Differentiating patterns of violence in the family

The feasibility and prevalence of Reciprocal, Hierarchical and Paternal patterns of family aggression hypothesised by Dixon and Browne (2003) were explored within a sample of maltreating families. The psychological reports of 67 families referred to services for alleged child maltreatment that evidenced concurrent physical intimate partner violence and child maltreatment were investigated. Of these, 29 (43.3%) cases were characterised by hierarchical; 28 (41.8%) Reciprocal and 10 (14.9%) Paternal patterns. Significant differences in the form of child maltreatment perpetrated by mothers and fathers and parent dyads living in different patterns were found. In Hierarchical sub-patterns, fathers were significantly more likely to have been convicted for a violent and/or sexual offence than mothers and were significantly less likely to be biologically related to the child. The findings demonstrate the existence of the different patterns in a sample of families involved in the Child Care Protection process in England and Wales, supporting the utility of a holistic approach to understanding aggression in the family

Prospect of Studying Hard X- and Gamma-Rays from Type Ia Supernovae

We perform multi-dimensional, time-dependent radiation transfer simulations for hard X-ray and gamma-ray emissions, following radioactive decays of 56Ni and 56Co, for two-dimensional delayed detonation models of Type Ia supernovae (SNe Ia). The synthetic spectra and light curves are compared with the sensitivities of current and future observatories for an exposure time of 10^6 seconds. The non-detection of the gamma-ray signal from SN 2011fe at 6.4 Mpc by SPI on board INTEGRAL places an upper limit for the mass of 56Ni of \lesssim 1.0 Msun, independently from observations in any other wavelengths. Signals from the newly formed radioactive species have not been convincingly measured yet from any SN Ia, but the future X-ray and gamma-ray missions are expected to deepen the observable horizon to provide the high energy emission data for a significant SN Ia sample. We predict that the hard X-ray detectors on board NuStar (launched in 2012) or ASTRO-H (scheduled for launch in 2014) will reach to SNe Ia at \sim15 Mpc, i.e., one SN every few years. Furthermore, according to the present results, the soft gamma-ray detector on board ASTRO-H will be able to detect the 158 keV line emission up to \sim25 Mpc, i.e., a few SNe Ia per year. Proposed next generation gamma-ray missions, e.g., GRIPS, could reach to SNe Ia at \sim20 - 35 Mpc by MeV observations. Those would provide new diagnostics and strong constraints on explosion models, detecting rather directly the main energy source of supernova light.Comment: 14 pages, 7 figures, 1 table, accepted for publication in Ap

Physical Structure and Nature of Supernova Remnants in M101

Supernova remnant (SNR) candidates in the giant spiral galaxy M101 have been previously identified from ground-based H-alpha and [SII] images. We have used archival Hubble Space Telescope (HST) H-alpha and broad-band images as well as stellar photometry of 55 SNR candidates to examine their physical structure, interstellar environment, and underlying stellar population. We have also obtained high-dispersion echelle spectra to search for shocked high-velocity gas in 18 SNR candidates, and identified X-ray counterparts to SNR candidates using data from archival observations made by the Chandra X-ray Observatory. Twenty-one of these 55 SNR candidates studied have X-ray counterparts, although one of them is a known ultra-luminous X-ray source. The multi-wavelength information has been used to assess the nature of each SNR candidate. We find that within this limited sample, ~16% are likely remnants of Type Ia SNe and ~45% are remnants of core-collapse SNe. In addition, about ~36% are large candidates which we suggest are either superbubbles or OB/HII complexes. Existing radio observations are not sensitive enough to detect the non-thermal emission from these SNR candidates. Several radio sources are coincident with X-ray sources, but they are associated with either giant HII regions in M101 or background galaxies. The archival HST H-alpha images do not cover the entire galaxy and thus prevents a complete study of M101. Furthermore, the lack of HST [SII] images precludes searches for small SNR candidates which could not be identified by ground-based observations. Such high-resolution images are needed in order to obtain a complete census of SNRs in M101 for a comprehensive investigation of the distribution, population, and rates of SNe in this galaxy.Comment: 37 pages, 4 Tables, 7 Figures, accepted for publication in the Astronomical Journa

Trauma history and depression predict incomplete adherence to antiretroviral therapies in a low income country.

