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Methods for assessing both the inclusion and impact of human rights within health program design and implementation are still nascent. We used human rights concepts and methods to evaluate the programs of three Kenyan nongovernmental organizations that integrate legal and health services as a means to empower key populations to better understand and claim their rights and improve their access to health care and justice. Drawing on evaluation experiences and results, this paper demonstrates that the systematic application of human rights principles and strategies can support the conceptualization of monitoring and evaluation objectives through logic model design, the identification and selection of appropriate evaluation measures, and the analysis of evaluation data. This evaluation represents an important step in moving human rights–related evaluation work beyond the mere conceptual and into the operational. © 2015 Wiley Periodicals, Inc., and the American Evaluation Association.

Objectives Late presentation to HIV/AIDS services compromises treatment outcomes and misses opportunities for biomedical and behavioral prevention. There has been significant heterogeneity in how the term “late presentation” (LP) has been used in the literature. In 2011, a consensus definition was reached using CD4 counts to define and measure late presenters and while it is useful for clinical care, the consensus definition has several important limitations that we discuss in this article.

We document the different types of restructuring activities undertaken during the private period after the reverse leveraged buyout (RLBO) of previously public firms. Preceding the LBO, firm leverage significantly exceeds that of their peers, while their profitability is better than the industry. However, despite their superior performance, these firms are undervalued before going private. While private firms undertake value-enhancement measures by increasing employee productivity, asset restructuring, decreasing cost of goods sold, and increasing ownership concentration. Enhanced valuation at the RLBO is a result of value capture, as well as efficiencies obtained from restructuring activities. We also identify factors determining the private period duration. [ABSTRACT FROM AUTHOR]

This study provides new evidence on the restructuring activities undertaken by public-to-private reverse leveraged buyouts (RLBOs) while owned by private equity firms. The authors' comprehensive sample of public-to-private LBOs that return to public ownership through IPOs enables them to observe changes in profitability, valuation, financial structure, operating structure, and cost structure from the time the firms go private through (and after) their emergence through (re-) IPOs. With their exclusive focus on reverse LBOs involving public-to-private deals, the authors reach findings that contradict previous conclusions about RLBOs. At the time of the LBO, the target firms in reverse LBOs are more levered than their peers, pay higher dividends, and are more profitable than their peers. At the same time, however, they appear to have lower market valuations before the buyouts. During the private period, the target firms of reverse LBOs achieve significant increases in employee productivity, asset restructuring, and improved gross margins, while operating with substantially higher levels of debt financing, lower levels of cash and working capital, and greater concentration of equity ownership. After the companies return to public ownership through IPOs, such companies continue to operate with higher leverage and ownership concentration than their publicly traded peers while producing further increases in profitability, resulting in substantial increases in both enterprise and equity valuation. The authors' analysis also shows that higher debt levels from the buyout play an important role in increased enterprise values. The evidence suggests that possible undervaluation as well as expected efficiency gains from restructuring actions are the primary motives for such reverse LBOs.

The use of polymethylmethacrylate (PMMA) to reinforce vertebral bodies (Vertebroplasty) leads to an increase in the Young's modulus of the augmented vertebral body. Fractures in the adjacent vertebrae may be the consequence thereof. Hence, PMMA with a reduced Young's modulus may be suitable for vertebroplasty. The goal of this study was to produce and characterize stiffness-adapted PMMA cements. Modified PMMA bone cements were produced by adding N-methyl-pyrrolidone (NMP). Young's modulus, yield strength, polymerization temperature, setting time, and hardening behavior of different cements were analyzed. Focus was on the mechanical properties of the material after different storage conditions (in air at room temperature and in PBS at 37 degrees C). The Young's modulus decreased from 2670 MPa (air)/2384 MPa (PBS) for the regular cement to 76 MPa (air)/320 MPa (PBS) for a material composition with 60% of the MMA substituted by NMP. Yield strength decreased from 85 MPa (air)/78 MPa (PBS) to 2 MPa (air)/24 MPa (PBS) between the regular cement and the 60% composition. Polymerization temperature decreased from 70 degrees C (regular cement) to 48 degrees C for the 30% composition. The hardening behavior exhibited an extension in handling time up to 200% by the modification presented. Modification of PMMA cement using NMP seems to be a promising method to make the PMMA cement more compliant for the use in cancellous bone augmentation in osteoporotic patients: adjustment of its mechanical properties close to those of cancellous bone, lower polymerization temperature, and extended handling time.

