Changing understandings of HIV and AIDS through treatment interactions

The problem of HIV internationally has many wide ranging impacts on people, communities and countries’ development. In the last decade antiretroviral (ARV) treatment has emerged as the major scientific-technical solution, albeit a costly one. Access to ARV treatment is of vital importance across Africa and around the world. Resources for HIV treatment, care and support are transferred globally on a massive scale. However, how such programmes operate ‘on the ground’ in different contexts is still unclear. This research contributes to understanding the experience of the people who access such treatment programmes in different contexts. This research focuses on this gap, exploring how treatment programmes are experienced, how the availability of treatment impacts both on people’s experience of being HIV+ and how the availability of treatment may also change perceptions of what it means to be HIV+, both individually and at a societal level. This research focuses on the lives and experiences, particularly the treatment experiences, of people living with HIV in peri-urban Gambia. Low prevalence countries such as The Gambia can provide a compelling example of the ways in which meanings and understandings of HIV are created. Here, entering a field of health pluralism and fluid knowledge creation around HIV-infection, came large scale actors providing a high-profile ARV treatment programme through clinic-based medicine, and an effective de-pluralisation of the medical field in relation to HIV, inviting scrutiny of how such knowledge relations and differences are experienced. Although not anticipated at the outset of the research, in parallel the Gambia has become the locus of a major, politically-backed, ‘alternative’ AIDS treatment programme. This has thrown the personal and societal meanings of HIV into a new and sensitive context, compelling research attention into how knowledge, status and meanings around HIV are negotiated, and how people make choices amongst different treatment options

Beyond Empathy: Examining the Emerging Field of Literature and Human Rights

Senior Project submitted to The Division of Languages and Literature of Bard College

Family Structure and Psychologyical Health in Young Adults

This study explored the effect of the gendered structure of siblings in intact and non-intact families, on family relations, social support, perceived control, and psychological distress in a sample of 708 young adults (294 males and 414 females) aged between 18 - 21 years. Of the sample 96 were singletons, 208 had both a brother and sister, 206 had a brother and no sister, and 198 had a sister and no brother. While the results show that both the gender of the participants and the gender of the sibling seem to impact on distress and its mediators; the more important factor is the gender of siblings. In essence the presence of a female sibling is associated with more perceived support, control and optimism, and with lower pessimism and psychological distress. The presence of a female is also associated with better family relations overall and it is suggested that the main mechanism for this positive impact of female siblings is through the lowered conflict and increased expressiveness and cohesion experienced in female versus male dominated sibling groups

Sibling constellations and wellbeing in intact and non-intact families

Background: There is little research on the impact of sibling relations on the development of resilience in families experiencing break up. Methods: The role of sex of siblings in family structures was explored in relation to mental health in young adults in a sample of 927 participants (460 males and 467 females), aged 18-21 years old. In addition the potential mediating relationship of family relations, self-efficacy, optimism and social support were added to the mix in order to provide some ex-planatory mechanism for any relationship that might exist. Results: Multivariate analysis of variance and path analysis were used and findings suggest that the presence of a female sib-ling may be a protective factor and may operate through improving family relationships and increasing self-efficacy, optimism, and perceived social support. Conclusions: It is suggested that the sex structure of siblings should be considered in any family focused intervention to improve mental health

Assessing wellbeing at school entry using the strengths and difficulties questionnaire: professional perspectives

