Peer education in the context of school-based HIV prevention programming in Kenya: An examination of process and outcome.

The main objective of this study was to examine the extent to which peer education could contribute to the effectiveness of a comprehensive, teacher-delivered primary school HIV prevention programme in Kenya. The study used a quasi-experimental design with sequential cross-sections of standard 6 and 7 students, sampled pre and nine months post implementation of the programme. Peer supporters from each experimental school were recruited and trained. Assessment then involved a pre-post test completion using both questionnaires and individual and group interviews to examine the effects of the PSABH programme on peer supporters and students. Outcomes of interest included HIV related knowledge, attitudes and behaviors. Overall, 2769 experimental and 1261 control students were sampled pre and nine-months post implementation of the programme. Peer supporters were assessed pre and post-training as well as six-months later. There was lack of evidence at nine months to credit any changes in students on the targeted outcomes to the intervention itself. Peer supporter training and working as a peer supporter however, was found to have a significant impact on peer supporters. This was evidenced by positive shifts in knowledge, attitudes, pursuit of information and communication as well as an increase in personal confidence and comfort in discussing HIV/AIDS related issues, activity within schools, reported interaction with students and other members of the community and favorable student response to and ratings of peer supporter work. Overall, the study suggested the influence of peer education on peers but not students. The findings are discussed in relation to methodological, theoretical and contextual factors. Suggestions are made concerning the importance of future research on the theoretical underpinnings of peer based HIV prevention programming, the integration of peer education within schools, and the selection, training, and integration of peer educators. Factors to be considered when designing HIV based interventions in AIDS endemic African countries are also discussed and some recommendations are outlined for carrying out future programming of this kind.Dept. of Psychology. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis2005 .G355. Source: Dissertation Abstracts International, Volume: 66-11, Section: A, page: 3943. Thesis (Ph.D.)--University of Windsor (Canada), 2005

Developmental sensitivity and immunotoxicity of benzo[a]pyrene in the amphibian Xenopus laevis

The immune system is increasingly recognized as a vulnerable and sensitive target of contaminant exposure. Disruption of this critical system can lead to significant morbidity and/or mortality of organisms in contaminated environments. Amphibians can be simultaneously exposed to both pathogens and contaminants within aquatic habitats, making contaminant-induced immunotoxicity particularly relevant for this taxonomic group. Polycyclic aromatic hydrocarbons (PAHs) are a major group of environmental contaminants that widely occur as mixtures in aquatic environments, including amphibian habitats. Benzo[a]pyrene (B[a]P) is recognized as the most potent toxicant of PAH mixtures and is the most extensively studied PAH with demonstrated adverse effects on the immune system of many vertebrate species. Understanding how aquatic contaminants, such as B[a]P, can impact the immune system of amphibians is imperative since contaminant-induced immunotoxicity is hypothesized to exacerbate disease-driven amphibian population decline. Thus, the overall goal of this thesis was to gain a better understanding of developmental and contaminant-induced changes in the immune system of amphibians, and ultimately how exposure to B[a]P modulates the response to immune stimulation. Specific research questions were addressed through four studies conducted within the broader goal of this thesis. The objective of the first study was to characterize the expression profiles of various pro-inflammatory cytokines in the model amphibian species, Xenopus laevis, throughout larval developmental stages and determine the impacts of thyroidal modulation on their expression. Results suggest that expression of two cytokines, tumor necrosis factor- (TNF) and interleukin-1β (IL-1β) varied over development, increasing with developmental stage, while interferon- (IFN-) remained relatively unchanged. Exogenous manipulation of thyroidal status was successful, as demonstrated by an altered rate of development and thyroid gland histology; however, thyroidal modulation had negligible effects on basal cytokine expression. The dynamic nature of the tadpole immune system suggested that the immunotoxic impacts of environmental contaminants may depend on the stage of development at the time of exposure. Therefore, the second study aimed to identify the sensitive developmental phases for sub-lethal effects of B[a]P exposure in terms of the development (stage, weight and length) and changes in the expression of immune- and detoxification-related genes. Exposure to B[a]P at all life-stages tested (embryo-larval, pre-metamorphic, and pro-metamorphic tadpoles) resulted in CYP1A7 mRNA induction (43, 53, and 47-fold, respectively) as well as stage-specific modulation of pro-inflammatory cytokine expression. Exposure of pre-metamorphic tadpoles to B[a]P demonstrated the greatest effect on weight, length and stage of development. Taken together, these initial studies indicate that the unique development of the tadpole immune system influences their susceptibility to contaminant-induced immune modulation despite having biotransformation capacity across tadpole life-stages. In the subsequent two studies, the ability of B[a]P to alter immune variables and impair a coordinated immune response was evaluated using an immune challenge model both in vivo and in vitro. Juvenile X. laevis were exposed to B[a]P for seven days and then immune stimulated with an injection of lipopolysaccharide (LPS). The highest concentration of B[a]P (350 g/L) impaired the inflammatory response to LPS as indicated by an inability to induce granulocyte:lymphocyte (G:L) ratio or IL-1β mRNA expression, demonstrating that B[a]P can impair the inflammatory immune response to a simulated pathogen. Next, to assess the mechanisms underlying B[a]P-induced effects in amphibians, X. laevis kidney A6 epithelial cell line were used to evaluate the cellular response to B[a]P exposure and identify if B[a]P could directly alter the ability of these cells to respond to an immune stimulation. A time-course of B[a]P exposure showed the progression from up-regulation of biotransformation-related genes, to reactive oxygen species production, and ultimately to cytotoxic effects; pre-exposure to B[a]P did not appear to impair the ability of the A6 cells to mount an inflammatory response to LPS. Taken together, the immune challenge models showed that B[a]P exposure can alter immune variables and impact the ability of juvenile X. laevis to appropriately respond to immune stimulation and that B[a]P-induced biostransformation pathways and production of reactive oxygen species may play a role in this response. Overall, the research presented in this thesis contributes to our understanding of developmental and contaminant-induced changes in the immune system of amphibians. This research provides a strong foundation for further study into the mechanisms underlying chemical-induced immunotoxicity in amphibians. The tools and approaches developed as part of this research could be used in screening chemicals for immunotoxic potential in amphibians and be expanded to evaluate immune responses of ecologically relevant species that are under real risk of compromised immune function and increased disease in contaminated environments

