Field evaluation of two point-of-care tests for syphilis among men who have sex with men, Verona, Italy

Objectives: The incidence of HIV and syphilis among men who have sex with men (MSM) in Europe has recently increased. Rapid point-of-care tests (POCTs) for syphilis can improve access to screening. The purpose of this study was to evaluate the performance of two syphilis POCTs compared with laboratory tests among MSM. Methods: The study was undertaken in Verona, Italy. Asymptomatic MSM, potentially exposed to syphilis, were enrolled prospectively. The POCTs evaluated were SD Bioline Syphilis 3.0 and Chembio DPP Syphilis Screen & Confirm Assay on both serum and fingerprick blood. The results of the POCTs were read by the naked eye by two independent readers and their concordance assessed. Results: A total of 289 MSM were enrolled in the study. Based on laboratory tests, 35 MSM (12.1%) were TPPA-positive alone and 16 (5.5%) were both Treponema pallidum particle agglutination test (TPPA) and rapid plasma reagin (RPR)-positive. The specificities of both POCTs were above 99% on both serum and fingerstick blood specimens, while sensitivities varied considerably. The sensitivity of the SD Bioline test was lower on fingerprick blood (51.4% and 54.3%, readers 1 and 2, respectively) compared with that on serum (80.0% and 82.9%). In contrast, the Chembio test exhibited similar sensitivity values for serum and fingerprick samples (57.7% and 64.0% on serum vs 65.4% and 69.2% on fingerprick for the treponemal component; 63.6% on both samples by both readers for the non-treponemal component). The positive predictive value ranged between 100% and 93.9% for the treponemal component of both syphilis POCTs, but was lower (76.3%-100%)%) for the non-treponemal component of the Chembio POCT. The negative predictive value surpassed 90% for both tests on both samples. The agreement between readers was very high (>99%). Conclusion: The diagnostic performance of the syphilis POCTs was lower than expected; however, considering the prevalence of syphilis among MSM, POCTs should be recommended to improve syphilis detection among MSM

Field evaluation of two point-of-care tests for syphilis among men who have sex with men, Verona, Italy.

OBJECTIVES: The incidence of HIV and syphilis among men who have sex with men (MSM) in Europe has recently increased. Rapid point-of-care tests (POCTs) for syphilis can improve access to screening. The purpose of this study was to evaluate the performance of two syphilis POCTs compared with laboratory tests among MSM. METHODS: The study was undertaken in Verona, Italy. Asymptomatic MSM, potentially exposed to syphilis, were enrolled prospectively. The POCTs evaluated were SD Bioline Syphilis 3.0 and Chembio DPP Syphilis Screen & Confirm Assay on both serum and fingerprick blood. The results of the POCTs were read by the naked eye by two independent readers and their concordance assessed. RESULTS: A total of 289 MSM were enrolled in the study. Based on laboratory tests, 35 MSM (12.1%) were TPPA-positive alone and 16 (5.5%) were both Treponema pallidum particle agglutination test (TPPA) and rapid plasma reagin (RPR)-positive. The specificities of both POCTs were above 99% on both serum and fingerstick blood specimens, while sensitivities varied considerably. The sensitivity of the SD Bioline test was lower on fingerprick blood (51.4% and 54.3%, readers 1 and 2, respectively) compared with that on serum (80.0% and 82.9%). In contrast, the Chembio test exhibited similar sensitivity values for serum and fingerprick samples (57.7% and 64.0% on serum vs 65.4% and 69.2% on fingerprick for the treponemal component; 63.6% on both samples by both readers for the non-treponemal component). The positive predictive value ranged between 100% and 93.9% for the treponemal component of both syphilis POCTs, but was lower (76.3%-100%)%) for the non-treponemal component of the Chembio POCT. The negative predictive value surpassed 90% for both tests on both samples. The agreement between readers was very high (>99%). CONCLUSION: The diagnostic performance of the syphilis POCTs was lower than expected; however, considering the prevalence of syphilis among MSM, POCTs should be recommended to improve syphilis detection among MSM

The Effectiveness of Village Consultative Body in Kuningan District in Implementing Legislative Function

