Symposium: ethical considerations in HIV preventive vaccine research: examining the 18 UNAIDS guidance points. The 18 UNAIDS guidance points.
Explore the source record for details and available documents.
AIDS Vaccines↗
SEARCH · PubMed Health
Results for “Unaids”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Comparative analysis of unaided emmetropic and unaided noncorrected myopic underwater visual acuity.
Explore the source record for details and available documents.
Adolescent↗
Speech recognition performance of patients with sensorineural hearing loss under unaided and aided conditions using linear and compression hearing AIDS.
OBJECTIVES: This study compared speech recognition performance on the Northwestern University Auditory Test No. 6 (NU-6) and the Connected Speech Test (CST) for three hearing aid circuits (peak clipping [PC], compression limiting [CL], and wide dynamic range compression [WDRC]) in adults with symmetrical sensorineural hearing loss. The study also questioned whether or not hearing aid benefit for the three circuits was dependent upon the speech level and the signal-to-babble ratio (S/B) and upon the degree and slope of hearing loss. DESIGN: Unaided speech recognition performance for NU-6 and CST materials presented from a loudspeaker at 0 degrees was measured during Visit 1, and both unaided and aided performance was measured at 3-mo intervals during Visits 2 to 4. The NU-6 was presented in quiet at a conversational speech level of 62 dB SPL. The CST was presented in 10 listening conditions-three S/B (-3, 0, and 3 dB) at each of three speech levels (soft speech at 52 dB SPL, conversational speech at 62 dB SPL, and loud speech at 74 dB SPL) and in quiet at 74 dB SPL. Uncorrelated multi-talker babble was presented from two loudspeakers at 45 degrees on each side of the main speaker. Hearing aid benefit was examined for 360 subjects divided into four groups of hearing loss, pure tone average <40 dB HL and slope <10 dB/octave or >10 dB/octave and hearing loss >40 dB HL for the two slope categories. RESULTS: Hearing aid benefit (aided minus unaided performance) measured on the NU-6 in quiet exceeded 31 rau for all three circuits. Although small statistical advantages were found for the WDRC, the differences were approximately 2% and are not considered clinically relevant. Unaided CST performance showed a complex relationship between presentation level and signal-to-babble ratio that was further confounded by the degree of hearing loss. For the two mild hearing loss groups and for each of the three nominal signal-to-babble ratios, CST performance decreased by 20 rau for the -3 dB S/B to 6 rau for the 3 dB S/B as speech level increased from 52 to 74 dB SPL. In contrast, unaided performance increased by 32 to 13 rau with signal level for all signal-to-babble ratios for the two >40 dB hearing loss groups. Overall, aided CST performance exceeded unaided performance for all 10 conditions. As expected, hearing aid benefit was greatest (27 rau) for soft speech and smallest for loud speech (6 rau). Differences among the hearing aid circuits were small with only one significant difference; the WDRC at 62/0 was poorer by 3 rau than the other two circuits. When the CST data were analyzed as a function of hearing loss, five pair-wise comparisons were significant. In contrast to the unaided performance, aided performance for all hearing loss groups decreased as presentation level increased, even though the signal-to-babble ratio was constant. CONCLUSIONS: All three hearing aids circuits provided benefit over the unaided condition in both quiet and noise. The greatest benefit was measured for soft speech in the more severe hearing loss groups. Although only small differences were measured among the three hearing aid circuits, significant differences favored the PC and CL circuits over the WDRC in the mild hearing loss groups and favored the WDRC over the PC in the more severe, sloping hearing loss group. An interesting interaction between speech level, signal-to-babble ratio, degree of hearing loss, and amplification was found. For a constant signal-to-babble ratio, recognition performance decreased as speech level increased from 52 to 74 dB SPL. The effect was most marked in the milder hearing loss groups and in the aided conditions, and occurred at even the lowest speech levels.
Adult↗
Unaided speech in long-term tube-free tracheostomy.
