANCER, Issue 2 2005Michael R. Jeng MD Abstract Background Immunosuppressive therapy (IS) is effective in the treatment of patients with acquired severe aplastic anemia (SAA). An enhanced myeloid response and decreased infection risk may be possible with the addition of a hematopoietic cytokine. Published data on the combination of cytokines and IS in patients with SAA are limited. The addition of G-CSF to IS shortens the time to neutrophil count recovery, but may not improve overall survival. Because GM-CSF acts differently than G-CSF, its use in combination with IS may be different. Procedure A retrospective chart review was performed on patients diagnosed with SAA and treated with IS and GM-CSF at St. Jude Children's Research Hospital. Hematologic recovery, prognostic factors, and infection data were collected. Results Eighteen patients were included in this study. The median age at diagnosis was 7.2 years (range 1.8,17.0). Ten patients (56%) had a complete response, four (22%) a partial response, and four (22%) no response. Median time to erythrocyte and platelet transfusion independence were 90 (18,243) and 64 days (18,243), and to discontinuation of treatment 287 days (90,730). Median time to partial (ANC,>,500) and full (ANC,>,1,500) neutrophil recovery were 41 and 51 days, respectively. Seventeen documented discrete infections occurred in six patients over 36 patient years. Conclusions GM-CSF, in addition to IS, may shorten time to neutrophil count recovery, may be beneficial in decreasing infection rates, and may improve platelet response in patients with SAA. However, consistent with studies utilizing G-CSF, GM-CSF probably does not affect overall response rate. To fully answer whether or not cytokine therapy is of added value to IS in pediatric patients, a multi-institutional randomized trial is needed. © 2004 Wiley-Liss, Inc. [source] Strong association between birth month and reproductive performance of Vietnamese womenAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 1 2009Susanne Huber Epidemiological studies on premodern and modern Western societies indicate that birth season may influence female reproduction. Nothing is known, however, about this effect in developing economies. Many of the latter are characterised by tropical climates with a rainy season associated with lower food availability and a greater prevalence of infectious diseases. We therefore predict that an association between birth month and reproductive output, if it exists, should be related to the rainy season. To test this prediction, we analysed census data of Vietnam obtained from IPUMS-International (Vietnam 1999 Population and Housing Census). Based on 493,853 women born between 1950 and 1977 and thus aged 22 to 49 years, we found that the time series of mean offspring count per month of birth has a highly significant period of 12 months (power = 46.871, P < 0.00001). Our results further indicate that the 12-month periodic signal has a maximum in July and a minimum in January. Accordingly, the peak corresponds to birth during the rainy season, the low if the third pregnancy month concurs with the rainy season. The month of birth is therefore clearly associated with the later reproductive performance of Vietnamese women, strongly supporting the assumption that environmental and maternal conditions during early development exert long-term effects on reproductive functioning. Provided the rainy season adversely affects developmental processes due to inadequate food and/or high infection risk, the association reported here points to a critical period of reproductive development during early pregnancy. Am. J. Hum. Biol., 2009. © 2008 Wiley-Liss, Inc. [source] Host intrinsic determinants and potential consequences of parasite infection in free-ranging red-fronted lemurs (Eulemur fulvus rufus)AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 3 2010Dagmar Clough Abstract Parasites and infectious diseases represent ecological forces shaping animal social evolution. Although empirical studies supporting this link abound in various vertebrate orders, both the study of the dynamics and impact of parasite infections and infectious diseases in strepsirrhine primates have received little empirical attention. We conducted a longitudinal parasitological study on four groups of wild red-fronted lemurs (Eulemur fulvus rufus) at Kirindy Forest, Madagascar, during two field seasons in consecutive years to investigate i) the degree of gastrointestinal parasite infection on population and individual levels and ii) factors potentially determining individual infection risk. Using a comprehensive dataset with multiple individually assignable parasite samples as well as