Recognising resilience factors among people living with HIV seeking to adopt

This article discusses the challenges faced by people living with HIV in the adoption process, looking especially at resilience factors. Resilience is framed in the context of HIV-related infertility that motivates people living with HIV to apply for adoption. The article draws on psychological definitions of resilience and presents four factors that promote and sustain it: individual strengths, good health management, social network and wider recognition in society. This is illustrated by a case study. The study emphasises that ‘the prospective adoptive child’ should always be at the centre of any assessments and encourages social workers to consider sensitive and inclusive practice when assessing prospective adopters living with HIV

Prevention and management of excessive gestational weight gain: a survey of overweight and obese pregnant women

Background - Excessive gestational weight gain is associated with adverse infant, childhood and maternal outcomes and research to develop interventions to address this issue is ongoing. The views of women on gestational weight gain and the resources they would consider helpful in addressing this are however largely unknown. This survey aimed to determine the views of newly pregnant women, living in areas of social disadvantage, on 1) their current body weight and potential gestational weight gain and 2) the resources or interventions they would consider helpful in preventing excessive gestational weight gain. Methods - A convenience sample of overweight and obese pregnant women living in Fife, UK, were invited to complete a short anonymised questionnaire at their 12 week booking visit. Results - 428 women, BMI>25 kg/m2, completed the questionnaire. Fifty-four per cent of respondents were obese (231) and 62% were living in areas of mild to moderate deprivation. Over three-quarters of participants felt dissatisfied with their current weight (81%). The majority of women (60%) expressed some concern about potential weight gain. Thirty-nine percent were unconcerned about weight gain during their pregnancy, including 34 women (19%) who reported having retained weight gained in earlier pregnancies. Amongst those concerned about weight gain advice on physical activity (41%) and access to sports/leisure facilities were favoured resources (36%). Fewer women (12%) felt that group sessions on healthy eating or attending a clinic for individualised advice (14%) would be helpful. "Getting time off work" was the most frequently cited barrier (48%) to uptake of resources other than leaflets. Conclusions- These data suggest a lack of awareness amongst overweight and obese women regarding excessive gestational weight gain. Monitoring of gestational weight gain, and approaches for its management, should be formally integrated into routine antenatal care. Barriers to the uptake of resources to address weight gain are numerous and must be considered in the design of future interventions and services

Right cranial lung lobe torsion after a diaphragmatic rupture repair in a Jack Russell terrier

A seven-year-old male Jack Russell terrier was presented with a history of coughing, generalised weakness and lethargy 10 days after an abdominal coeliotomy to repair a large diaphragmatic rupture. Thoracic radiographs demonstrated a soft tissue mass in the midcaudal right thoracic cavity. Ultrasonographic studies, bronchoscopy and subsequent exploratory thoracotomy confirmed a diagnosis of a right cranial lung lobe torsion (LLT), with an anomalous caudodorsal displacement of the affected lobe. LLT should be considered as a differential diagnosis for respiratory tract disease following diaphragmatic rupture repair

The XMM cluster survey: Testing chameleon gravity using the profiles of clusters

The chameleon gravity model postulates the existence of a scalar field that couples with matter to mediate a fifth force. If it exists, this fifth force would influence the hot X-ray emitting gas filling the potential wells of galaxy clusters. However, it would not influence the clusters weak lensing signal. Therefore, by comparing X-ray and weak lensing profiles, one can place upper limits on the strength of a fifth force. This technique has been attempted before using a single, nearby cluster (Coma, z = 0.02). Here we apply the technique to the stacked profiles of 58 clusters at higher redshifts (0.1 R0| R0| on cosmological scales. We hope to improve this constraint in future by extending the study to hundreds of clusters using data from the Dark Energy Survey

Dental management considerations for the patient with an acquired coagulopathy. Part 1: Coagulopathies from systemic disease

