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  1. Drug Issues Affecting Chinese, Indian and Pakistani People Living in Greater Glasgow

    ERIC Educational Resources Information Center

    Ross, A. J.; Heim, D.; Bakshi, N.; Davies, J. B.; Flatley, K. J.; Hunter, S. C.

    2004-01-01

    This paper describes research on drug issues affecting Chinese, Indian and Pakistani people living in Greater Glasgow. There were two strands: (i) a questionnaire-based survey of young people and focus groups; (ii) interviews with young people and adults. The primary aims were to gather prevalence data and to investigate perceptions about current…

  2. Factors That Affect Quality of Life among People Living with HIV Attending an Urban Clinic in Uganda: A Cohort Study

    PubMed Central

    Mutabazi-Mwesigire, Doris

    2015-01-01

    Introduction With the availability of antiretroviral therapy (ART) and primary general care for people living with HIV (PLHIV) in resource limited settings, PLHIV are living longer, and HIV has been transformed into a chronic illness. People are diagnosed and started on treatment when they are relatively well. Although ART results in clinical improvement, the ultimate goal of treatment is full physical functioning and general well-being, with a focus on quality of life rather than clinical outcomes. However, there has been little research on the relationship of specific factors to quality of life in PLHIV. The objective of this study was to investigate factors associated with quality of life among PLHIV in Uganda receiving basic care and those on ART. Methods We enrolled 1274 patients attending an HIV outpatient clinic into a prospective cohort study. Of these, 640 received ART. All were followed up at 3 and 6 months. Health related quality of life was assessed with the MOS-HIV Health Survey and the Global Person Generated Index (GPGI). Multivariate linear regression and logistic regression with generalized estimating equations were used to examine the relationship of social behavioral and disease factors with Physical Health Summary (PHS) score, Mental Health Summary (MHS) score, and GPGI. Results Among PLHIV receiving basic care, PHS was associated with: sex (p=0.045) - females had lower PHS; age in years at enrollment (p=0.0001) - older patients had lower PHS; and depression (p<0.001) - depressed patients had lower PHS. MHS was only associated with opportunistic infection (p=0.01) - presence of an opportunistic infection was associated with lower MHS. For the GPG the associated variables were age (p=0.03) - older patients had lower GPGI; education (p=0.01) – higher education associated with higher GPGI; and depression - patients with depression had a lower GPGI (p<0.001). Among patients on ART, PHS was associated with: study visit (p=0.01), with increase in

  3. How do people live in the Anthropocene?

    NASA Astrophysics Data System (ADS)

    Robin, Libby

    2016-04-01

    While geologists have focused their efforts on which changes in the strata might constitute a functional shift out of the present epoch, environmental humanities scholars, museums and creative artists have taken up the Anthropocene as a concept raising new moral and practical dilemmas. A central concern is with how people adapt and live creatively in a world that is functioning beyond the physical planetary boundaries defined by the Holocene. This paper will provide an overview of the lively scholarly and popular debates on the question of what it means, ethically, to be human in an Age of Humans. Major questions include the question of who are 'we' in the Anthropocene, and how the conditions of the putative new epoch will affect 'more-than-human-others'. Creative and justice activist responses to the Anthropocene typically distinguish among humans, focusing not on the causes, but rather on concerns of the people on the receiving end of global change (for example, the Small Islands Developing States (SIDS) group of 39+8). Some are concerned about the collateral effects of technological 'fixes' for energy transformations and climate, and others about economic shifts and market-based incentives. As a historian of ideas, I explore the multiple paths by which people have come to the Anthropocene concept, and the uses to which it has already been put, even before a final decision is made on its formal status. The Anthropocene already arouses anxiety about 'the future'. One big idea that is shared across activists and scholars (and not just those in the humanities) is the question of enabling hopeful responses. A diversity of creative projects for living in the Anthropocene, which can contribute to coping with the stress of accelerating global change, is essential to this.

  4. Engagement with Health Care Providers Affects Self- Efficacy, Self-Esteem, Medication Adherence and Quality of Life in People Living with HIV.

    PubMed

    Chen, Wei-Ti; Wantland, Dean; Reid, Paula; Corless, Inge B; Eller, Lucille S; Iipinge, Scholastika; Holzemer, William L; Nokes, Kathleen; Sefcik, Elizbeth; Rivero-Mendez, Marta; Voss, Joachim; Nicholas, Patrice; Phillips, J Craig; Brion, John M; Rose, Caro Dawson; Portillo, Carmen J; Kirksey, Kenn; Sullivan, Kathleen M; Johnson, Mallory O; Tyer-Viola, Lynda; Webel, Allison R

    2013-11-01

    The engagement of patients with their health care providers (HCP) improves patients' quality of life (QOL), adherence to antiretroviral therapy, and life satisfaction. Engagement with HCP includes access to HCP as needed, information sharing, involvement of client in decision making and self-care activities, respect and support of the HCP for the client's choices, and management of client concerns. This study compares country-level differences in patients' engagement with HCP and assesses statistical associations relative to adherence rates, self-efficacy, self-esteem, QOL, and symptom self-reporting by people living with HIV (PLHIV). A convenience sample of 2,182 PLHIV was enrolled in the United States, Canada, Puerto Rico, Namibia, and China. Cross-sectional data were collected between September 2009 and January 2011. Inclusion criteria were being at least 18 years of age, diagnosed with HIV, able to provide informed consent, and able to communicate in the local language with site researchers. In the HCP scale, a low score indicated greater provider engagement. Country comparisons showed that PLHIV in Namibia had the most HCP engagement (OR 2.80, p < 0.001) and that PLHIV in China had the least engagement (OR -7.03, p < 0.0001) compared to the PLHIV in the Western countries. Individuals having better HCP engagement showed better self-efficacy for adherence (t = -5.22, p < 0.0001), missed fewer medication doses (t = 1.92, p ≤ 0.05), had lower self-esteem ratings (t = 2.67, p < 0.01), fewer self-reported symptoms (t = 3.25, p < 0.0001), and better overall QOL physical condition (t = -3.39, p < 0.001). This study suggests that promoting engagement with the HCP is necessary to facilitate skills that help PLHIV manage their HIV. To improve ART adherence, HCPs should work on strategies to enhance self-efficacy and self-esteem, therefore, exhibiting fewer HIV-related symptoms and missing less medication doses to achieve better QOL. PMID:24575329

  5. Engagement with Health Care Providers Affects Self- Efficacy, Self-Esteem, Medication Adherence and Quality of Life in People Living with HIV