OBJECTIVES/HYPOTHESIS: Objectives of the current study were as follows: 1) to determine whether a self-sustaining, tube-free tracheostomy with unaided speech capability can be achieved, 2) to propose new surgical techniques to enhance voluntary constriction of a tube-free tracheostoma to improve cough and speech production, and 3) to explain the mechanism involved in unaided speech after long-term tracheostomy. The hypotheses were that long-term, tube-free tracheostomy could minimize the unwanted effects of conventional tube-dependent tracheotomy; that surgical shunting of the trachea to the skin surface can be established through a short, skin-lined, self-supporting, nostril-like opening; and that patients could generate speech and cough without the need to occlude the stoma or use stents and/or one-way valves if such a long-term tube-free tracheostoma were established. STUDY DESIGN: A prospective study of tube-free tracheostomy intended to establish unaided cough and speech. METHODS: Thirty-five patients who underwent long-term flap tracheostomies between 1992 and 1999 with the prospective intent of establishing a self-sustaining stoma without the need for tubes or stents were reviewed. The patients were trained to intentionally constrict the stoma for production of unaided speech and cough. The pertinent techniques developed for successful achievement of these characteristics are presented and reviewed. A new surgical technique using a local tendinous muscular sling was designed to further improve the efficacy of stomal constriction. RESULTS: A tube-free stoma was successfully established in all 35 patients. Eighteen patients achieved effective intentional constriction of the stoma and thereby were capable of unaided speech production. Four patients required an additional new surgical sling procedure to optimize unaided cough and speech production. Thirteen patients achieved only limited unaided speech production, but were satisfied to do nothing further. CONCLUSIONS: New surgical techniques and postoperative management to create a modified tube-free tracheostomy with self-constricting capabilities can enable production of effective cough and near-normal generation of unaided speech. In this manner, the airway can be secured with little or no voice compromise.
Adolescent↗
Differing risk factors for falls in nursing home and intermediate-care residents who can and cannot stand unaided.
OBJECTIVES: To determine fall risk factors in nursing home and intermediate-care residents who can and cannot stand unaided. DESIGN: Prospective cohort study. SETTING: Residential elderly care facilities in Sydney, Australia. PARTICIPANTS: One thousand people aged 65 to 103 (mean age +/- standard deviation: 85.0 +/- 7.4). MEASUREMENTS: Accidental falls. RESULTS: Fall rates were highest in those with fair standing balance, intermediate in those with the best standing balance, and lowest in those with the worst standing balance. This nonlinear pattern was even more striking when subjects were categorized according to their standing balance and ability to rise from a chair. Using this dual classification, fall rates were highest in those who could rise from a chair but could not stand unaided (81%) and lowest in those who could neither rise from a chair nor stand unaided (48%). In residents who could stand unaided, risk factors included increased age, male sex, higher care classifications, incontinence, psychoactive medication use, previous falls, and slow reaction times. In contrast, quite different risk factors were evident in residents who could not stand unaided, with a number of known fall risk factors (previous stroke, reduced ability to rise from a chair, slow reaction times) being associated with fewer falls. In this group, risk factors were intermediate versus nursing home care, poor health status, psychoactive medication use, Parkinson's disease, previous falls, and being able to get out of a chair. CONCLUSION: The findings indicate that there are different risk factors for falls for people living in residential aged care facilities who can and cannot stand unaided. These findings provide important information for developing fall-prevention strategies and suggest that those who can stand unaided but have multiple falls risk factors constitute the highest priority group for such interventions.
Accidental Falls↗
Child sexual abuse--genital tract findings in prepubertal girls. II. Comparison of colposcopic and unaided examinations.
