HIV as an internal object : the subjective experience of HIV infection in women on ARVs.

HIV/AIDS research has proven crucial in an effort to prevent and manage this epidemic. However, there is little research being done in an attempt to understand the internal worlds of those living with HIV/AIDS. The purpose of this research was to begin to explore the relationship that exists between the person living with HIV/AIDS and the virus, as an internal object, inside them. This study focused on 6 women who were on Anti-Retroviral Medication (ARVs), and who have been diagnosed for at least one year. The participants’ mental representations of the virus as an object inside them was explored, as well as how they experienced and viewed the triangular relationship that exists between themselves, the HI Virus, and the ARVs. This exploratory research utilised a qualitative framework in order to understand and explore these relationships and perceptions, with psychoanalytic theory being used a lens through which to view the data that emerged. In depth semi-structured interviews were conducted with the participants, and the corpus of data was analyzed using a thematic content analysis. In addition, the participants were asked to draw the virus inside their bodies. These were analyzed using a technique devised by Paola Luzzatto (1987) in a study exploring the internal world of drug-abusers. For the purpose of this study, a variation of the same art therapy technique was used in that the participants were asked the ‘draw the virus in their bodies’. Whilst the drawings allowed for insight into the internal worlds of the participants, the drawings were also used as a point of departure. For most of the women, HIV was drawn using a red crayon, whilst the ARVs were drawn in either yellow or green. As depicted in the drawings, post diagnosis the HIV/red seemed to cover most of the body, but later when the ARVs/green was added, more of a balance was achieved. Results show that for these women, HIV was often perceived as dangerous and criminal, whilst the ARVs were often associated with security. From the perspective of Kleinian theory, the perception of the HIV and the ARVs seemed to be dependent upon the position from where they were functioning: either a paranoid-schizoid or a depressive position

Eating Disorder Programming in Four-Year College Recreation Wellness Centers

Eating disorders are more prevalent in the college-age group when compared to the lifetime prevalence. Because of this increased prevalence, college recreation/wellness center staff should be aware of their clients in terms of the increased risk for eating disorders. College wellness/recreation centers, while serving the campus community, also serve the individuals within this community diagnosed with or at-risk for an eating disorder. Through survey research, we show who is employed at wellness/recreation centers, what type of training they receive regarding eating disorder, how this training is provided along with its content, and what method of public awareness on eating disorders is utilized within the facility. Directors of 686 wellness/recreation centers listed in the 2005 NIRSA Recreational Sports Directory were contacted via internet survey. The response rate was 25.0%. The data evaluation (using SPSS) included descriptive statistics to summarize the overall number and percentage of responses. Results indicated that less than half (44%) of the staff at recreation/wellness centers receive training on eating disorders. For individuals who received training, the focus was in the following categories: identification of red flags (73%), general education on eating disorders (65%), and appropriate referral sources (60%). Minimal training appears to be provided on how to provide appropriate intervention (29%). In an attempt to minimize the pressure of environmental interactions that may exacerbate an eating disorder, a majority of facilities have a client dress code, promote a healthy body image, and promote eating disorder awareness to the campus community. As noted, there is an increased prevalence of eating disorders in college-age individuals. There is a low amount of staff training in wellness/recreation centers which illustrates the need for improvement. We recommend an overall increase in eating disorder training, especially with regard to appropriate interventions that should take place within these facilities

Out of (West) Africa-Who Lost in the End?

On October 29, 2014, 4 days before the annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH) to be held in New Orleans, LA, meeting registrants received an e-mail letter from the Louisiana Department of Health and Hospitals stating "we have requested that any individuals that will be traveling to Louisiana following a trip to the West African countries of Guinea, Liberia, and Sierra Leone or have had contact with an Ebola-infected individual remain in a self-quarantine for the 21 days following their relevant travel history…we see no use in you traveling to New Orleans to simply be confined to your room." This communication made it clear that those recently in countries experiencing the 2014 Ebola epidemic would not be able to participate in the meeting. The ASTMH sent their own communication stating that the Society did not agree with the State's policy, but had no choice but to abide. However inconvenient and upsetting this decision might have been, what really matters transcends the mere disturbance of long-planned schedules. More broadly, we lost on five levels

Methyl and Butyl-Parabens Initiate Myeloid Derived Suppressor Cell (MDSC) Activity

Examined if methyl and butyl parabens would mimic estrogen within the body and lead to an increase in MDSC activit

KINERJA PENYISIHAN NITROGEN DENGAN BAKTERI ANAMMOX DARI TELAGA KOTO BARU MENGGUNAKAN MEMBRANE BIOREACTOR (MBR)