    PubMed Central

    Chen, Wei-Ti; Wantland, Dean; Reid, Paula; Corless, Inge B; Eller, Lucille S.; Iipinge, Scholastika; Holzemer, William L; Nokes, Kathleen; Sefcik, Elizbeth; Rivero-Mendez, Marta; Voss, Joachim; Nicholas, Patrice; Phillips, J. Craig; Brion, John M.; Rose, Caro Dawson; Portillo, Carmen J; Kirksey, Kenn; Sullivan, Kathleen M; Johnson, Mallory O; Tyer-Viola, Lynda; Webel, Allison R

    2014-01-01

    The engagement of patients with their health care providers (HCP) improves patients’ quality of life (QOL), adherence to antiretroviral therapy, and life satisfaction. Engagement with HCP includes access to HCP as needed, information sharing, involvement of client in decision making and self-care activities, respect and support of the HCP for the client’s choices, and management of client concerns. This study compares country-level differences in patients’ engagement with HCP and assesses statistical associations relative to adherence rates, self-efficacy, self-esteem, QOL, and symptom self-reporting by people living with HIV (PLHIV). A convenience sample of 2,182 PLHIV was enrolled in the United States, Canada, Puerto Rico, Namibia, and China. Cross-sectional data were collected between September 2009 and January 2011. Inclusion criteria were being at least 18 years of age, diagnosed with HIV, able to provide informed consent, and able to communicate in the local language with site researchers. In the HCP scale, a low score indicated greater provider engagement. Country comparisons showed that PLHIV in Namibia had the most HCP engagement (OR 2.80, p < 0.001) and that PLHIV in China had the least engagement (OR −7.03, p < 0.0001) compared to the PLHIV in the Western countries. Individuals having better HCP engagement showed better self-efficacy for adherence (t = −5.22, p < 0.0001), missed fewer medication doses (t = 1.92, p ≤ 0.05), had lower self-esteem ratings (t = 2.67, p < 0.01), fewer self-reported symptoms (t = 3.25, p < 0.0001), and better overall QOL physical condition (t = −3.39, p < 0.001). This study suggests that promoting engagement with the HCP is necessary to facilitate skills that help PLHIV manage their HIV. To improve ART adherence, HCPs should work on strategies to enhance self-efficacy and self-esteem, therefore, exhibiting fewer HIV-related symptoms and missing less medication doses to achieve better QOL. PMID:24575329

  6. People with Disabilities on Tribal Lands: Education, Health Care, Vocational Rehabilitation, and Independent Living.

    ERIC Educational Resources Information Center

    National Council on Disability, Washington, DC.

    This report is the product of a project that examined services to people with disabilities living on American Indian or Alaska Native (AI/AN) tribal lands. Research such as the American Indian Disability Legislative Project and other studies on health, rehabilitation, independent living, and education issues that affect people with disabilities…

  7. Living Arrangement Preferences among Elderly People.

    ERIC Educational Resources Information Center

    Beland, Francois

    1987-01-01

    Compared older adults living alone or with only a spouse to those living with children, relatives, or friends. Found that those living alone or with a spouse were more likely to prefer to move into alternate setting (senior housing or nursing home). Findings revealed limited evidence to support view that residency with others is substitute for…

  8. Substance Use among Young People Living in Residential State Care

    ERIC Educational Resources Information Center

    McCrystal, Patrick; Percy, Andrew; Higgins, Kathryn

    2008-01-01

    Existing empirical evidence on substance use among young people living in residential state care during adolescence is comparatively limited. This paper reports on substance use trends of young people living in residential state care during three annual data-sweeps when aged 14, 15 and 16 years. A repeated cross-sectional research design was…

  9. Resilience Factors in Families Living with People with Mental Illnesses

    ERIC Educational Resources Information Center

    Jonker, Liezl; Greeff, Abraham P.

    2009-01-01

    In South Africa, a substantial burden is placed on families living with people with mental illnesses. The aim of this study was to identify resilience factors in families living in an underprivileged area, caring for people with mental illnesses. Data was obtained from family representatives (N=34) using semistructured interviews and a set of…

  10. PLUTONIUM BURDENS IN PEOPLE LIVING AROUND THE ROCKY FLATS PLANT

    EPA Science Inventory

    A study was conducted to determine whether the tissues of people who lived near to or downwind from the Rocky Flats nuclear weapons facility in Colorado contained more plutonium than the tissues from people who lived farther away. Information was collected on the age, sex, smokin...

  11. Shoving Our Way into Young People's Lives

    ERIC Educational Resources Information Center

    McGraw, Amanda

    2011-01-01

    This paper uses Sizer and Sizer's concept of "shoving" to examine the school experiences of a group of young people who left mainstream school early and some time later enrolled in an alternative educational setting designed to reengage early school leavers in formal learning. "Shoving" is a way to explain why so many young people feel alienated…

  12. Physical Activity among Older People Living Alone in Shanghai, China

    ERIC Educational Resources Information Center

    Chen, Yu; While, Alison E; Hicks, Allan

    2015-01-01

    Objective: To investigate physical activity among older people living alone in Shanghai, People's Republic of China, and key factors contributing to their physical activity. Methods: A cross-sectional questionnaire survey was administered in nine communities in Shanghai, using a stratified random cluster sample: 521 community-dwelling older…

  13. Living Accommodation for Young People. Report of An Exploratory Review.

    ERIC Educational Resources Information Center

    Allen, Phyllis G.; Miller, A.

    The Building Research Station has embarked on a series of case-studies on the provision of living accommodations for single young people in the 15 to 24 age group in England who live away from home because of education, training or employment. An exploratory review of the existing literature on the subject was made. Discussed are some of the…

  14. Maximizing quality of life in people living with epilepsy.

    PubMed

    Sherman, Elisabeth M S

    2009-08-01

    Improving quality of life is now seen as a major challenge facing people with epilepsy. Can research on human happiness shed light on why it is that the wellbeing and quality of life of people with epilepsy is worse than the condition's clinical and medical prognosis would predict? Empirical research on subjective wellbeing and happiness in healthy people indicates that there are a small number of key factors that are related to wellbeing, including employment, social interactions, family relationships, and experiential activities. This paper reviews these crucial components of wellbeing, discusses how each factor applies to people living with epilepsy, and identifies epilepsy-specific factors such as stigma and comorbidity that contribute to low quality of life. Lastly, this review provides a list of program-based approaches to improving quality of life, as well as practical recommendations for use by practitioners and people living with epilepsy. PMID:19760895

