Measuring and Analysing the Chain of Implicit Trust: AStudy of Third-party Resources Loading

The web is a tangled mass of interconnected services, whereby websites import a range of external resources from various third-party domains. The latter can also load further resources hosted on other domains. For each website, this creates a dependency chain underpinned by a form of implicit trust between the first-party and transitively connected third parties. The chain can only be loosely controlled as first-party websites often have little, if any, visibility on where these resources are loaded from. This article performs a large-scale study of dependency chains in the web to find that around 50% of first-party websites render content that they do not directly load. Although the majority (84.91%) of websites have short dependency chains (below three levels), we find websites with dependency chains exceeding 30. Using VirusTotal, we show that 1.2% of these third parties are classified as suspicious—although seemingly small, this limited set of suspicious third parties have remarkable reach into the wider ecosystem. We find that 73% of websites under-study load resources from suspicious third parties, and 24.8% of first-party webpages contain at least three third parties classified as suspicious in their dependency chain. By running sandboxed experiments, we observe a range of activities with the majority of suspicious JavaScript codes downloading malware

Risky behaviour and psychosocial correlates in adolescents – is there a link with tuberculosis?

Objective: Reasons for the increase in incidence of Tuberculosis (TB) in late adolescence are poorly understood. One hypothesis is that psychological and behavioural variables associated with adolescence may increase risk of developing TB. The study aimed to determine whether psychosocial and behavioural variables affect incidence of TB disease in adolescents. Methods: A casecontrol study design was used in adolescents who were participants in a TB epidemiological study. Cases were adolescents diagnosed with TB disease. Approximately half of the controls had no TB disease but a positive TST indicative of latent TB. Half had neither TB disease nor latent TB. A self-administered questionnaire was completed by participants. The questionnaire consisted of a combination of standardised psychosocial instruments. Results: Of 292 participants, 62 were cases, 112 had latent TB and 118 neither TB disease nor latent TB. There were no significant differences in instrument scores between cases and controls. There was a trend for certain adverse life events to be more common in the TB-disease group. Conclusion: In adolescents, a trend for association between TB incidence and psychosocial and behavioural variables was not statistically significant. Given the trend, research with larger samples, and more comprehensive assessment of the relationship between stressors and TB, is warranted.Keywords: Tuberculosis; Adolescents; Self-injurious behaviour; Psychosocial factor

Risky behaviour and psychosocial correlates in adolescents - is there a link with tuberculosis?

Reasons for the increase in incidence of Tuberculosis (TB) in late adolescence are poorly understood. One hypothesis is that psychological and behavioural variables associated with adolescence may increase risk of developing TB. The study aimed to determine whether psychosocial and behavioural variables affect incidence of TB disease in adolescents. Methods: A case control study design was used in adolescents who were participants in a TB epidemiological study. Cases were adolescents diagnosed with TB disease. Approximately half of the controls had no TB disease but a positive TST indicative of latent TB. Half had neither TB disease nor latent TB. A self-administered questionnaire was completed by participants. The questionnaire consisted of a combination of standardised psychosocial instruments. Results: Of 292 participants, 62 were cases, 112 had latent TB and 118 neither TB disease nor latent TB. There were no significant differences in instrument scores between cases and controls. There was a trend for certain adverse life events to be more common in the TB-disease group. Conclusion: In adolescents, a trend for association between TB incidence and psychosocial and behavioural variables was not statistically significant. Given the trend, research with larger samples, and more comprehensive assessment of the relationship between stressors and TB, is warranted

A blood RNA signature for tuberculosis disease risk: a prospective cohort study.

