Experiences of women who have lost young children to AIDS in KwaZulu-Natal, South Africa: a qualitative study

Background AIDS continues to be the leading cause of death in South Africa. Little is known about the experiences of mothers who have lost a young child to AIDS. The purpose of this qualitative study was to explore the attitudes and experiences of women who had lost a young child to HIV/AIDS in KwaZulu-Natal Province, South Africa. Methods In-depth interviews were conducted with 10 women who had lost a child to AIDS. The average age of the deceased children was six years. Interviews were also conducted with 12 key informants to obtain their perspectives on working with women who had lost a child to AIDS. A thematic analysis of the transcripts was performed. Results In addition to the pain of losing a child, the women in this study had to endure multiple stresses within a harsh and sometimes hostile environment. Confronted with pervasive stigma and extreme poverty, they had few people they could rely on during their child\u27s sickness and death. They were forced to keep their emotions to themselves since they were not likely to obtain much support from family members or people in the community. Throughout the period of caring for a sick child and watching the child die, they were essentially alone. The demands of caring for their child and subsequent grief, together with daily subsistence worries, took its toll. Key informants struggled to address the needs of these women due to several factors, including scarce resources, lack of training around bereavement issues, reluctance by people in the community to seek help with emotional issues, and poverty. Conclusions The present study offers one of the first perspectives on the experiences of mothers who have lost a young child to AIDS. Interventions that are tailored to the local context and address bereavement issues, as well as other issues that affect the daily lives of these mothers, are urgently needed. Further studies are needed to identify factors that promote resilience among these women

EBR-II Primary Tank Wash-Water Alternatives Evaluation

The EBR-II reactor at Idaho National Laboratory was a liquid sodium metal cooled reactor that operated for 30 years. It was shut down in 1994; the fuel was removed by 1996; and the bulk of sodium metal coolant was removed from the reactor by 2001. Approximately 1100 kg of residual sodium remained in the primary system after draining the bulk sodium. To stabilize the remaining sodium, both the primary and secondary systems were treated with a purge of moist carbon dioxide. Most of the residual sodium reacted with the carbon dioxide and water vapor to form a passivation layer of primarily sodium bicarbonate. The passivation treatment was stopped in 2005 and the primary system is maintained under a blanket of dry carbon dioxide. Approximately 670 kg of sodium metal remains in the primary system in locations that were inaccessible to passivation treatment or in pools of sodium that were too deep for complete penetration of the passivation treatment. The EBR-II reactor was permitted by the Idaho Department of Environmental Quality (DEQ) in 2002 under a RCRA permit that requires removal of all remaining sodium in the primary and secondary systems by 2022. The proposed baseline closure method would remove the large components from the primary tank, fill the primary system with water, react the remaining sodium with the water and dissolve the reaction products in the wash water. This method would generate a minimum of 100,000 gallons of caustic, liquid, low level radioactive, hazardous waste water that must be disposed of in a permitted facility. On February 19-20, 2008, a workshop was held in Idaho Falls, Idaho, to look at alternatives that could meet the RCRA permit clean closure requirements and minimize the quantity of hazardous waste generated by the cleanup process. The workshop convened a panel of national and international sodium cleanup specialists, subject matter experts from the INL, and the EBR-II Wash Water Project team that organized the workshop. The workshop was conducted by a trained facilitator using Value Engineering techniques to elicit the most technically sound solutions from the workshop participants. The path forward includes developing the OBA into a well engineered solution for achieving RCRA clean closure of the EBR-II Primary Reactor Tank system. Several high level tasks are also part of the path forward such as reassigning responsibility of the cleanup project to a dedicated project team that is funded by the DOE Office of Environmental Management, and making it a priority so that adequate funding is available to complete the project. Based on the experience of the sodium cleanup specialists, negotiations with the DEQ will be necessary to determine a risk-based de minimus quantity for acceptable amount of sodium that can be left in the reactor systems after cleanup has been completed