Since the introduction of drugs to prevent vertical transmission of HIV, the purpose of and approach to HIV testing of pregnant women has increasingly become an area of major controversy. In recent years, many strategies to increase the uptake of HIV testing have focused on offering HIV tests to women in pregnancy-related services. New global guidance issued by the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) specifically notes these services as an entry point for provider-initiated HIV testing and counseling (PITC). The guidance constitutes a useful first step towards a framework within which PITC sensitive to health, human rights and ethical concerns can be provided to pregnant women in health facilities. However, a number of issues will require further attention as implementation moves forward. It is incumbent on all those involved in the scale up of PITC to ensure that it promotes long-term connection with relevant health services and does not result simply in increased testing with no concrete benefits being accrued by the women being tested. Within health services, this will require significant attention to informed consent, pre- and post-test counseling, patient confidentiality, referrals and access to appropriate services, as well as reduction of stigma and discrimination. Beyond health services, efforts will be needed to address larger societal, legal, policy and contextual issues. The health and human rights of pregnant women must be a primary consideration in how HIV testing is implemented; they can benefit greatly from PITC but only if it is carried out appropriately.

We have previously shown that positively charged beads (DEAE A25) increase wound breaking strength in linear incisions in rats and nonhuman primates at days 10-14 post-wounding. The increased wound strength may result in part from a stimulation of cells adjacent to the DEAE A25 beads to produce growth factors important for wound healing. In this report, we investigate this hypothesis by comparing the relative expression levels of transforming growth factor-beta1 and its receptor transforming growth factor-beta receptor type I in DEAE A25-treated and contralateral untreated rat linear incisions. DEAE A25-treated incisions were stronger than untreated control wounds at 3 days post-wounding, and the difference in breaking strength reached statistical significance at days 5, 7 and 10. Immunohistochemical analysis revealed a significant increase in transforming growth factor-beta1 and transforming growth factor-beta receptor type I expression in DEAE A25-treated incisions, up to 7 days post-wounding, as compared to untreated control wounds. FACS analysis revealed that macrophage cell lines exposed to DEAE A25 in vitro upregulate transforming growth factor-beta1 and transforming growth factor-beta receptor type I expression by 2-3 fold. Therefore, the increase in expression of transforming growth factor-beta1 and transforming growth factor-beta receptor type I in DEAE A25-treated incisions may be due to an increase in the concentration of macrophages adjacent to DEAE A25 beads, as well as the stimulation of individual macrophages to produce greater amounts of transforming growth factor-beta1 and transforming growth factor-beta receptor type I. This study also supports the significance of transforming growth factor-beta1 in wound healing.

Carrier mediated uptake (uptake-1) transport of norepinephrine (NE) plays a key role in the regulation of sympathetic neurotransmission. Recent investigations indicate that nitric oxide (NO) may modulate uptake-1 activity, possibly in a cyclic GMP independent manner. Carrier mediated transport of [3H-NE] and [3H-dopamine, DA] was examined in CHO cells transfected with cDNA for the NE and DA transporters (NET, DAT) respectively. While exposure to the NO donor S-nitroso-N-acetylpenicillamine (100 μM, SNAP) significantly reduced [3H-NE] uptake (P

