HIV post-exposure prophylaxis for child rape survivors in KwaZulu-Natal, South Africa: who qualifies and who complies?

OBJECTIVE: Our objective was to audit the provision and utilization of HIV post-exposure prophylaxis (PEP) to child rape survivors in the Province of KwaZulu-Natal, South Africa. METHODS: A prospective design was used to collect data from a convenience sample of 200 consecutive cases of child rape referred for medico-legal assessment to a state hospital located to the north of the City of Durban (South Africa) in the period October to December 2004. For each case, information was obtained regarding demographic characteristics of the child, the child's HIV status at presentation, any excluding factors for PEP therapy, and the extent of adherence to the antiretroviral therapy regimen. RESULTS: One hundred and twenty children (60%) qualified for PEP provision, with children being excluded because they refused initial HIV testing (1.5%), tested HIV positive at presentation (6.5%), or because of delayed (>72hour) presentation (32%). Of the 113 children who were followed through the PEP provision system, 40 (35.4%) returned for the full 28-day course, and only 4 (3.5%) returned at both 3- and 6-month follow up. CONCLUSIONS: Adherence rates for PEP therapy following child rape in South Africa are extremely low, with low adherence rates being associated with a theoretical risk of both reduced efficacy and drug resistance. In this context, there is a need for further research designed to identify the reasons for such non-adherence as well as a need for secondary prevention programs designed to both encourage more immediate reporting of child rape and to increase adherence to the PEP regimen.     

Notices

In this study, we examined whether a preparatory perceptual ‘anchoring’ technique would enhance the reproducibility (test–retest reliability) of adolescent children in their ability to self-regulate their exercise output on the basis of their effort perceptions. Forty-one adolescents aged 12.6±0.7 years (mean±s), randomly assigned to either an anchor or non-anchor group, undertook two identical production trials (three 3-min cycle ergometer bouts at levels 3, 6 and 8 of the Children's Effort Rating Table) over 8 days. Before each trial, the anchor group received an experiential (exercise) trial intended to provide a frame of reference for their perceived exertions. The test–retest reproducibility of the heart rates and power outputs produced during the production trials was assessed using intraclass correlation coefficients and 95% limits of agreement analysis. For the anchor group, the intraclass correlation coefficients ranged from 0.68 to 0.81 for heart rate and from 0.39 to 0.86 for power output. For the non-anchor group, they were generally higher: 0.86 to 0.93 and 0.81 to 0.95 for heart rate and power output, respectively. The 95% limits of agreement indicated no marked differences between the two groups in the amount of bias and within-subject error. The results suggest that among these adolescents, the implementation of an experiential anchoring protocol had no positive effect on the reproducibility of their exercise regulation during prescribed cycling.     

Fluid and electrolyte balance in elite male football (soccer) players training in a cool environment

There are few data in the published literature on sweat loss and drinking behaviour in athletes training in a cool environment. Sweat loss and fluid intake were measured in 17 first-team members of an elite soccer team training for 90 min in a cool (5°C, 81% relative humidity) environment. Sweat loss was assessed from the change in body mass after correction for the volume of fluid consumed. Sweat electrolyte content was measured from absorbent patches applied at four skin sites. Mean (?± s) sweat loss during training was 1.69?±?0.45 l (range 1.06?-?2.65 l). Mean fluid intake during training was 423?±?215 ml (44?-?951 ml). There was no apparent relationship between the amount of sweat lost and the volume of fluid consumed during training (r ² = 0.013, P = 0.665). Mean sweat sodium concentration was 42.5?±?13.0 mmol?·?l^?1 and mean sweat potassium concentration was 4.2?±?1.0 mmol?·?l^?1. Total salt (NaCl) loss during training was 4.3?±?1.8 g. The sweat loss data are similar to those recorded in elite players undergoing a similar training session in warm environments, but the volume of fluid ingested is less.     

Sharing designer and user perspectives of web site evaluation: a cross-campus collaborative learning experience

In this paper we present an online, collaborative process that facilitates usability evaluation of web sites. The online workspace consists of simple and effective proformas and computer–mediated discussion space to support usability evaluation. The system was designed and used by staff and students at two universities. Students, working in small teams, at each university, developed web sites and then evaluated the usability of web sites developed at the other university, using the results to improve their own sites. Our project evaluations show that the process provides valuable feedback on web site usability and provides students with the experience of usability evaluation from two important perspectives: those of a user and of a developer. Further, students develop important generic skills: the ability to participate in and critique computer supported cooperative work environments.     

The effect of ball carrying method on sprint speed in rugby union football players

Different methods of ball carrying can be used when a player runs with the ball in rugby union. We examined how three methods of ball carrying influenced sprinting speed: using both hands, under the left arm and under the right arm. These methods were compared with running without the ball. Our aim was to determine which method of ball carrying optimizes sprinting speed. Altogether, 48 rugby union players (age 21±2 years, height 1.83±0.1?m, body mass 85.3±12?kg, body fat 14?±?5%; mean±s) were recruited. The players performed twelve 30-m sprints in total (each player performed three trials under each of three methods of carrying the ball and sprinting without the ball). The design of the study was a form of Latin rectangle, balanced across the trial order for each of the methods and for pairwise combinations of the methods in blocks of four per trial. Each sprint consisted of a 10-m rolling start, followed by a 20-m timed section using electronic timing gates. Compared with sprinting 20?m without the ball (2.58±0.16?s), using both hands (2.62±0.16?s) led to a significantly slower time (P?<0.05). Sprinting 20?m with the ball under the left arm (2.61±0.15?s) or under the right arm (2.60± 0.17?s) was significantly quicker than when using ‘both hands’ (P?<0.05), and both these methods were significantly slower than when running without the ball (P?<0.05). Accordingly, running with the ball in both hands led to the greatest decrement in sprinting performance, although carrying the ball under one arm also reduced the players' sprinting ability. Our results indicate that to gain a speed advantage players should carry the ball under one arm.