information on age, sex, group size, social rank, and endocrine status (fecal androgen and glucocorticoid), we examined parasite infection patterns and host traits that may affect individual infection risk. In addition, we examined whether parasite infection affects mating and reproductive success. Our results indicated high variability in parasite infection on individual and population levels. Time of year and group size was important determinants of variability in parasite infection. Variation in hormone levels was also associated with parasite species richness and parasite infection intensity. Differences in parasite infection between years indicate a potential immune-enhancing function of steroid hormones on nematode infections, which has not been reported before from other vertebrates studied under natural conditions. Male mating and reproductive success were not correlated to any measure of parasite infection, which suggests a nonfunctional role of the parasites we examined in primate sexual selection. Am J Phys Anthropol, 2010. © 2010 Wiley-Liss, Inc. [source] Forest fragmentation, the decline of an endangered primate, and changes in host,parasite interactions relative to an unfragmented forestAMERICAN JOURNAL OF PRIMATOLOGY, Issue 3 2008Thomas R. Gillespie Abstract Forest fragmentation may alter host,parasite interactions in ways that contribute to host population declines. We tested this prediction by examining parasite infections and the abundance of infective helminths in 20 forest fragments and in unfragmented forest in Kibale National Park, Uganda. Over 4 years, the endangered red colobus (Procolobus rufomitratus) declined by 20% in fragments, whereas the black-and-white colobus (Colobus guereza) in fragments and populations of both colobines in unfragmented forest remained relatively stable. Seven nematodes (Strongyloides fulleborni, Strongyloides stercoralis, Oesophagostomum sp., an unidentified strongyle, Trichuris sp., Ascaris sp., and Colobenterobius sp.), one cestode (Bertiella sp.), and three protozoans (Entamoeba coli, Entamoebahistolytica/dispar, and Giardia sp.) were detected. Infection prevalence and the magnitude of multiple infections were greater for red colobus in fragmented than in unfragmented forest, but these parameters did not differ between forests for black-and-white colobus. Infective-stage colobus parasites occurred at higher densities in fragmented compared with unfragmented forest, demonstrating greater infection risk for fragmented populations. There was little evidence that the nature of the infection was related to the size of the fragment, the density of the host, or the nature of the infection in the other colobine, despite the fact that many of the parasites are considered generalists. This study suggests that forest fragmentation can alter host,parasite dynamics and demonstrates that such changes can correspond with changes in host population size in forest fragments. Am. J. Primatol. 70:222,230, 2008. © 2007 Wiley-Liss, Inc. [source] Dried blood spot sampling in combination with LC-MS/MS for quantitative analysis of small moleculesBIOMEDICAL CHROMATOGRAPHY, Issue 1 2010Wenkui Li Abstract The collection of whole blood samples on paper, known as dried blood spot (DBS), dates back to the early 1960s in newborn screening for inherited metabolic disorders. DBS offers a number of advantages over conventional blood collection. As a less invasive sampling method, DBS offers simpler sample collection and storage and easier transfer, with reduced infection risk of various pathogens, and requires a smaller blood volume. To date, DBS-LC-MS/MS has emerged as an important method for quantitative analysis of small molecules. Despite the increasing popularity of DBS-LC-MS/MS, the method has its limitations in assay sensitivity due to the small sample size. Sample quality is often a concern. Systematic assessment on the potential impact of various blood sample properties on accurate quantification of analyte of interest is necessary. Whereas most analytes may be stable on DBS, unstable compounds present another challenge for DBS as enzyme inhibitors cannot be conveniently mixed during sample collection. Improvements on the chemistry of DBS card are desirable. In addition to capturing many representative DBS-LS-MS/MS applications, this review highlights some important aspects of developing and validating a rugged DBS-LC-MS/MS method for quantitative analysis of small molecules along with DBS sample collection, processing and storage. Copyright © 2009 John Wiley & Sons, Ltd. [source] Suspected infections in children treated for ALLACTA PAEDIATRICA, Issue 7 2009Sólveig Hafsteinsdóttir Abstract Aim:, The aim of our study