Anaerobic ammonium oxidation (anammox) merupakan proses oksidasi amonium secara biologis menjadi gas nitrogen (N2) dengan nitrit sebagai penerima elektron. Penelitian ini bertujuan untuk menganalisis kinerja penyisihan nitrogen pada suhu ambien menggunakan Membrane Bioreactor (MBR) dengan bakteri anammox, Candidatus Brocadia fulgida, yang dikultivasi dari Telaga Koto Baru, Tanah Datar, Indonesia. MBR dioperasikan selama 48 hari dengan hydraulic retention time (HRT) 24 jam dan suplai substrat secara kontinu yang mengandung amonium dan nitrit dalam tiga periode konsentrasi yaitu 70 mg-N/L, 150 mg-N/L dan 250 mg-N/L masing-masingnya. Sampel influen dan efluen diambil dua kali seminggu dan diuji konsentrasi amonium dan nitrit dan nitrat menggunakan spektrofotometer UV-Vis. Berdasarkan penelitian yang telah dilakukan nilai rasio stoikiometri "∆" 〖"NO" 〗_"2" ^"-" "-N/∆" 〖"NH" 〗_"4" ^"+" "-N" and "∆" 〖"NO" 〗_"3" ^"-" "-N/∆" 〖"NH" 〗_"4" ^"+" "-N" sebesar 1,13 dan 0,15, mendekati stoikiometri reaksi anammox. Kinerja penyisihan maksimum nitrogen dengan nilai Nitrogen Removal Rate (NRR), , Ammonium Conversion Efficiency (ACE), dan Nitrogen Removal Efficiency (NRE) yaitu 0,515 kg-N/m3∙h; 92,76%; dan 91,27% pada Nitrogen Loading Rate (NLR) 0,566 kg-N/m3∙h. Bakteri anammox dari Telaga Koto Baru, Tanah Datar, Sumatra Barat, Indonesia, memiliki kinerja penyisihan nitrogen yang tinggi pada suhu ambien menggunakan MBR

Exploring the epidemiology of malaria and the impact of malaria control interventions in malaria-endemic and Ebola-epidemic West Africa

Despite significant advances in the number and type of control measures available, malaria remains one of the leading causes of death worldwide, with the majority of burden concentrated in sub-Saharan Africa. Long-lasting insecticide treated bed nets, antimalarial treatment using artemisinin combination therapies, mass drug administrations, indoor residual spraying and seasonal malaria chemoprevention, are used individually and in combination, supported by community education programs and early detection and treatment protocols. Despite these advances, little evidence exists on how to utilize these interventions effectively in hyperendemic settings or during emergencies. This thesis focuses on malaria control and surveillance in West Africa, particularly Guéckédou Prefecture, the Republic of Guinea and Monrovia, Liberia. Issues that malaria control programs face and the impact that such programs can have in hyperendemic settings and other challenging environments, specifically, the West Africa Ebola epidemic are explored. The evidence presented here builds a case for placing a stronger emphasis on implementing and sustaining control measures in areas of hyperendemicity. Additionally, the need to develop alternative strategies for managing the burden of malaria in both hyperendemic settings and during outbreaks is emphasized. A multi-component malaria control intervention that was implemented in program conditions from 2011-2014 in Guéckédou Prefecture. In Chapter 4, both intervention coverage and the impact of the malaria control intervention on malaria parasite prevalence are quantified using data from biannual population based cross-sectional surveys. Over time, intervention coverage increased while rapid diagnostic test confirmed malaria parasite prevalence decreased in areas where the control activities were implemented. Yet, in the comparison area where activities were not implemented there was no significant change. Nevertheless, while the decrease in malaria parasite prevalence measured during the period of intervention was encouraging, the overall decline was relatively small and suggests a need to develop new or modify currently available control strategies in order to have a greater impact on malaria burden in similar areas. During the study period, the area of intervention became the initial epicenter of the 2013-2016 Ebola Virus Disease (EVD) outbreak. Malaria control activities were reduced because of the outbreak in Guéckédou and all activities related to the multi-component malaria control intervention ceased. In Chapter 5 data collected from the cross-sectional surveys was used to parameterize a stochastic malaria transmission model to assess the impact of the sudden cessation of malaria activities in this context. The model predicted the monthly incidence of malaria cases according to two scenarios, i) a counterfactual scenario that assumes no reinforced malaria interventions occurred between 2011 and 2014, and ii) a scenario with reinforced malaria interventions that ceased at the start of the Ebola outbreak. Interrupted time series analysis was used to assess the impact of malaria control activity cessation on malaria incidence from April 2014. The incidence of uncomplicated malaria was estimated to have resurged to levels higher than that predicted to have occurred in the counterfactual scenario within 8 months of activity cessation in Guéckédou (April 2014). The models show that gains made in malaria control are not sustained and resurgence becomes a significant risk. In areas where malaria is highly endemic, advances made during control activity implementation are quickly negated when activities stop. Upon arrival in Guéckédou in 2010, data from health facility based surveillance was deemed unreliable due to underreporting. Consequently, concurrent with the cross-sectional surveys, community-based sentinel site mortality surveillance was implemented in the same areas in order to monitor malaria attributable mortality. As described in Chapter 6, data on mortality from 43,000 individuals under surveillance was collected for 36 months. The ability of the surveillance system to capture mortality, health-seeking behavior and quantify malaria attributable mortality is described. No early warning system was in place prior to the Ebola outbreak, consequently it was detected 4 months after it began. Data collected through the community-based mortality surveillance system was evaluated retrospectively for its ability to detect outbreaks, specifically of Ebola, when adapted to syndromes. Indeed, two of the suspect Ebola deaths captured through the surveillance system were among the first laboratory confirmed cases from the 2013-2016 outbreak. Although challenging, this demonstrates that prospective community-based mortality surveillance using sentinel sites can provide a means to document mortality and facilitate outbreak detection in low resource settings. As the Ebola outbreak evolved into a multi-country epidemic, the response moved from vertical programming to a more holistic response that incorporated the innovative use of classic malaria control strategies. One of these strategies included the first mass drug administration (MDA) of malaria chemoprevention carried out during an Ebola outbreak. In post distribution surveys of individuals attending the distributions reported in Chapter 7, the incidence of self-reported fever decreased from 4.2% in the month prior to the first distribution to 1.5% after the first distribution. Yet, only 52% of household members initiated treatment after round 1 and only 22% after round 2. While the reduction in self-reported fever cases suggests that MDA may be effective in reducing cases of fever during Ebola outbreaks, the low treatment initiation suggests the need for longer-term interventions to prevent malaria and to improve access to healthcare. All of these different aspects combined provide a unique perspective on malaria control in normal and emergency settings in malaria endemic areas of West Africa. Malaria control programs implemented in hyperendemic settings in program conditions can result in a decrease in malaria parasite prevalence and malaria attributable mortality. Yet, malaria morbidity can be expected to resurge quite quickly if activities are not sustained. In areas where health facility surveillance is weak, community-based surveillance can be implemented to both capture malaria related mortality and detect outbreaks. Finally, in order to mitigate the mortality that is inherent with both malaria and Ebola infections, particularly during outbreaks, the ability to differentiate between the two (in light of their common features) need to be improved. These lessons need to be translated into improved surveillance and response strategies in order to detect and respond to both diseases, potentially resulting in a synergistic decrease in mortality

