Development of structured support groups for HIV-positive women in South Africa

Women living with HIV in a stigmatising community need support to cope with their HIV status. In a process of action research, a structured support group programme was designed to meet the needs of women to cope with their diagnosis and interpersonal relationships. The emphasis was on identifying their needs and developing programme material to address those needs through group participation and interaction. The programme was pilot-tested at two sites located in two townships in Tshwane, South Africa. Feedback after each session made it possible to adjust the programme to the needs of the participants. In a formative evaluation, audio-taped sessions, process notes of facilitators, and experiences of the participants were used to identify therapeutic elements, the value of the groups and the problems in the implementation process. Women reported benefit from participation in the support groups. A 10-session structured programme to be used in support groups addressing the most important needs of HIV-positive women was developed.Keywords: support groups, HIV-positive women, South AfricaRésuméLes femmes vivant avec le VIH dans une communauté stigmatisante ont besoin de soutien afin de faire face à leur statut de VIH.Au cours du processus de la recherche active, un programme de groupe de soutien structuré a été conçu avec le but de répondre aux besoins de ces femmes pour qu'elles puissent faire face au diagnostic et aux relations personnelles. L'important était d'identifier les besoins et de développer le matériel nécessaire au programme afin d'aborder ces besoins à travers la participation et l'interaction du groupe. Des essais pilotes du programme ont été fait dans deux sites situés dans deux banlieues à Tshwane, Afrique du Sud. La réaction au bout de chacune des sessions a permis une adaptation du programme aux besoins des participants. Durant l'évaluation formative les enregistrements de sessions, les notes du processus des animateurs et les expériences personnelles des participants ont été employé dans le but de relever les éléments thérapeutiques, l'importance de groupes et les problèmes émergeant de l'exécution du processus. Les femmes ont signalé que la participation aux groupes de soutien a été rentable. Un programme structuré, ayant dix sessions, a été aménagé pour être utilisé dans les groupes de soutien avec le but d'aborder les besoins les plus importants des femmes séropositives.Mots clés: groupes de soutien, femmes séropositives, Afrique du Sud SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance) Vol. 2(3) 2005: 333-34

Impact of structured support groups for pregnant South African women recently diagnosed HIV positive

The authors of this study evaluated a structured 10-session psy- chosocial support group intervention for newly HIV-diagnosed pregnant South African women. Participants were expected to display increases in HIV disclosure, self-esteem, active coping and positive social support, and decreases in depression, avoidant coping, and negative social support. Three hundred sixty-one pregnant HIV-infected women were recruited from four antenatal clinics in Tshwane townships from April 2005 to September 2006. Using a quasi-experimental design, assessments were conducted at baseline and two and eight months post-intervention. A series of random effects regression analyses were conducted, with the three assessment points treated as a random effect of time. At both follow-ups, the rate of disclosure in the intervention group was significantly higher than that of the comparison group (p < 0.001). Compared to the comparison group at the first follow-up, the intervention group displayed higher levels of active coping (t = 2.68, p < 0.05) and lower levels of avoidant coping (t = -2.02, p < 0.05), and those who attended at least half of the intervention sessions exhibited improved self-esteem (t = 2.11, p < 0.05). Group interventions tailored for newly HIV positive pregnant women, implemented in resource-limited settings, may accelerate the process of adjusting to one’s HIV status, but may not have sustainable benefits over time.http://www.tandfonline.com/loi/wwah2

Where now for infection services in the NHS? How lessons from the pandemic should drive long-overdue integration of microbiology and infectious diseases

During its first 20 years, the NHS witnessed the almost entire disappearance of epidemic, community-acquired infections such as scarlet fever, tuberculosis and measles with the resulting closure of hundreds of ‘fever hospitals’. Meanwhile, social and medical advances ushered in different problems, for example, infections related to an ageing population or proliferation of immunosuppressive treatments. An estimated 300,000 NHS patients develop a healthcare-associated infection (HCAI) each year, incurring costs estimated at up to £2 billion. Antimicrobial-resistance (AMR) threatens to undo decades of medical progress and is predicted to cause more deaths than cancer by 2050. Causing over 500,000 UK hospitalisations, COVID-19 has recently highlighted that life-threatening pandemics are not consigned to history and crucial lessons must be learnt from our national response. A fundamental review of NHS ‘Infection’ (Infectious Diseases, Microbiology and Virology) provision is overdue and must resolve long-standing training issues that hamper integration of these key component services. Profound changes to system-wide healthcare, including creation of Integrated Care Systems (ICSs) and the UK Health Security Agency (UKSHA) - formerly Public Health England (PHE), create an opportunity to coordinate these distinct but integral disciplines to ensure parity of access to high-quality infection prevention, diagnosis and management expertise

Factors affecting HIV-infected mothers' ability to adhere to antenatally intended infant feeding choice in Tshwane

