A Youth Participatory Project to Address STIs and HIV among Homeless Youth.

The purpose of this study was to conduct a youth participatory action research project to address the disparities in sexually transmitted infection (STI) and HIV rates among homeless youth. Four youth served as co-investigators and cultural informants for the project. The team conducted focus groups (N = 22; ages 16-22) and in-depth interviews (N = 20; ages 18-24) with homeless youth to explore decisions about condomless sex, knowledge of STIs and HIV, health-care access for STI-related services, and perceptions about STI testing. Findings revealed that homeless youth have good general knowledge about STIs, are receptive to STI testing for themselves and their sexual partners, and have heightened concerns about being HIV positive and peers knowing their STI status. Results from the current study could contribute to the development of youth-informed tailored interventions to increase protective sexual behavior, reduce health disparities, and improve access to and the quality of health-care services for homeless youth.

An integrative approach to cultural competence education for advanced practice nurses.

A project funded by Health Resources and Services Administration (HRSA) provided the impetus for the development of four cultural competence modules taught in a graduate program at a university-based school of nursing. These modules have been consistently taught for 6 years. The authors describe the modules' content, educational strategies, required faculty training, and evaluation and measurement of outcomes. The authors recommend use of the modules and make suggestions for future implementation. Cultural competence is essential for 21st-century practice. The impending national and global health care crises require educational approaches that are cost-effective and tested. These modules are recommended to meet this educational challenge.

Assessing social preparedness for antiretroviral therapy in a generalized AIDS epidemic: a diffusion of innovations approach.

Researchers conducted focus groups in the Eastern Cape Province of South Africa concerning AIDS and treatment options. Constituent groups included adults aged 25-45, HIV/AIDS caregivers, HIV-positive adults, nurses, rural elders, teenagers, and traditional healers. This pilot work aimed to gather early evidence on perceptions about the government's rollout of antiretroviral treatment (ART), identify potential barriers to success, and inform a subsequent pilot survey. Diffusion of innovations theory was used to interpret the data and helped identify potential obstacles to the ART rollout. AIDS stigma and a weakened healthcare system were negatively impacting the program. There was a lack of accurate knowledge about HIV/AIDS and antiretroviral treatment, with wide disparities among groups. Many people were not convinced that antiretroviral treatment is superior to other treatments, and a few people were afraid it was poisonous. There was no evidence that people were aware of the long-term difficulties of adherence to the regimen.

Modification and translation of the Thai version of the Youth Risk Behavior Survey.

The Youth Risk Behavior Survey (YRBS) has been used as a standard and updated as required for 15 years to measure risk behavior among American youth. This article discusses the modification and translation of the YRBS to be used to measure risk among youth in Thailand. The steps involved included not only modification and translation but also testing of cross-cultural equivalences (semantic, content, and conceptual) and assessment of feasibility and acceptability of the modified survey among adolescents in Thailand. The process is described and findings discussed.

Public health nurses for Virginia's future: a collaborative project to increase the number of nursing students choosing a career in public health nursing.

A shift in the role of public health practice in the United States to population-focused care, together with demographic shifts increasing the diversity and age of the population, has created a need for a public health workforce more highly skilled in community and population-based practices. Despite this need, few changes have been made in the pattern of field placements for nursing students, in part because many public health nurses in population-focused roles are unfamiliar with models of successful student fieldwork in their areas. We describe the Public Health Nurses for Virginia's Future project, a successful project undertaken by nurse educators and public health leaders to increase the number of highly qualified graduates working in state and local health departments.

Ultrasonographic appearance and etiology of corrugated small intestine.