In recent years the inspection of the vulva of sexually abused girls by magnification with a colposcope has become increasingly popular. However, data concerning the usefulness of colposcopy in such evaluations are lacking. In a prospective study, 130 prepubertal girls (mean age 5.5 years) who were identified by child protective agencies to be victims of sexual abuse were evaluated both by an unaided examination and by colposcopy. If the colposcopic findings differed from those of the unaided inspection, the macroscopic examination was repeated to determine whether the abnormality could have been detected without magnification. Altogether, 92 of the 130 girls were found to have abnormal findings. In the majority of girls with abnormalities (96%), the abnormalities were observed during the unaided examination. Of the four patients in whom the findings were detected initially by the colposcopic examination, these findings were observed during the repeat unaided examination. The findings were observed by colposcopic examination alone in only one patient. We conclude that unaided examination is adequate for the evaluation of most victims of sexual abuse.
Child↗
Restorative treatment decision making with unaided visual examination, intraoral camera and operating microscope.
This study assessed the restorative treatment options of the occlusal surfaces of teeth examined with unaided visual assistance, an intraoral camera and an operating microscope. Sixty-eight extracted human molars were mounted to perform mouth models with a premolar in contact on both sides. Four observers examined the models in a phantom head, which simulated clinical conditions, using three techniques: unaided visual examination, intraoral camera and operating microscope. The observers were asked to assess the occlusal surface of each tooth and make a treatment decision based on the following scale: 1) the occlusal surface being sound and "not needing a restoration," 2) the occlusal surface having a subsurface or enamel lesion. No operative treatment was needed at this visit, but special attention was given to this surface at recall visits: "preventive care-defer treatment" and 3) the surface had a carious lesion and "needed a restoration." The teeth were then sectioned in the mesio-distal direction and examined under a stereomicroscope with 10x magnification to determine the true extent of caries. Statistical analysis was conducted by calculating percentages and kappa values of the restorative treatment scores based on examinations by four observers. According to all the observers' treatment decisions, the kappa values were found to be 0.341 (p<0.001), 0.471 (p<0.001) and 0.345 (p<0.001) for unaided visual examination, intra-oral camera and operating microscope, respectively. There was a statistically significant difference between the intraoral camera and the other two methods (p<0.05), while there was no significant difference between the unaided visual examination and operating microscope (p>0.05). As a result of a comparison between the unaided visual examination and operating microscope, the use of an intraoral camera improved the restorative treatment decisions of the occlusal surfaces on posterior teeth.
Bicuspid↗
Is the unaided ear effect independent of auditory aging?
As a group, adults with bilateral symmetric sensorineural hearing loss (SNHL) who receive a monaural hearing aid fitting experience a progressive decline in their word recognition score (WRS) for monosyllabic word materials in the unaided ear but not in the aided ear. However, adults with binaural fittings do not demonstrate a similar deterioration in their WRS. In an effort to determine the role of senescent auditory changes on the unaided ear effect, a retrospective investigation was carried out on a group of hearing aid wearers. Using NU-6 to assess the WRS, this investigation attempted to answer the following question: is the unaided ear effect related to asymmetric senescent auditory changes? The present results indicate that the unaided ear effect is not related to such an asymmetric effect since it is shown to occur in adults with SNHL whether in the fourth or seventh decade of life.
Adult↗
Improved methods and assumptions for estimation of the HIV/AIDS epidemic and its impact: Recommendations of the UNAIDS Reference Group on Estimates, Modelling and Projections.
UNAIDS and WHO produce biannual country-specific estimates of HIV/AIDS and its impact. These estimates are based on methods and assumptions that reflect the best understanding of HIV epidemiology and demography at the time. Where significant advances are made in epidemiological and demographic research, the methods and assumptions must evolve to match these advances. UNAIDS established an Epidemiology Reference Group in 1999 to advise them and other organisations on HIV epidemiology and methods for making estimates and projections of HIV/AIDS. During the meeting of the reference group in 2001, four priority areas were identified where methods and assumptions should be reviewed and perhaps modified: a) models of the HIV epidemic, b) survival of adults with HIV-1 in low and middle income countries, c) survival of children with HIV-1 in low and middle income countries, and d) methods to estimate numbers of AIDS orphans. Research and literature reviews were carried out by Reference Group members and invited specialists, prior to meetings held during 2001-2. Recommendations reflecting the consensus of the meeting participants on the four priority areas were determined at each meeting. These recommendations were followed in UNAIDS and WHO development of country-specific estimates of HIV/AIDS and its impact for end of 2001.
