Use of antiretroviral HIV post-exposure prophylaxis in sexually abused children and adolescents treated in an inner-city pediatric emergency department

BACKGROUND: In 2002, Georgia had the United States' eighth highest number of persons living with AIDS. Human immunodeficiency virus (HIV) transmission as a result of sexual abuse is uncommon but definitely occurs. In certain circumstances of sexual abuse, antiretroviral post-exposure prophylaxis (ARV-PEP) has been suggested as a means to decrease the risk of HIV infection. Our objective was to assess the utilization of ARV-PEP in patients being evaluated for sexual abuse at a pediatric emergency department in a city with high HIV prevalence. METHODS: A retrospective survey of the characteristics of sexual abuse victims was conducted using information abstracted from sexual abuse report forms of minors examined in 2002 at an inner-city Atlanta children's hospital. RESULTS: Of 227 victims, aged 9 months to 18 years, most were Black, inner-city residents; 190 (84%) patients were female. Only 87 of 227 (38.3%) were seen within 72 h of the abuse, the time frame for offering ARV-PEP. Twenty-three of the 87 had anogenital trauma or bleeding. Five (5.7%), were provided ARV-PEP, whereas 60 (69%) received antibiotic prophylaxis for non-HIV diseases. Those assaulted by strangers were greater than 10 times more likely to be provided ARV-PEP than others (p=.02). Assailants of the 82 victims who did not receive ARV-PEP included 22 strangers and 60 "acquaintances" of unknown serostatus. CONCLUSIONS: For a high HIV prevalence area, the proportion of sexual abuse victims prescribed ARV-PEP was small in relation to those at risk of HIV sexual exposure. Clinicians should be provided guidance on interpretation of community HIV and sexual abuse victim data to assess the appropriateness of ARV-PEP.     

Distance reached in the Anteromedial Reach Test as a function of learning and leg length

The anteromedial reach test (ART) is a new outcome measure for assessing dynamic knee stability in anterior cruciate ligament-injured patients. The effect of learning and leg length on distance reached in the ART was examined. Thirty-two healthy volunteers performed 15 trials of the ART on each leg. There was a moderate correlation (r = .44-.50) between reach distance and leg length, therefore reach distances were normalized for leg length. Normalized reach distance increased significantly over the 15 trials (p < .01), reaching a plateau after 8 trials, identified by a moving average graph. It is recommended that participants be afforded eight practice trials and that reach distances be normalized by expressing them as a percentage of leg length.     

Golfers do not respond to changes in shaft mass properties in a mechanically predictable way

A common belief in the golf community is that a lighter shaft allows the golfer to swing the club faster. From a mechanical point of view, reducing the mass of the shaft would result in a faster swing. However, a golfer is not a purely mechanical system, and so it is simplistic to assume that identical loads will be applied when swinging different clubs. Therefore, the purpose of this study was to test the hypothesis that golfers behave similar to a mechanical model when swinging clubs of varying mass. A torque driven model estimated the effects caused by the addition of 22?g to the shaft. Twelve golfers hit balls with a standard driver as well as a driver fitted with the same 22?g increase in mass. Club kinematics were collected with a high-speed motion capture system. The model predicted a 1.7?% lower club head speed for the club with additional mass. One subject showed a similar reduction (1.4?%), but one subject showed an increase in club head speed by 3.0?%. Ten subjects did not show any significant differences. These results suggest that golfers do not respond to changes in club mass in a mechanically predictable way.     

Portfolio People: Teaching and Learning Dossiers and Innovation in Higher Education

As teaching portfolios have become more commonplace in higher education, interest has grown in student portfolios. Both innovations embody the same core process—reflection—and both have similar potential benefits and similar drawbacks. This paper commends portfolios as innovative in themselves and as a response to the new mandates that are confronting higher education. Accounts of the potential of and problems with portfolios are summarized, and attention is then given to key issues in successfully introducing them. The underlying position is that students can best gain from their years of study when the systemic reflection that is characteristic of portfolios engages them (through learning portfolios) and their teachers (through teaching portfolios). Embedding such thinking in practice is, itself, a powerful and innovative approach to re-framing the curriculum.     

Training in Its Organizational Context: Sharing Responsibility

A persistent concern of those involved with planning, delivering, and evaluating training as well as of managers is whether training “works.” Addressing that question, this paper proposes that training must be integrated into other aspects of the organization if it is to achieve lasting results. In other words, training must be viewed within its organizational context rather than as a stand‐alone activity. Viewing training contextually raises both training implementation and training evaluation issues. From the implementation perspective, issues abound concerning the best way to link training with other parts of the organization to enhance its effectiveness. From the perspective of evaluation, the difficult issue of accountability arises: Training cannot take responsibility for things beyond its control, but it also cannot abdicate responsibility. How does shared responsibility for results work within an organization? This paper explores these issues by reviewing literature related to training in context, presenting a model for understanding training within an organizational context, and presenting practice implications for trainers.     

Error detection processes during observational learning

The purpose of this experiment was to determine whether a faded knowledge of results (KR) frequency during observation of a model's performance enhanced error detection capabilities. During the observation phase, participants observed a model performing a timing task and received KR about the model's performance on each trial or on one of two trials. Delayed retention and transfer tests were used to assess the observer's ability to detect error in the model's performance and in the participant's performance while physically practicing the task. Results indicated a beneficial effect of a reduced KR frequency for performance stability and the ability to detect errors in both the model and the participant's own performance. The results suggest that aspects of the processing mechanism(s) developed in observational learning and related to KR are probably similar to those developed through physical practice.