OBJECTIVES: To determine the factors influencing the ability of HIV-infected mothers to adhere to antenatal feeding choices after routine prevention of mother-to-child transmission counselling. PATIENTS and METHODS: The postnatal feeding practices of 222 HIV-infected mothers were compared with their prenatal intentions and with those of 53 uninfected mothers. RESULTS: Ninety-four per cent of HIV-negative mothers were breastfeeding their babies at age 6 weeks, while 69% of HIV-positive mothers were formula feeding. Of the HIV-positive mothers who intended to formula feed prenatally, 25% changed their minds and breastfed, while 50% of 52 women planning to breastfeed switched to formula feeds. Mothers who did not adhere to their original intention to formula feed were significantly younger than those who remained with their original choice, and were more likely to have received negative or domineering support and to share their home with someone other than their partner. CONCLUSION: Women are influenced by circumstances in their homes and at the hospital to depart from their original feeding intent

Impaired vascular permeability regulation caused by the VEGF165b splice variant in pre-eclampsia

OBJECTIVE: Pre-eclampsia is diagnosed by hypertension and proteinuria, probably caused by endothelial dysfunction, resulting in symptoms including oedema, inflammation and altered metabolism. Vascular endothelial growth factor A (VEGF-A) is detected at higher concentrations in plasma from patients with pre-eclampsia than in plasma from normotensive pregnant patients when determined by radioimmunoassay. This study tested the hypothesis that circulating VEGF-A in pre-eclamptic plasma is biologically active in vivo, and aimed to identify specific isoforms responsible for this activity. DESIGN: Plasma from pre-eclamptic (n = 17) and normotensive (n = 10) pregnant women was perfused into Rana mesenteric microvessels, and the subsequent change in microvascular permeability was measured using a single-vessel perfusion micro-occlusion technique. RESULTS: Pre-eclamptic but not normotensive plasma resulted in a 5.25 ± 0.8-fold acute increase in vascular permeability (P = 0.0003). This increase could be blocked by the incubation of plasma with bevacizumab, an antibody to VEGF-A (n = 7; P = 0012), and by VEGF-A receptor inhibition by SU5416 at doses specific to VEGF-A receptor-1 (VEGFR1), but not by the VEGF-A receptor-2 inhibitor, ZM323881. Although VEGF165b levels were not significantly altered in the PET samples, the increase in permeability was also inhibited by incubation of pre-eclamptic plasma with an inhibitory monoclonal antibody specific for VEGF165b (n = 6; P < 0.01), or by the addition of placental growth factor 1 (PlGF-1; n = 3; P < 0.001). PlGF-1 was detected at lower concentrations in pre-eclamptic plasma than in normotensive plasma. CONCLUSIONS: These findings suggest that circulating VEGF-A levels in pre-eclampsia are biologically active because of a loss of repression of VEGFR1 signalling by PlGF-1, and VEGF165b may be involved in the increased vascular permeability of pre-eclampsia.This work was supported by the British Heart Foundation (FS/05/100 to VLB and BS/06/005 to DOB), and the Medical Research Council (RD1627 to DOB/SJH, and G0802829 to AHS).http://www.bjog.or

Physical activity and activity space in patients with pulmonary fibrosis not prescribed supplemental oxygen

Abstract Background Patients with pulmonary fibrosis (PF) have impaired quality of life, and research suggests that dyspnea and physical activity are primary drivers. As PF progresses, some patients notice the disease “shrinks their worlds”. The objective of this study is to describe movement (both physical activity and activity space) in a cohort of patients with PF of various etiologies who have not been prescribed supplemental oxygen (O2). Methods Subjects with PF not on supplemental O2 during the day were enrolled from across the U.S. from August 2013 to October 2015. At enrollment, each subject completed questionnaires and, for seven consecutive days, wore an accelerometer and GPS tracker. Results One hundred ninety-four subjects had a confirmed diagnosis of PF and complete, analyzable GPS data. The cohort was predominantly male (56%), Caucasian (95%) and had idiopathic pulmonary fibrosis (30%) or connective tissue disease related-PF (31%). Subjects walked a median 7497 (interquartile range [IQR] 5766-9261) steps per day. Steps per day were correlated with symptoms and several quality of life domains. In a model controlling for age, body mass index, wrist- (vs. waist) worn accelerometer and percent predicted diffusing capacity (DLCO%), fatigue (beta coefficient = −51.5 ± 11.7, p < 0.0001) was an independent predictor of steps per day (model R2=0.34). Conclusions Patients with PF, who have not been prescribed O2 for use during the day, have wide variability in their mobility. Day-to-day physical activity is related to several domains that impact quality of life, but GPS-derived activity space is not. Wearable data collection devices may be used to determine whether and how therapeutic interventions impact movement in PF patients. Trial registration NCT01961362 . Registered 9 October, 2013

Dataset and R codes for the paper: Dusenge ME, Warren JM, Reich PB, Ward EJ, Murphy BK, Stefanski A, Villanueva R, Cruz M, McLennan DA, King AW, Montgomery RA, Hanson PJ, Way DA. Boreal conifers maintain carbon uptake with warming despite failure to track optimal temperatures

