The role of children in their HIV-positive parents’ management of antiretroviral therapy in Uganda

Adjustment to life on antiretroviral therapy (ART) and living with HIV as a long-term chronic condition, pose significant medical, social and economic challenges. We investigated children’s role in supporting HIV-positive parents to self-manage life on ART. Between 2010 and 2012, we conducted a qualitative study using semi-structured interviews with 38 HIV-positive parents who had been on ART for over a year. They were randomly selected from people accessing ART from three delivery sites in Wakiso district, Uganda. Data were analysed thematically. Participants reported children between the ages of 1 and 47 years providing support. Children were a source of happiness, self-worth, encouragement, and comfort. Both younger and older children supported parents’ adherence to treatment through reminding them to take the drugs and honour clinic appointments. Older children provided money to buy medication, food and shelter. Parents reported that the encouragement they received after they disclosed to their children enhanced their survival. After HIV disclosure to their children many of their fears about the future were allayed. Thinking about their children’s future brought hope. However, looking after younger children while on ART could be burdensome since some parents could not work to their full capacity due to reduced physical health. Children are an important resource in their parents’ adjustment to living with HIV while taking ART. There is a need for children to be supported by appropriate policy and other social and health development structures

Disks in Expanding FRW Universes

We construct exact solutions to Einstein equations which represent relativistic disks immersed into an expanding FRW Universe. It is shown that the expansion influences dynamical characteristics of the disks such as rotational curves, surface mass density, etc. The effects of the expansion is exemplified with non-static generalizations of Kuzmin-Curzon and generalized Schwarzschild disks.Comment: Revised version to appear in ApJ, Latex, 17 pages, 10 figures, uses aaspp4 and epsf style file

Development of a Childhood Attachment and Relational Trauma Screen (CARTS): a relational-socioecological framework for surveying attachment security and childhood trauma history

Background : Current psychometric measures of childhood trauma history generally fail to assess the relational-socioecological context within which childhood maltreatment occurs, including the relationship of abusers to abused persons, the emotional availability of caregivers, and the respondent's own thoughts, feelings, and actions in response to maltreatment. Objective : To evaluate a computerized approach to measuring the relational-socioecological context within which childhood maltreatment occurs. Method : The psychometric properties of a Childhood Attachment and Relational Trauma Screen (CARTS) were evaluated as a retrospective survey of childhood maltreatment history designed to be appropriate for completion by adults. Participants were undergraduates (n=222), an internet sample (n=123), and psychiatric outpatients (n=30). Results : The internal reliability, convergent, and concurrent validity of the CARTS were supported across samples. Paired differences in means and correlations between rated item-descriptiveness to self, mothers, and fathers also accorded with findings of prior attachment and maltreatment research, illustrating the utility of assessing the occurrence and effects of maltreatment within a relational-socioecological framework. Conclusions : Results preliminarily support a new survey methodology for assessing childhood maltreatment within a relational-socioecological framework. Further psychometric evaluation of the CARTS is warranted

Making Sense of Family Deaths in Urban Senegal: Diversities, Contexts, and Comparisons

Despite calls for cross-cultural research, Minority world perspectives still dominate death and bereavement studies, emphasizing individualized emotions and neglecting contextual diversities. In research concerned with contemporary African societies, on the other hand, death and loss are generally subsumed within concerns about AIDS or poverty, with little attention paid to the emotional and personal significance of a death. Here, we draw on interactionist sociology to present major themes from a qualitative study of family deaths in urban Senegal, theoretically framed through the duality of meanings-in-context. Such themes included family and community as support and motivation; religious beliefs and practices as frameworks for solace and (regulatory) meaning; and material circumstances as these are intrinsically bound up with emotions. Although we identify the experience of (embodied, emotional) pain as a common response across Minority and Majority worlds, we also explore significant divergencies, varying according to localized contexts and broader power dynamics

A subcutaneous adipose tissue-liver signalling axis controls hepatic gluconeogenesis.

The search for effective treatments for obesity and its comorbidities is of prime importance. We previously identified IKK-ε and TBK1 as promising therapeutic targets for the treatment of obesity and associated insulin resistance. Here we show that acute inhibition of IKK-ε and TBK1 with amlexanox treatment increases cAMP levels in subcutaneous adipose depots of obese mice, promoting the synthesis and secretion of the cytokine IL-6 from adipocytes and preadipocytes, but not from macrophages. IL-6, in turn, stimulates the phosphorylation of hepatic Stat3 to suppress expression of genes involved in gluconeogenesis, in the process improving glucose handling in obese mice. Preliminary data in a small cohort of obese patients show a similar association. These data support an important role for a subcutaneous adipose tissue-liver axis in mediating the acute metabolic benefits of amlexanox on glucose metabolism, and point to a new therapeutic pathway for type 2 diabetes

The effects of elevated CO2 and eutrophication on surface elevation gain in a European salt marsh.

