Lipid-soluble Vitamins A, D, and E in HIV-Infected Pregnant women in Tanzania.

There is limited published research examining lipid-soluble vitamins in human immunodeficiency virus (HIV)-infected pregnant women, particularly in resource-limited settings. This is an observational analysis of 1078 HIV-infected pregnant women enrolled in a trial of vitamin supplementation in Tanzania. Baseline data on sociodemographic and anthropometric characteristics, clinical signs and symptoms, and laboratory parameters were used to identify correlates of low plasma vitamin A (<0.7 micromol/l), vitamin D (<80 nmol/l) and vitamin E (<9.7 micromol/l) status. Binomial regression was used to estimate risk ratios and 95% confidence intervals. Approximately 35, 39 and 51% of the women had low levels of vitamins A, D and E, respectively. Severe anemia (hemoglobin <85 g/l; P<0.01), plasma vitamin E (P=0.02), selenium (P=0.01) and vitamin D (P=0.02) concentrations were significant correlates of low vitamin A status in multivariate models. Erythrocyte Sedimentation Rate (ESR) was independently related to low vitamin A status in a nonlinear manner (P=0.01). The correlates of low vitamin D status were CD8 cell count (P=0.01), high ESR (ESR >81 mm/h; P<0.01), gestational age at enrollment (nonlinear; P=0.03) and plasma vitamins A (P=0.02) and E (P=0.01). For low vitamin E status, the correlates were money spent on food per household per day (P<0.01), plasma vitamin A concentration (nonlinear; P<0.01) and a gestational age <16 weeks at enrollment (P<0.01). Low concentrations of lipid-soluble vitamins are widely prevalent among HIV-infected women in Tanzania and are correlated with other nutritional insufficiencies. Identifying HIV-infected persons at greater risk of poor nutritional status and infections may help inform design and implementation of appropriate interventions

Community Organizing and Employee Representation

The decline in the scope and power of American unions has led to a search for new strategies and new organizational forms to better succeed in representing the interests of employees in the labour market. This paper examines the role of community-based organizations of the sort that proved so powerful during the Civil Rights Movement. The subject of the paper is a strong national network of community organizations that is neighbourhood-based and draws heavily on churches and other community institutions. The organizations are put together in neighbourhoods, yet they also wield power at the city and state levels. The paper describes the organizations and examines and assesses their labour market policies. The second part of the paper takes up organizational issues and, in particular, describes how the structure and culture of these organizations enable them to avoid some of the organizational perils that have befallen unions and other social movement organizations. The paper concludes by comparing these organizations with traditional unions and by discussing their prospects for growth as well as their limitations. Copyright Blackwell Publishing Ltd/London School of Economics 2006.