Acquired Immunodeficiency Syndrome↗
Gender differences in the outcome of an unaided smoking cessation attempt.
There is conflicting evidence concerning gender differences in success at quitting smoking. Information is especially lacking regarding gender differences among unaided quitters who make up the vast majority of those attempting to quit. One hundred thirty-five smokers who made an unaided attempt at quitting were interviewed before quitting and were followed for 1 year after cessation. Relapse rates were extremely high both for men and women, with 62% of participants returning to regular smoking within 15 days after cessation. Women and men were equally likely to maintain short-term abstinence (through 15 days), but women were more than three times as likely to relapse subsequently. Nine percent of men, but no women, had biochemically verified sustained abstinence throughout the 1-year follow-up period. For both men and women, any smoking after the quit attempt inevitably led to full-blown relapse. Most participants resumed regular smoking within 24 hours after the first episode of smoking. Gender differences were observed for several variables related to smoking history, demographics, social support, perceived stress, and motivational factors, but these differences did not explain the increased risk of relapse for women. Our results clearly indicate that women are less likely than men to maintain long-term smoking abstinence following an unaided quit attempt, but reasons for this gender difference need further exploration.
Adult↗
Spectacle use and reduced unaided vision in third grade students: a comparative study in different educational settings.
BACKGROUND: The development of myopia is influenced by hereditary factors, environmental factors and gene-environment interaction. Reading and near-work activity are associated with myopia and myopic progression. This study sought to determine and compare the prevalence of reduced unaided vision and spectacle use among third grade Israeli students from three different educational settings. METHOD: A sample of 917 students (mean age 8.5 years, range seven to 10 years) was drawn from the three Israeli educational streams: secular, Orthodox and ultra-Orthodox. Children in the ultra-Orthodox education pathway begin studying at the age of three years and their daily reading involves sustained near work with increased accommodative effort accompanied by head-rocking movements. Reduced distance vision was used to indicate the likely development of or an increase in the amount of myopia. Spectacle lenses were measured to determine the prevalence of myopia. RESULTS: Of the 917 students studied, 103 (11.2 per cent) wore spectacles (14.2 per cent of the males and eight per cent of the females); 82.5 per cent of those who wore spectacles were myopic. Males from ultra-Orthodox schools had the highest rate of reduced unaided vision (72.5 per cent) compared with males from secular schools (27.3 per cent), males from Orthodox schools (59.3 per cent) or with females from all three groups (average of 34.8 per cent, p < 0.0001, chi squared). Males had a higher rate of reduced unaided vision, especially in the Orthodox and ultra-Orthodox schools. CONCLUSIONS: Our study suggests that Jewish ultra-Orthodox males have a higher prevalence and degree of myopia. The study habits of young children, including exposure to prolonged near tasks, high accommodative demands and possibly optical defocus induced by body sway, may contribute to the development of myopia.
Accommodation, Ocular↗
[The UNAIDS strategy in the prevention of HIV/AIDS in the countries of Eastern Europe].
Grounds for the necessity of the formation of effective approaches to the prevention of HIV epidemic with a view to counteract the rapid spread of infection in East European countries are presented. Attention is specially drawn to fact that the epidemic will not be limited by drug users, but will quickly cross the boundaries of this group. The development of preventive measures must be based on the use of the world experience. New effective approaches to work with vulnerable groups (the strategy of harm reduction, work in communities, consultations, etc.) must be widely used. The program of actions of the UNAIDS European Section, stipulating the strengthening and extension of the potential of the countries in the region for the effective counteraction to the epidemic, is formulated. As priority areas, activities covering vulnerable groups and with young people have been determined. The strategy of UNAIDS is realized through 20 UN theme groups on HIV/AIDS in the countries of Eastern Europe. Special attention is drawn to the creation of methodological networks. The creation of a unified strategic plan for counteraction the epidemic of HIV/AIDS is regarded by UNAIDS as its perspective for the future.