Salt marshes can play a vital role in mitigating the effects of global environmental change by dissipating incident storm wave energy and, through accretion, tracking increasing water depths consequent upon sea level rise. Atmospheric CO2 concentrations and nutrient availability are two key variables that can affect the biological processes that contribute to marsh surface elevation gain. We measured the effects of CO2 concentrations and nutrient availability on surface elevation change in intact mixed-species blocks of UK salt marsh using six open-top chambers receiving CO2 -enriched (800 ppm) or ambient (400 ppm) air. We found more rapid surface elevation gain in elevated CO2 conditions: an average increase of 3.4 mm over the growing season relative to ambient CO2 . Boosted regression analysis to determine the relative influence of different parameters on elevation change identified that a 10% reduction in microbial activity in elevated CO2 -grown blocks had a positive influence on elevation. The biomass of Puccinellia maritima also had a positive influence on elevation, while other salt marsh species (e.g. Suaeda maritima) had no influence or a negative impact on elevation. Reduced rates of water use by the vegetation in the high CO2 treatment could be contributing to elevation gain, either directly through reduced soil shrinkage or indirectly by decreasing microbial respiration rates due to lower redox levels in the soil. Eutrophication did not influence elevation change in either CO2 treatment despite doubling aboveground biomass. The role of belowground processes (transpiration, root growth and decomposition) in the vertical adjustment of European salt marshes, which are primarily minerogenic in composition, could increase as atmospheric CO2 concentrations rise and should be considered in future wetland models for the region. Elevated CO2 conditions could enhance resilience in vulnerable systems such as those with low mineral sediment supply or where migration upwards within the tidal frame is constrained.Marie Curie Incoming International Fellowship (Grant ID: FP7-PEOPLE-IIF 623720 STORM)This is the author accepted manuscript. The final version is available from Wiley via https://doi.org/10.1111/gcb.1339

Evaluation of the risk of cardiovascular events with clarithromycin using both propensity score and self-controlled study designs

Aim: Some previous studies suggest a long term association between clarithromycin use and cardiovascular events. This study investigates this association for clarithromycin given as part of Helicobacter pylori treatment (HPT). Methods: Our source population was the Clinical Practice Research Datalink (CPRD), a UK primary care database. We conducted a self-controlled case series (SCCS), a case–time–control study (CTC) and a propensity score adjusted cohort study comparing the rate of cardiovascular events in the 3 years after exposure to HPT containing clarithromycin with exposure to clarithromycin free HPT. Outcomes were first incident diagnosis of myocardial infarction (MI), arrhythmia and stroke. For the cohort analysis we included secondary outcomes all cause and cardiovascular mortality. Results: Twenty-eight thousand five hundred and fifty-two patients were included in the cohort. The incidence rate ratio of first MI within 1 year of exposure to HPT containing clarithromycin was 1.07 (95% CI 0.85, 1.34, P = 0.58) and within 90 days was 1.43 (95% CI 0.99, 2.09 P = 0.057) in the SCCS analysis. CTC and cohort results were consistent with these findings. Conclusions There was some evidence for a short term association for first MI but none for a long term association for any outcome

Understanding Middle Neolithic food and farming in and around the Stonehenge World Heritage Site: an integrated approach

Little synthesis of evidence for Middle Neolithic food and farming in Wiltshire, particularly in and around the Stonehenge World Heritage Site (WHS) has been possible, until now, due to a paucity of assemblages. The excavation of a cluster of five Middle Neolithic pits and an inhumation burial at West Amesbury Farm (WAF) has prompted a review of our understanding of pit sites of this period from the county. Bioarchaeological assemblages are used to investigate evidence for the consumption of animal and plant-based foods, and for agricultural and pastoral farming. For the first time Middle Neolithic zooarchaeological evidence, including strontium isotope data, is considered alongside archaeobotanical data, and radiocarbon dating. The absence of cultivated plants from WAF and contemporary sites in the county is consistent with the hypothesis that the reduction in cereal cultivation and greater reliance of wild plants witnessed in the later part of the Neolithic in southern England began in the Middle Neolithic. The zooarchaeological evidence from the same sites demonstrates that the shift away from cereal cultivation may be concurrent with, rather than earlier than, an increase in the relative proportion of deposited pig bones relative to cattle. Both cattle and pigs deposited in pits at WAF have strontium and sulphur isotope values consistent with the local biosphere, and therefore were potentially raised in the area. Zooarchaeological data from WAF compliments that from human dental calculus and lipid residues in associated Peterborough Ware pottery that local cattle husbandry included exploitation of dairy. It also highlights the presence of consistent food preparation methods between pits as seen through butchery practice. The faunal and archaeobotanical remains from contemporary pit deposits suggest that similar farming and subsistence strategies can be proposed across the county, though with some inter-site variation in deposition. Together these excavated pit sites are likely to represent only a sample of those present in the area. Application of a similar integrated approach to material from other Middle Neolithic pits holds potential for better understanding of food and farming in this previously neglected period