  15. Traditional beliefs part of people's lives.

    PubMed

    Keller, S

    1996-01-01

    Many couples worldwide practice rituals, herbal approaches, and similar traditional approaches to regulate fertility, but many of them are ineffective at preventing pregnancy and some may even be harmful. Health providers who are familiar with cultural beliefs about fertility may use nonharmful practices (e.g., rituals or storytelling) to teach couples about the fertile period or modern contraception. In fact, providers gain credibility when they teach family planning in ways that include traditional beliefs. In Nigeria, fertility regulation methods were used before modern contraception was introduced. In both Nigeria and Niger, some customs prohibit premarital sexual intercourse. Others promote sexual abstinence for up to three years to promote proper birth spacing. Even though many beliefs do not prevent pregnancy and cause no harm, they can be used to assure women that they are in control of their own fertility. Such beliefs include avoiding the sun or moon at certain times or wearing charms (e.g., dead spiders, children's teeth, or leopard skin bracelets). Providers should discourage dangerous or counterproductive beliefs, however. For example, the Nigerian belief that intercourse during menstruation turns people into albinos (although it is not harmful) may encourage sex during the fertile period. Some harmful beliefs or practices include douching with hot water, salt, vinegar, lemon, or potassium after sex; eating arsenic or castor oil seeds; and drinking water used to wash dead bodies. A 28-bead necklace is being used to help women keep track of their menstrual cycle and know when the risk of pregnancy is greatest. 11 white beads designate the fertile period, with fluorescent beads indicating the peak days of ovulation. In Brazil, the third most popular family planning method is natural family planning (NFP), indicating a clear demand for NFP; yet many couples use NFP incorrectly. In the Philippines, lime juice is used to prevent bean pods from opening and

  16. People who live in green houses.

    PubMed

    Stetson, M

    1991-01-01

    This article examines the struggle between developed and developing countries when it comes to reducing energy consumption and limit carbon emissions, necessary steps for averting global warming. Negotiators from across the world have begun discussing the issue, hoping to come to an agreement by next June, when the UN Conference on Environment and Development will meet in Brazil. Disagreement centers around the question of who is responsible for the greenhouse effect and who will pay to fix the problem. The report discusses energy consumption and its effects, the cost of producing energy, and possible ways of eliminating energy waste -- especially as it relates to the 3rd world. Currently, the industrialized world (along with the USSR and Eastern Europe) account for 70% of all carbon emissions from fossil fuel consumption. Experts predict, however, that by the year 2025, the 3rd World will surpass the industrialized world in fossil fuel consumption. The author emphasizes the difference in energy use between the 2 regions: while people in developing countries burn wood and biomass to take care of basic necessities, much of the consumption in the developed world to goes towards luxuries and amenities. Inefficient power plants waste much of the energy consumed in the 3rd World. Although hundreds of billions of dollars could be saved annually by introducing energy-saving devices, skewed international lending, underpriced electricity, and the vested interests of the 3rd World industries work against such measures. The author explains that the technology necessary to significantly reduced carbon emissions already exists. Furthermore, 3rd World countries and most industrialized nations (with the exception of the US and the USSR) have agreed on the need to reduce carbon emissions. PMID:12343295

  17. Explanatory Models and Illness Experience of People Living with HIV.

    PubMed

    Laws, M Barton

    2016-09-01

    Research into explanatory models of disease and illness typically explores people's conceptual understanding, and emphasizes differences between patient and provider models. However, the explanatory models framework of etiology, time and mode of onset of symptoms, pathophysiology, course of sickness, and treatment is built on categories characteristic of biomedical understanding. It is unclear how well these map onto people's lived experience of illness, and to the extent they do, how they translate. Scholars have previously studied the experience of people living with HIV through the lenses of stigma and identity theory. Here, through in-depth qualitative interviews with 32 people living with HIV in the northeast United States, we explored the experience and meanings of living with HIV more broadly using the explanatory models framework. We found that identity reformation is a major challenge for most people following the HIV diagnosis, and can be understood as a central component of the concept of course of illness. Salient etiological explanations are not biological, but rather social, such as betrayal, or living in a specific cultural milieu, and often self-evaluative. Given that symptoms can now largely be avoided through adherence to treatment, they are most frequently described in terms of observation of others who have not been adherent, or the resolution of symptoms following treatment. The category of pathophysiology is not ordinarily very relevant to the illness experience, as few respondents have any understanding of the mechanism of pathogenesis in HIV, nor much interest in it. Treatment has various personal meanings, both positive and negative, often profound. For people to engage successfully in treatment and live successfully with HIV, mechanistic explanation is of little significance. Rather, positive psychological integration of health promoting behaviors is of central importance. PMID:26971285

  18. Physical parameters affecting living cells in space.

    PubMed

    Langbein, D

    1986-01-01

    The question is posed: Why does a living cell react to the absence of gravity? What sensors may it have? Does it note pressure, sedimentation, convection, or other parameters? If somewhere in a liquid volume sodium ions are replaced by potassium ions, the density of the liquid changes locally: the heavier regions sink, the lighter regions rise. This may contribute to species transport, to the metabolism. Under microgravity this mechanism is strongly reduced. On the other hand, other reasons for convection like thermal and solutal interface convection are left. Do they affect species transport? Another important effect of gravity is the hydrostatic pressure. On the macroscopic side, the pressure between our head and feet changes by 0.35 atmospheres. On the microscopic level the hydrostatic pressure on the upper half of a cell membrane is lower than on the lower half. This, by affecting the ion transport through the membrane, may change the surrounding electric potential. It has been suggested to be one of the reasons for graviperception. Following the discussion of these and other effects possibly important in life sciences in space, an order of magnitude analysis of the residual accelerations tolerable during experiments in materials sciences is outlined. In the field of life sciences only rough estimates are available at present. PMID:11537842

  19. Education, Training and Rural Living: Young People in Ryedale

    ERIC Educational Resources Information Center

    Henderson, Roger

    2005-01-01

    Purpose ? To evaluate the impact of rural renaissance projects aimed at overcoming issues of accessibility and out-migration of the younger, more economically active population and to consider what young people feel about education, training and rural living in Ryedale, North Yorkshire. Design/methodology/approach ? Twenty Single Regeneration…

  20. Discourse as Medium of Knowledge: Transmission of Knowledge by Transmission of Discourse People Live

    ERIC Educational Resources Information Center

    Hassen, Rukya

    2015-01-01

    This is a study on discourse as medium of knowledge. Informal education is a system of transmission of knowledge by transmission of discourse people live by. In the humanities and social sciences, the term discourse describes a formal way of thinking that can be expressed through language. Discourses are seen to affect our views on all things; it…