Village Government has a very significant role in managing social processes in the society. The purpose of this research is to examine the process of village regulations making in Kuningan District and the effectiveness of the Village Consultative Body (BPD) in implementing legislative function. The method used in this research was a juridical-empirical research method. A rational analysis based on juridical references was then conducted through literature and field research. The results showed that the Village Consultative Body as a legislative institution at the lower level has an important role in establishing government legal products to realize checks and balances system and accommodating the society’s aspirations. Normatively, the establishment of village regulations in Sukaharja village is not running properly, and in its implementation, the establishment of village regulation in Sukaharja has not fully contained the principles of good regulations making based on Law Number 12 of 2011 concerning Establishment of Legislation. In its process, there are some stages which are not implemented by both village head and BPD so that the regulation is less effective for the society. The Village Consultative Body has three main functions, namely legislation, supervision, and aspiration. Here, the Village Consultative Body is still less effective in implementing those three functions, especially the legislative function. It can be seen from the period of 2010-2015 in which the legal products produced by the BPD are very low, whereas there are many provisions that should have a legal umbrella in order to create legal certainty for the society. This situation happens because there is a lack of human resources in forming the village regulation draft, and the village government does not understand what the contents of the village regulations that should have a legal umbrella in village regulations making.Pemerintah Desa memiliki peran yang sangat signifikan dalam pengelolaan proses sosial di dalam masyarakat. Tujuan penelitian ini adalah untuk mengetahui dan mengkaji bagaimana proses pembentukan peraturan desa di Kabupaten Kuningan dan evektifitas Badan Permusyawaratan Desa dalam menjalankan fungsi legislasi. Metode penelitian yang digunakan dalam penelitian ini adalah metode penelitian yuridis-empiris selanjutnya dilakukan analisa rasional berdasarkan acuan yuridis melalui penelitian kepustakaan dan lapangan. Hasil penelitian bahwa Badan Permusyawaratan Desa merupakan lembaga legislatif di tingkat bawah yang mana memiliki peranan penting dalam pembentukan produk hukum pemerintahan desa untuk mewujudkan sistem check and balences dan penyambung lidah masyarakat dalam menyampaikan aspirasi. Secara normatif pembentukan perdes di desa Sukaharja belum sesuai, namun dalam tarap implementasinya dalam pembentukan peraturan desa di desa Sukaharja belum sepenuhnya memuat asas-asas pembentukan peraturan yang baik menurut Undang-Undang Nomor 12 Tahun 2011 tentang Pembentukan Peraturan Perundang-undangan. Dalam prosesnya masih terdapat tahapan-tahapan yang tidak dijalankan baik oleh kepala desa maupun BPD, sehingga peraturan tersebut kurang berdaya guna bagi masyarakat. Badan Permusyawaratan Desa memiliki tiga fungsi yaitu legislasi, pengawasan, dan menampung aspirasi masyarakat. Dalam menjalankan fungsi legislasi tertutama dalam hal ini masih kurang efektif dilihat dari kurun waktu tahun 2010-2015 produk hukum yang dihasilkan oleh BPD sangat rendah, seyogianya banyak ketentuan yang harus dibuatkan payung hukum agar terciptanya kepastian hukum bagi masyarakat setempat. Hal tersebut terjadi karena masih minimnya sumber daya manusia dalam menyusun draf rancangan perdes, serta pemerintah desa belum memahami apa saja materi muatan dari  peraturan desa yang harus dibuat payung hukum dalam pembuatan perdes

A Sustainable Tourism Paradigm: Opportunities and Limits for Forest Landscape Planning

The promotion of sustainable tourism models has been widely debate

Factors related to condomless anal intercourse between men who have sex with men: results from a European bio-behavioural survey

Background Relationship status is an important factor associated with condomless anal intercourse (CAI) amongst men who have sex with men (MSM). Methods A multi-centre bio-behavioural survey with MSM was conducted in 13 European cities (n=4,901) exploring factors associated with CAI via bivariate and multivariate multilevel logistic regression analyses. Results Likelihood of CAI with casual partners was associated with being ‘out’ to a majority (AOR=1.19;95% CI 1,1.42); knowing their HIV status (AOR=1.86; 95% CI 1.25,2.76); using substances (1-2 AOR=1.39; 95% CI 1.16,1.63, 2+ AOR=1.81; 95% CI 1.35,2.42); being older (AOR=0.98; 95% CI 0.97,0.99); successful sero-communication (AOR=0.79; 95% CI 0.67,0.94); and, not having a recent HIV test (AOR=0.78; 95% CI 0.66,0.92). CAI with steady partners was associated with successful sero-communication (AOR=2.72; 95% CI 2.72,3.66); not having a recent HIV test (AOR=1.26; 95% CI 1.09,1.46), and; being older (AOR=0.99; 95% CI 0.98,0.99). Conclusions Understandings of partner type and/or relationship status in relation to CAI amongst MSM can potentially play an important role in the development of culturally appropriate HIV/STI prevention and risk-reduction efforts targeting at-risk MSM. Our results speak to the need to consider segmented and tailored public health and health promotion initiatives for MSM with differing CAI behaviours and relationship profiles

