Studies on the resting behaviour and host choice of Anopheles gambiae and An. arabiensis from Muleba, Tanzania.

The relative efficacy of a mechanical (Prokopack) collection method vs. manual aspiration in the collection of resting mosquitoes was evaluated in northern Tanzania before and after an intervention using indoor residual spraying and longlasting insecticide-treated nets. In smoke-free houses mosquitoes were collected from the roof and walls, but in smoky houses mosquitoes were found predominantly on the walls. Anopheles gambiae (Diptera: Culicidae) constituted 97.7% of the 312 An. gambiae complex specimens identified before but only 19.3% of the 183 identified after the intervention. A single sampling with the Prokopack collected a third of the available insects. Anopheles gambiae completed its gonotrophic development indoors, whereas Anopheles arabiensis did so outdoors. In both species gonotrophic development took 2 days. Most unfed resting An. arabiensis collected outdoors were virgins, whereas the majority of engorged insects were parous (with well-contracted sacs). Daily survival was estimated to be 80.0%. Only 9.4% of the engorged An. arabiensis collected outdoors and 47.1% of those collected indoors had fed on humans. Using the Prokopack sampler is more efficient than manual methods for the collection of resting mosquitoes. Malaria transmission may have been affected by a change in vector composition resulting from a change in feeding, rather than reduced survival. Monitoring the proportions of members of the An. gambiae complex may provide signals of an impending breakdown in control.

A qualitative exploration of fear of cancer recurrence (FCR) amongst Australian and Canadian breast cancer survivors.

PURPOSE: Few studies have explored coping strategies used by cancer survivors to deal with fear of cancer recurrence (FCR), and little research has been conducted on the specific content of recurrence fears. This study aims to qualitatively explore the strategies used by younger breast cancer survivors to cope with FCR and whether women with low, medium and high levels of FCR employ different coping strategies. An additional aim was to understand the specific content of worst recurrence fears. METHOD: Twenty Australian and 10 Canadian women aged ≤ 45 years diagnosed with stages 0-II disease at least 1 year prior completed telephone interviews. The transcripts of audio-taped interviews were analysed using the qualitative methodology of transcendental realism. RESULTS: Women with higher FCR described using distraction and avoidance and fewer coping skills. The fear of death was a common worst fear at all levels of FCR. However, participants with higher FCR described more elaborate fears of death often involving themes of pain and suffering. Cross-cultural differences were not observed. CONCLUSIONS: Women with higher FCR report using fewer and more avoidance-based coping techniques. Whilst many participants feared death, those with higher FCR reported more elaborate death fears. Women with high levels of FCR may benefit from learning a greater repertoire of coping skills. Understanding the specific content of FCR can help refine existing psychological treatment protocols for FCR. Implications for FCR treatment are discussed.

Potential of ozonation for the degradation of antibiotics in wastewater.

Increasing concern in recent years over the occurrence and fate of low-level concentrations of pharmaceuticals in the aquatic environment stimulates research on alternative treatment methods. This paper presents a study of the degradation of sulphamethoxazole, an antibiotic used on humans and animals in order to treat various bacterial infections, by ozonation. After 4.5 min of treatment, the concentration of sulphamethoxazole was below the HPLC detection limit of 0.6 mgL(-1), indicating degradation efficiency higher than 99.24%. This value is comparable and in some cases higher than published data on the degradation in drinking water. Kinetic analysis of the data indicated an overall first-order reaction with a rate constant of 1.0594 min(-1) at 20 degrees C. The reaction order differs with the second-order reaction observed by other researchers. This change of reaction order could be explained by the different treatment conditions used. Preliminary analysis using the FT-IR technique was also performed in order to obtain information on the structure of the degradation products. Further analysis using a GC-MS is needed in order to elucidate the structure of the degradation products. Finally, based on the experiments performed, ozonation seems to be a promising technique for the degradation of antibiotics, even in wastewater.

Building a patient-focused unit: the nurse manager's challenge.

Developing a patient-focused unit is necessary to attain the highest standards of patient care. It is only when we can view our unit through the eyes of a patient that we will be able to see ourselves as others see us. Professionally, we have committed ourselves to creating caring environments that promote healing. We cannot meet this goal until we make a commitment to be patient-focused and give up being nurse-focused or facility-focused.

Case study. Outcomes management in orthopaedics.

Improving outcomes while maintaining quality and satisfaction in today's healthcare environment is a challenge. This article shares some of the foundation work and the results of an interdisciplinary team effort toward that goal. Changes in care practices and their impact on outcomes can promote the welfare of the patient, institution, and the nation's health.

Activation of innate immunity in nonhuman primates following intraportal administration of adenoviral vectors.

The innate immune response to intraportally infused adenoviral vector was evaluated in rhesus monkeys. A first-generation adenovirus-expressing lacZ (Ad-lacZ) was administered at a dose just below that which causes severe morbidity. The response to vector was evaluated for the initial 24 h following infusion. Clinical findings during this time were primarily limited to petechiae, consistent with the development of thrombocytopenia and biochemical evidence of disseminated intravascular coagulation. Serum transaminases were elevated and a lymphopenia developed. Tracking of fluorescent-labeled vector demonstrated distribution to macrophages and dendritic cells of the spleen and Kupffer cells of the liver. A systemic release of the cytokine IL-6 occurred soon after vector infusion. Analysis of splenic cells revealed acute activation of macrophages and dendritic cells followed by massive apoptosis. Bone marrow cultures demonstrated normal erythroid and primitive progenitors with a significant decrease in myeloid progenitors. Similar findings, except the abnormality in bone marrow cultures, were observed in monkeys who received an identical dose of Ad-lacZ in which vector genes were inactivated with psoralen and UV irradiation. These data suggest that inadvertent targeting of antigen-presenting cells following intraportal infusion of vector leads to a systemic cytokine syndrome which may be triggered by the viral capsid proteins.