Height and timing of growth spurt during puberty in young people living with vertically acquired HIV in Europe and Thailand.

OBJECTIVE: The aim of this study was to describe growth during puberty in young people with vertically acquired HIV. DESIGN: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand. METHODS: One thousand and ninety-four children initiating a nonnucleoside reverse transcriptase inhibitor or boosted protease inhibitor based regimen aged 1-10 years were included. Super Imposition by Translation And Rotation (SITAR) models described growth from age 8 years using three parameters (average height, timing and shape of the growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics associated with these three parameters. RESULTS: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8, 9.0] years and -1.2 (IQR: -2.3 to -0.2), respectively. Median follow-up was 9.1 (IQR: 6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20-0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years and 1.50 (1.21-1.78) years later in those starting with HAZ less than -3 compared with HAZ at least -1. Later growth spurts in girls resulted in continued height growth into later adolescence. In boys starting ART with HAZ less than -1, growth spurts were later in children starting ART in the oldest age group, but for HAZ at least -1, there was no association with age. Girls and boys who initiated ART with HAZ at least -1 maintained a similar height to the WHO reference mean. CONCLUSION: Stunting at ART initiation was associated with later growth spurts in girls. Children with HAZ at least -1 at ART initiation grew in height at the level expected in HIV negative children of a comparable age

Height and timing of growth spurt during puberty in young people living with vertically acquired HIV in Europe and Thailand

Objective: The aim of this study was to describe growth during puberty in young people with vertically acquired HIV. Design: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand. Methods: One thousand and ninety-four children initiating a nonnucleoside reverse transcriptase inhibitor or boosted protease inhibitor based regimen aged 1-10 years were included. Super Imposition by Translation And Rotation (SITAR) models described growth from age 8 years using three parameters (average height, timing and shape of the growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics associated with these three parameters. Results: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8, 9.0] years and -1.2 (IQR: -2.3 to -0.2), respectively. Median follow-up was 9.1 (IQR: 6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20-0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years and 1.50 (1.21-1.78) years later in those starting with HAZ less than -3 compared with HAZ at least -1. Later growth spurts in girls resulted in continued height growth into later adolescence. In boys starting ART with HAZ less than -1, growth spurts were later in children starting ART in the oldest age group, but for HAZ at least -1, there was no association with age. Girls and boys who initiated ART with HAZ at least -1 maintained a similar height to the WHO reference mean. Conclusion: Stunting at ART initiation was associated with later growth spurts in girls. Children with HAZ at least -1 at ART initiation grew in height at the level expected in HIV negative children of a comparable age

Altered communication in Parkinson’s disease, its role in stigmatisation of the condition and effect on social relationships

Communication difficulties in Parkinson’s disease (PD) arise not only as the result of the motor symptoms of the disorder, but also as a consequence of cognitive and affective impairments which are recognised as being part of the disease process. These changes are thought to account for much of the stigma associated with the condition, thereby complicating the ability of patients to inter-relate with others, including their closest family. This inevitably affects quality of life for both the patient and those family members involved in his/her care. The present paper presents an analysis of how the deficits in motor and cognitive function associated with PD in the form of reduced facial expressivity, altered language skills, motor and cognitive slowness and disturbances in the pragmatic aspects of language affect the communication abilities of patients with the disorder and give rise to stigmatisation, which in turn impacts the disability seen in PD

Constitutive versus heat and biotic stress induced BVOC emissions in Pseudotsuga menziesii

Induced volatiles have been a focus of recent research, as not much is known of their emission behavior or atmospheric contribution. BVOC emissions were measured from Pseudotsuga menziesii saplings under natural environmental conditions, using a dynamic branch enclosure system and GC-MS for their analysis. We determined temperature and light dependency of the individual compounds, studied seasonality of the emissions and discuss the effect of heat stress in comparison with two specific biotic stresses that occurred naturally on the trees. A standardized emission rate of 6.8 μg g (dw) -1 h -1 for monoterpenes under stressed conditions was almost a magnitude higher than that obtained for healthy trees (0.8 ± 0.2 μg g (dw) -1 h -1), with higher beta factors characterizing the stressed trees. The response of the emissions to light intensity was different for the individual compounds, suggesting a distinct minimum light intensity to reach saturation. Heat stress changed the relative contribution of specific volatiles, with larger extent of increase of sesquiterpenes, methyl salicylate and linalool emissions compared to monoterpenes. Biotic stress kept low the emissions of sesquiterpenes, (E)-4,8-dimethyl-1,3,7-nonatriene and methylbutenol isomers, and increased the level of methyl salicylate and monoterpenes. The ratio of β-pinene/α-pinene was also found to be significantly enhanced from 1.3 to 2.4 and 3.2 for non-stressed, heat stressed and combined biotic and heat stressed, respectively

Clear link between drought stress, photosynthesis and biogenic volatile organic compounds in Fagus sylvatica L.