<p>Background: Emotional and behavioural disorders in early childhood are related to poorer academic attainment and school engagement, and difficulties already evident at the point of starting school can affect a child’s later social and academic development. Successful transfer from pre-school settings to primary education is helped by communication between pre-school staff and primary school teachers. Typically, in Scotland, pre-school establishments prepare individual profiles of children before they start school around the age of five years, highlighting their strengths and development needs, for transfer to primary schools. There is, however, no consistent approach to the identification of potential social, emotional and behavioural problems. In 2010, in one local authority area in Scotland, the Strengths and Difficulties Questionnaire (SDQ) was introduced for children about to start school as a routine, structured, component of the transition process to help teachers plan support arrangements for classes and individual children. The SDQ assesses emotional, conduct, hyperactivity/ inattention and peer-relationship problems as well as pro-social behaviour. In order to be an effective means of communicating social and emotional functioning, the use of instruments such as the SDQ needs to be practicable. Finding out the views of pre-school education staff with experience of assessing children using the SDQ was, therefore, essential to establish its future utility.</p> <p>Aim: The purpose of this study was to explore the views of pre-school education staff about assessing social and emotional wellbeing of children at school entry using the SDQ. The objectives were to examine the opinions of pre-school workers about completing the SDQ and to elicit their thoughts on the value of doing this and their perceptions of the usefulness of the information collected.</p> <p>Method: Pre-school establishments were approached using a purposive sampling strategy in order to achieve a mix of local authority (n=14) and ‘partnership’ establishments (n=8) as well as different socio-economic areas. Semi-structured interviews (n=25) were conducted with pre-school head teachers (n=14) and child development officers (n=11) in order to explore the process of completing the SDQ along with perceptions of its value. The interviews were transcribed verbatim and analysed thematically.</p> <p>Results: In general, staff in pre-school establishments viewed the use of the SDQ positively. It was seen as a chance to highlight the social and emotional development of children rather than just their academic or educational ability. Most felt that the SDQ had not identified anything they did not already know about a child. A minority, nevertheless, suggested that a previously unrecognised potential difficulty was brought to light, most commonly emotional problems. Completing the SDQ was felt to be relatively straightforward even though the staff felt under pressure from competing priorities. Concerns were, however, raised about the potential of labelling a child at an early stage of formal education.</p> <p>Conclusion: The findings from this small scale study suggest that, from the point of view of pre-school education staff, it is feasible to assess children systematically for social and behavioural problems as part of the routine transition process at school entry.</p&gt

Sports Bra Preferences by Age and Impact of Breast Size on Physical Activity among American Females

For many females, sports bras are an essential piece of equipment for participation in sports and physical activity. Breast pain or discomfort from lack of support may be a contributing factor to the noted gender disparity in physical activity of females compared to males. Our objective was to evaluate sports bra usage and characterize sports bra preferences of an active female cohort. This multicenter cross-sectional survey study was conducted at five geographically distinct academic centers. Our measure was administered during outpatient sports medicine clinic visits to females aged 11–64 years old. Chi-square tests were used to compare characteristics across subgroups. Our analysis consisted of 438 respondents, with a mean age of 22 ± 12.2 years. More than a quarter (27.4%) reported lack of breast support prevented them from being active or exercising. Age (p = 0.03), breast size (p < 0.0001), and household income (p = 0.01) were significantly associated with greater frequency of physical activity being limited by lack of breast support. Lack of breast support may be an important barrier for young females of specific populations to meeting physical activity recommendations. Further research is needed to improve the understanding of this important piece of sporting equipment for women

Evaluation of an Interprofessional Problem-based Learning Module on Care of Persons Living with HIV/AIDS

Background: Interprofessional education (IPE) holds great promise in continuing to reform the management of complex chronic conditions such as HIV/AIDS, and Problem-based Learning (PBL) is a suitable format for IPE. This study aimed to evaluate the effectiveness of a large scale, compulsory interprofessional PBL module on HIV/AIDS education. In 2004, 30 physical therapy and 30 medical students at the University of Saskatchewan engaged in the HIV/AIDS PBL module. By 2007 over 300 students from seven healthcare programs were involved.Methods and Findings: The module was evaluated over the years using student satisfaction surveys, focus groups, self-assessments, and in 2007 with written pretest/post-tests. Students rated the learning experience about both HIV/AIDS and about interprofessional collaboration, at 4 or 5 out of 6 and effect sizes fell between d = .70 and 3.19. That only one pre-test/post-test study was conducted at a single institution is one of the limitations of this study.Conclusions: Students generally thought highly of the interprofessional PBL module on HIV/AIDS and learned a considerable amount. Although more research is needed to substantiate the self-assessment data, establish what and how much is being learned, and compare PBL to alternative methodologies, PBL is a promising approach to IPE

Daily morphine injection and withdrawal disrupt 24-h wheel running and PERIOD2 expression patterns in the rat limbic forebrain