The effects of an emotional disclosure writing task on the physical and psychological functioning of children of alcoholics.

The present study investigated the effects of an emotional disclosure writing task on the physical and psychological functioning of preteen and adolescent children of alcoholics (N = 53). It was hypothesized that writing about stressful events would have significant physical and psychological health benefits. Physical and psychological health were assessed with measures of strength and difficulties, internalizing symptoms, affect, and physical symptoms. These measures were administered at baseline and again at follow-up. Participants were randomly assigned to one of three conditions: an emotional writing group (N1 = 18) who wrote about their thoughts and feelings with respect to stressful events, a non-emotional writing group (N2 = 19) who wrote descriptions of non-emotional events, or a non-writing control group (N3 = 16). Participants in the writing groups wrote for a period of 25 minutes on each of three consecutive days. There was evidence that the intervention was effectively executed as the essays written by participants in both the emotional and non-emotional conditions differed significantly in content in the hypothesized ways. Contradictory to the major hypothesis, emotional disclosure failed to convey any additional health benefits. A general improvement was found for all groups over time on internalizing symptoms, affect, and physical symptoms. Analysis of gender and age differences uncovered some noteworthy findings. The current study indicated that it is beneficial to have young people participate in studies in which they are given an opportunity to think about how they act and feel.Dept. of Psychology. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis2001 .G35. Source: Masters Abstracts International, Volume: 40-06, page: 1618. Adviser: Kathryn Lafreniere. Thesis (M.A.)--University of Windsor (Canada), 2001

Bone Mineral Density in HIV-Negative Men Participating in a Tenofovir Pre-Exposure Prophylaxis Randomized Clinical Trial in San Francisco

Pre-exposure prophylaxis (PrEP) trials are evaluating regimens containing tenofovir-disoproxil fumarate (TDF) for HIV prevention. We determined the baseline prevalence of low bone mineral density (BMD) and the effect of TDF on BMD in men who have sex with men (MSM) in a PrEP trial in San Francisco.We evaluated 1) the prevalence of low BMD using Dual Energy X-ray Absorptiometry (DEXA) in a baseline cohort of 210 HIV-uninfected MSM who screened for a randomized clinical trial of daily TDF vs. placebo, and 2) the effects of TDF on BMD in a longitudinal cohort of 184 enrolled men. Half began study drug after a 9-month delay to evaluate changes in risk behavior associated with pill-use. At baseline, 20 participants (10%) had low BMD (Z score≤-2.0 at the L2-L4 spine, total hip, or femoral neck). Low BMD was associated with amphetamine (OR = 5.86, 95% CI 1.70-20.20) and inhalant (OR = 4.57, 95% CI 1.32-15.81) use; men taking multivitamins, calcium, or vitamin D were less likely to have low BMD at baseline (OR = 0.26, 95% CI 0.10-0.71). In the longitudinal analysis, there was a 1.1% net decrease in mean BMD in the TDF vs. the pre-treatment/placebo group at the femoral neck (95% CI 0.4-1.9%), 0.8% net decline at the total hip (95% CI 0.3-1.3%), and 0.7% at the L2-L4 spine (95% CI -0.1-1.5%). At 24 months, 13% vs. 6% of participants experienced >5% BMD loss at the femoral neck in the TDF vs. placebo groups (p = 0.13).Ten percent of HIV-negative MSM had low BMD at baseline. TDF use resulted in a small but statistically significant decline in BMD at the total hip and femoral neck. Larger studies with longer follow-up are needed to determine the trajectory of BMD changes and any association with clinical fractures.ClinicalTrials.gov: NCT00131677

Using Bio-Spiritual Music Focused Energetics for Social Workers to Enhance Personal Identity and Professional Transformation: The Power of Self-Reflective Empathy

