The Perceived Impact of Disclosure of Pediatric HIV Status on Pediatric Antiretroviral Therapy Adherence, Child Well-Being, and Social Relationships in a Resource-Limited Setting

This is a copy of an article published in AIDS Patient Care and STDs © 2010 [copyright Mary Ann Liebert, Inc.]; [AIDS Patient Care and STDs] is available online at: http://online.liebertpub.com.In resource-limited settings, beliefs about disclosing a child’s HIV status and the subsequent impacts of disclosure have not been well studied. We sought to describe how parents and guardians of HIV-infected children view the impact of disclosing a child’s HIV status, particularly for children’s antiretroviral therapy (ART) adherence. A qualitative study was conducted using involving focus groups and interviews with parents and guardians of HIV-infected children receiving ART in western Kenya. Interviews covered multiple aspects of the experience of having children take medicines. Transcribed interview dialogues were coded for analysis. Data were collected from 120 parents and guardians caring for children 0–14 years (mean 6.8 years, standard deviation [SD] 6.4); 118 of 120 had not told the children they had HIV. Children’s caregivers (parents and guardians) described their views on disclosure to children and to others, including how this information-sharing impacted pediatric ART adherence, children’s well-being, and their social relationships. Caregivers believed that disclosure might have benefits such as improved ART adherence, especially for older children, and better engagement of a helping social network. They also feared, however, that disclosure might have both negative psychological effects for children and negative social effects for their families, including discrimination. In western Kenya, caregivers’ views on the risks and benefits to disclosing children’s HIV status emerged a key theme related to a family’s experience with HIV medications, even for families who had not disclosed the child’s status. Assessing caregivers’ views of disclosure is important to understanding and monitoring pediatric ART

Fractional recurrence in discrete-time quantum walk

Quantum recurrence theorem holds for quantum systems with discrete energy eigenvalues and fails to hold in general for systems with continuous energy. We show that during quantum walk process dominated by interference of amplitude corresponding to different paths fail to satisfy the complete quantum recurrence theorem. Due to the revival of the fractional wave packet, a fractional recurrence characterized using quantum P\'olya number can be seen.Comment: 10 pages, 11 figure : Accepted to appear in Central European Journal of Physic

Impact of an Educational Intervention on Breast Cancer Knowledge in Western Kenya

Our objective was to assess the effectiveness of educational sessions that accompanied breast cancer screening events in three communities in western Kenya between October and November 2013. Five hundred and thirty-two women were recruited to complete a test of breast cancer-relevant knowledge and randomly allocated to ‘pre-test’ or ‘post-test’ groups that immediately preceded or followed participation in the educational sessions. The education was organized as a presentation by health professionals and focused mainly on causes of breast cancer, early and late cancer presentation signs, high-risk groups, screening methods to find early-stage breast cancer, self-breast exam procedures and treatment options for this disease. Participants were invited to ask questions and practice finding nodules in silicone breast models. The median age was 35 years (interquartile range: 28–45), and 86% had not undergone breast cancer screening previously. Many individual items in our test of knowledge showed statistically significant shifts to better-informed responses. When all items in the assessment questionnaire were scored as a ‘test’, on average there was a 2.80 point (95% CI: 2.38, 3.22) significant improvement in knowledge about breast cancer after the educational session. Our study provides evidence for the effectiveness of an educational strategy carefully tailored for women in these communities in Kenya

Comprehensive evaluation of caregiver-reported antiretroviral therapy adherence for HIV-infected children

For HIV-infected children, adherence to antiretroviral therapy (ART) is often assessed by caregiver report but there are few data on their validity. We conducted prospective evaluations with 191 children ages 0-14 years and their caregivers over 6 months in western Kenya to identify questionnaire items that best predicted adherence to ART. Medication Event Monitoring Systems(®) (MEMS, MWV/AARDEX Ltd., Switzerland) electronic dose monitors were used as external criterion for adherence. We employed a novel variable selection tool using the LASSO technique with logistic regression to identify items best correlated with dichotomized MEMS adherence (≥90 or <90 % doses taken). Nine of 48 adherence items were identified as the best predictors of adherence, including missed or late doses in the past 7 days, problems giving the child medicines, and caregiver-level factors like not being present at medication taking. These items could be included in adherence assessment tools for pediatric patients