  1. "Affective Encounters": Live Intermedial Spaces in Sites of Trauma

    ERIC Educational Resources Information Center

    Scott, Jo

    2016-01-01

    This article addresses live intermediality as a tool for creative learning in the context of workshops carried out with young people in the town of Terezin, in the Czech Republic, site of the Nazi concentration camp, Theresienstadt. Live intermediality, as a mode of live media practice, involves the real time mixing and merging of sound, image,…

  2. Personal health records for people living with HIV: a review.

    PubMed

    Turner, Kea; Klaman, Stacey L; Shea, Christopher M

    2016-09-01

    Personal health records have the potential to improve patient outcomes, but the state of the literature on personal health record usage by people living with the human immunodeficiency virus (HIV) is unclear. The purpose of this review is to examine the impact of personal health records on HIV-related health beliefs and behaviors. We used the Health Belief Model to guide a review of studies examining the impact of electronic personal health records on the health beliefs and behaviors among people living with HIV. The search yielded 434 results. Following abstract review, 19 papers were selected for full-text review, and 12 were included in the review. A limited number of studies in this review found a positive impact of personal health records on HIV-related beliefs and behaviors. Additional research is needed to identify which personal health record features are most influential in changing health behaviors and why adoption rates remain low, particularly for groups at greatest risk for poor HIV outcomes. Theory-informed interventions are needed to identify which patients are likely to benefit from using personal health records and how to reduce barriers to personal health record adoption for people living with HIV. PMID:26917113

  3. Patient-centered care for people living with multimorbidity

    PubMed Central

    Boyd, Cynthia M.; Lucas, Gregory M.

    2014-01-01

    Purpose of review The purpose of this review is to consider a patient-centred approach to the care of people living with HIV (PLWH) who have multimorbidity, irrespective of the specific conditions. Recent findings Interdisciplinary care to achieve patient-centred care for people with multimorbidity is recognized as important, but the evaluation of models designed to achieve this goal are needed. Key elements of such approaches include patient preferences, interpretation of the evidence, prognosis as a tool to inform patient-centred care, clinical feasibility and optimization of treatment regimens. Summary Developing and evaluating the best models of patient-centred care for PLWH who also have multimorbidity is essential. This challenge represents an opportunity to leverage the lessons learned from the care of people with multimorbidity in general, and vice versa. PMID:24871089

  4. Preterm delivery among people living around Portland cement plants.

    PubMed

    Yang, Chun-Yuh; Chang, Chih-Ching; Tsai, Shang-Shyue; Chuang, Hung-Yi; Ho, Chi-Kung; Wu, Trong-Neng; Sung, Fung-Chang

    2003-05-01

    The Portland cement industry is the main source of particulate air pollution in Kaohsiung city. Data in this study concern outdoor air pollution and the health of individuals living in communities in close proximity to Portland cement plants. The prevalence of delivery of preterm birth infants was significantly higher in mothers living within 0-2 km of a Portland cement plant than in mothers living within 2-4 km. After controlling for several possible confounders (including maternal age, season, marital status, maternal education, and infant sex), the adjusted odds ratio was 1.30 (95% CI=1.09-1.54) for the delivery of preterm infants for mothers living close to the Portland cement plants, chosen at the start to be from 0 to 2 km. These data provide further support for the hypothesis that air pollution can affect the outcome of pregnancy. PMID:12706757

  5. [The way people would like their lives to end].

    PubMed

    Tobler, K; Scholian, U

    2009-01-21

    By means of four dying trajectories we carried out a survey with people working in nursing institutions and participants of workshops preparing for retirement about the way they would like to spend the final phase of their lives (n = 159). The average lifetime women desired was 85,6 years, that of men 83,8 years. 43% wished for a sudden death to avoid suffering. 50% preferred to die within a couple of weeks or months to have time to say goodbye. In order to avoid dependence on others and the need for care 34% would forfeit at least six years, 61% at least two years of their lives. 14% would not trade off any time at all. PMID:19153954

  6. Ambient Assisted Nutritional Advisor for elderly people living at home.

    PubMed

    Lazaro, Juan P; Fides, Alvaro; Navarro, Ana; Guillen, Sergio

    2010-01-01

    Nutrition is a critical aspect when getting older because bad nutrition habits can accelerate the process of degradation of the physical condition of the old person. In order to mitigate this problem, an Ambient Assisted Living service has been developed. Research with this service is focused on demonstrating that with an Ambient Intelligence systems it is possible to make the nutritional management much more effective by influencing the user, by automatically and seamlessly monitoring and by facilitating tools for nutritional management for people that want to be autonomous. In this paper both requirement acquisition and development processes are described as well. PMID:21097180

  7. Percentage of People with at Least One Activities of Daily Living (ADL) Limitation

    MedlinePlus

    ... ADL) Limitation Percentage of People with at Least One Activities of Daily Living (ADL) Limitation This measure ... Age Group Percentage of People with at Least One Activities of Daily Living Limitation by Age Group ...

  8. Identifying Symptom Patterns in People Living With HIV Disease.

    PubMed

    Wilson, Natalie L; Azuero, Andres; Vance, David E; Richman, Joshua S; Moneyham, Linda D; Raper, James L; Heath, Sonya L; Kempf, Mirjam-Colette

    2016-01-01

    Symptoms guide disease management, and patients frequently report HIV-related symptoms, but HIV symptom patterns reported by patients have not been described in the era of improved antiretroviral treatment. The objectives of our study were to investigate the prevalence and burden of symptoms in people living with HIV and attending an outpatient clinic. The prevalence, burden, and bothersomeness of symptoms reported by patients in routine clinic visits during 2011 were assessed using the 20-item HIV Symptom Index. Principal component analysis was used to identify symptom clusters and relationships between groups using appropriate statistic techniques. Two main clusters were identified. The most prevalent and bothersome symptoms were muscle aches/joint pain, fatigue, and poor sleep. A third of patients had seven or more symptoms, including the most burdensome symptoms. Even with improved antiretroviral drug side-effect profiles, symptom prevalence and burden, independent of HIV viral load and CD4+ T cell count, are high. PMID:26790340

  9. Saving Lives and Protecting People from Injuries and Violence

    PubMed Central

    Houry, Debra

    2016-01-01

    Emergency physicians witness the impact of injury and violence every day. Traumatic brain injury, assault-related trauma, motor vehicle crashes, and drug overdoses make up only some of these injuries—many of which can be prevented and better understood. CDC’s National Center for Injury Prevention and Control—the Injury Center—is uniquely poised to measure the toll of injury and violence on the lives of Americans, to communicate such injury inequities, and to reduce the factors that increase their risk. Injury is the leading cause of death for people ages 1–44 in the United States. The Injury Center seeks to prevent violence and injuries and to reduce their consequences. For more than 20 years, Injury Center researchers have investigated those factors that put Americans at risk through surveillance and research and translated these findings into evidence-based strategies and interventions. Many of these efforts are directly relevant to emergency medicine through preventing injuries and violence to save lives. PMID:27033143

  10. Advance Care Planning among People Living with Dialysis

    PubMed Central

    Elliott, Barbara A.; Gessert, Charles E.