BACKGROUND: Identification of blood biomarkers that prospectively predict progression of Mycobacterium tuberculosis infection to tuberculosis disease might lead to interventions that combat the tuberculosis epidemic. We aimed to assess whether global gene expression measured in whole blood of healthy people allowed identification of prospective signatures of risk of active tuberculosis disease. METHODS: In this prospective cohort study, we followed up healthy, South African adolescents aged 12-18 years from the adolescent cohort study (ACS) who were infected with M tuberculosis for 2 years. We collected blood samples from study participants every 6 months and monitored the adolescents for progression to tuberculosis disease. A prospective signature of risk was derived from whole blood RNA sequencing data by comparing participants who developed active tuberculosis disease (progressors) with those who remained healthy (matched controls). After adaptation to multiplex quantitative real-time PCR (qRT-PCR), the signature was used to predict tuberculosis disease in untouched adolescent samples and in samples from independent cohorts of South African and Gambian adult progressors and controls. Participants of the independent cohorts were household contacts of adults with active pulmonary tuberculosis disease. FINDINGS: Between July 6, 2005, and April 23, 2007, we enrolled 6363 participants from the ACS study and 4466 from independent South African and Gambian cohorts. 46 progressors and 107 matched controls were identified in the ACS cohort. A 16 gene signature of risk was identified. The signature predicted tuberculosis progression with a sensitivity of 66·1% (95% CI 63·2-68·9) and a specificity of 80·6% (79·2-82·0) in the 12 months preceding tuberculosis diagnosis. The risk signature was validated in an untouched group of adolescents (p=0·018 for RNA sequencing and p=0·0095 for qRT-PCR) and in the independent South African and Gambian cohorts (p values <0·0001 by qRT-PCR) with a sensitivity of 53·7% (42·6-64·3) and a specificity of 82·8% (76·7-86) in the 12 months preceding tuberculosis. INTERPRETATION: The whole blood tuberculosis risk signature prospectively identified people at risk of developing active tuberculosis, opening the possibility for targeted intervention to prevent the disease. FUNDING: Bill & Melinda Gates Foundation, the National Institutes of Health, Aeras, the European Union, and the South African Medical Research Council

RISK6, a 6-gene transcriptomic signature of TB disease risk, diagnosis and treatment response

Improved tuberculosis diagnostics and tools for monitoring treatment response are urgently needed. We developed a robust and simple, PCR-based host-blood transcriptomic signature, RISK6, for multiple applications: identifying individuals at risk of incident disease, as a screening test for subclinical or clinical tuberculosis, and for monitoring tuberculosis treatment. RISK6 utility was validated by blind prediction using quantitative real-time (qRT) PCR in seven independent cohorts. Prognostic performance significantly exceeded that of previous signatures discovered in the same cohort. Performance for diagnosing subclinical and clinical disease in HIV-uninfected and HIV-infected persons, assessed by area under the receiver-operating characteristic curve, exceeded 85%. As a screening test for tuberculosis, the sensitivity at 90% specificity met or approached the benchmarks set out in World Health Organization target product profiles for non-sputum-based tests. RISK6 scores correlated with lung immunopathology activity, measured by positron emission tomography, and tracked treatment response, demonstrating utility as treatment response biomarker, while predicting treatment failure prior to treatment initiation. Performance of the test in capillary blood samples collected by finger-prick was noninferior to venous blood collected in PAXgene tubes. These results support incorporation of RISK6 into rapid, capillary blood-based point-of-care PCR devices for prospective assessment in field studies

Factors associated with prevalence of mental disorder in people living with HIV/AIDS in South Africa

The study examines the association between the presence of mental disorder and a range of independent variables. A sample of 900 HIV-positive individuals was administered the Composite International Diagnostic Interview to determine the presence of selected mental disorders. A structured interview assessed support received and factors that may contribute to mental disorder. Overall prevalence of mental disorder was 43.7% - though higher in Stage 3 (49.7%) and in Stage 4 (68%) of the disease. Eighteen percent of respondents were receiving antiretroviral treatment. Having had pre- and post-test counselling was not related to mental disorder; nor were the number of sessions, the professional status of the counsellor and perceived helpfulness of counselling. Being in an HIV support group was related to presence of a mental disorder, although the frequency of attendance was not. Although most of those who disclosed their HIV status found the experience helpful there was a significant positive association between presence of a mental disorder and having disclosed HIV-positive status. Although being a member of an association for people with HIV/AIDS and being religious was perceived as helpful, neither was statistically associated with the presence of mental disorder. Discrimination by community and family and isolation were related to mental disorder. Death of a significant other due to AIDS was related to mental disorder. The findings suggest a strong need for provision of psychiatric care as part of AIDS care as well as strengthening of support services.

