Risk management information for HIV infection

This article discusses HIV infection in terms of the risk manager's information needs in the health care environment. The malpractice problem, increasing workman's compensation suits, the greater role of the ombudsman, implementation of the National Practitioner Data Bank, and the Joint Commission on Accreditation of Health Care Organizations' (JCAHO) emphasis on clinical excellence are conditions which have given greater importance to the risk manager's position. Included in this article are hedges to retrieve various components of risk management and a select bibliography from AIDSLINE.     

Short-term reliability of inflammatory mediators and response to exercise in the heat

Prospective application of serum cytokines, lipopolysaccharide (LPS), and heat shock proteins (eHSPs) requires reliable measurement of these biomarkers that can signify exercise-induced heat stress in hot conditions. To accomplish this, both short-term (7 day) reliability (at rest, n = 12) and the acute responsiveness of each biomarker to exercise in the heat (pre and post 60-min cycling, 34.5°C and 70% RH, n = 20) were evaluated. Serum was analysed for the concentration of C-reactive protein (CRP), interleukin-6 (IL-6), heat shock protein 72 (eHSP72), immunoglobulin M (IgM) and LPS. Test–retest reliability was determined as the coefficient of variation (CV). Biomarkers with the least short-term within-participant variation were IL-6 (19%, ±20%; CV, ±95% confidence limits (CL)) and LPS (23%, ±13%). Greater variability was observed for IgM, eHSP72 and CRP (CV range 28–38%). IL-6 exhibited the largest increase in response to acute exercise (95%, ±11%, P = < 0.001) and although CRP had a modest CV (12%, ±7%), it increased substantially post-exercise (P = 0.02, ES; 0.78). In contrast, eHSP72 and LPS exhibited trivial changes post-exercise. It appears variation of common inflammatory markers after exercise in the heat is not always discernible from short-term (weekly) variation.     

RECEPTIVITY TO PEER TEACHING AND PEER LEARNING ABOUT THE SAFE AND APPROPRIATE USE OF MEDICATIONS AMONG OLDER ADULTS

The purpose of this study was to assess receptivity to peer teaching and peer learning about the safe and appropriate use of medications among communitydwelling older adults. The sample was predominately White (88.5%), female (75.9%) older adults with an average age of 80.2 ( - 9.1) years. On average, the participants perceived their health status as good (2.8 - 0.6). In addition, participants reported using an average number of 4.4 ( - 3.3) prescribed medications. The majority (75%) of participants also reported no problems with their medications. With respect to receptivity to peer teaching and peer learning, the participants, on average, were neutral to peer teaching (6.0 - 2.4), but were somewhat receptive to peer learning (6.7 - 2.2). The number of prescribed medications that a participant reported taking and the age of a participant were identified as significant predictors of receptivity to peer teaching and accounted for 14.5% of the total variance ( F = 5.84, df = 2, p = 0.005). For receptivity to peer learning, the number of prescribed medications also was a significant predictor ( F = 7.50, df = 1, p = 0.008). This study provides the initial step to identifying community-dwelling older adults who would be receptive to peer teaching and peer learning about the safe and appropriate use of medications.