Laboratory Evaluation of Underwater Grouting of CPP-603 Basins

A project is underway to deactivate a Fuel Storage Basin. The project specifies the requirements and identifies the tasks that will be performed for deactivation of the CPP- 603 building at the Idaho Nuclear Technology and Engineering Center of the Idaho National Engineering and Environmental Laboratory. The Fuel Receiving and Storage Building (CPP- 603) was originally used to receive and store spent nuclear fuel from various facilities. The area to undergo deactivation includes the three spent nuclear fuel storage basins and a transfer canal (1.5 million gallons of water storage). Deactivation operations at the task site include management of the hot storage boxes and generic fuel objects, removal of the fuel storage racks, basin sludge, water evaporation and basin grouting, and interior equipment, tanks, and associated components. This includes a study to develop a grout formulation and placement process for this deactivation project. Water will be allowed to passively evaporate to r educe the spread of contamination from the walls of the basin. The basins will be filled with grout, underwater, as the water evaporates to maintain the basin water at a safe level. The objective of the deactivation project is to eliminate potential exposure to hazardous and radioactive materials and eliminate potential safety hazards associated with the CPP-603 building

Engaging Communities in Sulawesi Island, Indonesia: A Collaborative Approach to Modelling Marine Plastic Debris through Open Science and Online Visualization

Marine litter poses a complex challenge in Indonesia, necessitating a well-informed and coordinated strategy for effective mitigation. This study investigates the seasonality of plastic concentrations around Sulawesi Island in central Indonesia during the monsoon-driven wet and dry seasons. By using open data and methodologies including the HYCOM and Parcels models, we simulated the dispersal of plastic waste over three months during both the southwest and northeast monsoons. Our research extended beyond data analysis, as we actively engaged with local communities, researchers, and policymakers through a range of outreach initiatives, including the development of a web application to visualize model results. Our findings underscore the substantial influence of monsoon-driven currents on surface plastic concentrations, highlighting the seasonal variation in the risk to different regional seas. This study adds to the evidence provided by coarser resolution regional ocean modelling studies, emphasizing that seasonality is a key driver of plastic pollution within the Indonesian archipelago. Inclusive international collaboration and a community-oriented approach were integral to our project, and we recommend that future initiatives similarly engage researchers, local communities, and decision-makers in marine litter modelling results. This study will work to support in the application of model results in solutions to the marine litter problem

Peripheral venous congestion causes time- and dose-dependent release of endothelin-1 in humans

Endothelin-1 (ET-1) is a pivotal mediator of vasoconstriction and inflammation in congestive states such as heart failure (HF) and chronic kidney disease (CKD). Whether peripheral venous congestion (VC) increases plasma ET-1 at pressures commonly seen in HF and CKD patients is unknown. We seek to characterize whether peripheral VC promotes time- and dose-dependent increases in plasma ET-1 and whether these changes are sustained after decongestion. We used a randomized, cross-over design in 20 healthy subjects (age 30 ± 7 years). To experimentally model VC, venous pressure was increased to either 15 or 30 mmHg (randomized at first visit) above baseline by inflating a cuff around the subject\u27s dominant arm; the nondominant arm served as a noncongested control. We measured plasma ET-1 at baseline, after 20, 60 and 120 min of VC, and finally at 180 min (60 min after cuff release and decongestion). Plasma ET-1 progressively and significantly increased over 120 min in the congested arm relative to the control arm and to baseline values. This effect was dose-dependent: ET-1 increased by 45% and 100% at VC doses of 15 and 30 mmHg, respectively

End of life care in sub-Saharan Africa: a systematic review of the qualitative literature

<p>Abstract</p> <p>Background</p> <p>End of life (EoL) care in sub-Saharan Africa still lacks the sound evidence-base needed for the development of effective, appropriate service provision. It is essential to make evidence from all types of research available alongside clinical and health service data, to ensure that EoL care is ethical and culturally appropriate. This article aims to synthesize qualitative research on EoL care in sub-Saharan Africa to inform policy, practice and further research. It seeks to identify areas of existing research; describe findings specifically relevant to the African context; and, identify areas lacking evidence.</p> <p>Methods</p> <p>Relevant literature was identified through eight electronic databases: AMED, British Nursing Index & Archive, CINAHL, EMBASE, IBSS, MEDLINE, PsycINFO, and the Social Sciences Citation Index; and hand searches. Inclusion criteria were: published qualitative or mixed-method studies in sub-Saharan Africa, about EoL care. Study quality was assessed using a standard grading scale. Relevant data including findings and practice recommendations were extracted and compared in tabular format.</p> <p>Results</p> <p>Of the 407 articles initially identified, 51 were included in the qualitative synthesis. Nineteen came from South Africa and the majority (38) focused on HIV/AIDS. Nine dealt with multiple or unspecified conditions and four were about cancer. Study respondents included health professionals, informal carers, patients, community members and bereaved relatives. Informal carers were typically women, the elderly and children, providing total care in the home, and lacking support from professionals or the extended family. Twenty studies focused on home-based care, describing how programmes function in practice and what is needed to make them effective. Patients and carers were reported to prefer institutional care but this needs to be understood in context. Studies focusing on culture discussed good and bad death, culture-specific approaches to symptoms and illness, and the bereavement process.</p> <p>Conclusions</p> <p>The data support or complement the findings from quantitative research. The review prompts a reconsideration of the assumption that in Africa the extended family care for the sick, and that people prefer home-based care. The review identifies areas relevant for a research agenda on socio-cultural issues at the EoL in sub-Saharan Africa.</p

