The Experience of Pregnancy for Women with Bipolar Disorder: An Exploratory Study

Background: Bipolar disorder often emerges in an individual’s late teens and early twenties, thus women with bipolar disorder are impacted for the majority of their childbearing years. Pregnancy brings a unique set of challenges to this population, including risk of relapse, teratogenicity of medications, and increased risk of postpartum psychosis, yet no research exists on this population’s experience of pregnancy. Design: This study utilized semi-structured telephone interviews to gather preliminary qualitative data on the experience of pregnancy for women with bipolar disorder with the long-term goal of developing patient education materials and improving nursing-led interventions to help manage illness during pregnancy and postpartum. Method: A purposive sample of four English-speaking women, age 29-39, with a confirmed diagnosis of bipolar disorder I or II and who had given birth within the last eighteen months, was recruited nationally via the electronic and mass media, and postings on bulletin boards in a range of educational and related settings. One open-ended focused telephone interview was held with each client, and conducted by the first author. She was also responsible for doing the audiotaping, transcription, and coding of the data using a descriptive qualitative design.  Results: Women with bipolar disorder described a unique pregnancy experience, influenced by the intersection of mental illness, pregnancy, and pharmacotherapy. Recurrent themes included hopefulness, patient and healthcare provider as advocates, the importance of interdisciplinary care, education, community support and the mixed impact of medication. Discussion & Conclusion: This research contributes to initiatives designed to improve healthcare for pregnant women with bipolar disorder, augment patient education materials, and inform the design of nurse-led interventions. Empirical research findings become even more valuable tools for improving patient care when paired with the voices of patients themselves. As pregnant women are a historically under-studied population, this study also contributes to the larger body of scientific research on this population.&nbsp

Factors Influencing Adherence to Antiretroviral Therapy for HIV-Infected Female Inmates

New HIV cases are increasing among women, especially women of color. Moreover, the rate of infection for incarcerated women is twice that of incarcerated men. With advances in medication therapy, HIV has become a chronic illness that can be successfully treated, provided the patient is able to achieve adherence with the prescribed antiretroviral medication regimen. Incarcerated women, however, frequently come from environments burdened with violence, substance and physical abuse, homelessness, child-care issues, and mental illness. Such burdens negatively affect the ability of these women to adhere to the medication plan. This study explored incarcerated HIV-infected women’s barriers to and facilitators of adherence to antiretroviral therapy (ART), the role of health care provider relationships in adherence, and the ways in which issues of medical privacy influence ability or desire to adhere while incarcerated. A secondary analysis of an existing set of qualitative interviews with HIV-infected female inmates was conducted

Disk Imaging Survey of Chemistry with SMA (DISCS): I. Taurus Protoplanetary Disk Data

Chemistry plays an important role in the structure and evolution of protoplanetary disks, with implications for the composition of comets and planets. This is the first of a series of papers based on data from DISCS, a Submillimeter Array survey of the chemical composition of protoplanetary disks. The six Taurus sources in the program (DM Tau, AA Tau, LkCa 15, GM Aur, CQ Tau and MWC 480) range in stellar spectral type from M1 to A4 and offer an opportunity to test the effects of stellar luminosity on the disk chemistry. The disks were observed in 10 different lines at ~3" resolution and an rms of ~100 mJy beam-1 at ~0.5 km s-1. The four brightest lines are CO 2-1, HCO+ 3-2, CN 2_3-1_2 and HCN 3-2 and these are detected toward all sources (except for HCN toward CQ Tau). The weaker lines of CN 2_2-1_1, DCO+ 3-2, N2H+ 3-2, H2CO 3_03-2_02 and 4_14-3_13 are detected toward two to three disks each, and DCN 3-2 only toward LkCa 15. CH3OH 4_21-3_12 and c-C3H2 are not detected. There is no obvious difference between the T Tauri and Herbig Ae sources with regard to CN and HCN intensities. In contrast, DCO+, DCN, N2H+ and H2CO are detected only toward the T Tauri stars, suggesting that the disks around Herbig Ae stars lack cold regions for long enough timescales to allow for efficient deuterium chemistry, CO freeze-out, and grain chemistry.Comment: 29 pages, 4 figures, accepted for publication in Ap