Acquired Immunodeficiency Syndrome↗
The assessment of unaided visual examination, intraoral camera and operating microscope for the detection of occlusal caries lesions.
This study compared the efficiency of unaided visual examination, intraoral camera and operating microscope according to a visual scoring system (ERK) at occlusal caries detection. A total of 84 extracted human molars were mounted to create mouth models with a premolar in contact on both sides. The models were examined in a phantom head simulating clinical conditions by four observers using the three techniques: unaided visual examination, an intraoral camera and on operating microscope according to the ERK scale. The teeth were than sectioned in a mesio-distal direction and examined under a stereomicroscope with 10x magnification for histological validation. The sensitivity, specificity, positive predictive and negative predictive values were calculated for the four observers with three techniques and statistical analyses were performed using Friedman and DUNN tests, while strength of agreement was determined by calculating Kappa values. From the data, mean sensitivity values were cal. culated as 0.26, 0.43, 0.49 and mean specificity values as 0.87, 0.80 and 0.73 for unaided visual examination, intraoral camera and operating micro scope, respectively. The Kappa values ranged between 0.187 and 0.301 for visual examination, 0.328 and 0.459 for intraoral camera and 0.363 and 0.516 for operating microscope. As a result, the use of an intraoral camera and operating microscope improved occlusal caries detection according to the ERK scale.
Bicuspid↗
Ethical considerations in international HIV vaccine trials: summary of a consultative process conducted by the Joint United Nations Programme on HIV/AIDS (UNAIDS).
Research that is initiated, designed or funded by sponsor agencies based in countries with relatively high social and economic development, and conducted in countries that are relatively less developed, gives rise to many important ethical challenges. Although clinical trials of HIV vaccines began ten years ago in the US and Europe, an increasing number of trials are now being conducted or planned in other countries, including several that are considered "developing" countries. Safeguarding the rights and welfare of individuals participating as research subjects in developing countries is a priority. In September, 1997, the Joint United Nations Programme on HIV/AIDS (UNAIDS) embarked on a process of international consultation; its purpose was further to define the important ethical issues and to formulate guidance that might facilitate the ethical design and conduct of HIV vaccine trials in international contexts. This paper summarises the major outcomes of the UNAIDS consultative process.
AIDS Vaccines↗
Test-retest reliability of in situ unaided thresholds in adults.
PURPOSE: The purpose of this study was to examine test-retest reliability of in situ unaided thresholds measured using a handheld hearing aid programmer coupled to a hearing aid transducer in adults with normal hearing. METHOD: Randomized in situ thresholds at 4 octave frequencies were established in 1 ear of 43 adults twice using the Widex Diva SP3 device with the stimulus generated by and transduced through a Widex Diva SD-9 behind-the-ear hearing aid. Insert earphone tips were used in each of the measures to couple the hearing aid/transducer to the ear canal. RESULTS: Mean decibel differences between the test and retest thresholds were less than 1 dB at each frequency. Using an 80% statistical test criterion, results revealed test-retest reliability within 5 dB for all frequencies: 98% at 500 Hz, 100% at 1000 and 2000 Hz, and 93% at 4000 Hz. CONCLUSIONS: Test-retest reliability of in situ unaided thresholds using the SP3/SD-9 device is equivalent to that of currently accepted audiometric procedures.
Acoustic Stimulation↗
Aided and unaided speech supplementation strategies: effect of alphabet cues and iconic hand gestures on dysarthric speech.