Lattice Distortion and Octupole Ordering Model in CexLa1-xB6

Possible order parameters of the phase IV in CexLa1-xB6 are discussed with special attention to the lattice distortion recently observed. A \Gamma_{5u}-type octupole order with finite wave number is proposed as the origin of the distortion along the [111] direction. The \Gamma_8 crystalline electric field (CEF) level splits into three levels by a mean field with the \Gamma_{5u} symmetry. The ground and highest singlets have the same quadrupole moment, while the intermediate doublet has an opposite sign. It is shown that any collinear order of \Gamma_{5u}-type octupole moment accompanies the \Gamma_{5g}-type ferro-quadrupole order, and the coupling of the quadrupole moment with the lattice induces the distortion. The cusp in the magnetization at the phase transition is reproduced, but the internal magnetic field due to the octupole moment is smaller than the observed one by an order of magnitude.Comment: 5 pages, 4 figures, submitted to J. Phys. Soc. Jp

Thermal Rounding of the Charge Density Wave Depinning Transition

The rounding of the charge density wave depinning transition by thermal noise is examined. Hops by localized modes over small barriers trigger ``avalanches'', resulting in a creep velocity much larger than that expected from comparing thermal energies with typical barriers. For a field equal to the $T=0$ depinning field, the creep velocity is predicted to have a {\em power-law} dependence on the temperature $T$; numerical computations confirm this result. The predicted order of magnitude of the thermal rounding of the depinning transition is consistent with rounding seen in experiment.Comment: 12 pages + 3 Postscript figure

Valence bond solids for SU(n) spin chains: exact models, spinon confinement, and the Haldane gap

To begin with, we introduce several exact models for SU(3) spin chains: (1) a translationally invariant parent Hamiltonian involving four-site interactions for the trimer chain, with a three-fold degenerate ground state. We provide numerical evidence that the elementary excitations of this model transform under representation 3bar of SU(3) if the original spins of the model transform under rep. 3. (2) a family of parent Hamiltonians for valence bond solids of SU(3) chains with spin reps. 6, 10, and 8 on each lattice site. We argue that of these three models, only the latter two exhibit spinon confinement and hence a Haldane gap in the excitation spectrum. We generalize some of our models to SU(n). Finally, we use the emerging rules for the construction of VBS states to argue that models of antiferromagnetic chains of SU(n) spins in general possess a Haldane gap if the spins transform under a representation corresponding to a Young tableau consisting of a number of boxes \lambda which is divisible by n. If \lambda and n have no common divisor, the spin chain will support deconfined spinons and not exhibit a Haldane gap. If \lambda and n have a common divisor different from n, it will depend on the specifics of the model including the range of the interaction.Comment: 26 pages two-column style, 15 figures, revtex4; references adde

Singlet Stripe Phases in the planar t-J Model

The energies of singlet stripe phases in which a plane is broken up into spin liquid ladders by lines of holes, is examined. If the holes were static then patterns containing spin liquids with a finite spin gap are favored. The case of dynamic holes is treated by assembling t-J ladders oriented perpendicular to the stripes. For a wide region around $J/t \approx 1$ the hole-hole correlations in a single ladder are found to be predominantly charge density wave type but an attraction between hole pairs on adjacent ladders leads to a stripe phase. A quantum mechanical melting of the hole lines at smaller $J/t$ values leads to a Bose condensate of hole pairs, i.e. a superconducting phase.Comment: 5 pages, uuencoded compressed PostScript file including 5 figures, ETH-TH/942

A past capture event at Sagittarius A* inferred from the fluorescent X-ray emission of Sagittarius B clouds

The fluorescent X-ray emission from neutral iron in the molecular clouds (Sgr B) indicates that the clouds are being irradiated by an external X-ray source. The source is probably associated with the Galactic central black hole (Sgr A*), which triggered a bright outburst one hundred years ago. We suggest that such an outburst could be due to a partial capture of a star by Sgr A*, during which a jet was generated. By constraining the observed flux and the time variability ($\sim$ 10 years) of the Sgr B's fluorescent emission, we find that the shock produced by the interaction of the jet with the dense interstellar medium represents a plausible candidate for the X-ray source emission.Comment: 7 pages, 1 figure, accepted for publication in MNRA