Working conditions, client demands, heavy workloads, and numerous other factors cause high levels of stress among social workers and undermine their potential for self-fulfilment and productivity. Bio-Spiritual – Music-Focus - Energetics (BSMFE) is a focusing technique used in this study for social workers and addiction counsellors as a part of staff training and development and re-certification. This article speaks to the need for creative and uniquely supportive approaches for helping professionals. It presents an account of addictions counsellor training and education (N=7) in Windsor, Ontario, Canada. During a day long workshop, social workers and counsellors participated to heighten their awareness of their own inner-directed processes. Implications are directed toward social workers, addiction counsellors, music therapists, helping professionals, clergy, and pastoral counsellors, in their own spiritual quest toward personal fulfilment and professional growth and transformation

Physiological responses to a short-term, environmentally realistic, acute heat stress in Atlantic salmon, Salmo salar

Atlantic salmon populations are declining, and warming river temperatures in the summer months are thought to be a significant contributing factor. We describe the time course of cellular and metabolic responses to an ecologically relevant short-term thermal cycle in juvenile Atlantic salmon. We then examined whether this heat event would affect tolerance to a subsequent heat shock in terms of critical thermal maximum (CTmax). Fish induced heat shock protein 70 in red blood cells, heart, liver, and red and white muscle; whole blood glucose and lactate transiently increased during the heat cycle. In contrast, we observed no significant effect of a prior heat shock on CTmax. The CTmax was positively correlated with Fulton’s condition factor suggesting that fish with greater energy reserves are more thermally tolerant. Atlantic salmon activate cellular protection pathways in response to a single thermal cycle and appear to cope with this short-term, ∼1 d heat shock, but this challenge may compromise the ability to cope with subsequent heat events

ADAMTS13 Deficiency Worsens Colitis and Exogenous ADAMTS13 Administration Decreases Colitis Severity in Mice.

Background: Inflammatory bowel disease (IBD) affects 1.6 million people in the United States. IBD is associated with an increased risk of thrombosis, which rises with disease activity. The pathogenesis of IBD and its increased thrombotic risk is not completely understood. Ultra large von Willebrand factor (ULVWF) multimers are secreted from activated endothelium, leading to recruitment of platelets and leukocytes. A disintegrin and metalloproteinase with thrombospondin type I repeats motif 13 (ADAMTS13) cleaves highly adhesive ULVWF into smaller, less bioactive, multimers, releasing them into circulation. Mice deficient in ADAMTS13 (ADAMTS13-/-) have heightened inflammatory and thrombotic responses. Objectives: We hypothesized that upon colitis induction, ADAMTS13-/- mice would have more severe symptoms compared with wild-type (WT) mice, and rhADAMTS13 administration to mice with colitis would improve their condition. Results: Dextran sodium sulfate-induced colitis was worse in ADAMTS13-/- mice than WT. ADAMTS13-/- showed increased weight loss, worse anemia, and increased clinical and histologic colitis severity, compared with WT mice. ADAMTS13-/- mice had increased VWF release, with accumulation at inflamed colonic sites. Also, the majority of mice showed one or more submucosal colonic thrombi. ADAMTS13 deficiency worsened colitis and propagated intestinal inflammation, most likely through increased platelet-leukocyte recruitment by VWF. Treatment of WT mice with rhA-DAMTS13 decreased colitis severity without worsening anemia. Additionally, several immune-mediated chronic murine colitis models, and inflamed colon tissue specimens from IBD patients, showed increased VWF release at inflamed sites, suggesting a generalizability of our findings. Conclusion: Measuring VWF/ADAMTS13 levels could have clinical utility. When applicable, the administration of ADAMTS13, in addition to primary treatment, may improve outcomes for IBD patients.status: publishe

Neutrophil histone modification by peptidylarginine deiminase 4 is critical for deep vein thrombosis in mice

Deep vein thrombosis and pulmonary embolism are major health problems associated with high mortality. Recently, DNA-based neutrophil extracellular traps (NETs) resulting from the release of decondensed chromatin, were found to be part of the thrombus scaffold and to promote coagulation. However, the significance of nuclear decondensation and NET generation in thrombosis is largely unknown. To address this, we adopted a stenosis model of deep vein thrombosis and analyzed venous thrombi in peptidylarginine deiminase 4 (PAD4)-deficient mice that cannot citrullinate histones, a process required for chromatin decondensation and NET formation. Intriguingly, less than 10% of PAD4(-/-) mice produced a thrombus 48 h after inferior vena cava stenosis whereas 90% of wild-type mice did. Neutrophils were abundantly present in thrombi formed in both groups, whereas extracellular citrullinated histones were seen only in thrombi from wild-type mice. Bone marrow chimera experiments indicated that PAD4 in hematopoietic cells was the source of the prothrombotic effect in deep vein thrombosis. Thrombosis could be rescued by infusion of wild-type neutrophils, suggesting that neutrophil PAD4 was important and sufficient. Endothelial activation and platelet aggregation were normal in PAD4(-/-) mice, as was hemostatic potential determined by bleeding time and platelet plug formation after venous injury. Our results show that PAD4-mediated chromatin decondensation in the neutrophil is crucial for pathological venous thrombosis and present neutrophil activation and PAD4 as potential drug targets for deep vein thrombosis.status: publishe