Sexuality, Sexual Practices, and HIV Risk Among Incarcerated African-American Women in North Carolina

Background—Women who have been in prison carry a greater lifetime risk of HIV for reasons that are not well understood. This effect is amplified in the Southeastern United States, where HIV incidence and prevalence is especially high among African American (AA) women. The role of consensual sexual partnerships in the context of HIV risk, especially same-sex partnerships, merits further exploration. Methods—We conducted digitally recorded qualitative interviews with 29 AA women (15 HIVpositive, 14 HIV-negative) within three months after entry into the state prison system. We explored potential pre-incarceration HIV risk factors, including personal sexual practices. Two researchers thematically coded interview transcripts and a consensus committee reviewed coding. Results—Women reported complex sexual risk profiles during the six months prior to incarceration, including sex with women as well as prior sexual partnerships with both men and women. Condom use with primary male partners was low and a history of transactional sex work was prevalent. These behaviors were linked to substance use, particularly among HIV-positive women. Conclusions—Although women may not formally identify as bisexual or lesbian, sex with women was an important component of this cohort’s sexuality. Addressing condom use, heterogeneity of sexual practices, and partner concurrency among at-risk women should be considered for reducing HIV acquisition and preventing forward transmission in women with a history of incarceration

Disk Imaging Survey of Chemistry with SMA: II. Southern Sky Protoplanetary Disk Data and Full Sample Statistics

This is the second in a series of papers based on data from DISCS, a Submillimeter Array observing program aimed at spatially and spectrally resolving the chemical composition of 12 protoplanetary disks. We present data on six Southern sky sources - IM Lup, SAO 206462 (HD 135344b), HD 142527, AS 209, AS 205 and V4046 Sgr - which complement the six sources in the Taurus star forming region reported previously. CO 2-1 and HCO+ 3-2 emission are detected and resolved in all disks and show velocity patterns consistent with Keplerian rotation. Where detected, the emission from DCO+ 3-2, N2H+ 3-2, H2CO 3-2 and 4-3,HCN 3-2 and CN 2-1 are also generally spatially resolved. The detection rates are highest toward the M and K stars, while the F star SAO 206462 has only weak CN and HCN emission, and H2CO alone is detected toward HD 142527. These findings together with the statistics from the previous Taurus disks, support the hypothesis that high detection rates of many small molecules depend on the presence of a cold and protected disk midplane, which is less common around F and A stars compared to M and K stars. Disk-averaged variations in the proposed radiation tracer CN/HCN are found to be small, despite two orders of magnitude range of spectral types and accretion rates. In contrast, the resolved images suggest that the CN/HCN emission ratio varies with disk radius in at least two of the systems. There are no clear observational differences in the disk chemistry between the classical/full T Tauri disks and transitional disks. Furthermore, the observed line emission does not depend on measured accretion luminosities or the number of infrared lines detected, which suggests that the chemistry outside of 100 AU is not coupled to the physical processes that drive the chemistry in the innermost few AU.Comment: accepted for publication in ApJ, 41 pages including 7 figure

Efficacy of an Adapted HIV and Sexually Transmitted Infection Prevention Intervention for Incarcerated Women: A Randomized Controlled Trial

Objectives. We tested the efficacy of an adapted evidence-based HIV–sexually transmitted infection (STI) behavioral intervention (Providing Opportunities for Women’s Empowerment, Risk-Reduction, and Relationships, or POWER) among incarcerated women