    2016-01-01

    Purpose: Recent nephrology literature focuses on the need for discussions regarding advance care planning (ACP) for people living with dialysis (PWD). PWD and their family members’ attitudes toward ACP and other aspects of late-life decision making were assessed in this qualitative study. Methodology: Thirty-one interviews were completed with 20 PWD over the age of 70 (mean dialysis 34 months) and 11 family members, related to life experiences, making medical decisions, and planning for the future. Interviews were recorded, transcribed and analyzed. Findings: Four themes regarding ACP emerged from this secondary analysis of the interviews: how completing ACP, advance directives (AD), and identifying an agent fit into PWD experiences; PWD understanding of their prognosis; what gives PWD lives meaning and worth; and PWD care preferences when their defined meaning and worth are not part of their experience. These PWD and family members revealed that ACP is ongoing and common among them. They did not seem to think their medical providers needed to be part of these discussions, since family members were well informed. Practical implications: These results suggest that if health care providers and institutions need AD forms completed, it will important to work with both PWD and their family members to assure personal wishes are documented and honored. PMID:27417605

  11. How many people have ever lived on earth?

    PubMed

    Haub, C

    1995-02-01

    An estimate of the total number of persons who have ever lived on earth depends on two factors: 1) the length of time humans have been on earth; and 2) the average size of human populations at different periods. According to the United Nations' "Determinants and Consequences of Population Trends," modern Homo sapiens appeared about 50,000 B.C. At the dawn of agriculture, about 8000 B.C., the world's population was around 5 million. By 1 A.D., the population had reached 300 million, which indicates a growth rate of 0.0512% per year. Life expectancy at birth averaged 10 years for most of human history. The birth rate would have to be about 80 per 1000 just for the species to survive. Infant mortality in the early days of human life would be high, probably 500 infant deaths per 1000. Children were probably economic liabilities in hunter-gatherer societies; this might have led to infanticide, which in turn would require a disproportionately high birth rate to maintain population growth. By 1650, the world's population had risen to 500 million, although the Black Plague, which began in 542 A.D. in western Asia and killed 50% of the Byzantine Empire in the sixth century (a total of 100 million deaths), had slowed the rate of growth. By 1800, the world's population passed 1 billion and continued to grow to its current total of 5.7 billion. Estimating the number of people ever born requires selecting population sizes for different points from antiquity to the present and applying assumed birth rates to each period. Assuming a constant growth rate and birth rates of 80 per 1000 through 1 A.D., 60 per 1000 from 2 A.D. to 1750, and the low 30s per 1000 by modern times, 105 billion people have lived on earth, of whom 5.5% are alive today. The assumption of constant population growth in the earliest period may have resulted in an underestimate, while an earlier date of the appearance of humans on earth would raise the number. A table of Population Reference Bureau statistics is

  12. Advance directives among people living with HIV: room for improvement.

    PubMed

    Barocas, Joshua A; Erlandson, Kristine M; Belzer, Blythe K; Hess, Timothy; Sosman, James

    2015-01-01

    While HIV has become a largely chronic disease, age-associated comorbidities are prevalent in people living with HIV (PLWH). Therefore, PLWH are appropriate for advance care planning (ACP) and advance directives (ADs) completion. We sought to characterize AD completion among outpatient PLWH. We conducted a retrospective chart review of PLWH who receive their routine care at the University of Wisconsin HIV clinic. Data were extracted from the electronic health record. Variables were entered into a stepwise multivariate logistic regression model to assess which factors were independently associated with AD completion. Five hundred and eighty eight charts were reviewed. Eighty-one percent of subjects were male and 72% were white; mean age was 46.8 years. ADs were completed by 134 subjects and 6.7% of those were completed at the HIV clinic. In the final multivariate model, those who had completed an AD were more likely to be older than age 45; ever been diagnosed with AIDS; have cardiovascular disease, neurologic disorder, chronic kidney disease, or malignancy. In this study, a small percentage of patients had documented ADs, with only a small proportion completed in the HIV clinic. The HIV clinic is an underutilized resource to offer ACP. Interventions are needed to provide the necessary ACP resources for PLWH. PMID:25307722

  13. The effect of living alone on the costs and benefits of surgery amongst older people.

    PubMed

    Turner, Alex J; Nikolova, Silviya; Sutton, Matt

    2016-02-01

    Older people who live alone are a growing, high-cost group for health and social services. The literature on how living alone affects health and the costs and benefits of healthcare has focused on crude measures of health and utilisation and gives little consideration to other cost determinants and aspects of patient experience. We study the effect of living alone at each stage along an entire treatment pathway using a large dataset which provides information on pre-treatment experience, treatment benefits and costs of surgery for 105,843 patients receiving elective hip and knee replacements in England in 2009 and 2010. We find that patients who live alone are healthier prior to treatment and experience the same gains from treatment. However, living alone is associated with a 9.2% longer length of in-hospital stay and increased probabilities of readmission and discharge to expensive destinations. These increase the costs per patient by £179.88 (3.12%) and amount to an additional £4.9 million per annum. A lack of post-discharge support for those living alone is likely to be a key driver of these additional costs. PMID:26741271

  14. Psychosocial challenges of young people affected by HIV: experiences from Hamilton County, Chattanooga, Tennessee.

    PubMed

    Chama, Samson; Ramirez, Octavio

    2015-01-01

    The number of young people affected by HIV and AIDS in Tennessee has steadily grown over the last few years. As a response to this situation, several organizations are working hard to address the needs of families impacted by HIV and AIDS. However, a close examination of some of the services provided suggests that young people within these families are ignored. Most of the services are geared toward HIV and AIDS-infected adult members of these families. Young people within these household are not targeted, and little is known about psychosocial challenges they experience in living with HIV-positive parents or guardians. In an attempt to address this gap, this small-scale qualitative study investigated the psychosocial challenges of young people affected by HIV and AIDS as a result of living with HIV-positive parents or guardians. Perceived sense of depression, experiencing stigma, self-blame, and lack of communication and loneliness were challenges that young people faced regularly. PMID:25495702