An ultrasound pattern of corrugated, and sometimes thickened, bowel wall has been associated with pancreatitis and small intestinal lymphangiectasia. In a retrospective study, records of dogs and cats with an ultrasound diagnosis of corrugated bowel were examined for age, breed, gender, presenting complaint, abdominal radiographic results, and final diagnosis. Eighteen dogs and six cats had an ultrasound diagnosis of corrugated bowel. The final diagnosis was pancreatitis (12 of 24), peritonitis (4 of 24), enteritis (2 of 24), pancreatic neoplasia (2 of 24), diffuse abdominal neoplasia (1 of 24), lymphocytic-plasmacytic enteritis (1 of 24), thrombosis/infarction (1 of 24), and protein-losing enteropathy and acute renal failure (1 of 24). The presence of bowel wall corrugation, although a nonspecific finding, should alert one-to the possibility of pancreatitis, enteritis, peritonitis, neoplasia, or bowel wall ischemia.

Caring for sexual minority youths. A guide for nurses.

Nurses have the opportunity to assist sexual minority youths in making healthy transitions to adulthood. Being aware of the challenges that sexual minority youths experience, nurses can be attentive to their specific needs and risk factors, and provide sensitive care. Nurses can draw on their interpersonal, nursing assessment, and advocacy skills to promote a positive health care experience for sexual minority youths.

Experimental evaluation of urinary bladder marsupialization in male goats.

OBJECTIVE: To evaluate the outcome of urinary bladder marsupialization in male goats. STUDY DESIGN: Prospective, experimental study. ANIMALS: Six healthy mixed-breed male goats. METHODS: After experimentally induced urethral obstruction, 6 male goats had urinary bladder marsupialization. Renal ultrasonography, complete blood count, and serum biochemical analysis were evaluated preoperatively (day 0), at 7 postoperative days, and then at 30-day intervals until 180 days. Stomal diameter was recorded immediately postoperatively and at each postoperative interval. Necropsy examination was performed on day 180 or when stomal stricture or death occurred. RESULTS: Stomal stricture occurred in 1 goat at 120 days. Another goat was found dead at 150 days; severe, suppurative cystitis was identified on necropsy. All goats had mild urine scald dermatitis. Serum biochemical values remained within normal limits, but significant decreases in white blood cell count, serum creatinine concentration, and stomal diameter occurred. At necropsy, all bladders were tubular in shape. Histological evidence of chronic suppurative cystitis and chronic, mild lymphoplasmacytic pyelitis occurred in all goats. Bacterial culture of renal tissue yielded growth in 3 goats, and bladder mucosal swabs yielded bacterial growth in all goats. CONCLUSIONS: Although clinical signs of ascending urinary tract infection were not observed in goats with patent stomata, urinary bladder marsupialization may result in ascending urinary tract inflammation or infection. CLINICAL RELEVANCE: Based on our results, urinary bladder marsupialization should be recommended with caution as the primary method for management of urinary tract obstruction in clinical cases.

Cretinism in a North American black bear (Ursus americanus).

Congenital hyperplastic goiter and cretinism were documented in a 16 month-old male North American black bear (Ursus americanus). The cub was captured at approximately 8 months of age and maintained for an additional 8 months in captivity. Clinical signs included growth retardation, clumsiness, and facial dysmorphism. Hypothyroidism was documented by determining serum triiodothyronine (T3) and thyroxine (T4) levels. Lysosomal storage disease was ruled out by measuring various lysosomal enzyme activities. Serologic, radiographic, computed tomographic, necropsy, and histopathologic findings were consistent with congenital hypothyroidism and cretinism.

Vaginal microbicides for HIV/STI prevention in Zimbabwe: what key informants say.

The purpose of this study was to assess the acceptability of vaginal microbicides as prevention methods for heterosexually transmitted HIV. Interviews were conducted with key informants in and around Harare using a semistructured questionnaire with probes. Twenty-seven interviews were conducted with a total of 48 informants. Most women were enthusiastic about the products but had concerns about safety and how the use of these products might affect their relationships with their husbands. Many men were concerned that women would be able to use the products without their consent or knowledge. Several products may be acceptable in this culture but must be introduced within the existing gender power structure. This study provides a model for involving community leaders in the design of culturally appropriate clinical trials.