Access to safe abortion: building choices for women living with HIV and AIDS

In many areas of the world where HIV prevalence is high, rates of unintended pregnancy and unsafe abortion have also been shown to be high. Of all pregnancies worldwide in 2008, 41% were reported as unintended or unplanned, and approximately 50% of these ended in abortion. Of the estimated 21.6 million unsafe abortions occurring worldwide in 2008 (around one in 10 pregnancies), approximately 21.2 million occurred in developing countries, often due to restrictive abortion laws and leading to an estimated 47,000 maternal deaths and untold numbers of women who will suffer long-term health consequences. Despite this context, little research has focused on decisions about and experiences of women living with HIV with regard to terminating a pregnancy, although this should form part of comprehensive promotion of sexual and reproductive health rights

A Naturally Occurring Bovine Tauopathy Is Geographically Widespread in the UK

Many human neurodegenerative diseases are associated with hyperphosphorylation and widespread intra-neuronal and glial associated aggregation of the microtubule associated protein tau. In contrast, animal tauopathies are not reported with only senescent animals showing inconspicuous tau labelling of fine processes albeit significant tau aggregation may occur in some experimental animal disease. Since 1986, an idiopathic neurological condition of adult cattle has been recognised in the UK as a sub-set of cattle slaughtered as suspect bovine spongiform encephalopathy cases. This disorder is characterised by brainstem neuronal chromatolysis and degeneration with variable hippocampal sclerosis and spongiform change. Selected cases of idiopathic brainstem neuronal chromatolysis (IBNC) were identified from archive material and characterised using antibodies specific to several tau hyperphosphorylation sites or different isoforms of the tau microtubule binding region. Labelling was also carried out for alpha synuclein, ubiquitin, TDP43, Aβ 1-42, Aβ 1-40. Widespread tau labelling was identified in all IBNC brains examined and with each of seven tau antibodies recognising different hyperphosphorylated sites. Labelling with each antibody was associated with dendrites, neuronal perikarya and glia. Thus IBNC is a sporadic, progressive neurological disease predominantly affecting aged cattle that occurs throughout the UK and is associated with hyperphosphorylation of tau, a rare example of a naturally-occurring tauopathy in a non-primate species. Secondary accumulation of alpha synuclein and ubiquitin was also present. The neuropathology does not precisely correspond with any human tauopathy. The cause of IBNC remains undetermined but environmental factors and exposure to agrochemicals needs to be considered in future aetiological investigations

Elevated protein concentrations in newborn blood and the risks of autism spectrum disorder, and of social impairment, at age 10 years among infants born before the 28th week of gestation

Among the 1 of 10 children who are born preterm annually in the United States, 6% are born before the third trimester. Among children who survive birth before the 28th week of gestation, the risks of autism spectrum disorder (ASD) and non-autistic social impairment are severalfold higher than in the general population. We examined the relationship between top quartile inflammation-related protein concentrations among children born extremely preterm and ASD or, separately, a high score on the Social Responsiveness Scale (SRS total score ≥65) among those who did not meet ASD criteria, using information only from the subset of children whose DAS-II verbal or non-verbal IQ was ≥70, who were assessed for ASD, and who had proteins measured in blood collected on ≥2 days (N = 763). ASD (N = 36) assessed at age 10 years is associated with recurrent top quartile concentrations of inflammation-related proteins during the first post-natal month (e.g., SAA odds ratio (OR); 95% confidence interval (CI): 2.5; 1.2–5.3) and IL-6 (OR; 95% CI: 2.6; 1.03–6.4)). Top quartile concentrations of neurotrophic proteins appear to moderate the increased risk of ASD associated with repeated top quartile concentrations of inflammation-related proteins. High (top quartile) concentrations of SAA are associated with elevated risk of ASD (2.8; 1.2–6.7) when Ang-1 concentrations are below the top quartile, but not when Ang-1 concentrations are high (1.3; 0.3–5.8). Similarly, high concentrations of TNF-α are associated with heightened risk of SRS-defined social impairment (N = 130) (2.0; 1.1–3.8) when ANG-1 concentrations are not high, but not when ANG-1 concentrations are elevated (0.5; 0.1–4.2)

Medical-surgical nursing:common health problems of adults and children across the llife span

The text can be used in a variety of curricular strictures. The lifespan provides the organizing framework for the text.vi, 1286 hlm.: ilus.; 27 c

Conscious engagement within patients’ and simulated participants’ personal space: medical students' perspective

BACKGROUND: #MeToo prompted a shift in acceptable societal norms, sparking global recognition of the complexities of entering another’s personal space. Physical examinations are an integral part of medicine yet have the capacity to encroach upon patient’s personal space, whether in simulated or clinical environments. Examinations may be misconstrued as inappropriate advances, with negative effects for both patient and doctor. Medical educators must consider how they teach students to approach this complex task. This study aimed to gain insight into the lived experiences of medical students when working within patient’s personal space. This builds on previous research from the perspective of simulated participants. METHOD: A hermeneutic phenomenology approach was used to explore lived experiences of working within patient’s personal space. Data was collected from seven medical students through semi-structured interviews and thematically analysed using template analysis. RESULTS: The analysis yielded four main themes: (1) transitioning into a privileged position; (2) negative role modelling: emphasising the physical; (3) consent: a dynamic and fragile state; and (4) a simple act or a complex performance? DISCUSSION: This study provides a unique insight into the lived experiences of medical students when working within a patient’s personal space. The physical examination is a complex process; the experiences of medical students can shape learning on crossing boundaries. Medical educators need to reflect this complexity in teaching, mirroring societal interest around the boundaries of consent. Students need a pedagogical space to develop these interpersonal skills, to prevent early adoption of the clinical gaze, and to create more consciously engaged doctors for the future

Neuronal and dendritic P-tau labelling.

<p>Dendrite and peri-neuronal tau immunohistochemical labelling patterns with AT8 antibody. (a) Detail of dendritic labelling of CA1 dendrites in hippocampus. Parallel rows of puncta suggest labelling is at or adjacent to the plasma-membrane. (b) Labelling around the perikarya and processes of neurons in the thalamus. (c) Some dendrites that are labelled with AT8 also appear to be the origins of loculated vacuoles. Bars: 100μm.</p

Table showing characteristics of some human tauopathies compared with IBNC.

<p>*variable Western blot immune-phenotypes are reported in Argyrophilic grain disease [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0129499#pone.0129499.ref028" target="_blank">28</a>].</p><p>Table showing characteristics of some human tauopathies compared with IBNC.</p

Alpha synuclein immunohistochemistry.

<p>(a) Generalised punctuate pattern of neuropil labelling in the dorso-lateral geniculate nucleus of the midbrain sparing neuronal perikarya. (b) Punctuate pattern labelling of dendrites in the substantia nigra. (c) Punctuate labelling of neuropil associated with dentate gyrus of hippocampus. (d) No labelling for alpha synuclein in the dentate gyrus of a control cow. Bars: 100μm.</p

Western Blot for tau on IBNC brains and controls.

<p>Western blot analysis of tau isoforms within the thalamus (Th), cerebellum (Cb) and hippocampus (H) from a single case of IBNC. Tau isoforms in the brains of animals in which no P-tau was detected (control A and control B) following immunohistochemistry are shown on the blot for comparison.</p