Cohort profile: the Siyakhula cohort, rural South Africa

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Living with HIV, disclosure patterns and partnerships a decade after the introduction of HIV programmes in rural South Africa

Prevention of mother-to-child Transmission and HIV Treatment programmes were scaled-up in resource-constrained settings over a decade ago, but there is still much to be understood about women's experiences of living with HIV and their HIV disclosure patterns. This qualitative study explored women's experiences of living with HIV, 6–10 years after being diagnosed during pregnancy. The area has high HIV prevalence, and an established HIV treatment programme. Participants were enrolled in a larger intervention, “Amagugu”, that supported women (n = 281) to disclose their HIV status to their children. Post-intervention we conducted individual in-depth interviews with 20 randomly selected women, stratified by clinic catchment area, from the total sample. Interviews were entered into ATLAS.ti computer software for coding. Most women were living with their current sexual partner and half were still in a relationship with the child's biological father. Household exposure to HIV was high with the majority of women knowing at least one other HIV-infected adult in their household. Eighteen women had disclosed their HIV status to another person; nine had disclosed to their current partner first. Two main themes were identified in the analyses: living with HIV and the normalisation of HIV treatment at a family level; and the complexity of love relationships, in particular in long-term partnerships. A decade on, most women were living positively with HIV, accessing care, and reported experiencing little stigma. However, as HIV became normalised new challenges arose including concerns about access to quality care, and the need for family-centred care. Women's sexual choices and relationships were intertwined with feelings of love, loyalty and trust and the important supportive role played by partners and families was acknowledged, however, some aspects of living with HIV presented challenges including continuing to practise safe sex several years after HIV diagnosis

Thoughts of self-harm in early and late pregnancy in urban South Africa: Investigating prevalence, predictors and screening options

Background. Thoughts of self-harm (TSH) are an important marker of mental health risk, and risk for attempted and completed suicide. While there is increasing attention being paid to mental health problems in pregnancy in South Africa (SA), TSH have received less attention despite some cross-sectional studies suggesting that prevalence may be high (12 - 39%). There is a dearth of longitudinal research to inform prevention and treatment.Objectives. To examine the rates of TSH across pregnancy in a longitudinal SA cohort and to investigate factors associated with the onset and persistence of TSH, as well as the relationship between TSH, depression and/or anxiety.Methods. Women were enrolled in a prospective pregnancy cohort (S1000) in Soweto, SA between 2014 and 2016, and assessed using validated screening measures (Edinburgh Postnatal Depression Scale (EPDS) and State Trait Anxiety Index short form) in early and later pregnancy. Data were available for 649 women. TSH were determined using EPDS item 10. Logistic regression and bifactor models were used to determine factors associated with TSH across pregnancy.Results. Of the 649 women, 18% reported TSH at some stage during their pregnancy. Prevalence of TSH was slightly higher in early pregnancy (12.5%) than later in pregnancy (11.6%). TSH were associated with a history of mental illness (adjusted odds ratio (aOR) 4.17; 95% confidence interval (CI) 1.3 - 13.7; p=0.020), concurrent depression (aOR 4.8; 95%CI 2.7 - 8.6; p<0.001); marital stress (aOR 1.74; 95% CI 1.0 - 3.0; p=0.040); and practical support (aOR 0.43; 95% CI 0.2 - 1.0; p=0.040) using a multivariate logistic regression. Bifactor analysis examining depression and anxiety scales showed that TSH contributed the highest variance to a shared depression and anxiety factor in early pregnancy. Logistic regressions showed that early depression was a strong predictor of later reports of TSH.Conclusions. The present study shows that the risk of TSH during pregnancy is relatively common, and starts early during pregnancy. Screening approaches could be simplified to encourage healthcare practitioners working in busy and over-burdened public healthcare settings to engage in identifying at-risk women. Efforts in improving early identification of mental health risk in pregnancy should be matched with strengthening of current treatment and referral options. Since practical support and a good marital relationship reduce the risk of TSH, these may be important avenues of focus for designing interventions

Stabilization of the cubic phase of HfO2 by Y addition in films grown by metal organic chemical vapor deposition

Addition of yttrium in HfO2 thin films prepared on silicon by metal organic chemical vapor deposition is investigated in a wide compositional range (2.0-99.5 at. %). The cubic structure of HfO2 is stabilized for 6.5 at. %. The permittivity is maximum for yttrium content of 6.5-10 at. %; in this range, the effective permittivity, which results from the contribution of both the cubic phase and silicate phase, is of 22. These films exhibit low leakage current density (5x10(-7) A/cm(2) at -1 V for a 6.4 nm film). The cubic phase is stable upon postdeposition high temperature annealing at 900 degrees C under NH3. (c) 2006 American Institute of Physics