Childhood Maltreatment and Adult Dispositional Mindfulness

Dispositional mindfulness has been conceptualized as both a trait and skill set for managing life stress. Levels of dispositional mindfulness appear to provide a meaningful barometer of emotional well-being and behavioral functioning. This chapter reviews selected literature regarding the potential effects of early life experience on the development of this important trait and coping skill. Empirical data regarding the developmental sources of this important psychological attribute has been surprisingly limited. Some prior research has implicated childhood maltreatment as disruptive to the development of this important coping skill. The present study examined the potential impact of six different forms of childhood maltreatment on dispositional mindfulness development. A number of parental relationship and resiliency protective factors were also added to the analysis. Survey respondents in this college sample (N = 978) completed indices of dispositional mindfulness, childhood maltreatment, parental relationship qualities, and resiliency factors. Respondents who described histories of sexual abuse, peer abuse, or sibling maltreatment showed lower levels of dispositional mindfulness. Parental temper was inversely related to dispositional mindfulness. Spirituality and larger childhood friendship circles provided favorable indicators. These results should encourage continued efforts to examine childhood maltreatment, early parent-child relationship qualities, and resiliency factors as potential sources of dispositional mindfulness development

Ranaviruses in North America: A Brief Review in Wild Herpetofauna

Ranaviruses are globally emerging pathogens of poikilothermic vertebrates. They affect over 40 species of amphibians in the USA and at least nine species in Canada. Additionally, ranaviruses have been found in at least eight species of reptiles in the USA and two species in Canada. Several of the species that are known to be affected are listed by state or federal agencies as they are of conservation concern (e.g., Cryptobranchus alleganiensis alleganiensis and Terrapene carolina carolina). In this brief review, we discuss the diversity and distribution, the species affected, the clinical signs of ranavirus disease (ranavirosis) that one would see in the field, morbidity and mortality events and their likely triggers, and conservation implications from the emergence of ranaviruses in populations of North American herpetofauna. We also would like to stress that ranaviruses are reportable infections in amphibians (according to the OIE, World Health Organization for Animals) and if an infection is suspected, the incident should be reported the proper authorities. Additionally, biosecurity measures should be taken to avoid the spread of ranaviruses between individuals and between field sites

TRANSPARANSI DAN AKUNTABILITAS DALAM PENGELOLAAN DANA BOS (Studi Kasus pada MI Al-Islamiyah Atambua)

This research on the implementation of transparency and accountability in the management of BOS fund. Purpose of this study is to determine how the application of transparency and accountability in the management of BOS gunds. The benefit of this research is to wheter the MI Al-Islamiyah of Atambua has implemented the principles of transparency and accountability in the management of BOS funds. This research was conducted in MI Al-Islamiyah Atambua. The method used in this research in descriptive qualitative method where data collection using interview techniques, and document study, the interviewed several speakers including: Head of Schools, Treasurer and principal BOS fund, teacher and Student at MI Al-Islamiyah of Atambua. Research results show the application of transparency and accountability in the management of BOS is good enough, namely the existence of BOS funds RKAM in the planning. Compliance rule and technical instructions of use and implementation of BOS funds and the realization and successs, as well as the reporting and accountability of BOS funds to school, city/county, and government. The disbursement process in accordance with government regulations or technical guidelines in this management