Sub-Regionalism Within the African Union: Does It Enhance Regional Integration?

The African continent renewed its commitment to regional integration in the post-1990s period in keeping with the global changes at the time. As part of this revitalization, the Organisation of African Union was transformed to the African Union which has broader aims, and sub-regionalism was also embraced with the establishment of regional economic communities that act as stepping stones to greater regional integration. Both continental and sub-regional efforts have placed emphasis on economic integration with states as key players in the integration projects. The relationship between these two groupings is complex as the AU, which is meant to coordinate the activities of sub-regions, has little authority over the overlapping sub-regions. The sub-regions have seen some progress not only in economic cooperation related areas, but also in their ability to develop some areas of functional cooperation. However, these gains have not translated at the continental level. This paper argues that a regional integration agenda, largely centered on economic integration, has not ushered in the expected results and makes a case for functional integration as a distinct goal for regional integration. This is a more balanced approach that allows countries to share in non-economic benefits by belonging to a regional grouping

The Impact of DSM-IV Mental Disorders on Adherence to Combination Antiretroviral Therapy Among Adult Persons Living with HIV/AIDS: A Systematic Review

This is a systematic review of eighty-two published studies investigating the impact of DSM-IV mental disorders on combination antiretroviral therapy (cART) adherence and persistence among persons living with HIV/AIDS (PLWHA). Sixty-two articles examined depression, with 58 % (N = 32/62) finding lower cART adherence and persistence. Seventeen articles examined one or more anxiety disorders, with the majority finding no association with cART adherence or persistence. Eighty percent of the studies that evaluated the impact of psychotic (N = 3), bipolar (N = 5) and personality disorders (N = 2) on cART adherence and persistence also found no association. Seven out of the nine studies (78 %) evaluating the impact of antidepressant treatment (ADT) on cART adherence found improvement. Adherence and depression measurements varied significantly in studies; common research measurements would improve data harmonization. More research specifically addressing the impact of other mental disorders besides depression on cART adherence and RCTs evaluating ADT on cART adherence are also needed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s10461-012-0212-3) contains supplementary material, which is available to authorized users

Advances in the prevention of heterosexual transmission of HIV/AIDS among women in the United States

Despite recent advances in testing and treatment, the incidence of HIV/AIDS in the United States has remained stagnant with an estimated 56,300 new infections every year. Women account for an increasing proportion of the epidemic. The vulnerability of women to HIV stems from both increased biologic susceptibility to heterosexual transmission and also the social, economic, and structural disadvantages they often confront. This review describes the main reasons for the increased vulnerability of U.S. women to HIV transmission with particular emphasis on specific high-risk groups including: non-Hispanic blacks, women who use drugs, women with a history of incarceration, and victims of intimate partner violence. Although behavioral approaches to HIV prevention may be effective, pragmatic implementation is often difficult, especially for women who lack sociocultural capital to negotiate condoms with their male partners. Recent advances in HIV prevention show promise in terms of female-initiated interventions. These notably include female condoms, non-specific vaginal microbicides, and antiretroviral oral and vaginal pre-exposure prophylaxis. In this review, we will present evidence in support of these new female-initiated interventions while also emphasizing the importance of advocacy and the political support for these scientific advances to be successful

HIV Treatment in the Criminal Justice System: Critical Knowledge and Intervention Gaps

The criminal justice system bears a disproportionate burden of the HIV epidemic. Continuity of care is critical for HAART-based prevention of HIV-related morbidity and mortality. This paper describes four major challenges to successful management of HIV in the criminal justice system: relapse to substance use, homelessness, mental illness, and loss of medical and social benefits. Each of these areas constitutes a competing priority upon release that demands immediate attention and diverts time, energy, and valuable resources away from engagement in care and adherence to HAART. Numerous gaps exist in scientific knowledge about these issues and potential solutions. In illuminating these knowledge deficits, we present a contemporary research agenda for the management of HIV in correctional systems. Future empirical research should focus on these critical issues in HIV-infected prisoners and releasees while interventional research should incorporate evidence-based solutions into the criminal justice setting

Ursodeoxycholic acid treatment in a rat model of cancer cachexia

UDCA treatment in the Yoshida hepatoma model showed a trend towards attenuation of tissue loss in animals with progressive weight loss in cancer cachexia. Tumor growth and activity indicators were not altered. Both doses of UDCA tended to reduce the mortality rates in tumor-bearing animals. Larger studies with longer follow-up are required to verify these findings

IGF-1 treatment reduces weight loss and improves outcome in a rat model of cancer cachexia

Background: A hallmark symptom of cancer cachexia is the loss of skeletal muscle. This is at least partially due to a deregulation of the growth hormone/IGF-1 axis and a subsequently impaired protein synthesis in skeletal muscle. Here, we investigated the effect of IGF-1 supplementation in a rat model of cancer cachexia. Methods: Juvenile rats were inoculated with the Yoshida AH-130 hepatoma and treated once daily with 0.3 mg kg−1 day−1 (low dose) or 3 mg kg−1 day−1 (high dose) IGF-1 or placebo for a period of maximal 16 days. Body weight and body composition (by NMR) were assessed at baseline and at the end of the study or day of death. Locomotor activity and food intake were assessed at baseline and day 10/11 after tumour inoculation for 24 h. Results: Untreated tumour-bearing rats lost 55.3 ± 2.14 g body weight, which was reduced by low-dose to −39.6 ± 11.1 g (p = 0.0434) and high-dose IGF-1 to −42.7 ± 8.8 g (p = 0.057). Placebo-treated rats lost 41.4 ± 2.0-g lean mass, which was attenuated by low-dose IGF-1 (−28.8 ± 8.3 g, p = 0.041) and high-dose IGF-1 (−30.9 ± 7.4, p = 0.067). Spontaneous activity and food intake were improved by low-dose IGF-1 only. No effect on fat mass was observed. Low-dose IGF-1 significantly reduced mortality (HR = 0.45, 95%CI = 0.21–0.93, p = 0.0315), whilst the high dose did not reach significance (HR = 0.68, 95%CI = 0.26–1.74, p = 0.42). Conclusion: Low-dose IGF-1 reduced mortality and attenuated loss of body weight as well as muscle mass in the Yoshida hepatoma rat model. Moreover, an improved quality of life was observed in these animals. Further experiments using different doses are necessary

Plasticity of topologically close-packed phases in the Fe-Ta(-Al) system

Understanding the structure-property relationships of materials plays a significant role in the development of materials for technical applications. Due to the many possible combinations of two or more elements, intermetallic phases can be very interesting for these developments. High strength up to high temperatures makes intermetallics promising materials for high-temperature applications. However, their complex structure, resulting in a pronounced brittleness, has so far limited their applicability. We focus on the understanding of plastic deformation in topologically close-packed (TCP) phases, which form one of the largest groups of intermetallics. To do this, we use nanomechanical tests that allow us to study plasticity even in the most brittle materials. Here, we consider the Fe-Ta(-Al) system that contains two closely related TCP phases, a C14 Laves phase and a µ-phase. The building block-like structure of these phases enables a systematic investigation as well as a transfer of the findings to other complex crystals. The mechanical properties of the two TCP phases in the Fe-Ta(-Al) system, investigated by state-of-the-art micromechanical testing, are introduced in this work. The influence of the crystal structure and chemical composition on the mechanical properties and the deformation mechanisms of the TCP phases are discussed