PURPOSE: This study compared the influence of speaker-implemented iconic hand gestures and alphabet cues on speech intelligibility scores and strategy helpfulness ratings for 3 adults with cerebral palsy and dysarthria who differed from one another in their overall motor abilities. METHOD: A total of 144 listeners (48 per speaker) orthographically transcribed sentences spoken with alphabet cues (aided), iconic hand gestures (unaided), and a habitual speech control condition; scores were compared within audio-visual and audio-only listening formats. RESULTS: When listeners were presented with simultaneous audio and visual information, both alphabet cues and hand gestures resulted in higher intelligibility scores and higher helpfulness ratings than the no-cues control condition for each of the 3 speakers. When listeners were presented with only the audio signal, alphabet cues and gestures again resulted in higher intelligibility scores than no cues for 2 of the 3 speakers. Temporal acoustic analyses showed that alphabet cues had consistent effects on speech production, including reduced speech rate, reduced articulation rate, and increased frequency and duration of pauses. Findings for gestures were less consistent, with marked differences noted among speakers. CONCLUSIONS: Results illustrate that individual differences play an important role in the value of supplemental augmentative and alternative communication strategies and that aided and unaided strategies can have similar positive effects on the communication of speakers with global motor impairment.
Adult↗
Estimation of client-assessed hearing aid performance based upon unaided variables.
The purpose of this study was to investigate the possibility of estimating client-assessed hearing aid performance before hearing aids are purchased. Aided performance was represented by the Profile of Hearing Aid Performance (PHAP, Cox & Gilmore, 1990). Multiple regression was applied to 16 unaided predictor variables and to 8 response variables. The response variables were the scores from the seven PHAP subscales plus the overall PHAP score, which were obtained from 46 participants. Audiologic, demographic, and psychological information was included among the 16 predictor variables. The average widths of 95% prediction intervals showed that, with the exception of the Aversiveness of Sounds and Ease of Communication subscales, PHAP subscale scores were predicted within 15% on average. Eighty percent or more of the individual participants' PHAP scores were predicted within 15% for all but the Aversiveness of Sounds subscale. The predictor variables appearing in regression equations for the greatest number of PHAP subscales include age, Communication Strategies and Personal Adjustment scores from the Communication Profile for the Hearing Impaired (Demorest & Erdman, 1986), Revised Speech Perception in Noise (Bilger, Neutzel, Rabinowitz, & Rzeczkowski, 1984; Kalikow, Stevens, & Elliott, 1977) test scores, comfortable loudness levels, and the difference between National Acoustic Laboratories' target gain (Byrne & Dillon, 1986) and actual insertion gain. Further testing of the models on additional participants would be needed to determine their clinical applicability. In addition to being potentially useful for predicting client-assessed aided performance, the equations obtained in this study identify relationships between the aided and unaided variables that can be applied in the counseling of new hearing aid users.
Aged↗
Unaided speech in tube-free tracheostomy: The supplementary sling procedure.
OBJECTIVE: In some patients after tube-free tracheostomy, air escape hinders voice optimization. Our objective was to determine whether a supplementary sling procedure could reduce air escape and improve unaided speech and cough in these patients. STUDY DESIGN AND SETTING: From September 1998 through June 2001, 12 patients underwent supplementary sling procedures at the Cleveland Clinic. After surgery, stoma constriction and voice production were assessed. RESULTS: Fifteen procedures were performed in 12 patients. Two patients required revision procedures. All 9 patients with sufficient follow-up have markedly improved stoma constriction and speech production. Three patients with less than 3 months' follow-up already show early improvement. CONCLUSION: The supplementary sling procedure effectively reduces air escape and helps unaided speech and cough in patients with tube-free tracheostomata. SIGNIFICANCE: As more patients undergo tube-free tracheostomy, the pool of patients who might benefit from a sling procedure will grow. Indications might extend to postlaryngectomy or post-laryngeal transplant patients.
Adult↗