Lowe syndrome

Lowe syndrome (the oculocerebrorenal syndrome of Lowe, OCRL) is a multisystem disorder characterised by anomalies affecting the eye, the nervous system and the kidney. It is a uncommon, panethnic, X-linked disease, with estimated prevalence in the general population of approximately 1 in 500,000. Bilateral cataract and severe hypotonia are present at birth. In the subsequent weeks or months, a proximal renal tubulopathy (Fanconi-type) becomes evident and the ocular picture may be complicated by glaucoma and cheloids. Psychomotor retardation is evident in childhood, while behavioural problems prevail and renal complications arise in adolescence. The mutation of the gene OCRL1 localized at Xq26.1, coding for the enzyme phosphatidylinositol (4,5) bisphosphate 5 phosphatase, PtdIns (4,5)P2, in the trans-Golgi network is responsible for the disease. Both enzymatic and molecular testing are available for confirmation of the diagnosis and for prenatal detection of the disease. The treatment includes: cataract extraction, glaucoma control, physical and speech therapy, use of drugs to address behavioural problems, and correction of the tubular acidosis and the bone disease with the use of bicarbonate, phosphate, potassium and water. Life span rarely exceeds 40 years

Using redundancy to cope with failures in a delay tolerant network

We consider the problem of routing in a delay tolerant net-work (DTN) in the presence of path failures. Previous work on DTN routing has focused on using precisely known network dy-namics, which does not account for message losses due to link failures, buffer overruns, path selection errors, unscheduled de-lays, or other problems. We show how to split, replicate, and erasure code message fragments over multiple delivery paths to optimize the probability of successful message delivery. We provide a formulation of this problem and solve it for two cases: a 0/1 (Bernoulli) path delivery model where messages are ei-ther fully lost or delivered, and a Gaussian path delivery model where only a fraction of a message may be delivered. Ideas from the modern portfolio theory literature are borrowed to solve the underlying optimization problem. Our approach is directly relevant to solving similar problems that arise in replica place-ment in distributed file systems and virtual node placement in DHTs. In three different simulated DTN scenarios covering a wide range of applications, we show the effectiveness of our ap-proach in handling failures

In vitro and in vivo studies on biocompatibility of carbon fibres

In the present study we focused on the in vitro and in vivo evaluation of two types of carbon fibres (CFs): hydroxyapatite modified carbon fibres and porous carbon fibres. Porous CFs used as scaffold for tissues regeneration could simultaneously serve as a support for drug delivery or biologically active agents which would stimulate the tissue growth; while addition of nanohydroxyapatite to CFs precursor can modify their biological properties (such as bioactivity) without subsequent surface modifications, making the process cost and time effective. Presented results indicated that fibre modification with HAp promoted formation of apatite on the fibre surface during incubation in simulated body fluid. The materials biocompatibility was determined by culturing human osteoblast-like cells of the line MG 63 in contact with both types of CFs. Both tested materials gave good support to adhesion and growth of bone-derived cells. Materials were implanted into the skeletal rat muscle and a comparative analysis of tissue reaction to the presence of the two types of CFs was done. Activities of marker metabolic enzymes: cytochrome c oxidase (CCO) and acid phosphatase were examined to estimate the effect of implants on the metabolic state of surrounding tissues. Presented results evidence the biocompatibility of porous CFs and activity that stimulates the growth of connective tissues. In case of CFs modified with hydroxyapatite the time of inflammatory reaction was shorter than in case of traditional CFs