We examined the existence of catecholamine metabolizing enzymes (catechol-O-methyltransferase, COMT, and monoamine oxidase, MAO) in CHO cells transfected with norepinephrine (NE) transporter (NET) cDNA. NET activity was studied by incubating cells with [3H]-NE (0.5 μCi ml−1, 20 min) in a Na+ containing medium. Incubation with [3H]-NE lead to [3H] accumulation at 47797±4864 d.p.m. per well. Specific inhibitors of NET abolished this uptake. During post-uptake incubation, [3H] leaked rapidly from cells and the extracellular phase comprised 89% of total radioactivity within 40 min. Both [3H] retention and [3H]‘leakage’ were largely unaffected by inhibitors for MAO. In contrast, COMT inhibitors, U-0521 and Ro 41-0960, dose-dependently increased intracellular [3H]-NE retention with a maximal increase of 4.5 fold. The EC50 for Ro 41-0960 was 139-times lower than that of U-0521. U-0521 largely inhibited [3H]‘leakage’ and doubled the apparent Vmax for [3H]-NE uptake. Addition of U-0521 during uptake incubation increased intracellular NE content by 8 fold. Normetanephrine, the COMT-dependent metabolite of NE, was formed in large quantities during post-uptake incubation. U-0521 significantly inhibited the formation of NMN with an equal preservation of intracellular NE. CHO cells expressing NET possess COMT activity, which is responsible for the metabolism of NE to form lipophilic metabolite normetanephrine. The apparent ‘properties’ of the NET function expressed in CHO cells changed, after inhibition of COMT, in such a way closer to that described in the native neuronal preparations. British Journal of Pharmacology (1999) 128, 774–780; doi:10.1038/sj.bjp.0702831

The study reported describes an experimental biodegradable polymer ceramic composite with wax-like handling properties that was combined with 2.0 μg of recombinant human transforming growth factor beta (rhTGF-β1). The polymer/rhTGF-β1 combination was introduced into standard-sized calvarial defects in rabbits to evaluate biodegradability, biocompatibility, hemostasis control, and bone promotion. The experimental wound model was a standard-sized circular calvarial defect 8 mm in diameter. The experimental design included 24 skeletally mature New Zealand white rabbits divided evenly between two time periods (6 and 12 weeks) and among three experimental treatments (untreated defects and defects treated with polymer with or without rhTGF-β1). Evaluations consisted of clinical examinations, standardized radiography, radiomorphometry, as well as histology and histomorphometry. Data were analyzed by an Analysis of Variance (ANOVA) and Fisher's Protected Least Significant Difference test at each time period (level of significance p⩽ 0.05). Radiomorphometry data indicated that standard-sized defects treated with the wax-like polymer alone and the polymer plus 2.0 μg of TGF-β1 were significantly more radiopaque than control sites at both 6 and 12 weeks. Histomorphometric data revealed the amount of new bone was significantly greater at 6 weeks in the polymer plus 2.0 μg of TGF-β1 and in the control group than in the polymer alone. Moreover, at 12 weeks, there was significantly more new bone in the control than in either the polymer alone or the polymer plus 2.0 μg of TGF-β1. We speculate the incomplete biodegradation of the polymer ceramic composite contributed to the radiopacity and may have retarded osseous regeneration. It is important that the bone wax-like polymer material was biocompatible and acted as a hemostatic agent. © 1998 John Wiley & Sons, Inc. J Biomed Mater Res, 41, 584–592, 1998.

Objective To evaluate biocompatibility of biodegradable sleeves containing antimicrobial agents, designed for local drug delivery to prevent implant-related infection. Study Design Synthetic polyester sleeves (a copolymer of glycolide, caprolactone, trimethylene carbonate, lactide) were cast as thin films. The antimicrobial agents incorporated in the sleeves included gentamicin sulfate, triclosan, or a combination of these drugs. Animals Adult sheep (n = 15). Methods Two limited contact dynamic compression plates (LC-DCP) with or without sleeves were implanted on tibiae (bilateral) of 15 sheep. Sleeves were placed over the plates before implantation. Beneath half of the plates, 5-mm drill hole defects were made in the near cortex. Samples were harvested 4 weeks later for histology and microradiography. Results Macroscopically, no irritation of bone or adjacent tissue was seen. Small remnants of sleeves were visible on histology, and positively correlated with the presence of macrophages and foreign body cells. Thick sections showed no difference between the test samples and controls in terms of fibrous capsule formation, periosteal remodeling, and defect remodeling. Inflammatory cells, macrophages, and foreign body cells were more prominent in sections with sleeves, but were not statistically significantly different from controls. Cell numbers were within normal physiologic limits normally seen as cellular response to foreign bodies consisting of polymers. Conclusion The normal healing response indicated that the biodegradable sleeves demonstrate tissue biocompatibility.

