Polyclonal Mycobacterium Avium Infections in Patients with AIDS: Variations in Antimicrobial Susceptibilities of Different Strains of M. Avium Isolated from the Same Patient.

Broth microdilution MICs were determined for pairs of strains isolated from five AIDS patients with polyclonal Mycobacterium avium infection. Four (80%) of the five patients were infected simultaneously with strains having different antimicrobial susceptibility patterns. These findings have implications for the interpretation of susceptibility data in M. avium prophylaxis and treatment trials

Minactivin expression in human monocyte and macrophage populations

Adherent monolayer cultures of human blood monocytes, peritoneal macrophages, bone marrow macrophages, and colonic mucosa macrophages were examined for their ability to produce and secrete minactivin, a specific inactivator of urokinase-type plasminogen activator. All except colonic mucosa macrophages produced and secreted appreciable amounts of minactivin, but only blood monocytes were stimulated by muramyl dipeptide (adjuvant peptide) to increase production. The minactivin from each of these populations could be shown to preferentially inhibit urokinase-type plasminogen activator and not trypsin, plasmin, or 'tissue'-type plasminogen activator (HPA66). A plasminogen-activating enzyme present in monocyte cultures appeared unaffected by the presence of minactivin and could be shown to be regulated independently by dexamethasone

Taking Foreign Policy Personally: Personal Values and Foreign Policy Attitudes

Previous research has shown that on issues of foreign policy, individuals have “general stances,” “postures,” “dispositions” or “orientations” that inform their beliefs toward more discrete issues in international relations. While these approaches delineate the proximate sources of public opinion in the foreign policy domain, they evade an even more important question: what gives rise to these foreign policy orientations in the first place? Combining an original survey on a nationally representative sample of Americans with Schwartz’s theory of values from political psychology, we show that people take foreign policy personally: the same basic values we know people use to guide choices in their daily lives also travel to the domain of foreign affairs, offering one potential explanation why people who are otherwise uninformed about world politics nonetheless express coherent foreign policy beliefs

Ecofeminism in the 21st Century

This paper considers the influence of ecofeminism on policy concerning gender (in)equality and the environment during the past 20 years. It reviews the broad contours of the ecofeminist debate before focusing on the social construction interpretation of women's relationship with the environment. It will argue that there have been substantial policy shifts in Europe and the UK in both the environmental and equalities fields, and that this is in part a result of lobbying at a range of scales by groups informed by ecofeminist debates. Nevertheless, the paper cautions that these shifts are largely incremental and operate within existing structures, which inevitably limit their capacity to create change. As policy addresses some of the concerns highlighted by ecofeminism, academic discourse and grass roots activity have been moving on to address other issues, and the paper concludes with a brief consideration of contemporary trajectories of ecofeminism and campaigning on issues that link women's, feminist and environment concerns

Test Characteristics of Urinary Lipoarabinomannan and Predictors of Mortality among Hospitalized HIV-Infected Tuberculosis Suspects in Tanzania.

Tuberculosis is the most common cause of death among patients with HIV infection living in tuberculosis endemic countries, but many cases are not diagnosed pre-mortem. We assessed the test characteristics of urinary lipoarabinomannan (LAM) and predictors of mortality among HIV-associated tuberculosis suspects in Tanzania. We prospectively enrolled hospitalized HIV-infected patients in Dar es Salaam, with ≥2 weeks of cough or fever, or weight loss. Subjects gave 2 mLs of urine to test for LAM using a commercially available ELISA, ≥2 sputum specimens for concentrated AFB smear and solid media culture, and 40 mLs of blood for culture. Among 212 evaluable subjects, 143 (68%) were female; mean age was 36 years; and the median CD4 count 86 cells/mm(3). 69 subjects (33%) had culture confirmation of tuberculosis and 65 (31%) were LAM positive. For 69 cases of sputum or blood culture-confirmed tuberculosis, LAM sensitivity was 65% and specificity 86% compared to 36% and 98% for sputum smear. LAM test characteristics were not different in patients with bacteremia but showed higher sensitivity and lower specificity with decreasing CD4 cell count. Two month mortality was 64 (53%) of 121 with outcomes available. In multivariate analysis there was significant association of mortality with absence of anti-retroviral therapy (p = 0.004) and a trend toward association with a positive urine LAM (p = 0.16). Among culture-negative patients mortality was 9 (75%) of 12 in LAM positive patients and 27 (38%) of 71 in LAM negative patients (p = 0.02). Urine LAM is more sensitive than sputum smear and has utility for the rapid diagnosis of culture-confirmed tuberculosis in this high-risk population. Mortality data raise the possibility that urine LAM may also be a marker for culture-negative tuberculosis