Symptoms of opiate withdrawal include disturbances in circadian rhythms. Here, we examined in male Wistar rats the effects of a daily, mid-morning morphine injection (5-40mg/kg, i.p.) and the subsequent withdrawal of morphine on 24-h patterns of wheel running and expression of the clock protein, PERIOD2 (PER2), in the master circadian clock, the suprachiasmatic nucleus (SCN), and regions of the limbic forebrain. Rats were killed either within 24 h of the last morphine injection or 2 days later. Nighttime wheel running was suppressed during daily morphine injections and following the withdrawal of morphine. Daily morphine injections and their subsequent withdrawal did not affect PER2 expression in the SCN, but blunted the normal daily peak of PER2 in the dorsal striatum, oval nucleus of the bed nucleus of the stria terminalis (BNSTov), central nucleus of the amygdala (CEA), basolateral amygdala (BLA), and dentate gyrus of the hippocampus (DG). We then examined the effect of injecting the D2/3 dopamine agonist, quinpirole (1 mg/kg, i.p.), or the alpha 2 adrenergic agonist, clonidine (0.1 mg/kg, i.p.), two drugs that alleviate opiate withdrawal symptoms, following withdrawal of the daily morphine injection. Quinpirole restored the daily PER2 pattern in the BNSTov and CEA, whereas clonidine restored and entrained a new PER2 pattern in the striatum, BLA, and DG. Together, these findings suggest that disruption of daily PER2 patterns in the forebrain might contribute to the circadian symptoms observed in opiate withdrawal. Furthermore, pharmacological treatments for withdrawal can restore PER2 patterns in regions of the limbic forebrain

Diet and bone mineral density study in postmenopausal women from the TwinsUK registry shows a negative association with a traditional English dietary pattern and a positive association with wine

Background: The effect of diet on bone mineral density (BMD) remains controversial, mainly because of difficulties in isolating dietary factors from the confounding influences of age, lifestyle, and genetic factors. Objective: The aim of this study was to use a novel method to examine the relation between BMD and diet. Design: A co-twin control study design with linear regression modeling was used to test for associations between BMD and habitual intakes of calcium, vitamin D, protein, and alcohol plus 5 previously identified dietary patterns in postmenopausal women from the TwinsUK registry. This approach exploited the unique matching of twins to provide an estimate of an association that was not confounded by age, genetic background, or shared lifestyle. Results: In >2000 postmenopausal women (BMD data on 1019, 1218, and 1232 twin pairs at the hip neck, hip, and spine, respectively), we observed a positive association between alcohol intake (from wine but not from beer or spirits) and spine BMD (P = 0.01) and a negative association with a traditional 20th-century English diet at the hip neck (P = 0.01). Both associations remained borderline significant after adjustment for mean twin-pair intakes (P = 0.04 and P = 0.055, respectively). Other dietary patterns and intakes of calcium, vitamin D, and protein were unrelated to BMD. Conclusion: Our results showed that diet has an independent but subtle effect on BMD; wine intake was positively associated with spine BMD, whereas a traditional (20th-century) English diet had a negative association with hip BMD

Philosophy with children : facilitating children's voices on childhood

Increasingly there is a search for participatory research methods that work to ensure children’s authentic voices are heard. In this presentation we will propose that Philosophy with Children might be employed as a research method that facilitates children’s participation and voice in research. Further, it may also impact positively in children’s wider participation and engagement in recognising children’s agency and conceptual autonomy. We will discuss the advantages of using philosophical dialogue as a method for collecting data and will also consider challenges that arise from using Philosophy with Children as a research tool. In discussing the challenges and opportunities afforded by such a method, the presentation will draw on two studies to exemplify the approach. One study explored what kind of society children want to live in, and the second is an on-going international study that aims to explore children’s conceptions of child/childhood. We will also suggest that using Philosophy with Children might be considered as addressing the need for rights-based approaches to research as in affording children ownership of the dialogue it does not assume children as deficient in their capacities and it recognises children’s particular perspectives on the world. In addition, we will suggest that using a philosophical approach to gathering children’s views might offer a deeper insight into their thinking of and understanding about the world. Elements of the approaches used in the study will be discussed in order to gauge the strengths and limitations of using practical philosophy as a means of gathering data in subsequent analysis. In juxtaposition to the Philosophy with Children approach discussed, we will comment briefly on the use of an alternative research method, Nominal Group Technique, which was also used in the first project. In comparing the two approaches we aim to show where Philosophy with Children may provide richer and deeper evidence when seeking children’s views. While the presentation will not share the findings of either of the projects mentioned above, the approach taken in using Philosophy with Children as a research method, relates strongly to the findings of the initial project and the goals of the Children’s Voices on Childhood project. In using Philosophy with Children, it will be proposed that, while there may be some limitations in using the approach, it takes account of children’s voices in research; it affords opportunities to explore children’s conceptual thinking and the application to ‘real life’; it allows children to have ownership of the topic under consideration; and it potentially leads to addressing children’s status in wider society