Social and Economic Stress Related to the HIV/AIDS Epidemic in Botswana

The paper describes the consequences of HIV/AIDS in Botswana; the country with the highest HIV prevalence rate in Africa. In addition to frequently experienced trauma due to sickness and death, many households experience rising health expenditures and a sharp deterioration of incomes. High levels of morbidity and mortality among workers result in depressed returns on investment, reduced productivity and increased expenditure on training and replacement of workers. As the health care system finds it increasingly difficult to cope, home-based care provides an inadequate solution since the home infrastructure of many households is inadequate for proper care of seriously ill patients. The stigma associated with AIDS often isolates fragile households and provides an environment in which abuse of infected individuals and of orphans whose parents have died of AIDS is not uncommon. The quality of education also suffers, resulting in an ill prepared skilled manpower, with adverse consequences for social, economic, and political development as well as for good future governance of the country

A comparative analysis of perceived stigma among HIV-positive Ghanaian and African American males

The purpose of this paper was to address two questions: (i) Do Ghanaian and African American males with HIV/AIDS experience different types and degrees of stigma? and (ii) Is the impact of stigma associated with HIV/AIDS on the self different for Ghanaian and African American males? A quantitative method was used, and the four dimensions of stigma (social rejection, financial insecurity, internalised shame, and social interaction) were identified and measured using combination Likert-type questionnaires. Data regarding positive feelings of selfworth and self-deprecation, stress related to body image, and personal control were also collected in Ghana and the southeastern USA.The sample consisted of 55 men from Ghana and 55 men from the southeastern USA. Results indicate that values for the scales measuring stigma and self-perception were significantly higher for the Ghanaian sample than for the African American sample.Thus we conclude that the Ghanaian sample living with HIV/AIDS experienced a greater amount of negative self-perception and stigma-related strife than the African American sample.Keywords: stigma, HIV/AIDS, social rejection, financial insecurity, internalised shame, cultureRésuméLe but de cette communication est d'aborder deux questions, à savoir: (i) Est-ce que les hommes Ghanéens et Afro-Américains vivant avec le VIH/SIDA éprouvent de types et de degrés différents de stigmatisation? et (ii) Estce que l'impact de stigmatisation liée au VIH/SIDA sur le moi est différent chez les Ghanéens en comparaison aux Afro-Américains? Une méthode quantitative a été employée et les quatre dimensions de stigmatisation (le rejet social, l'insécurité financière, la honte intériorisée et l'interaction sociale) ont été identifiés et mesurés grâce à une combinaison des questionnaires Likert-type. Des données concernant des sentiments positifs de la valeur personnelle et d'auto-dénigrement, le stresse lié à l'image corporel et le contrôle de soi-même ont été recueilles au Ghana et au sud-est des États Unis. L'échantillon consistait de 55 hommes du Ghana et 55 hommes du sud-est des États Unis. Les chiffres des barèmes utilisées pour mesurer la stigmatisation et la perception de soi-même étaient sensiblement élevés pour l'échantillon ghanéen par rapport à l'échantillon afro-américain. L'échantillon ghanéen vivant avec le VIH/SIDA a davantage de perception négative de soi-même ainsi que la lutte liée à la stigmatisation par rapport à l'échantillon afro-américain.Mots clés: stigmatisation,VIH, SIDA, rejet social, insécurité financière, honte intériorisée, culture SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance) Vol. 2(3) 2005: 344-35

Attitudes towards the use and acceptance of eHealth technologies : a case study of older adults living with chronic pain and implications for rural healthcare