  15. Community Disclosure by People Living With HIV in Rural China.

    PubMed

    Lan, Chiao-Wen; Li, Li; Lin, Chunqing; Feng, Nan; Ji, Guoping

    2016-08-01

    The decision to disclose HIV serostatus is a complex and a challenging task because of potential stigma, blame, and fear associated with HIV infection. Despite continued research on HIV disclosure, literature on HIV disclosure to community is still scarce. The purpose of the study is to describe patterns of HIV status disclosure to community members in a sample of HIV-infected men and women in rural China. This study used the baseline data of a randomized controlled intervention trial for HIV-affected families in China. The data was collected between late 2011 to early 2013. In addition to demographic and HIV-related clinical characteristics, we collected the extent of HIV disclosure to members within the community. We first calculated descriptive statistics and frequencies to describe the demographics of the sample. We then compared the extents of HIV disclosure to different community members. We performed chi-square tests to determine whether the demographic and socioeconomic variables were associated with the extent of HIV disclosure to community. A total of 522 PLH were included in the study. The results show that age and family income are associated with the extent of disclosure of HIV status to members within the community, including neighbor, village leaders, people in the village, and coworkers. More disclosures were found among older age groups. People with less family income tend to disclose more to the community than those with higher family income. There is a need to explore the association of HIV disclosure to the community to help realize the public health and personal implications of disclosure. Our results underscore the potential benefits of age and socioeconomic status-specific interventions in the efforts to dispel barriers to HIV status disclosure to the community. PMID:27427924

  16. Who Needs Enemies with Friends like These? The Importance of Place for Young People Living in Known Gang Areas

    ERIC Educational Resources Information Center

    Ralphs, Robert; Medina, Juanjo; Aldridge, Judith

    2009-01-01

    Despite a growing concern about gangs in Britain, academic research that focuses on gangs remains scarce. Drawing on data from the ESRC-funded ethnographic research YOGEC (Youth Gangs in an English City) project, this paper explores the negotiation of space and place by young people living in inner-city areas affected by gangs. Using a combination…

  17. Behavioral Intention to Use a Virtual Instrumental Activities of Daily Living System Among People With Stroke

    PubMed Central

    Adams, Richard; White, Marga; Diamond, Paul

    2015-01-01

    OBJECTIVE. The purpose of this study was to investigate the behavioral intention to use (BIU) regarding a virtual system for practicing instrumental activities of daily living (IADLs) among people with stroke. METHOD. Fourteen people who had sustained a stroke used a virtual world–based system over four sessions to participate in virtual occupations of preparing meals and putting away groceries. To investigate intention to use the technology, participants responded to a questionnaire based on the Technology Acceptance Model and were interviewed about the experience. RESULTS. Analysis of questionnaire responses revealed favorable attitudes toward the technology and statistically significant correlations between these attitudes and positive BIU. Analysis of qualitative data revealed four themes to support system use: Use of the affected arm increased, the virtual practice was enjoyable, the technology was user-friendly, and the system reflected real-life activities. CONCLUSION. This study shows that participants reported a positive BIU for the virtual system for practicing IADLs. PMID:25871604

  18. Living with companion animals after stroke: experiences of older people in community and primary care nursing.

    PubMed

    Johansson, Maria; Ahlström, Gerd; Jönsson, Ann-Cathrin

    2014-12-01

    Older people often have companion animals, and the significance of animals in human lives should be considered by nurses-particularly in relation to older people's health, which can be affected by diseases. The incidence of stroke increases with age and disabilities as a result of stroke are common. This study aimed to explore older people's experiences of living with companion animals after stroke, and their life situation with the animals in relation to the physical, psychological and social aspects of recovery after stroke. The study was performed using individual interviews approximately 2 years after stroke with 17 participants (10 women and 7 men) aged 62-88 years. An overarching theme arising from the content analysis was contribution to a meaningful life. This theme was generated from four categories: motivation for physical and psychosocial recovery after stroke; someone to care for who cares for you; animals as family members; and providers of safety and protection. The main conclusion was that companion animals are experienced as physical and psychosocial contributors to recovery and a meaningful life after stroke. PMID:25475671

  19. Changeover-time in psychosocial wellbeing of people living with HIV and people living close to them after an HIV stigma reduction and wellness enhancement community intervention.

    PubMed

    Chidrawi, H Christa; Greeff, Minrie; Temane, Q Michael; Ellis, Suria

    2015-01-01

    HIV stigma continues to affect the psychosocial wellbeing of people living with HIV (PLWH) and people living close to them (PLC). Literature unequivocally holds the view that HIV stigma and psychosocial wellbeing interact with and have an impact on each other. This study, which is part of a larger research project funded by the South Africa Netherlands research Programme on Alternatives in Development (SANPAD), responds to the lack of interventions mitigating the impactful interaction of HIV stigma and psychosocial wellbeing and tests one such intervention. The research objectives were to test the changeover-time in the psychosocial wellbeing of PLWH and PLC in an urban and a rural setting, following a comprehensive community-based HIV stigma reduction and wellness enhancement intervention. An experimental quantitative single system research design with a pre- and four repetitive post-tests was used, conducting purposive voluntary sampling for PLWH (n = 18) and snowball sampling for PLC (n = 60). The average age of participants was 34 years old. The five measuring instruments used for both groups were the mental health continuum short-form scale, the patient health questionnaire, the satisfaction with life scale, the coping self-efficacy scale and the spirituality wellbeing scale. No significant differences were found between the urban-rural settings and data were pooled for analysis. The findings show that initial psychosocial wellbeing changes after the intervention were better sustained (over time) by the PLC than by the PLWH and seemed to be strengthened by interpersonal interaction. Recommendations included that the intervention should be re-utilised and that its tenets, content and activities be retained. A second intervention three to six months after the first should be included to achieve more sustainability and to add focused activities for the enhancement of psychosocial wellbeing. PLWH and PLC are to be encouraged to engage with innovative community

  20. The role of the occupational therapist in the care of people living with lung cancer

    PubMed Central

    2016-01-01

    This paper aims to explore the vital role occupational therapists play in enabling people living with lung cancer to continue to actively live. Core assessments and interventions employed by occupational therapists are described in a case study. It will demonstrate how people living with lung cancer can continue to participate in meaningful and chosen life roles, even in the face of functional decline. Skilled management by the occupational therapist of the refractory symptoms of advanced lung cancer supports this participation. PMID:27413702

  1. Integrated Living for Severely Disabled People: A Radical Approach.

    ERIC Educational Resources Information Center

    Pagano, Nicholas A., Jr.