Current teaching suggests that many patients are at risk for prolonged bleeding during and following invasive dental procedures, due to an acquired coagulopathy from systemic disease and/or from medications. However, treatment standards for these patients often are the result of long-standing dogma with little or no scientific basis. The medical history is critical for the identification of patients potentially at risk for prolonged bleeding from dental treatment. Some time-honoured laboratory tests have little or no use in community dental practice. Loss of functioning hepatic, renal, or bone marrow tissue predisposes to acquired coagulopathies through different mechanisms, but the relationship to oral haemostasis is poorly understood. Given the lack of established, science-based standards, proper dental management requires an understanding of certain principles of pathophysiology for these medical conditions and a few standard laboratory tests. Making changes in anticoagulant drug regimens are often unwarranted and/or expensive, and can put patients at far greater risk for morbidity and mortality than the unlikely outcome of postoperative bleeding. It should be recognised that prolonged bleeding is a rare event following invasive dental procedures, and therefore the vast majority of patients with suspected acquired coagulopathies are best managed in the community practice setting

Application of Nitrogen and Carbon Stable Isotopes (δ15Ν and δ13C) to Quantify Food Chain Length and Trophic Structure

Increasingly, stable isotope ratios of nitrogen (delta N-15) and carbon (delta C-13) are used to quantify trophic structure, though relatively few studies have tested accuracy of isotopic structural measures. For laboratory-raised and wild-collected plant-invertebrate food chains spanning four trophic levels we estimated nitrogen range (NR) using delta N-15, and carbon range (CR) using delta C-13, which are used to quantify food chain length and breadth of trophic resources respectively. Across a range of known food chain lengths we examined how NR and CR changed within and between food chains. Our isotopic estimates of structure are robust because they were calculated using resampling procedures that propagate variance in sample means through to quantified uncertainty in final estimates. To identify origins of uncertainty in estimates of NR and CR, we additionally examined variation in discrimination (which is change in delta N-15 ordelta C-13 from source to consumer) between trophic levels and among food chains. delta N-15 discrimination showed significant enrichment, while variation in enrichment was species and system specific, ranged broadly (1.4‰ to 3.3‰), and importantly, propagated variation to subsequent estimates of NR. However, NR proved robust to such variation and distinguished food chain length well, though some overlap between longer food chains infers a need for awareness of such limitations. delta C-13 discrimination was inconsistent; generally no change or small significant enrichment was observed. Consequently, estimates of CR changed little with increasing food chain length, showing the potential utility of delta C-13 as a tracer of energy pathways. This study serves as a robust test of isotopic quantification of food chain structure, and given global estimates of aquatic food chains approximate four trophic levels while many food chains include invertebrates, our use of four trophic level plant-invertebrate food chains makes our findings relevant for a majority of ecological systems

The XMM Cluster Survey: New evidence for the 3.5-keV feature in clusters is inconsistent with a dark matter origin

There have been several reports of a detection of an unexplained excess of X-ray emission at $\simeq$3.5 keV in astrophysical systems. One interpretation of this excess is the decay of sterile neutrino dark matter. The most influential study to date analysed 73 clusters observed by the XMM-Newton satellite. We explore evidence for a â 3.5-keV excess in the XMM-PN spectra of 117 redMaPPer galaxy clusters (0.1 < z < 0.6). In our analysis of individual spectra, we identify three systems with an excess of flux at $\simeq$3.5 keV. In one case (XCS J0003.3+0204), this excess may result from a discrete emission line. None of these systems are the most dark matter dominated in our sample. We group the remaining 114 clusters into four temperature (TX) bins to search for an increase in â 3.5-keV flux excess with TX-a reliable tracer of halo mass. However, we do not find evidence of a significant excess in flux at â 3.5 keV in any TX bins. To maximize sensitivity to a potentially weak dark matter decay feature at â 3.5 keV, we jointly fit 114 clusters. Again, no significant excess is found at â 3.5 keV. We estimate the upper limit of an undetected emission line at â 3.5 keV to be 2.41 × 10-6 photons cm-2 s-1, corresponding to a mixing angle of sin 2(2θ) = 4.4 × 10-11, lower than previous estimates from cluster studies. We conclude that a flux excess at â 3.5 keV is not a ubiquitous feature in clusters and therefore unlikely to originate from sterile neutrino dark matter decay. © 2020 The Author(s) Published by Oxford University Press on behalf of the Royal Astronomical Society