Challenges of a Hidden Epidemic: HIV Prevention Among Women in the United States

HIV/AIDS trends in the United States depict a concentrated epidemic with hot spots that vary by location, poverty, race/ethnicity, and transmission mode. HIV/AIDS is a leading cause of death among US women of color; two thirds of new infections among women occur in black women, despite the fact that black women account for just 14% of the US female population. The gravity of the HIV epidemic among US women is often not appreciated by those at risk as well as by the broader scientific community. We summarize the current epidemiology of HIV/AIDS among US women and discuss clinical, research, and public health intervention components that must be brought together in a cohesive plan to reduce new HIV infections in US women. Only by accelerating research and programmatic efforts will the hidden epidemic of HIV among US women emerge into the light and come under control

Identification and Validation of Novel Cerebrospinal Fluid Biomarkers for Staging Early Alzheimer's Disease

Ideally, disease modifying therapies for Alzheimer disease (AD) will be applied during the 'preclinical' stage (pathology present with cognition intact) before severe neuronal damage occurs, or upon recognizing very mild cognitive impairment. Developing and judiciously administering such therapies will require biomarker panels to identify early AD pathology, classify disease stage, monitor pathological progression, and predict cognitive decline. To discover such biomarkers, we measured AD-associated changes in the cerebrospinal fluid (CSF) proteome.CSF samples from individuals with mild AD (Clinical Dementia Rating [CDR] 1) (n = 24) and cognitively normal controls (CDR 0) (n = 24) were subjected to two-dimensional difference-in-gel electrophoresis. Within 119 differentially-abundant gel features, mass spectrometry (LC-MS/MS) identified 47 proteins. For validation, eleven proteins were re-evaluated by enzyme-linked immunosorbent assays (ELISA). Six of these assays (NrCAM, YKL-40, chromogranin A, carnosinase I, transthyretin, cystatin C) distinguished CDR 1 and CDR 0 groups and were subsequently applied (with tau, p-tau181 and Aβ42 ELISAs) to a larger independent cohort (n = 292) that included individuals with very mild dementia (CDR 0.5). Receiver-operating characteristic curve analyses using stepwise logistic regression yielded optimal biomarker combinations to distinguish CDR 0 from CDR>0 (tau, YKL-40, NrCAM) and CDR 1 from CDR<1 (tau, chromogranin A, carnosinase I) with areas under the curve of 0.90 (0.85-0.94 95% confidence interval [CI]) and 0.88 (0.81-0.94 CI), respectively.Four novel CSF biomarkers for AD (NrCAM, YKL-40, chromogranin A, carnosinase I) can improve the diagnostic accuracy of Aβ42 and tau. Together, these six markers describe six clinicopathological stages from cognitive normalcy to mild dementia, including stages defined by increased risk of cognitive decline. Such a panel might improve clinical trial efficiency by guiding subject enrollment and monitoring disease progression. Further studies will be required to validate this panel and evaluate its potential for distinguishing AD from other dementing conditions

Sexuality, Sexual Practices, and HIV Risk Among Incarcerated African-American Women in North Carolina

BACKGROUND: Women who have been in prison carry a greater lifetime risk of HIV for reasons that are not well understood. This effect is amplified in the Southeastern United States, where HIV incidence and prevalence is especially high among African American (AA) women. The role of consensual sexual partnerships in the context of HIV risk, especially same-sex partnerships, merits further exploration. METHODS: We conducted digitally recorded qualitative interviews with 29 AA women (15 HIV-positive, 14 HIV-negative) within three months after entry into the state prison system. We explored potential pre-incarceration HIV risk factors, including personal sexual practices. Two researchers thematically coded interview transcripts and a consensus committee reviewed coding. RESULTS: Women reported complex sexual risk profiles during the six months prior to incarceration, including sex with women as well as prior sexual partnerships with both men and women. Condom use with primary male partners was low and a history of transactional sex work was prevalent. These behaviors were linked to substance use, particularly among HIV-positive women. CONCLUSIONS: Although women may not formally identify as bisexual or lesbian, sex with women was an important component of this cohort’s sexuality. Addressing condom use, heterogeneity of sexual practices, and partner concurrency among at-risk women should be considered for reducing HIV acquisition and preventing forward transmission in women with a history of incarceration