    This presentation outlines the approach to integrated living for severely disabled individuals which was developed by Independent Living for the Handicapped of Brooklyn, New York. After a brief overview of the history and philosophy of this organization, the 'how-to' approach is explained. This program model coordinates services which are…

  2. Assessing Risk of Injury in People with Mental Retardation Living in an Intermediate Care Facility

    ERIC Educational Resources Information Center

    Konarski, Edward A.; Tasse, Marc

    2005-01-01

    A brief instrument to assess risk of injury was applied retrospectively for 2 years and prospectively for 1 year to all people living in a large ICF/MR. Results suggest that the percentage of people who experienced an injury significantly increased across the levels of increasing risk indicated by the assessment. Furthermore, people who…

  3. Ready, Steady, Action: What Enables Young People to Perceive Themselves as Active Agents in Their Lives?

    ERIC Educational Resources Information Center

    Sharp, Russell

    2014-01-01

    Government and educational priorities place importance on young people of secondary school age being active, having their voices heard, and participating in their community. This paper explores an understanding of the role of agency in young people's lives and how the concept is developing. Young people who perceive themselves as having…

  4. Stories of Growth and Wisdom: A Mixed-Methods Study of People Living Well With Pain.

    PubMed

    Owens, Justine E; Menard, Martha; Plews-Ogan, Margaret; Calhoun, Lawrence G; Ardelt, Monika

    2016-01-01

    Chronic pain remains a daunting clinical challenge, affecting 30% of people in the United States and 20% of the global population. People meeting this challenge by achieving wellbeing while living with pain are a virtually untapped source of wisdom about this persistent problem. Employing a concurrent mixed-methods design, we studied 80 people living with chronic pain with "positive stories to tell" using semi-structured interviews and standardized questionnaires. In-depth interviews focused on what helped, what hindered, how they changed, and advice for others in similar circumstances. Major qualitative themes included acceptance, openness, self-efficacy, hope, perseverance, self-regulation, kinesthetic awareness, holistic approaches and integrative therapies, self-care, spirituality, social support, and therapeutic lifestyle behaviors such as music, writing, art, gardening, and spending time in nature. Themes of growth and wisdom included enhanced relationships, perspective, clarity, strength, gratitude, compassion, new directions, and spiritual change. Based on narrative analysis of the interviews and Ardelt's Three-Dimensional Wisdom Model, participants were divided into 2 groups: 59 wisdom exemplars and 21 nonexemplars. Non-exemplar themes were largely negative and in direct contrast to the exemplar themes. Quantitatively, wisdom exemplars scored significantly higher in Openness and Agreeableness and lower in Neuroticism compared to non-exemplars. Wisdom exemplars also scored higher in Wisdom, Gratitude, Forgiveness, and Posttraumatic Growth than nonexemplars, and more exemplars used integrative therapies compared to the non-exemplars. As a whole, the exemplar narratives illustrate a Positive Approach Model (PAM) for living well with pain, which allows for a more expansive pain narrative, provides positive role models for patients and clinicians, and contributes to a broader theoretical perspective on persistent pain. PMID:26937311

  5. Stories of Growth and Wisdom: A Mixed-Methods Study of People Living Well With Pain

    PubMed Central

    Menard, Martha; Plews-Ogan, Margaret; Calhoun, Lawrence G.; Ardelt, Monika

    2016-01-01

    Chronic pain remains a daunting clinical challenge, affecting 30% of people in the United States and 20% of the global population. People meeting this challenge by achieving wellbeing while living with pain are a virtually untapped source of wisdom about this persistent problem. Employing a concurrent mixed-methods design, we studied 80 people living with chronic pain with “positive stories to tell” using semi-structured interviews and standardized questionnaires. In-depth interviews focused on what helped, what hindered, how they changed, and advice for others in similar circumstances. Major qualitative themes included acceptance, openness, self-efficacy, hope, perseverance, self-regulation, kinesthetic awareness, holistic approaches and integrative therapies, self-care, spirituality, social support, and therapeutic lifestyle behaviors such as music, writing, art, gardening, and spending time in nature. Themes of growth and wisdom included enhanced relationships, perspective, clarity, strength, gratitude, compassion, new directions, and spiritual change. Based on narrative analysis of the interviews and Ardelt's Three-Dimensional Wisdom Model, participants were divided into 2 groups: 59 wisdom exemplars and 21 nonexemplars. Non-exemplar themes were largely negative and in direct contrast to the exemplar themes. Quantitatively, wisdom exemplars scored significantly higher in Openness and Agreeableness and lower in Neuroticism compared to non-exemplars. Wisdom exemplars also scored higher in Wisdom, Gratitude, Forgiveness, and Posttraumatic Growth than nonexemplars, and more exemplars used integrative therapies compared to the non-exemplars. As a whole, the exemplar narratives illustrate a Positive Approach Model (PAM) for living well with pain, which allows for a more expansive pain narrative, provides positive role models for patients and clinicians, and contributes to a broader theoretical perspective on persistent pain. PMID:26937311

  6. Writing Direction Affects How People Map Space Onto Time

    PubMed Central

    Bergen, Benjamin K.; Chan Lau, Ting Ting

    2012-01-01

    What determines which spatial axis people use to represent time? We investigate effects of writing direction. English, like Mandarin Chinese in mainland China, is written left to right and then top to bottom. But in Taiwan, characters are written predominantly top to bottom and then right to left. Because being a fluent reader–writer entails thousands of hours of experience with eye and hand movement in the direction dictated by one’s writing system, it could be that writing system direction affects the axis used to represent time in terms of space. In a behavioral experiment, we had native speakers of English, Mandarin Chinese from mainland China, and Mandarin Chinese from Taiwan place sets of cards in temporal order. These cards depicted stages of development of plants and animals, for instance: tadpole, froglet, frog. Results showed that English speakers always represented time as moving from left to right (LR). Mainland Chinese participants trended in the same direction, but a small portion laid the cards out from top to bottom. Taiwanese participants were just as likely to depict time as moving from LR as from top to bottom, with a large minority depicting it as moving from right to left. Native writing system affects how people represent time spatially. PMID:22514546

