nPEP protocol implementation and evaluation at a local US Crisis Center.

Non-occupational Post-Exposure Prophylaxis for HIV (nPEP) is recommended by the CDC for isolated exposures that pose "substantial risk" for HIV transmission. To combat multiple barriers to nPEP utilization, a comprehensive program was developed through the local community sexual assault provider. The purpose of this study was to evaluate nPEP protocol implementation. A retrospective chart review was conducted of all sexual assault victims seen during a six-month period, and all patients who accepted nPEP were selected for follow-up phone interviews. 157 patients presented during the study period. Mean time to care was 32.4hrs, with 126/157 (80%) presenting ≤72hrs. 114/157 (73%) patients were offered nPEP by providers. 67/114 (59%) patients accepted, with the most common reason for declining being needing more time to decide. 10/13 (77%) patients able to be contacted reported completing nPEP, with side-effects cited as the most common noncompletion reason. 9 reported side effects and 4 received recommended follow-up HIV testing. 83/99 (84%) patients clearly eligible by chart review were offered nPEP, suggesting good adherence to CDC guidelines. Most patients contacted completed nPEP despite side-effects, suggesting good adherence. Our findings demonstrated multiple points status post-sexual assault to potentially improve the nPEP process.

Acute effects of unilateral static stretching on handgrip strength of the stretched and non-stretched limb.

PURPOSE: To determine the effects of an acute bout of unilateral static stretching on handgrip strength of both the stretched and non-stretched limb. It was reasoned that if the non-stretched limb experienced a decrease in force output, further evidence for a neural mechanism to explain a post-stretch force reduction would be obtained as no mechanical adaptation would have occurred. METHODS: Thirty participants performed maximum voluntary unilateral handgrip contractions of both limbs before and after stretching the finger flexors of the strength-dominant side only. Each trial was assessed for peak force, muscle activity (iEMG), and rate of force generation. RESULTS: Following the stretching bout, peak force and iEMG decreased by 4.4% (p = 0.001) and 6.4% (p = 0.000) respectively in the stretched limb only. However, rate of force generation was significantly impaired in both the stretched (- 17.3%; p = 0.000) and non-stretched limbs (- 10.8%; p = 0.003) 1 min post-stretch, and remained similarly depressed for both limbs 15 min later. CONCLUSION: Acute stretching negatively impacts rate of force generation more than peak force. Moreover, a reduced rate of force generation from the non-stretched limb indicates the presence of a cross-over inhibitory effect through the nervous system, which provides additional evidence for a neural mechanism.

Factors predicting the capacity of Los Angeles city-region recreation programs to promote energy expenditure.

An audit of recreation programs with moderate or higher levels of physical activity (PA) in Los Angeles area cities (N=82) was conducted using internet, telephone, and survey methods. Metabolic Equivalents (METs) were used to code programs׳ physical activity intensity. MET-hours per recreation program was associated with required age for enrollment, percent of residents >64 years of age, and fiscal capacity of cities. Capacity to promote energy expenditure may depend on targeted age groups, age of population, and municipal fiscal capacity. Cities with lower fiscal capacity might offer those higher MET-hour activities which require less specialized equipment and seek outside funding to offer higher MET programs.