This data set contains empirical physiological, morphological, and chemical data collected on two dominant conifer species, Picea mariana and Larix laricina, in June and August 2017 at the SPRUCE (Spruce and Peatland Responses Under Changing Environments) experiment that assesses the response of peatland ecosystems to whole-ecosystem warming and elevated atmospheric CO2 concentrations. The SPRUCE experiment is located 40 km north of Grand Rapids, MN, in the USDA Forest Service Marcell Experimental Forest.</p

Factors Affecting Disclosure in South African HIV-Positive Pregnant Women

To provide understanding of social and psychological factors that affect disclosure of HIV status among women diagnosed HIV-positive in pregnancy, 438 HIV positive women attending antenatal clinics in Pretoria, South Africa were invited to participate in a longitudinal study. A total of 293 (62%) women were enrolled from June 2003 to December 2004. Questionnaires assessing sociodemographics and psychological measures were administered during pregnancy and at 3 months postdelivery. At enrollment, 59% had disclosed to their partners and 42% to others. This rose to 67% and 59%, respectively, by follow-up. Logistic regression analysis identified being married (adjusted odds Ratio [AOR] 2.32; 95% confidence interval [CI] 1.20–4.47), prior discussion about testing (AOR 4.19; CI 2.34–7.49), having a partner with tertiary education (AOR 2.76; CI 1.29–5.88) and less experience of violence (AOR 0.48; CI 0.24–0.97) as factors associated with having disclosed to partners prior to enrollment. Better housing (AOR 1.26; CI 1.06–1.49), less financial dependence on partners (AOR 0.46; CI 0.25–0.85), and knowing someone with HIV (AOR 2.13; CI 1.20–3.76) were associated with prior disclosure to others. Increased levels of stigma at baseline decreased the likelihood of disclosure to partners postenrollment (AOR 0.91; CI 0.84–0.98) and increased levels of avoidant coping decreased subsequent disclosure to others (AOR 0.84; CI 0.72–0.97). These results provide understanding of disclosure for women diagnosed as HIV positive in pregnancy, and identify variables that could be used to screen for women who require help

A Common Haplotype of the Glucokinase Gene Alters Fasting Glucose and Birth Weight: Association in Six Studies and Population-Genetics Analyses

Fasting glucose is associated with future risk of type 2 diabetes and ischemic heart disease and is tightly regulated despite considerable variation in quantity, type, and timing of food intake. In pregnancy, maternal fasting glucose concentration is an important determinant of offspring birth weight. The key determinant of fasting glucose is the enzyme glucokinase (GCK). Rare mutations of GCK cause fasting hyperglycemia and alter birth weight. The extent to which common variation of GCK explains normal variation of fasting glucose and birth weight is not known. We aimed to comprehensively define the role of variation of GCK in determination of fasting glucose and birth weight, using a tagging SNP (tSNP) approach and studying 19,806 subjects from six population-based studies. Using 22 tSNPs, we showed that the variant rs1799884 is associated with fasting glucose at all ages in the normal population and exceeded genomewide levels of significance (P=10(-9)). rs3757840 was also highly significantly associated with fasting glucose (P=8×10(-7)), but haplotype analysis revealed that this is explained by linkage disequilibrium (r(2)=0.2) with rs1799884. A maternal A allele at rs1799884 was associated with a 32-g (95% confidence interval 11–53 g) increase in offspring birth weight (P=.002). Genetic variation influencing birth weight may have conferred a selective advantage in human populations. We performed extensive population-genetics analyses to look for evidence of recent positive natural selection on patterns of GCK variation. However, we found no strong signature of positive selection. In conclusion, a comprehensive analysis of common variation of the glucokinase gene shows that this is the first gene to be reproducibly associated with fasting glucose and fetal growth

MycoDB, a Global Database of Plant Response to Mycorrhizal Fungi

Plants form belowground associations with mycorrhizal fungi in one of the most common symbioses on Earth. However, few large-scale generalizations exist for the structure and function of mycorrhizal symbioses, as the nature of this relationship varies from mutualistic to parasitic and is largely context-dependent. We announce the public release of MycoDB, a database of 4,010 studies (from 438 unique publications) to aid in multi-factor meta-analyses elucidating the ecological and evolutionary context in which mycorrhizal fungi alter plant productivity. Over 10 years with nearly 80 collaborators, we compiled data on the response of plant biomass to mycorrhizal fungal inoculation, including meta-analysis metrics and 24 additional explanatory variables that describe the biotic and abiotic context of each study. We also include phylogenetic trees for all plants and fungi in the database. To our knowledge, MycoDB is the largest ecological meta-analysis database. We aim to share these data to highlight significant gaps in mycorrhizal research and encourage synthesis to explore the ecological and evolutionary generalities that govern mycorrhizal functioning in ecosystems