Acknowledgements The research described here is supported by the award made by the RCUK Digital Economy programme to the dot.rural Digital Economy Hub; award reference: EP/G066051/1. MC’s time writing the paper is funded by the Scottish Government’s Rural and Environmental Science and Analytical Services Division (RESAS) under Theme 8 ‘Vibrant Rural Communities’ of the Food, Land and People Programme (2011–2016). MC is also an Honorary Research Fellow at the Division of Applied Health Sciences, University of Aberdeen. The input of other members of the TOPS research team, Alastair Mort, Fiona Williams, Sophie Corbett, Phil Wilson and Paul MacNamee who contributed to be wider study and discussed preliminary findings reported here with the authors of the paper is acknowledged. We acknowledge the feedback on earlier versions of this paper provided by members of the Trans-Atlantic Rural Research Network, especially Stefanie Doebler and Carmen Hubbard. We also thank Deb Roberts for her comments.Peer reviewedPublisher PD

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

A comparative analysis of perceived stigma among HIV-positive Ghanaian and African American males

The purpose of this paper was to address two questions: (i) Do Ghanaian and African American males with HIV/AIDS experience different types and degrees of stigma? and (ii) Is the impact of stigma associated with HIV/AIDS on the self different for Ghanaian and African American males? A quantitative method was used, and the four dimensions of stigma (social rejection, financial insecurity, internalised shame, and social interaction) were identified and measured using combination Likert-type questionnaires. Data regarding positive feelings of selfworth and self-deprecation, stress related to body image, and personal control were also collected in Ghana and the southeastern USA.The sample consisted of 55 men from Ghana and 55 men from the southeastern USA. Results indicate that values for the scales measuring stigma and self-perception were significantly higher for the Ghanaian sample than for the African American sample.Thus we conclude that the Ghanaian sample living with HIV/AIDS experienced a greater amount of negative self-perception and stigma-related strife than the African American sample.Keywords: stigma, HIV/AIDS, social rejection, financial insecurity, internalised shame, cultureRésuméLe but de cette communication est d'aborder deux questions, à savoir: (i) Est-ce que les hommes Ghanéens et Afro-Américains vivant avec le VIH/SIDA éprouvent de types et de degrés différents de stigmatisation? et (ii) Estce que l'impact de stigmatisation liée au VIH/SIDA sur le moi est différent chez les Ghanéens en comparaison aux Afro-Américains? Une méthode quantitative a été employée et les quatre dimensions de stigmatisation (le rejet social, l'insécurité financière, la honte intériorisée et l'interaction sociale) ont été identifiés et mesurés grâce à une combinaison des questionnaires Likert-type. Des données concernant des sentiments positifs de la valeur personnelle et d'auto-dénigrement, le stresse lié à l'image corporel et le contrôle de soi-même ont été recueilles au Ghana et au sud-est des États Unis. L'échantillon consistait de 55 hommes du Ghana et 55 hommes du sud-est des États Unis. Les chiffres des barèmes utilisées pour mesurer la stigmatisation et la perception de soi-même étaient sensiblement élevés pour l'échantillon ghanéen par rapport à l'échantillon afro-américain. L'échantillon ghanéen vivant avec le VIH/SIDA a davantage de perception négative de soi-même ainsi que la lutte liée à la stigmatisation par rapport à l'échantillon afro-américain.Mots clés: stigmatisation,VIH, SIDA, rejet social, insécurité financière, honte intériorisée, culture SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance) Vol. 2(3) 2005: 344-35

Life in extreme environments: Single molecule force spectroscopy as a tool to explore proteins from extremophilic organisms

Extremophiles are organisms which survive and thrive in extreme environments. The proteins from extremophilic single-celled organisms have received considerable attention as they are structurally stable and functionally active under extreme physical and chemical conditions. In this short article, we provide an introduction to extremophiles, the structural adaptations of proteins from extremophilic organisms and the exploitation of these proteins in industrial applications. We provide a review of recent developments which have utilized single molecule force spectroscopy to mechanically manipulate proteins from extremophilic organisms and the information which has been gained about their stability, flexibility and underlying energy landscapes

Effect of Antiplatelet Therapy on Survival and Organ Support–Free Days in Critically Ill Patients With COVID-19

International audienc