As antiretroviral therapy (ART) for HIV becomes increasingly available in low and middle income countries (LMICs), understanding reasons for lack of adherence is critical to stemming the tide of infections and improving health. Understanding the effect of psychosocial experiences and mental health symptomatology on ART adherence can help maximize the benefit of expanded ART programs by indicating types of services, which could be offered in combination with HIV care. The Coping with HIV/AIDS in Tanzania (CHAT) study is a longitudinal cohort study in the Kilimanjaro Region that included randomly selected HIV-infected (HIV+) participants from two local hospital-based HIV clinics and four free-standing voluntary HIV counselling and testing sites. Baseline data were collected in 2008 and 2009; this paper used data from 36 month follow-up interviews (N = 468). Regression analyses were used to predict factors associated with incomplete self-reported adherence to ART. INCOMPLETE ART ADHERENCE WAS SIGNIFICANTLY MORE LIKELY TO BE REPORTED AMONGST PARTICIPANTS WHO EXPERIENCED A GREATER NUMBER OF CHILDHOOD TRAUMATIC EVENTS: sexual abuse prior to puberty and the death in childhood of an immediate family member not from suicide or homicide were significantly more likely in the non-adherent group and other negative childhood events trended toward being more likely. Those with incomplete adherence had higher depressive symptom severity and post-traumatic stress disorder (PTSD). In multivariable analyses, childhood trauma, depression, and financial sacrifice remained associated with incomplete adherence.\ud This is the first study to examine the effect of childhood trauma, depression and PTSD on HIV medication adherence in a low income country facing a significant burden of HIV. Allocating spending on HIV/AIDS toward integrating mental health services with HIV care is essential to the creation of systems that enhance medication adherence and maximize the potential of expanded antiretroviral access to improve health and reduce new infections

Test site predicts HIV care linkage and antiretroviral therapy initiation: a prospective 3.5 year cohort study of HIV-positive testers in northern Tanzania

Abstract Background Linkage to HIV care is crucial to the success of antiretroviral therapy (ART) programs worldwide, loss to follow up at all stages of the care continuum is frequent, and long-term prospective studies of care linkage are currently lacking. Methods Consecutive clients who tested HIV-positive were enrolled from four HIV testing centers (1 health facility and 3 community-based centers) in the Kilimanjaro region of Tanzania as part of the larger Coping with HIV/AIDS in Tanzania (CHAT) prospective observational study. Biannual interviews were conducted over 3.5 years, assessing care linkage, retention, and mental health. Bivariable and multivariate logistic regression analyses were conducted to determine associations with early death (prior to the second follow up interview) and delayed (>6 months post-test) or failed care linkage. Results A total of 263 participants were enrolled between November, 2008 and August, 2009 and 240 participants not already linked to care were retained in the final dataset. By 6 months after enrollment, 169 (70.4 %) of 240 participants had presented to an HIV care and treatment facility; 41 (17.1 %) delayed more than 6 months, 15 (6.3 %) died, and 15 (6.3 %) were lost to follow up. Twenty-six patients died before their second follow up visit and were analyzed in the early death group (10.8 %). Just 15 (9.6 %) of those linked to care had started ART within 6 months, but 123 (89.1 %) of patients documented to be ART eligible by local guidelines had started ART by the end of 3.5 years. On multivariate analysis, male gender (OR 1.72; 95 % CI 1.08, 2.75), testing due to illness (OR 1.63; 95 % CI 1.01, 2.63), and higher mean depression scale scores (4 % increased risk per increase in depression score; 95 % CI 1 %, 8 %) were associated with early death. Testing at a community versus a hospital-based site (OR 2.89; 95 % CI 1.79, 4.66) was strongly associated with delaying or never entering care. Conclusions Nearly 30 % of the cohort did not have timely care linkage, ART initiation was frequently delayed, and testing at a hospital outpatient department versus community-based testing centers was strongly associated with successful care linkage

The effectiveness of depression management for improving HIV care outcomes in Malawi: Protocol for a quasi-experimental study

Background: Depression, prevalent among people living with HIV (PLWH) in Malawi, is associated with negative HIV patient outcomes and likely affects HIV medical management. Despite the high prevalence of depression, its management has not been integrated into HIV care in Malawi or most low-income countries. Methods: This study employs a pre-post design in two HIV clinics in Lilongwe, Malawi, to evaluate the effect of integrating depression management into routine HIV care on both mental health and HIV outcomes. Using a multiple baseline design, this study is examining mental health and HIV outcome data of adult (≥18 years) patients newly initiating ART who also have depression, comparing those entering care before and after the integration of depression screening and treatment into HIV care. The study is also collecting cost information to estimate the cost-effectiveness of the program in improving rates of depression remission and HIV treatment engagement and success. Discussion: We anticipate that the study will generate evidence on the effect of depression management on HIV outcomes and the feasibility of integrating depression management into existing HIV care clinics. The results of the study will inform practice and policy decisions on integration of depression management in HIV care clinics in Malawi and related settings, and will help design a next-step strategy to scale-up integration to a larger scale. Trial registration: ClinicalTrials.gov ID [ NCT03555669 ]. Retrospectively registered on 13 June 2018