was to get epidemiological information on bacterial infections in children treated for ALL and to analyse which patients have an enhanced infection risk. Methods:, Episodes of suspected or confirmed infections were evaluated during the first 12 months of treatment for childhood acute lymphoblastic leukaemia (ALL). Results:, The number of patients was 73 (43 boys). The median age was 4.6 years. A total of 179 episodes occurred, varying from none in six patients to eight in one. Bacteria were cultured in 57 episodes (31.8%), the most common being coagulase-negative staphylococci. The number of episodes fell significantly with increasing age for suspected and confirmed infections (p < 0.001 and p = 0.03). The proportion of confirmed infections was significantly higher (p < 0.001) in the first episodes. The average number of suspected infections was higher in girls than in boys (p = 0.03), but confirmed infections were not. Conclusion:, Most of the serious infections occur early in the treatment and the number of suspected and confirmed infections falls with age. Suspicion of infection is more likely in girls, but the number of confirmed infections is equal in both sexes. Coagulase-negative staphylococcus was most commonly isolated, highlighting the importance of careful handling of central venous devices. [source] Coherence and correspondence criteria for rationality: experts' estimation of risks of sexually transmitted infectionsJOURNAL OF BEHAVIORAL DECISION MAKING, Issue 3 2005Mary B. Adam Abstract The aim of this study is to examine both coherence and correspondence criteria for rationality in experts' judgments of risk. We investigated biases in risk estimation for sexually transmitted infections (STIs) predicted by fuzzy-trace theory, i.e., that specific errors would occur despite experts' knowledge of correct responses. One hundred twenty professionals with specific knowledge of STI risks in adolescents were administered a survey questionnaire to test predictions concerning: knowledge deficits (producing underestimation of risks); gist-based representation of risk categories (producing overestimation of condom effectiveness); retrieval failure for risk knowledge (producing lower risk estimates); and processing interference in combining risk estimates (producing biases in post-test diagnosis of infection). Retrieval was manipulated by asking estimation questions that "unpacked" the STI category into infection types or did not specify infection types. Other questions differentiated processing biases from knowledge deficits or retrieval failure by directly providing requisite knowledge. Experts' knowledge of STI transmission and infection risks was verified empirically. Nevertheless, under predictable conditions, they misestimated risk, overestimated the effectiveness of condoms, and also suffered from processing biases. When questions provided better retrieval supports (unpacked format), risk estimates improved. Biases were linked to gist representations, retrieval failures, and processing errors, as opposed to knowledge about STIs. Results support fuzzy-trace theory's dual-process assumptions that different types of errors are dissociated from one another, and separate failures of coherence and correspondence among the same sample of experts. Copyright © 2005 John Wiley & Sons, Ltd. [source] Pregnancy and contraceptive use in a national representative sample of Australian secondary school studentsAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 6 2006Paul Agius Objective: To determine rate of pregnancy and use of contraception in a nationally representative sample of school students. Methods: Year 10 and 12 students from a representative random sample of schools throughout Australia completed a survey concerning health and sexual behaviour. Results: Thirty-five per cent of students had experienced sexual intercourse. Of these, 6.1% (males 4.1%, females 7.8%) reported they had experienced sex that resulted in pregnancy, and a further 7.5% were unsure. Most sexually active students reported using a condom (65%), and a further 36.8% reported using the pill for contraception the last time they had sex. Relatively few students (17.2%) used a dual contraceptive (female method and condom). Conclusions: Rates of reported pregnancy among Year 10 and 12 students are relatively high. Although the majority of students used some form of contraception when they had sex, a significant minority practised unprotected and unsafe sex. Implications for public health practice: Sex education concerning pregnancy and sexually transmitted infection risks must be delivered early enough to influence first and early sexual activity. [source] | ||||||||||||||||