Impact of ART on the fertility of HIV-positive women in sub-Saharan Africa.

OBJECTIVE: Understanding the fertility of HIV-positive women is critical to estimating HIV epidemic trends from surveillance data and to planning resource needs and coverage of prevention of mother-to-child transmission services in sub-Saharan Africa. In the light of the considerable scale-up in antiretroviral therapy (ART) coverage over the last decade, we conducted a systematic review of the impact of ART on the fertility outcomes of HIV-positive women. METHODS: We searched Medline, Embase, Popline, PubMed and African Index Medicus. Studies were included if they were conducted in sub-Saharan Africa and provided estimates of fertility outcomes (live births or pregnancies) among women on ART relative to a comparison group. RESULTS: Of 2070 unique references, 18 published papers met all eligibility criteria. Comparisons fell into four categories: fertility of HIV-positive women relative to HIV-negative women; fertility of HIV-positive women on ART compared to those not yet on ART; fertility differences by duration on ART; and temporal trends in fertility among HIV-positive women. Evidence indicates that fertility increases after approximately the first year on ART and that while the fertility deficit of HIV-positive women is shrinking, their fertility remains below that of HIV-negative women. These findings, however, were based on limited data mostly during the period 2005-2010 when ART scaled up. CONCLUSIONS: Existing data are insufficient to characterise how ART has affected the fertility of HIV-positive women in sub-Saharan Africa. Improving evidence about fertility among women on ART is an urgent priority for planning HIV resource needs and understanding HIV epidemic trends. Alternative data sources such as antenatal clinic data, general population cohorts and population-based surveys can be harnessed to understand the issue

The Missed Patient With Diabetes: How access to health care affects the detection of diabetes

OBJECTIVE—This study examined the association between access to health care and three classifications of diabetes status: diagnosed, undiagnosed, and no diabetes

Wider sampling reveals a non-sister relationship for geographically contiguous lineages of a marine mussel

The accuracy of phylogenetic inference can be significantly improved by the addition of more taxa and by increasing the spatial coverage of sampling. In previous studies, the brown mussel Perna perna showed a sister-lineage relationship between eastern and western individuals contiguously distributed along the South African coastline. We used mitochondrial (COI) and nuclear (ITS) sequence data to further analyze phylogeographic patterns within P.perna. Significant expansion of the geographical coverage revealed an unexpected pattern. The western South African lineage shared the most recent common ancestor (MRCA) with specimens from Angola, Venezuela, and Namibia, whereas eastern South African specimens and Mozambique grouped together, indicating a non-sister relationship for the two South African lineages. Two plausible biogeographic scenarios to explain their origin were both supported by the hypotheses-testing analysis. One includes an Indo-Pacific origin for P.perna, dispersal into the Mediterranean and Atlantic through the Tethys seaway, followed by recent secondary contact after southward expansion of the western and eastern South African lineages. The other scenario (Out of South Africa) suggests an ancient vicariant divergence of the two lineages followed by their northward expansion. Nevertheless, the Out of South Africa hypothesis would require a more ancient divergence between the two lineages. Instead, our estimates indicated that they diverged very recently (310 kyr), providing a better support for an Indo-Pacific origin of the two South African lineages. The arrival of the MRCA of P.perna in Brazil was estimated at 10 [0-40] kyr. Thus, the hypothesis of a recent introduction in Brazil through hull fouling in wooden vessels involved in the transatlantic itineraries of the slave trade did not receive strong support, but given the range for this estimate, it could not be discarded. Wider geographic sampling of marine organisms shows that lineages with contiguous distributions need not share a common ancestry.Portuguese National Science Foundation (FCT) [EXPL/BIA-BIC/1471/2012]; South Africa Research Chairs Initiative (SARChI) of the Department of Science and Technologyinfo:eu-repo/semantics/publishedVersio

Competing Demands for Time and Self-Care Behaviors, Processes of Care, and Intermediate Outcomes Among People With Diabetes: Translating Research Into Action for Diabetes (TRIAD)

ObjectiveTo determine whether competing demands for time affect diabetes self-care behaviors, processes of care, and intermediate outcomes.Research design and methodsWe used survey and medical record data from 5,478 participants in Translating Research Into Action for Diabetes (TRIAD) and hierarchical regression models to examine the cross-sectional associations between competing demands for time and diabetes outcomes, including self-management, processes of care, and intermediate health outcomes.ResultsFifty-two percent of participants reported no competing demands, 7% reported caregiving responsibilities only, 36% reported employment responsibilities only, and 6% reported both caregiving and employment responsibilities. For both women and men, employment responsibilities (with or without caregiving responsibilities) were associated with lower rates of diabetes self-care behaviors, worse processes of care, and, in men, worse HbA(1c).ConclusionsAccommodations for competing demands for time may promote self-management and improve the processes and outcomes of care for employed adults with diabetes