Direct plant stress sensing is the key for a quantitative understanding of drought stress effects on biogenic volatile organic compound (BVOC) emissions. A given level of drought stress might have a fundamentally different effect on the BVOC emissions of different plants. For the first time, we continuously quantified the level of drought stress in a young potted beech (Fagus sylvatica L.) with a linear variable displacement transducer (LVDT) installed at stem level in combination with simultaneous measurements of BVOC emissions and photosynthesis rates at leaf level. This continuous set of measurements allowed us to examine how beech alters its pattern of photosynthesis and carbon allocation to BVOC emissions (mainly monoterpenes, MTs) and radial stem growth during the development of drought stress. We observed an increasing-decreasing trend in the MT emissions as well as in the fraction of assimilated carbon re-emitted back into the atmosphere (ranging between 0.14 and 0.01%). We were able to link these dynamics to pronounced changes in radial stem growth, which served as a direct plant stress indicator. Interestingly, we detected a sudden burst in emission of a non-identified, non-MT BVOC species when drought stress was acute (i.e. pronounced negative stem growth). This burst might have been caused by a certain stress-related green leaf volatile, which disappeared immediately upon re-watering and thus the alleviation of drought stress. These results highlight that direct plant stress sensing creates opportunities to understand the overall complexity of stress-related BVOC emissions

Nurses' health, age and the wish to leave the profession-findings from the European NEXT-Study.

BACKGROUND AND OBJECTIVES: In many industrialised countries the number of workers with low health is expected to increase in the nursing profession. This will have implications for occupational health work in health care. The European NEXT-Study (www. next-study. net, funded by EU) investigates working conditions of nurses in ten European countries and provides the opportunity to evaluate the role of health with respect to age and the consideration of leaving nursing. METHODS: 26,263 female registered nurses from Belgium, Germany, Finland, France, England, Italy, Netherlands, Poland and Slovakia were eligible for analysis. RESULTS: In most countries, older nurses considered leaving the profession more frequently than younger nurses. 'Health' was--next to 'professional opportunities' and 'work organisational factors'--strongly associated with the consideration of leaving nursing. However, more than half of all nurses with low health wanted to remain in the profession. This group reported rather positive psychosocial working conditions--but also the highest fear for unemployment. CONCLUSIONS: The findings indicate that 'the nurse with low health' is reality in many health care settings. Both positive supporting working conditions but also lack of occupational alternatives and fear of unemployment may contribute to this. Current economic, political and demographic trends implicate that the number of active nurses with low health will increase. Occupational health surveillance will be challenged by this. But NEXT findings implicate that prevention also will have to regard work organisational factors if the aim is to sustain nurses' health and to enable nurses to remain healthy in their profession until retirement age

Nurses' health, age and the wish to leave the profession--findings from the European NEXT-Study.

BACKGROUND AND OBJECTIVES: In many industrialised countries the number of workers with low health is expected to increase in the nursing profession. This will have implications for occupational health work in health care. The European NEXT-Study (www. next-study. net, funded by EU) investigates working conditions of nurses in ten European countries and provides the opportunity to evaluate the role of health with respect to age and the consideration of leaving nursing. METHODS: 26,263 female registered nurses from Belgium, Germany, Finland, France, England, Italy, Netherlands, Poland and Slovakia were eligible for analysis. RESULTS: In most countries, older nurses considered leaving the profession more frequently than younger nurses. 'Health' was--next to 'professional opportunities' and 'work organisational factors'--strongly associated with the consideration of leaving nursing. However, more than half of all nurses with low health wanted to remain in the profession. This group reported rather positive psychosocial working conditions--but also the highest fear for unemployment. CONCLUSIONS: The findings indicate that 'the nurse with low health' is reality in many health care settings. Both positive supporting working conditions but also lack of occupational alternatives and fear of unemployment may contribute to this. Current economic, political and demographic trends implicate that the number of active nurses with low health will increase. Occupational health surveillance will be challenged by this. But NEXT findings implicate that prevention also will have to regard work organisational factors if the aim is to sustain nurses' health and to enable nurses to remain healthy in their profession until retirement age