Factors associated with prevalence of mental disorder in people living with HIV/AIDS in South Africa

The study examines the association between the presence of mental disorder and a range of independent variables. A sample of 900 HIV-positive individuals was administered the Composite International Diagnostic Interview to determine the presence of selected mental disorders. A structured interview assessed support received and factors that may contribute to mental disorder. Overall prevalence of mental disorder was 43.7% - though higher in Stage 3 (49.7%) and in Stage 4 (68%) of the disease. Eighteen percent of respondents were receiving antiretroviral treatment. Having had pre- and post-test counselling was not related to mental disorder; nor were the number of sessions, the professional status of the counsellor and perceived helpfulness of counselling. Being in an HIV support group was related to presence of a mental disorder, although the frequency of attendance was not. Although most of those who disclosed their HIV status found the experience helpful there was a significant positive association between presence of a mental disorder and having disclosed HIV-positive status. Although being a member of an association for people with HIV/AIDS and being religious was perceived as helpful, neither was statistically associated with the presence of mental disorder. Discrimination by community and family and isolation were related to mental disorder. Death of a significant other due to AIDS was related to mental disorder. The findings suggest a strong need for provision of psychiatric care as part of AIDS care as well as strengthening of support services. © 2007 Taylor & Francis.Articl

The development and evaluation of content validity of the Zambia Spina Bifida Functional Measure: Preliminary studies

Background: Very little is known on outcome measures for children with spina bifida (SB) in Zambia. If rehabilitation professionals managing children with SB in Zambia and other parts of sub-Saharan Africa are to instigate measuring outcomes routinely, a tool has to be made available. The main objective of this study was to develop an appropriate and culturally sensitive instrument for evaluating the impact of the interventions on children with SB in Zambia. Methods: A mixed design method was used for the study. Domains were identified retrospectively and confirmation was done through a systematic review study. Items were generated through semi-structured interviews and focus group discussions. Qualitative data were downloaded, translated into English, transcribed verbatim and presented. These were then placed into categories of the main domains of care deductively through the process of manifest content analysis. Descriptive statistics, alpha coefficient and index of content validity were calculated using SPSS. Results: Self-care, mobility and social function were identified as main domains, while participation and communication were sub-domains. A total of 100 statements were generated and 78 items were selected deductively. An alpha coefficient of 0.98 was computed and experts judged the items. Conclusions: The new functional measure with an acceptable level of content validity titled Zambia Spina Bifida Functional Measure (ZSBFM) was developed. It was designed to evaluate effectiveness of interventions given to children with SB from the age of 6 months to 5 years. Psychometric properties of reliability and construct validity were tested and are reported in another study

Paediatric HIV/AIDS disclosure : towards a developmental and process-oriented approach

CITATION: Lesch, A., et al. 2007. Paediatric HIV/AIDS disclosure : towards a developmental and process-oriented approach. AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, 19(6): 811-816, doi: 10.1080/09540120601129301.The original publication is available at http://www.tandfonline.comPlease help us populate SUNScholar with the post print version of this article. It can be e-mailed to: [email protected] antiretroviral therapy becomes more widely available in low-resource settings and children with HIV/AIDS live for longer periods, disclosure of HIV diagnosis to infected children is becoming increasingly important. This article reviews the current literature on HIV-related disclosure in light of theories of cognitive development, and argues for the adoption of a process-oriented approach to discussing HIV with infected children. Disclosure presents unique challenges to healthcare workers and caregivers of children with HIV/AIDS that include controlling the flow of information about the child's HIV status to him/her and deciding on what is in his/her best interest. Health care workers' and caregivers' views regarding disclosure to children may often be contradictory, with healthcare workers likely to support disclosing the diagnosis of HIV/AIDS to children and caregivers more reluctant to discuss the disease with them. There is a clear need for practical interventions to support paediatric HIV disclosure which provide children with age-appropriate information about the disease. © 2007 Taylor & Francis.http://www.tandfonline.com/doi/full/10.1080/0954012060112930