PENERAPAN ASAS PERLINDUNGAN YANG SEIMBANG MENURUT KUHPERDATA DALAM PELAKSANAAN PERJANJIAN KERJA UNTUK WAKTU TERTENTU DIHUBUNGKAN DENGAN UNDANG-UNDANG NOMOR 13 TAHUN 2003 TENTANG KETENAGAKERJAAN

Peranan hukum di dalam pergaulan hidup adalah sebagai sesuatu yang melindungi, memberi rasa aman, tentram dan tertib untuk mencapai kedamaian dan keadilan setiap orang. Apabila dalam pergaulan hidup terjadi peristiwa seseorang berjanji kepada orang lain atau dua orang berjanji untuk melaksanakan sesuatu hal, maka timbulah suatu perjanjian. Demikian juga di bidang pekerjaan, orang melakukan pekerjaan sehingga berakhir adanya perikatan.Jadi dalam bentuknya perjanjian itu berupa suatu rangkaian perkataan yang mengandung janji-janji atau kesanggupan yang diucapkan atau ditulis.Dari perjanjian tertulis tersebut terjadi hubungan hukum antara dua orang atau lebih yang lazim disebut perikatan. Perjanjian menerbitkan perikatan antara dua orang atau lebih.Suatu perjanjian dinamakan juga persetujuan, karena dua orang atau lebih itu sepakat untuk melakukan sesuatu.Suatu perikatan adalah suatu hubungan antara dua orang atau lebih, yang mewajibkan pihak yang satu untuk memenuhi tuntutan, demikian juga sebaliknya. Syarat pertama dan syarat kedua disebut sebagai syarat subjektif, karena menyangkut orang atau para pihak, sedangkan syarat ketiga dan syarat keempat disebut sebagai syarat objektif karena menyangkut objek perjanjian. Tidak terpenuhinya syarat subjektif berakibat dapat dibatalkannya sebuah perjanjian oleh salah satu pihak. Artinya sekalipun perjanjian telah ditandatangani maka salah satu pihak yang merasa keberatan atas proses perjanjian itu dapat mengajukan pembatalan isi perjanjian ke Pengadilan, sedangkan apabila syarat objektif tidak terpenuhi maka perjanjian tersebut batal demi hukum, artinya isi perjanjian itu tidak membawa akibat apapun terhadap kedua belah pihak karena secara hukum perjanjian itu dianggap tidak pernah ada, karena dalam perjanjian pemborongan pekerjaan juga berlaku syarat-syarat subjektif dan syarat objektif, maka perusahaan pengguna tenaga kerja harus memperhatikan dan memenuhi syarat-syarat sebagaimana yang terdapat dalam ketentuan UndangUndang Nomor 13 Tahun 2003 tentang Ketenagakerjaan. Kata kunci : perjanjian,perlindungan,tenaga kerj

Main drivers of the evolution of grazing in the alpine area of Valli del Leno (Trentino, Northern Italy) during the last two centuries: natural resources, labour and investments

In the Alps as in many mountain areas, livestock farming has constituted an important source of income, especially since the Middle Ages. The importance of livestock farming within the Alpine economy has changed over time due to the dynamics of supply and demand combined with evolving environmental, technological and institutional constraints. This paper focuses on the latter aspect and attempts to reconstruct how the relative importance of the production factors of land, labour and capital changed throughout the nineteenth and twentieth centuries in a mountainous area of eastern Trentino. The underlying objective of the investigation is to provide a micro-level empirical basis for hypotheses advanced in the literature regarding the evolution of a crucial sector in the Alpine economy, drawing attention to the long-term role of exogenous and endogenous factors as well as elements of continuity and change. The work is grounded in multiple sources drawn from local archives and official statistics. It demonstrates the flexibility of local communities in managing to sustainably utilize local resources over several periods.En muchas zonas de montaña la ganadería ha constituido, a partir de la Edad Media, una fuente importante de recursos económicos. La trasformación que ha habido del peso relativo de la ganadería en la economía alpina ha sido fruto de una combinación de dinámicas, por un lado concernientes a la demanda, y, por otro, de la oferta, con los cambios introducidos por los vínculos normativos medioambientales, tecnológicos e institucionales de dicha actividad. En nuestro estudio nos centramos en este último aspecto, tratando de reconstruir el cambio que ha tenido lugar en el curso de los siglos xix y xx del peso relativo de los factores de producción tierra, trabajo y capital en una zona montañosa del Trentino oriental. El objetivo principal de nuestra investigación es el de proporcionar una base empírica, en microperspectiva, a las hipótesis avanzadas en la literatura en mérito a la evolución de un sector crucial de la economía alpina, mostrando cuál ha sido a lo largo del tiempo el rol de los factores exógenos y de los endógenos y subrayando elementos de continuidad y factores de transformación