We qualitatively investigated perspectives on HIV disclosure to health care providers (HCP) by people living with HIV (PLWH). Perspectives varied across PLWH and between PLWH and HCP. Some PLWH felt ...they should always disclose so that HCP could take necessary precautions or because disclosure optimized care. Others felt that disclosure was not an obligation but a courtesy. Still others felt that disclosure was unnecessary as all HCP should apply universal precautions or because HIV status was not relevant to care. Most HCP claimed they should be informed about patients' HIV status as this would reduce occupational risk of infection and improve care. HCP also felt that disclosure concerns by PLWH were unnecessary given the HCP' duty of professional confidentiality. Some acknowledged that disclosure was not always necessary but still indicated wanting to be informed. Perspectives on HIV disclosure in health care settings differed substantially between PLWH and HCP.
Biomechanical analysis of Indy car crashes using on-board impact recorders (Melvin et al. 1998, Melvin et al. 2001) indicates that Indy car driver protection in high-energy crashes can be achieved in ...frontal, side, and rear crashes with severities in the range of 100 to 135 G peak deceleration and velocity changes in the range of 50 to 70 mph. These crashes were predominantly single-car impacts with the rigid concrete walls of oval tracks. This impressive level of protection was found to be due to the unique combination of a very supportive and tight-fitting cockpit-seating package, a six-point belt restraint system, and effective head padding with an extremely strong chassis that defines the seat and cockpit of a modern Indy car. In 2000 and 2001, a series of fatal crashes in stock car racing created great concern for improving the crash protection for drivers in those racecars. Unlike the Indy car, the typical racing stock car features a more spacious driver cockpit due to its resemblance to the shape of a passenger car. The typical racing seat used in stock cars did not have the same configuration or support characteristics of the Indy car seat, and five-point belt restraints were used. The tubular steel space frame chassis of a stock car also differs from an Indy car's composite chassis structure in both form and mechanical behavior. This paper describes the application of results of the biomechanical analysis of the Indy car crash studies to the unique requirements of stock car racing driver crash protection. Sled test and full-scale crash test data using both Hybrid III frontal crash anthropomorphic test devices (ATDs) and BioSID side crash ATDs for the purpose of evaluating countermeasures involving restraint systems, seats and head/neck restraints has been instrumental in guiding these developments. In addition, the development of deformable walls for oval tracks (the SAFER Barrier) is described as an adjunct to improved occupant restraint through control of the crash forces acting on a racing car. NASCAR (National Association for Stock Car Auto Racing, Inc) implemented crash recording in stock car racing in its three national series in 2002. Data from 2925 crashes from 2002 through the 2005 season are summarized in terms of crash severity, crash direction, injury outcome, and protective system performance.
A new transparent noise barrier system was developed for use on rigid bridge railings and other rigid structures. The crashworthy noise barrier system incorporated specially designed, strategically ...located structural hardware into a noncrashworthy noise barrier system. The noise barrier system was anchored to the back face of a reinforced concrete parapet with vertical steel posts. Transparent sound panels surrounded by a metallic frame were dropped between the spaced posts to create a noise barrier. Three horizontal rails were used to prevent errant vehicles from penetrating into sound panels, snagging on the support posts, or both. The test installation consisted of a 34.56-m-long Paraglas Soundstop TL-4 noise barrier system supported by 18 steel posts. Two full-scale crash tests—one with a single-unit truck and one with a pickup truck—were conducted and reported in accordance with the requirements specified in NCHRP Report No. 350: Recommended Procedures for the Safety Performance Evaluation of Highway Features. The safety performance of the transparent noise barrier system was determined to be acceptable according to Test Level 4 evaluation criteria specified in NCHRP Report No. 350.
The synthesis, X‐ray structure, and the magnetic properties of 2‐(2‐methyl‐1,3‐propanediol)‐4,4,5,5‐tetramethyl‐3‐oxylimidazoline 1‐oxide are described. The nitronyl nitroxide packs in stacks of ...dimers. Two CH2O−H···O−N hydrogen bonds and one CH2OH group of each nitronyl nitroxide link two molecules into a dimer. The additional CH2OH group in each molecule forms CH2O−H···O−N hydrogen bonds to a second dimer and so on, leading finally to columns of dimers. Each column is surrounded by six other columns. The magnetic behaviour of the crystal is strongly temperature dependent, evidence for intermolecular interactions between the molecules at room temperature. DFT calculations support an antiferromagnetic coupling of nitronyl nitroxide molecules in the dimer.
A new design of a detector plane of sub-millimetre thickness for an electromagnetic sampling calorimeter is presented. It is intended to be used in the luminometers LumiCal and BeamCal in future ...linear \(e^+e^-\) collider experiments. The detector planes were produced utilising novel connectivity scheme technologies. They were installed in a compact prototype of the calorimeter and tested at DESY with an electron beam of energy 1-5 GeV. The performance of a prototype of a compact LumiCal comprising eight detector planes was studied. The effective Moli`ere radius at 5 GeV was determined to be (8.1 +/- 0.1 (stat) +/- 0.3 (syst)) mm, a value well reproduced by the Monte Carlo (MC) simulation (8.4 +/- 0.1) mm. The dependence of the effective Moli`ere radius on the electron energy in the range 1-5 GeV was also studied. Good agreement was obtained between data and MC simulation.
In der Schwangerschaft steigt das zirkulierende Blutvolumen an, so dass es zu einer physiologischen Hämodilution mit vermindertem Hämoglobin, Hämatokrit und verminderter Erythrozytenzahl kommt. ...Typischerweise bleibt dabei jedoch das MCV (mittleres korpuskuläres Volumen) stabil. Eine Anämie wird bei einer Schwangeren je nach Empfehlung bei Werten unter 10–11g/dl angenommen. Mit der mütterlichen Anämie sind fetale Risiken wie Frühgeburt und niedriges Geburtsgewicht assoziiert. Die häufigste Anämieform in der Schwangerschaft ist die Eisenmangelanämie bei einem MCV unter 80mg/dl. Liegen Serumeisen und Ferritin im Normbereich muss zur weiteren Differentialdiagnose eine Hämoglobin-Elektrophorese durchgeführt werden, um die häufigsten Formen erblicher Anämien ausschließen zu können, wie beispielsweise Thalassämie oder Sichelzellanämie. Wir berichten über den Verlauf einer schweren Eisenmangelanämie, einer unkompliziert verlaufenen heterozygoten Beta-Thalassämie sowie einer Beta-Thalassämia intermedia mit akuter Hämolyse im dritten Trimenon. In den Schilderungen der Fälle findet das jeweils erforderliche diagnostische Vorgehen sowie das klinische Management der unterschiedlichen Anämieformen besondere Berücksichtigung. Da es sich um Fälle unterschiedlichen Schweregrades handelt, wird auf den Stellenwert einer strukturierten interdisziplinären Betreuung von Schwangeren mit dieser häufigen internistischen Grunderkrankungen eingegangen.
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