While officials at almost every higher education institution already understand that making investments in signature buildings is a time-honored way to communicate the promise and excitement of an education at that particular university or college, there are ways to make smaller, strategic investments in both new and existing facilities.

Introduction Even as the number of women living with HIV around the globe continues to grow, realization of their sexual and reproductive health and human rights remains compromised. The objective of this study was to review the current state of knowledge on the sexual and reproductive health and human rights of women living with HIV to assess evidence and gaps. Methods Relevant databases were searched for peer-reviewed and grey literature. Search terms included a combination of MeSH terms and keywords representing women, HIV/AIDS, ART, human rights, sexual and reproductive health. We included both qualitative and quantitative literature published in English, French, or Spanish between July 2011 and December 2014. Results and discussion The search yielded 2228 peer-reviewed articles, of which 40 met the inclusion criteria in the final review. The grey literature search yielded 2186 documents of which seven met the inclusion criteria in the final review. Of the articles and documents reviewed, not a single peer-reviewed article described the explicit implementation of rights in programming, and only two documents from the grey literature did so. With one possible exception, no articles or documents were found which addressed rights comprehensively, or addressed the majority of relevant rights (i.e. equality; non-discrimination; participation; privacy and confidentiality; informed decision making; availability, accessibility, acceptability and quality (3AQ) of services individually or in their totality; and accountability). Additional findings indicate that the language of rights is used most often to describe the apparent neglect or violation of human rights and what does exist only addresses a few rights in the context of a few areas within sexual and reproductive health. Conclusions Findings from this review suggest the need to better integrate rights into interventions, particularly with attention to provider training, service delivery, raising awareness and capacity building among the community of women living with HIV. Further research is urgently needed to support the sexual and reproductive health and rights of women living with HIV, to identify what works and to inform future programming and policies to improve care, treatment and support for women living with HIV.

Introduction: Attention to the negative effects of structural barriers on HIV efforts is increasing. Reviewing national legal and policy environments with attention to the international human rights commitments of states is a means of assessing and providing focus for addressing these barriers to effective HIV responses. Methods: Law and policy data from the 171 countries reporting under the Declaration of Commitment from the 2001 United Nations General Assembly Special Session on HIV/AIDS were analyzed to assess attention to human rights in national legal and policy environments as relevant to the health and rights of key populations such as people who inject drugs, men who have sex with men and sex workers. Results: Seventy-eight governments and civil society in 106 countries report the existence of laws and policies which present obstacles to accessing HIV services for key populations. Laws and policies which positively affect access to HIV-related services, in and of themselves constituting structural interventions, were also reported. The dissonance between laws and how this impacts the availability and use of HIV-related services deserve greater attention. Conclusions: Recognition of the harms inherent in laws that constitute structural barriers to effective HIV responses and the potential positive role that a supportive legal environment can play suggests the need for legal reform to ensure an enabling regulatory framework within which HIV services can be effectively delivered and used by the populations who need them. Moving beyond laws and policies, further efforts are required to determine how to capture information on the range of structural barriers. Teasing apart the impact of different barriers, as well as the structural interventions put in place to address them, remains complicated. Capturing the impact of policy and legal interventions can ultimately support governments and civil society to ensure the human rights of key populations are protected in national HIV responses. Keywords: AIDS; HIV; human rights; key populations; law; policy; structural barriers. (Published: 26 April 2013) Citation: Gruskin S et al. Journal of the International AIDS Society 2013, 16 :18000 http://www.jiasociety.org/index.php/jias/article/view/18000 | http://dx.doi.org/10.7448/IAS.16.1.18000