OQuPy : a Python package to efficiently simulate non-Markovian open quantum systems with process tensors

Funding: G.E.F. acknowledges the support from EPSRC (Grant No. EP/L015110/1) and from ERC under Grant Agreement No. 101053159 (RAVE). J.B. acknowledges the support from the Laidlaw Foundation (Leadership and Research Program scholarship). E.P.B. acknowledges the support from the Irish Research Council (Grant No. GOIPG/2019/1871). D.G. acknowledges the support from the QuantERA II Program that has received funding from the European Union’s Horizon 2020 research and innovation program under Grant Agreement No. 101017733 (“QuSiED”). P.R.E. acknowledges the support from Science Foundation Ireland (Grant No. 21-FFP-10142). E.D.C.L. acknowledges the support from EPSRC (Grant No. EP/T517938/1). R.d.W. acknowledges the support from EPSRC (Grant No. EP/W524505/1). B.W.L. and J.K. acknowledge the support from EPSRC (Grant No. EP/T014032/1).Non-Markovian dynamics arising from the strong coupling of a system to a structured environment is essential in many applications of quantum mechanics and emerging technologies. Deriving an accurate description of general quantum dynamics including memory effects is however a demanding task, prohibitive to standard analytical or direct numerical approaches. We present a major release of our open source software package, OQuPy (Open Quantum System in Python), which provides several recently developed numerical methods that address this challenging task. It utilizes the process tensor approach to open quantum systems in which a single map, the process tensor, captures all possible effects of an environment on the system. The representation of the process tensor in a tensor network form allows an exact yet highly efficient description of non-Markovian open quantum systems (NM-OQS). The OQuPy package provides methods to (1) compute the dynamics and multi-time correlations of quantum systems coupled to single and multiple environments, (2) optimize control protocols for NM-OQS, (3) simulate interacting chains of NM-OQS, and (4) compute the mean-field dynamics of an ensemble of NM-OQS coupled to a common central system. Our aim is to provide an easily accessible and extensible tool for researchers of open quantum systems in fields such as quantum chemistry, quantum sensing, and quantum information.Peer reviewe

Educational Disparities in Rates of Smoking Among Diabetic Adults: The Translating Research Into Action for Diabetes Study

Objectives. We assessed educational disparities in smoking rates among adults with diabetes in managed care settings. Methods. We used a cross-sectional, survey-based (2002–2003) observational study among 6538 diabetic patients older than 25 years across multiple managed care health plans and states. For smoking at each level of self-reported educational attainment, predicted probabilities were estimated by means of hierarchical logistic regression models with random intercepts for health plan, adjusted for potential confounders. Results. Overall, 15% the participants reported current smoking. An educational gradient in smoking was observed that varied significantly (P<.003) across age groups, with the educational gradient being strong in those aged 25 to 44 years, modest in those aged 45 to 64 years, and nonexistent in those aged 65 years or older. Of particular note, the prevalence of smoking observed in adults aged 25–44 years with less than a high school education was 50% (95% confidence interval: 36% to 63%). Conclusions. Approximately half of poorly educated young adults with diabetes smoke, magnifying the health risk associated with early-onset diabetes. Targeted public health interventions for smoking prevention and cessation among young, poorly educated people with diabetes are needed

Eating Paradise: Food as Coloniality and Leisure

Sandals Resorts’ Gourmet Discovery Dining programme continues the company’s practice of marketing difference by combining tourism with the commodification of food from non-Western cultures (Dodman and Rhiney 2008). The article draws on bell hooks’ (1992) concept of ‘eating the other’ and the analysis undertakes an interdisciplinary approach that combines visual analysis with Anibal Quijano’s (2007) concept of modernity/coloniality. The discussion explores the trends of global multiculturalism that have been adopted by Sandals in a hybridized cut and mix approach to selling a packaged ideal of the Caribbean. The visual techniques devised to create a culinary holiday package are overlaid onto a manufactured and homogenised or McDonaldized (Ritzer and Liska 1997) Caribbean that provides insight into the way in which global neoliberal multiculturalism is framed by ongoing colonial relations after formal colonial rule has ended in the Caribbean region