Search

Following the introduction of highly active antiretroviral therapy, an expanding cohort of adolescents with perinatally acquired HIV (PaHIV) is surviving and emerging from pediatric services with complex transition health care requirements. Transfer from pediatric to adult services has been associated with poorer health outcomes in other chronic diseases. Young people with HIV have the additional burden of stigma, secrecy, and the risk of transmitting HIV to partners and offspring. Maintaining engagement in health care during adolescence is critical. We compare reported satisfaction surveys of health care experiences and preferences of young people with PaHIV attending a U.K. transition outpatient service with young people attending a young persons' diabetes transition service in Australia. All 21 patients in the United Kingdom and 39 young people approached in Australia agreed to participate. The median age for both groups was 19 years, 67% of the PaHIV group were black African and 74% of diabetic group white Australian. Ninety-five percent (18/19) of those with PaHIV and 87% (34/39) with diabetes felt their transition was an easy process. Sixty-eight percent (13/19) of young people with PaHIV and 72% (28/39) of diabetic patients felt moving to their current service had a positive effect on their health. Being treated as an individual, comprehensive management explanations and encouragement to develop independence were cited as 'strongly important' by over three quarters of participants with PaHIV. This service evaluation illustrates that careful transition can be a positive event for young people with PaHIV, comparable to that of a well-established diabetes services. [ABSTRACT FROM AUTHOR]

Water-use efficiency in grapevines is dependent on the aerial and below-ground environment of the plant. Specifically, transpiration efficiency, the ratio of net carbon fixation to water loss, may be influenced by soil moisture and the leaf-to-air vapour pressure deficit (VPD) in the soil-plant-atmosphere continuum. The interactive effect of these abiotic parameters, however, has not been suitably investigated in field-grown grapevines. Accordingly, gas exchange of an anisohydric variety, Semillon, was assessed across a number of vineyards in two warm grape-growing regions of New South Wales (NSW) to ascertain how soil moisture and VPD interact to affect transpiration efficiency at the leaf level. Leaf gas exchange measurements demonstrated that the rate of transpiration ( E) was driven by VPD, particularly under high soil moisture. Both high VPD and low soil moisture decreased photosynthesis ( A) and instantaneous leaf transpiration efficiency ( A/ E). Increased intrinsic leaf transpiration efficiency ( A/ g) in response to drying soil was limited to vines growing in a non-irrigated vineyard. In this site, A/ g was negatively related to vine water status. VPD did not have a substantial influence on A/ g in any vineyard. While VPD is the main driver for A/ E, soil moisture is an important determinant of A/ g. Under high VPD, stomatal closure in Semillon leaves was not substantial enough to suitably curtail transpiration, and as a consequence A/ E declined. These data indicate that in warm climates, irrigation scheduling of anisohydric varieties must take into account both VPD and soil moisture so that vine water status can be maintained. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether recent Australian practice conforms to the draft 2009 National Health and Medical Research Council (NHMRC) guidelines on the management of attention deficit hyperactivity disorder., Methods: Data from the 2007 Special Review on Attention Deficit Hyperactivity Disorder in Children and Adolescents in New South Wales (NSW) were examined., Results: Two hundred seven approved stimulant prescribers in NSW responded to a detailed survey on treatment practice (including 121 paediatricians and 67 psychiatrists). Overall, the practice identified in this survey of NSW approved stimulant prescribers was consistent with that recommended in the draft NHMRC guidelines. Paediatricians were more likely to inform families of developmental therapies. Most prescribers (67%) considered stimulants to be the first line of treatment for at least half of their patients. Psychiatrists were more likely to use stimulants as first-line treatments, while those recently qualified were less likely to prescribe. Half of the prescribers were willing to consider prescribing for children 4 years of age and younger. Paediatricians were more likely to consider prescribing to this age group, while those recently qualified were less likely. There were no significant differences in prescribing practice between child and adult psychiatrists. Most prescribers (67-97%) routinely monitored patients on stimulants for weight, height, blood pressure and academic progress. Psychiatrists were less likely to review these parameters than paediatricians, with this difference being largely due to adult psychiatrists., Conclusions: There are significant differences in prescribing practice between paediatricians and psychiatrists. These variations may reflect differing training programs and patient populations, and merit close consideration in any review arising from the publication of the recent NHMRC guideline., (© 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).)

Objective: The aim of this study was to understand relations between cognitive and affective self-evaluations about the body for adolescent girls in the context of their diverse experiences of the body., Method: The project involved adolescent girls (N = 141), including underweight to overweight schoolgirls, and hospitalized girls with anorexia nervosa (AN). Materials were brief, reliable inventories of self-concepts about body, movement and appearance, and feelings about the body., Results: Measurement models confirmed the related yet discrete self-concepts about the body, movement and appearance, and feeling OK, guilt, worry, disgust, and anger about the body. Self-concepts and feelings were not correlated with body weight, and were sensitive and specific for girls with AN versus low-weight schoolgirls. Relations among self-concepts and feelings about the body vary with the context. In particular, self-concepts and feelings about the body were incongruent for AN girls with acute experiences of making self-evaluations of their bodies., Discussion: It is clear that self-evaluations by adolescent girls do not necessarily reflect actual body weight. Findings suggest that associations between thoughts and feelings about the body vary with diverse experiences of the body. Results support brief, reliable, and valid indicators of self-concepts and feelings about the body that are vital in the design of prevention, intervention, and monitoring, and the evaluation of programmes for girls in clinical and educational settings.