Development of an exercise intervention for the prevention of musculoskeletal shoulder problems after breast cancer treatment : the prevention of shoulder problems trial (UK PROSPER)

Background Musculoskeletal shoulder problems are common after breast cancer treatment. There is some evidence to suggest that early postoperative exercise is safe and may improve shoulder function. We describe the development and delivery of a complex intervention for evaluation within a randomised controlled trial (RCT), designed to target prevention of musculoskeletal shoulder problems after breast cancer surgery (The Prevention of Shoulder Problems Trial; PROSPER). Methods A pragmatic, multicentre RCT to compare the clinical and cost-effectiveness of best practice usual care versus a physiotherapy-led exercise and behavioural support intervention in women at high risk of shoulder problems after breast cancer treatment. PROSPER will recruit 350 women from approximately 15 UK centres, with follow-up at 6 and 12 months. The primary outcome is shoulder function at 12 months; secondary outcomes include postoperative pain, health related quality of life, adverse events and healthcare resource use. A multi-phased approach was used to develop the PROSPER intervention which was underpinned by existing evidence and modified for implementation after input from clinical experts and women with breast cancer. The intervention was tested and refined further after qualitative interviews with patients newly diagnosed with breast cancer; a pilot RCT was then conducted at three UK clinical centres. Discussion The PROSPER intervention incorporates three main components: shoulder-specific exercises targeting range of movement and strength; general physical activity; and behavioural strategies to encourage adherence and support exercise behaviour. The final PROSPER intervention is fully manualised with clear, documented pathways for clinical assessment, exercise prescription, use of behavioural strategies, and with guidance for treatment of postoperative complications. This paper adheres to TIDieR and CERT recommendations for the transparent, comprehensive and explicit reporting of complex interventions. Trial registration: International Standard Randomised Controlled Trial Number: ISRCTN 35358984

Faster ocean warming threatens richest areas of marine biodiversity

First published: 07 July 2022The vulnerability of marine biodiversity to accelerated rates of climatic change is poorly understood. By developing a new method for identifying extreme oceanic warming events during Earth's most recent deglaciation, and comparing these to 21st century projections, we show that future rates of ocean warming will disproportionately affect the most speciose marine communities, potentially threatening biodiversity in more than 70% of current-day global hotspots of marine species richness. The persistence of these richest areas of marine biodiversity will require many species to move well beyond the biogeographic realm where they are endemic, at rates of redistribution not previously seen. Our approach for quantifying exposure of biodiversity to past and future rates of oceanic warming provides new context and scalable information for deriving and strengthening conservation actions to safeguard marine biodiversity under climate change.Stuart C. Brown, Camille Mellin, Jorge García Molinos, Eline D. Lorenzen, Damien A. Fordha

Conceptualizing community resilience to natural hazards - the emBRACE framework

Abstract. The level of community is considered to be vital for building disaster resilience. Yet, community resilience as a scientific concept often remains vaguely defined and lacks the guiding characteristics necessary for analysing and enhancing resilience on the ground. The emBRACE framework of community resilience presented in this paper provides a heuristic analytical tool for understanding, explaining and measuring community resilience to natural hazards. It was developed in an iterative process building on existing scholarly debates, on empirical case study work in five countries and on participatory consultation with community stakeholders, where the framework was applied and ground-tested in different contexts and for different hazard types. The framework conceptualizes resilience across three core domains: resources and capacities; actions; and learning. These three domains are conceptualized as intrinsically conjoined within a whole. Community resilience is influenced by these integral elements as well as by extra-community forces, comprising disaster risk governance and thus laws, policies and responsibilities on the one hand and on the other, the general societal context, natural and human-made disturbances and system change over time. The framework is a graphically rendered heuristic, which through application can assist in guiding the assessment of community resilience in a systematic way and identifying key drivers and barriers of resilience that affect any particular hazard-exposed community