ABSTRACT
AIDS clinical trials (ACTs) are critical to the development of new treatments for HIV infection. However, people of color living with HIV/AIDS are involved in ACTs at disproportionally low rates, with African-Americans experiencing the greatest under-representation. In this article, we describe the core elements and key characteristics of a highly efficacious multi-component peer-driven intervention (PDI) designed to increase rates of screening for and enrollment into ACTs among African-American and Latino/Hispanic individuals, by addressing the main complex, multi-level barriers they experience to ACTs. We discuss the process of developing the intervention, the theoretical models guiding its delivery format and content, and provide an overview of the intervention's components. We then use brief case studies to illustrate a number of key issues that may arise during intervention implementation. Finally, we describe lessons learned and provide recommendations for the PDI's uptake in clinical and clinical trials settings.
Subject(s)
Acquired Immunodeficiency Syndrome/drug therapy , Black or African American/psychology , Clinical Trials as Topic/psychology , Health Knowledge, Attitudes, Practice/ethnology , Hispanic or Latino/psychology , Patient Selection , Acquired Immunodeficiency Syndrome/diagnosis , Acquired Immunodeficiency Syndrome/ethnology , Black or African American/education , Black or African American/statistics & numerical data , Attitude of Health Personnel , Clinical Trials as Topic/standards , Clinical Trials as Topic/statistics & numerical data , Fear/psychology , Female , Hispanic or Latino/education , Hispanic or Latino/statistics & numerical data , Humans , Male , Mass Screening/psychology , Patient Education as Topic/methods , Patient Navigation/methods , Patient Navigation/organization & administration , Peer Group , Selection Bias , Trust/psychologyABSTRACT
Materials used in the construction industry frequently contain large quantities of silica. When they are cut or shaped with power tools considerable respirable dust can be produced. Three dust control systems for use with cut-off saws have been evaluated on site: wet dust suppression using mains water, the same system using water from a portable water tank, and local exhaust ventilation. The efficiency of water suppression on cut-off saws has been precisely quantified in controlled laboratory conditions by means of measurements with and without dust control. When dust control was used on-site, the mean concentrations of airborne silica were reduced by a factor of between three and seven, the accuracy being limited by the relatively high limit of detection for silica. All controls systems generally reduced respirable dust levels by at least 90%. Although the effectiveness of dust suppression did not depend on blade type, a diamond blade was more effective than a resin-bonded blade with the pressurised water system; cutting a slab with this type of blade could be completed before the water tank required repressurization. In laboratory tests, the application of water reduced the dust concentration to < 4% of its value without control. The method for monitoring the dust concentration was sufficiently sensitive to measure a difference in concentration produced during cutting in different directions. It is important, however, that the pressure in supply reservoirs is properly maintained, that the water is correctly applied and that it is used at the correct rate. If this is done effective dust control can be achieved.
