Talking with My Sistahs: Examining Discussions About HIV Risk and Prevention Outcomes Within Black Women Sistah Circles.

Black women's health is in a state of crisis. Though Black women make up roughly 12% of the US population, they account for 66% of new HIV cases. One understudied barrier to Black women's sexual health is their communication about the topic of HIV with others and proclivity to dismiss HIV-related information based on self-exemption. Using a group-centered approach called the "sistah circle," this study examines group gatherings of Black women to assess their communication about HIV and determine potential gaps in their understanding of information and HIV-related behavior. Data were derived from five focus groups, with four Black women in each group engaging in a facilitated discussion. Findings from the project extend knowledge about how socializing agents such as school, parents, church, and interventionists have the potential to delay or deter Black women from engaging in communication that supports risk-reducing behaviors and prevention efforts.

Foodborne disease outbreaks in Barbados (1998-2009): a 12-year review.

INTRODUCTION: Microbes such as Salmonella, Campylobacter and S. aureus have been implicated in Foodborne disease outbreaks (FBDOs) worldwide, yet information on their occurrence in Barbados is scanty. The purpose of this study was to determine the aetiological agents, food vehicles, locations and peak seasons of FBDOs in Barbados; assess the quality of epidemiological investigations; and identify deficiencies in food production practices and laboratory detection. METHODOLOGY: A search of FBDOs occurring in Barbados between 1998-2009 was conducted among published and unpublished literature sources and reports. The search terms included the keywords "foodborne disease," "outbreaks" and "Barbados". RESULTS: During the period 1998 to 2009, there were 24 foodborne outbreaks, 215 cases of illness, one hospitalisation and no deaths. Overall, 37.5% of outbreaks were associated with hotels/resorts. Salmonella Enteritidis phage type 8 was most commonly implicated with eggs and poultry being the primary vehicles. Three outbreak reports were available for assessment and revealed that there were deficiencies in the outbreak investigations. These reports also recorded high levels of food contamination with indicator organisms, suggesting that improvements in food hygiene and production practices were required. CONCLUSIONS: The number of FBDOs is low in comparison to developed countries. However, the data was likely affected by under-reporting and inadequacies in the outbreak investigations and laboratory detection. Improvements in these areas would lead to not only better detection and characterisation of FBDOs in Barbados but improved food safety control measures.

Visitor Perceptions of Food Safety and Sociodemographic Determinants in Barbados, West Indies.

In Barbados, tourism is a significant pillar of the economy; however, there has been no research to document the food safety concerns of tourists. Therefore, the purpose of this study was to survey visitors' perceptions of food safety to understand their concerns, influences, and experiences with foodborne illness. A descriptive cross-sectional quantitative survey was conducted among 398 tourists, using stratified random sampling. Visitors were surveyed at two departure ports, the Grantley Adams International Airport (GAIA) ( n = 240) and the Bridgetown Cruise Terminal (BCT) ( n = 158). Descriptive statistics included frequency distributions. Cross tabulations were performed to determine associations among key variables, and logistic regression analyses were used to report predictor variables at a significance level of P ≤ 0.05. In both surveys (GAIA and BCT), most respondents had a positive perception of food safety (75.8 and 99.4%) and a low frequency of foodborne illness (6.0 and 0.6%), respectively. Most visitors perceived the likelihood of acquiring food poisoning as a result of eating food from local retailers as "not common," and more visitors were "not concerned" about food hazards than concerned. Significant associations ( P ≤ 0.05) were found among sociodemographic parameters such as age, gender, ethnicity, and education and three variables of risk perception. The findings in this study can be used to guide risk communication and food safety and risk management within the hospitality industry, and they add to the body of knowledge surrounding consumer risk perceptions.

Discovery and Partial Genomic Characterisation of a Novel Nidovirus Associated with Respiratory Disease in Wild Shingleback Lizards (Tiliqua rugosa).