Validity of the FACIT-Sp to assess spiritual well-being in elderly patients

Among instruments measuring spiritual well-being, the Functional Assessment of Chronic Illness Therapy-Spiritual well-being (FACIT-Sp-12) is the most widely used instrument in research. It has been validated in patients suffering from cancer or HIV/AIDS, but has rarely been used in elderly patients. The objectives of this study were to determine the psychometric properties and suitability of the FACIT-Spto assess spiritual well-being in hospitalized elderly patients. This cross-sectional study uses a mixed method approach. Subjects were patients (N = 208), aged 65 years and older, consecutively admitted in post-acute rehabilitation. Psychometric properties of the FACITSp were investigated. The internal structure of the FACIT-Sp (factor structure and internal consistency) was assessed. Convergent validity of the FACIT-Sp was assessed using the Spiritual Distress Assessment Tool (SDAT), the question "Are you at peace?" and the Geriatric Depression Scale (GDS). Predictive validity was assessed using length of stay (LOS) and discharge destination. Understanding and interpretation of FACIT-Sp items were consecutively assessed in a sub-sample of 135 patients. Results show that FACIT-Sp scores ranged from 7 to 46 (mean 29.6 ± 7.8); 23.1% of the patients had high spiritual well-being. Cronbach's α was g ood ( 0.85). Item-to-total correlations were all significant (0.34 to 0.73). Principal component analyses performed with 2 or 3 factors were only moderately consistent with previous work. FACIT-Sp correlated with SDAT, "Are you at peace?" and GDS (Rho = −0.45, P < 0.001; 0.51, P < 0.001 and −0.38, P < 0.001). No association was found with LOS or discharge destination. Spontaneous comments about one or more FACIT-Sp items were made by 97/135 (71.9%). Specifically, items that address purpose and meaning in life were frequently found difficult to answer. Analyses suggest that the FACIT-Sp may underestimate spiritual well-being in older patients. In conclusion, despite having acceptable psychometric properties, the FACIT-Sp presents limitations for measurement of spiritual well-being in hospitalized elderly patients

Polymer of intrinsic microporosity (PIM-7) coating affects triphasic palladium electrocatalysis

A film of the polymer of intrinsic microporosity PIM-7 is coated onto a glassy carbon electrode and the resulting effects on electron transfer reactions are studied for three different types of processes: (i) aqueous solution based, (ii) solid state surface immobilised, and (iii) electrocatalytic processes on electrodeposited palladium. The effects on reactivity for hydroquinone oxidation in aqueous phosphate buffer are shown to be linked to microporosity causing a slightly lower rate of mass transport without detrimental effects on electron transfer and reaction kinetics. Next, water-insoluble microcrystalline anthraquinone is immobilised directly into the PIM-7 film and shown to give a chemically reversible reduction process, which is enhanced in the presence of PIM-7, when compared to the case of anthraquinone immobilised directly onto bare glassy carbon. Electrodeposition of a film of nano-palladium is demonstrated to give catalytically active electrodes for the reduction/oxidation of protons/hydrogen, the reduction of oxygen, and for the oxidation of formic acid and methanol. With the PIM-7 film applied onto palladium, a mechanical stabilisation effect occurs. In addition, both the hydrogen insertion and the hydrogen evolution reactions as well as formic acid oxidation are enhanced. Effects are discussed in terms of PIM-7 beneficially affecting the interfacial reaction under triphasic conditions. The microporous polymer acts as an interfacial “gas management” layer

Maternal Influenza Immunization and Reduced Likelihood of Prematurity and Small for Gestational Age Births: A Retrospective Cohort Study

In an analysis of surveillance data from the state of Georgia (US), Saad Omer and colleagues show an association between receipt of influenza vaccination among pregnant women and reduced risk of premature births

Searching for faint companions with VLTI/PIONIER. I. Method and first results

Context. A new four-telescope interferometric instrument called PIONIER has recently been installed at VLTI. It provides improved imaging capabilities together with high precision. Aims. We search for low-mass companions around a few bright stars using different strategies, and determine the dynamic range currently reachable with PIONIER. Methods. Our method is based on the closure phase, which is the most robust interferometric quantity when searching for faint companions. We computed the chi^2 goodness of fit for a series of binary star models at different positions and with various flux ratios. The resulting chi^2 cube was used to identify the best-fit binary model and evaluate its significance, or to determine upper limits on the companion flux in case of non detections. Results. No companion is found around Fomalhaut, tau Cet and Regulus. The median upper limits at 3 sigma on the companion flux ratio are respectively of 2.3e-3 (in 4 h), 3.5e-3 (in 3 h) and 5.4e-3 (in 1.5 h) on the search region extending from 5 to 100 mas. Our observations confirm that the previously detected near-infrared excess emissions around Fomalhaut and tau Cet are not related to a low-mass companion, and instead come from an extended source such as an exozodiacal disk. In the case of del Aqr, in 30 min of observation, we obtain the first direct detection of a previously known companion, at an angular distance of about 40 mas and with a flux ratio of 2.05e-2 \pm 0.16e-2. Due to the limited u,v plane coverage, its position can, however, not be unambiguously determined. Conclusions. After only a few months of operation, PIONIER has already achieved one of the best dynamic ranges world-wide for multi-aperture interferometers. A dynamic range up to about 1:500 is demonstrated, but significant improvements are still required to reach the ultimate goal of directly detecting hot giant extrasolar planets.Comment: 11 pages, 6 figures, accepted for publication in A&

A detector interferometric calibration experiment for high precision astrometry

Context: Exoplanet science has made staggering progress in the last two decades, due to the relentless exploration of new detection methods and refinement of existing ones. Yet astrometry offers a unique and untapped potential of discovery of habitable-zone low-mass planets around all the solar-like stars of the solar neighborhood. To fulfill this goal, astrometry must be paired with high precision calibration of the detector. Aims: We present a way to calibrate a detector for high accuracy astrometry. An experimental testbed combining an astrometric simulator and an interferometric calibration system is used to validate both the hardware needed for the calibration and the signal processing methods. The objective is an accuracy of 5e-6 pixel on the location of a Nyquist sampled polychromatic point spread function. Methods: The interferometric calibration system produced modulated Young fringes on the detector. The Young fringes were parametrized as products of time and space dependent functions, based on various pixel parameters. The minimization of func- tion parameters was done iteratively, until convergence was obtained, revealing the pixel information needed for the calibration of astrometric measurements. Results: The calibration system yielded the pixel positions to an accuracy estimated at 4e-4 pixel. After including the pixel position information, an astrometric accuracy of 6e-5 pixel was obtained, for a PSF motion over more than five pixels. In the static mode (small jitter motion of less than 1e-3 pixel), a photon noise limited precision of 3e-5 pixel was reached