Development of a modified floristic quality index as a rapid habitat assessment method in the northern Everglades

Floristic quality assessments (FQA) using floristic quality indices (FQIs) are useful tools for assessing and comparing vegetation communities and related habitat condition. However, intensive vegetation surveys requiring significant time and technical expertise are necessary, which limits the use of FQIs in environmental monitoring programs. This study modified standard FQI methods to develop a rapid assessment method for characterizing and modeling change in wetland habitat condition in the northern Everglades. Method modifications include limiting vegetation surveys to a subset of taxa selected as indicators of impact and eliminating richness and/or abundance factors from the equation. These modifications reduce the amount of time required to complete surveys and minimizes misidentification of species, which can skew results. The habitat characterization and assessment tool (HCAT) developed here is a FQA that uses a modified FQI to detect and model changes in habitat condition based on vegetation communities, characterize levels of impact as high, moderate, or low, provide predictive capabilities for assessing natural resource management or water management operation alternatives, and uniquely links a FQI with readily accessible environmental data. For application in the northern Everglades, surface water phosphorus concentrations, specific conductivity, distance from canal, and days since dry (5-year average) explained 67% of the variability in the dataset with \u3e 99.9% confidence. The HCAT approach can be used to monitor, assess, and evaluate habitats with the objective of informing management decisions (e.g., as a screening tool) to maximize conservation and restoration of protected areas and is transferable to other wetlands with additional modification

Profile of blood cells and inflammatory mediators in periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome

<p>Abstract</p> <p>Background</p> <p>This study aimed to profile levels of blood cells and serum cytokines during afebrile and febrile phases of periodic fever, aphthous <b>s</b>tomatitis, pharyngitis and adenitis (PFAPA) syndrome to advance pathophysiological understanding of this pediatric disease.</p> <p>Methods</p> <p>A cohort of patients with a median age of 4.9 years experiencing 'typical PFAPA' episodes participated in this study. Blood cells and serum cytokines were analyzed by CBC analysis and multiplex ELISA.</p> <p>Results</p> <p>Oscillations in the concentration of blood cells during the afebrile and febrile phases of typical PFAPA syndrome were observed; novel findings include increased monocytes and decreased eosinophils during a febrile episode and increased thrombocytes in the afebrile interval. Relatively modest levels of pro-inflammatory cytokines were present in sera. IFNγ-induced cytokine IP10/CXCL10 was increased after the onset of fever while T cell-associated cytokines IL7 and IL17 were suppressed during afebrile and febrile periods.</p> <p>Conclusions</p> <p>Identification of dysregulated blood cells and serum cytokines is an initial step towards the identification of biomarkers of PFAPA disease and/or players in disease pathogenesis. Future investigations are required to conclusively discern which mediators are associated specifically with PFAPA syndrome.</p

Linking direct and indirect pathways mediating earthworms, deer, and understory composition in Great Lakes forests

Ahistorical drivers such as nonnative invasive earthworms and high deer densities can have substantial impacts on ecosystem processes and plant community composition in temperate and boreal forests of North America. To assess the roles of earthworm disturbance, deer, and environmental factors in the understory, we sampled 125 mixed temperate-boreal forest sites across the western Great Lakes region. We utilized structural equation modeling (SEM) to address the hypothesis that earthworm disturbance to the upper soil horizons and selective herbivory by deer are associated with depauperate understory plant communities dominated by graminoid and nonnative species. Evidence of earthworm activity was found at 93 % of our sites and 49 % had high to very high severity earthworm disturbance. The SEM fit the data well and indicated that widespread nonnative earthworm disturbance and high deer densities had similar magnitudes of impact on understory plant communities and that these impacts were partially mediated by environmental characteristics. One-third of the variation in earthworm disturbance was explained by soil pH, precipitation, and litter quality. Deer density and earthworm disturbance both increased graminoid cover while environmental variables showed direct and indirect relationships. For example, the positive relationship between temperature and graminoids was indirect through a positive temperature effect on deer density. This research characterizes an integrated set of key environmental variables driving earthworm disturbance and deer impacts on the forest understory, facilitating predictions of the locations and severity of future change in northern temperate and boreal forest ecosystems