A respiratory disease syndrome has been observed in large numbers of wild shingleback lizards (Tiliqua rugosa) admitted to wildlife care facilities in the Perth metropolitan region of Western Australia. Mortality rates are reportedly high without supportive treatment and care. Here we used next generation sequencing techniques to screen affected and unaffected individuals admitted to Kanyana Wildlife Rehabilitation Centre in Perth between April and December 2015, with the resultant discovery of a novel nidovirus significantly associated with cases of respiratory disease according to a case definition based on clinical signs. Interestingly this virus was also found in 12% of apparently healthy individuals, which may reflect testing during the incubation period or a carrier status, or it may be that this agent is not causative in the disease process. This is the first report of a nidovirus in lizards globally. In addition to detection of this virus, characterisation of a 23,832 nt segment of the viral genome revealed the presence of characteristic nidoviral genomic elements providing phylogenetic support for the inclusion of this virus in a novel genus alongside Ball Python nidovirus, within the Torovirinae sub-family of the Coronaviridae. This study highlights the importance of next generation sequencing technologies to detect and describe emerging infectious diseases in wildlife species, as well as the importance of rehabilitation centres to enhance early detection mechanisms through passive and targeted health surveillance. Further development of diagnostic tools from these findings will aid in detection and control of this agent across Australia, and potentially in wild lizard populations globally.

Improving operating room cleaning results with microfiber and steam technology.

Microfiber and steam technology is a novel cleaning method that has advantages for clinical applications. We describe its use in the operating room. The benefits include improved cleaning for every patient regardless of known or perceived risk, occupational health and safety advantages, and reduced cost of cleaning, allowing for expansion of cleaning activity without the need for additional human resources. Continuous surgical site infection surveillance demonstrated that infections remained at previously low levels.

Exploring clinical wisdom in nursing education.

The recent interest in wisdom in professional health care practice is explored in this article. Key features of wisdom are identified via consideration of certain classical, ancient and modern sources. Common themes are discussed in terms of their contribution to 'clinical wisdom' itself and this is reviewed against the nature of contemporary nursing education. The distinctive features of wisdom (recognition of contextual factors, the place of the person and timeliness) may enable their significance for practice to be promoted in more coherent ways in nursing education. Wisdom as practical knowledge (phronesis) is offered as a complementary perspective within the educational preparation and practice of students of nursing. Certain limitations within contemporary UK nursing education are identified that may inhibit development of clinical wisdom. These are: the modularization of programmes in higher education institutions, the division of pastoral and academic support and the relationship between theory and practice.

Evidence into practice: evaluating a child-centred intervention for diabetes medicine management. The EPIC Project.

BACKGROUND: There is a lack of high quality, child-centred and effective health information to support development of self-care practices and expertise in children with acute and long-term conditions. In type 1 diabetes, clinical guidelines indicate that high-quality, child-centred information underpins achievement of optimal glycaemic control with the aim of minimising acute readmissions and reducing the risk of complications in later life. This paper describes the development of a range of child-centred diabetes information resources and outlines the study design and protocol for a randomized controlled trial to evaluate the information resources in routine practice. The aim of the diabetes information intervention is to improve children and young people's quality of life by increasing self-efficacy in managing their type 1 diabetes. METHODS/DESIGN: We used published evidence, undertook qualitative research and consulted with children, young people and key stakeholders to design and produce a range of child-centred, age-appropriate children's diabetes diaries, carbohydrate recording sheets, and assembled child-centred, age-appropriate diabetes information packs containing published information in a folder that can be personalized by children and young people with pens and stickers. Resources have been designed for children/young people 6-10; 11-15; and 16-18 years.To evaluate the information resources, we designed a pragmatic randomized controlled trial to assess the effectiveness, cost effectiveness, and implementation in routine practice of individually tailored, age-appropriate diabetes diaries and information packs for children and young people age 6-18 years, compared with currently available standard practice.Children and young people will be stratified by gender, length of time since diagnosis (< 2 years and > 2 years) and age (6-10; 11-15; and 16-18 years). The following data will be collected at baseline, 3 and 6 months: PedsQL (generic, diabetes and parent versions), and EQ-5 D (parent and child); NHS resource use and process data (questionnaire and interview). Baseline and subsequent HbA1c measurements, blood glucose meter use, readings and insulin dose will be taken from routine test results and hand-held records when attending routine 3-4 monthly clinic visits.The primary outcome measure is diabetes self-efficacy and quality-of-life (Diabetes PedsQL). Secondary outcomes include: HbA1c, generic quality of life, routinely collected NHS/child-held data, costs, service use, acceptability and utility. TRIAL REGISTRATION: ISRCTN17551624.