Ongoing life stressors and suicidal ideation among HIV-infected adults with depression

Suicidal ideation is the most proximal risk factor for suicide and can indicate extreme psychological distress; identification of its predictors is important for possible intervention. Depression and stressful or traumatic life events (STLEs), which are more common among HIV-infected individuals than the general population, may serve as triggers for suicidal thoughts

Water vapor in the starburst galaxy NGC 253: A new nuclear maser?

22 GHz water vapor emission was observed toward the central region of the spiral starburst galaxy NGC 253. Monitoring observations with the 100-m telescope at Effelsberg and measurements with the BnC array of the VLA reveal three distinct velocity components, all of them blueshifted with respect to the systemic velocity. The main component arises from a region close to the dynamical center and is displaced by <1 arcsec from the putative nuclear continuum source. The bulk of this maser component is spread over an area not larger than 70 x 50 mas. Its radial velocity may be explained by masing gas that is part of a nuclear accretion disk or of a counterrotating kinematical subsystem or by gas that is entrained by the nuclear superwind or by an expanding supernova shell. A weaker feature, located 5 arcsec to the northeast, is likely related to an optically obscured site of massive star formation.Comment: 6 pages, 4 Postscript figures, A&A Main Journa

The Chandra ACIS Survey of M33 (ChASeM33): The final source catalog

This study presents the final source catalog of the Chandra ACIS Survey of M33 (ChASeM33). With a total exposure time of 1.4 Ms, ChASeM33 covers ~70% of the D25 isophote (R\approx4kpc) of M33 and provides the deepest, most complete, and detailed look at a spiral galaxy in X-rays. The source catalog includes 662 sources, reaches a limiting unabsorbed luminosity of ~2.4x10^(34) erg/s in the 0.35-8.0keV energy band, and contains source positions, source net counts, fluxes and significances in several energy bands, and information on source variability. The analysis challenges posed by ChASeM33 and the techniques adopted to address these challenges are discussed. To constrain the nature of the detected X-ray source, hardness ratios were constructed and spectra were fit for 254 sources, followup MMT spectra of 116 sources were acquired, and cross-correlations with previous X-ray catalogs and other multi-wavelength data were generated. Based on this effort, 183 of the 662 ChASeM33 sources could be identified. Finally, the luminosity function for the detected point sources as well as the one for the X-ray binaries in M33 is presented. The luminosity functions in the soft band (0.5-2.0 keV) and the hard band (2.0-8.0 keV) have a limiting luminosity at the 90% completeness limit of 4.0x10^(34) erg/s and 1.6x10^(35) erg/s (for D=817kpc), respectively, which is significantly lower than what was reported by previous X-ray binary population studies in galaxies more distant than M33. The resulting distribution is consistent with a dominant population of high mass X-ray binaries as would be expected for M33.Comment: 186 pages, 11 figures, 10 tables. Accepted for publication in the ApJS. For a high resolution version of the paper, see http://hea-www.harvard.edu/vlp_m33_public

The Seyfert-Starburst Connection in X-rays. I. The Data

We analyze X-ray spectra and images of a sample of Seyfert 2 galaxies that unambiguously contain starbursts, based on their optical and UV characteristics. Although all sample members contain active galactic nuclei (AGNs), supermassive black holes or other related processes at the galactic centers alone cannot account for the total X-ray emission in all instances. Eleven of the twelve observed galaxies are significantly resolved with the ROSAT HRI, while six of the eight sources observed with the lower-resolution PSPC also appear extended on larger scales. The X-ray emission is extended on physical scales of 10 kpc and greater, which we attribute to starburst-driven outflows and supernova-heating of the interstellar medium. Spectrally, a physically-motivated composite model of the X-ray emission that includes a heavily absorbed (N_H > 10^{23} cm^{-2}) nuclear component (the AGN), power-law like scattered AGN flux, and a thermal starburst describes this sample well. Half the sample exhibit iron K alpha lines, which are typical of AGNs.Comment: 31 pages including 12 figures and 9 tables; to appear in the ApJS, April 2001; full-resolution figures are available at http://www.pha.jhu.edu/~levenson/papers/lwhpaper1.p