Women experience a better long-term immune recovery and a better survival on HAART in Lao People's Democratic Republic.

<p>Abstract</p> <p>Background</p> <p>In April 2003, Médecins Sans Frontières launched an HIV/AIDS programme to provide free HAART to HIV-infected patients in Laos. Although HIV prevalence is estimated as low in this country, it has been increasing in the last years. This work reports the first results of an observational cohort study and it aims to identify the principal determinants of the CD4 cells evolution and to assess mortality among patients on HAART.</p> <p>Methods</p> <p>We performed a retrospective database analysis on patients initiated on HAART between 2003 and 2009 (CD4<200cells/μL or WHO stage 4). We excluded from the analysis patients who were less than 16 years old and pregnant women. To explore the determinants of the CD4 reconstitution, a linear mixed model was adjusted. To identify typical trajectories of the CD4 cells, a latent trajectory analysis was carried out. Finally, a Cox proportional-hazards model was used to reveal predictors of mortality on HAART including appointment delay greater than 1 day.</p> <p>Results</p> <p>A total of 1365 patients entered the programme and 913 (66.9%) received an HAART with a median CD4 of 49 cells/μL [IQR 15–148]. High baseline CD4 cell count and female gender were associated with a higher CD4 level over time. In addition, this gender difference increased over time. Two typical latent CD4 trajectories were revealed showing that 31% of women against 22% of men followed a high CD4 trajectory. In the long-term, women were more likely to attend appointments without delay. Mortality reached 6.2% (95% CI 4.8-8.0%) at 4 months and 9.1% (95% CI 7.3-11.3%) at 1 year. Female gender (HR=0.17, 95% CI 0.07-0.44) and high CD4 trajectory (HR=0.19, 95% CI 0.08-0.47) were independently associated with a lower death rate.</p> <p>Conclusions</p> <p>Patients who initiated HAART were severely immunocompromised yielding to a high early mortality. In the long-term on HAART, women achieved a better CD4 cells reconstitution than men and were less likely to die. This study highlights important differences between men and women regarding response to HAART and medical care, and questions men’s compliance to treatment.</p

Genome-wide Association Study Combining UK Biobank and GASP Consortium Highlights Novel Loci Associated with Moderate-Severe Asthma

The genetic architecture of asthma to date has been described by the discovery of around 20 loci from genome-wide association studies (GWAS), primarily with cases covering mild-to-moderate asthma. We hypothesised that moderate-to-severe asthma, which is currently difficult to treat, may have a specific genetic architecture, however there have not been large GWAS of moderate-to-severe asthma.Accordingly, we selected 5,135 European ancestry moderate-severe asthma cases (British Thoracic Society criteria 3 or above) and 25,675 controls free from lung disease, allergic rhinitis and atopic dermatitis, from UK Biobank and the Genetics of Asthma Severity & Phenotypes (GASP) cohort (cases only). We tested 33,771,858 SNPs and indels genome-wide (imputation against combined UK10K and 1000 genomes phase 3 panels) for association with moderate-severe asthma.We identified 23 independent signals associated with moderate-to-severe asthma (P -8), including novels signals in or near GATA3, RIC1, ZNF652, RPAP3 and MUC5AC, highlighting regions that harbour variants that effect gene expression or genes that play a role in respiratory disease and immune response. Previously described asthma loci where replicated including signals in or near D2HGDH, CD247, HLA-DQB1, HLA-DQA1, TSLP/WDR36, IL1RL1/IL18R1, CLEC16A, GATA3, IL33, SMAD3, SLC22A5/IL13, C11orf30, ZBTB10, IKZF3-ORMDL3 and IKZF4.This largest GWAS of moderate-severe asthma to date and highlights novel loci that may provide new biological insights relevant to treatment of severe asthma.</p

'Siting' voice in stories of conflict: Bounding conflict in place and time through social memory and acts of remembering

This chapter takes the idea of ‘voice’ as it communicates stories of conflict and trauma, and reimages place as the ‘site’ from which voice emanates: a complex entanglement of social, political, material, human and non-human forces that differs across the voice of history, the collective voice of a community and voice as emerging from the site of an individual life. Focusing specifically on conflict stories obtained from fieldwork in Aceh, Indonesia, the chapter argues that history and collective remembering may function as Mazzei’s (2016) ‘voice without subject.’ However, in listening to individuals’ stories, ethnographers and oral historians participate in the formation of a voice that is localized at the site of the individual’s life and constructs a new ethical-political relation between storyteller and listener

Religião e espiritualidade no ensino e assistência de enfermagem Religión y espiritualidad en la educación y asistencia de enfermería Religion and spirituality in education and nursing assistance

Estudo da interseção entre o discurso da enfermagem e os preceitos que albergam a religião/religiosidade e espiritualidade, e como se deu a incorporação e o reflexo desse discurso nas práticas assistenciais, no ensino e no delineamento da organização da profissão. Para revisão bibliográfica, utilizaram-se as bases de dados LILACS e BDENF, da Biblioteca Virtual de Saúde. Um total de 57 artigos completos, publicados entre 1957 e 2007, foram analisados à luz das idéias sobre " memória coletiva" , de Maurice Halbwachs. Verificou-se que há uma raiz religiosa com ramificações profundas na conformação da enfermagem brasileira. Esta configuração está tão imbricada na memória coletiva que, mesmo com a expansão de instituições que não se declaram religiosas, os pressupostos cristãos se mantêm presentes e com vitalidade.<br>Estudio de la intersección entre el discurso del oficio de enfermera y preceptos que alojan la religión/el religiosidad y el espiritualidad, y como ha dado la incorporación y a la consecuencia de este discurso en los asistencias prácticos, la educación y la delineación de la organización de la profesión. Para la revisión bibliográfica, las bases de datos LILACS y BDENF de la Biblioteca Virtual de Salud, fueron utilizadas. Un total de 57 artículos completos, publicados entre 1957 y 2007, fueron analizados a la luz de las ideas en " memoria colectiva" , de Maurice Halbwachs. Se verificó que hay una raíz religiosa con ramificaciones profundas en la conformación del oficio de enfermera brasileño. Esta configuración es tan imbricada en la memoria colectiva que, mismo con la expansión de las instituciones que non se declaran religiosas, el presupuestos cristanos se mantiene presentes y con vitalidad.<br>Intersectional study between nursing discourse and precepts which embrace religion/religiousness and spirituality, and how these were incorporated and their reflection upon nursing practice, education and the history of the organization of the profession. For bibliographic review LILACS and BDENF databases of the Electronic Health Library were used. A total of 57 full-text articles, published from 1957 to 2007, were analyzed upon the light of the ideas of Maurice Halbwachs, about " collective memory" . The results show that Brazilian nursing has a religious root with profound ramifications on its development. This configuration is so embedded in the collective memory that, even with the expansion of non-religious institutions, the Christian precepts remain present and strong