Leptospirosis in water buffalo (Bubalus bubalis) in Trinidad.

The seroprevalence of leptospirosis in water buffalo (Bubalus bubalis) reared for meat in semi-intensive and extensive managed farms in Trinidad was determined. All sera were tested for specific antibodies against 17 internationally recognized serovars of Leptospira using the microscopic agglutination test (MAT). Animals withtitres greater or equal to 100 were considered as seropositive indicating exposure to Leptospira and those withtitres greater or equal to 800 were interpreted as cases of acute leptospirosis. Of a total of 226 apparently healthy water buffalo from five major farms in Trinidad tested, 33 (14.6 per cent) were seropositive with titres ranging from 100 to 400. Three (60.0 per cent) of 5 farms had seropositive animals with seropositivity rates ranging from 2.0 per cent (1 of 50) on Farm A to 32.7 per cent (16 of 49) on Farm B. The difference was statistically signifi cant (P<0.05; X2). Age and sex of animals had no significant (P>0.05; X2) effect on infection rate. The prevalent antibodies to serovars of Leptospira were farm specific with specific antibodies to serovars Copenhageni and Georgia being predominant on Farm B having been detected in 10 (62.5 per cent) and 9 (56.3 per cent) respectively of 16 seropositive animals. On Farm D however, also with 16 seropositive animals, specifi c antibodies to serovars Patoc and Bratislava were most frequently detected, found in 11 (68.8 per cent) and 5 (31.3 per cent) respectively of seropositive animals. This is the first documentation of leptospirosis in water buffalo in the Caribbean region and the health risk posed to farm workers, abattoir workers and veterinarians cannot be ignored.

The patient with cold hands: understanding Raynaud's disease.

The availability of new treatments for Raynaud's disease, as with any medical condition, depends on how convincing the results of clinical research prove to be. The validity and reliability of research in Raynaud's disease is subject to two major constraints: the seasonal and intermittent nature of the condition limits the amount of time patients can be studied continuously, and researchers have failed to agree on objective outcome measures. Vascular physiology is, and no doubt is destined to remain, a dynamic and technology-driven clinical realm. Despite the wide array of promising treatments, the best and most basic management of Raynaud's disease seems to be behavioral and at least partly pharmaceutical. The two biggest behavioral factors are nicotine use and exposure to cold environments. Giving up nicotine can be a daunting challenge for long-term smokers and chewing-tobacco users. Avoiding cold environments may be easier said than done, especially for patients who work outdoors or in air-conditioned spaces. Perhaps the best treatment for Raynaud's disease is a reliable diagnosis and the positive prognosis that comes with it. Most patients have a stable course, and nearly half will actually improve with time and steady reassurance.

The importance of first-time parent groups for new parents.

First-time parent groups are offered to all new parents in Victoria, Australia through the Maternal and Child Health Service, which is funded by state and local governments. Parents who join a group attend a series of eight sessions that emphasize parenting skills, relationship development and social support in order to increase confidence and skills in parenting. The present paper highlights the importance of first-time parent groups, claiming that these groups serve an important social support and health function amid a climate of early discharge policies and changing family structures. Although there are a number of challenges to the successful running of groups, it is argued that first-time parents benefit from participating in these groups in a number of ways: by developing social networks, gaining self confidence, and through access to relevant information on child health and parenting. Research indicates that first-time parent groups provide lasting benefits not only for families, but also for society as a whole. Maternal and child health nurses play a key role in facilitating groups for first-time parents.