  7. Yesterday Still Lives...Our Native People Remember Alaska.

    ERIC Educational Resources Information Center

    DeMarco, Pat, Ed.; And Others

    In the summer of 1978, seven teenagers and several staff members from the Fairbanks Native Association-Johnson O'Malley program set out to record some of Alaska's past by interviewing a number of older Alaska Natives and writing their biographical sketches. Some of the students spent a week along the Yukon River taping and photographing people;…

  8. Flood information from affected people - gains and uncertainties

    NASA Astrophysics Data System (ADS)

    Kreibich, Heidi; Poser, Kathrin; Pech, Ina; Müller, Meike

    2013-04-01

    For emergency management and reconstruction planning, a broad overview of the flood event is required. For this overview, information from many different sources has to be acquired and integrated. Observations from the affected population can be an important source of information. New Internet technologies facilitate fast and easy data collection from the public, but also interviews with the affected population can be used. A major obstacle for using such kind of information is its unknown quality. Thus, information about a flood event, i.e. impact data and associated losses collected in telephone interviews, is assessed for its reliability and fitness for use for flood loss modeling. First results show that water level can be estimated by observers with very good accuracy in comparison with results of hydraulic models. Flow velocity, however, is very difficult to estimate and the estimates differ significantly from modeled values. Household specific flood damage data compares very well with official damage information. Some information like precautionary and emergency measures undertaken can only be gained from affected people.

  9. Social, Psychological and Health Concerns of People Living with HIV/AIDS in Mysore District, Karnataka

    PubMed Central

    Siddanna, Sunitha

    2016-01-01

    Introduction One of the significant health and social problem the world facing today is Acquired immune deficiency syndrome (AiDS). The patients affected with HIV and their family may face various psychosocial problems during diagnosis and treatment due to the stigma associated with this disease. Aim The objective of the study was to identify social, psychological and health concerns of people living with HIV/AIDS (PLWHA) and its association with the demographic factors in Mysore District, Karnataka, India. Materials and Methods A questionnaire based study was conducted among 194 participants in Mysore District, Karnataka state who were receiving care and support services. A 22-item questionnaire provided information regarding social, psychological and health concerns of PLWHA in Mysore district. A general linear regression model was used for assessing the predictors of social, psychological and health concerns. Results The main social concern was that of "Fear of Losing a loved one" whereas the main psychological concern was "Too much worry", "No cure for AIDS" was the highly rated health concern. Males had more social, psychological and health concerns when compared to females but was not statistically significant. Employed people were having fewer psychological concerns when compared to unemployed people. Unemployed people were having fewer health concerns than employed people. For every unit increase in age there were fewer social and health concerns and both these findings were statistically significant. Conclusion PLWHA in the present study reported that they were concerned about social, psychological and health issues in spite of the fact they were attending counseling. Health care workers, including those in public health sector should be educated about the importance of these factors that influence the health of the population they are caring for. PMID:27134901

  10. Differences between family caregivers and people with dementia in recognizing the difficulties encountered in the lives of people with dementia.

    PubMed

    Miyamura, Toshihiro

    2016-01-01

    Objectives Dementia brings new difficulties in the lives of people with this disorder. It is important that family caregivers accurately recognize these difficulties to help their family members live fulfilling lives. Based on information gathered from people with dementia, family caregivers, and nurses providing medical care to this population, this study compared the differences in perspectives related to the difficulties associated with dementia between the family member with dementia and the family caregiver.Methods The primary participants in this investigation were 106 people with dementia and their family caregivers. Participants with dementia were 65 years and older who were receiving home care in Tokyo. Participants were interviewed about their difficulties while family caregivers completed a questionnaire with basic information regarding people with dementia. Additionally, the nurse providing medical care to the person with dementia completed a questionnaire about the medical care. In this study, difficulties in the lives of people with dementia was defined as impediments in life due to dementia. Difficulties were classified according to 12 symptoms based on responses that appeared frequently in the interviews. The 12 symptoms were pain, hallucinations/delusions, aggressive behavior, memory loss, disorientation, communication impairment, anxiety/confusion, toileting problems, gait disturbance, dietary deficiency, sleep disorder, and social withdrawal. Additional information was gathered and analyzed that included diagnosis and severity of dementia, need for long-term care, core symptoms of dementia, behavioral and psychological symptoms of dementia (BPSD), and delirium.Results The family caregiver's perspective about the difficulties encountered in the life of their family member with dementia was often different from the perspective of the associated family member. No family caregivers recognized that pain was a difficulty, and there were only a

  11. Native Americans: The People and How They Lived.

    ERIC Educational Resources Information Center

    Potter, Eloise F.; Funderburg, John B.

    This large format book with many color illustrations describes native American history on the American continents from the Ice Age to the present, concentrating on Indian history in North Carolina. The book examines living arrangements, objects of daily use, animal husbandry and agriculture, tribal leagues, and architecture. It describes the 28…

  12. Counseling People Living in Poverty: The CARE Model

    ERIC Educational Resources Information Center

    Foss, Louisa L.; Generali, Margaret M.; Kress, Victoria E.

    2011-01-01

    Counselors frequently counsel clients who live in poverty. The authors describe the new CARE model that addresses the influence of multiple systems on poor clients' experiences. A social justice, humanistic intervention, the CARE model emphasizes cultivating a positive counseling relationship with poor clients, empathizing with their unique…

  13. Neural activities during affective processing in people with Alzheimer's disease.

    PubMed

    Lee, Tatia M C; Sun, Delin; Leung, Mei-Kei; Chu, Leung-Wing; Keysers, Christian

    2013-03-01

    This study examined brain activities in people with Alzheimer's disease when viewing happy, sad, and fearful facial expressions of others. A functional magnetic resonance imaging and a voxel-based morphometry methodology together with a passive viewing of emotional faces paradigm were employed to compare the affective processing in 12 people with mild Alzheimer's disease and 12 matched controls. The main finding was that the clinical participants showed reduced activations in regions associated with the motor simulation system (the ventral premotor cortex) and in regions associated with emotional simulation-empathy (the anterior insula and adjacent frontal operculum). This regional decline in blood oxygen level-dependent signals appeared to be lateralized in the left hemisphere and was not related to any structural degeneration in the clinical participants. Furthermore, the regions that showed changes in neural activity differed for the 3 emotional facial expressions studied. Findings of our study indicate that neural changes in regions associated with the motor and emotional simulation systems might play an important role in the development of Alzheimer's disease. PMID:22840336

  14. Experiences of people living with HIV and people living close to them of a comprehensive HIV stigma reduction community intervention in an urban and a rural setting

    PubMed Central

    French, Heleen; Greeff, Minrie; Watson, Martha J.

    2014-01-01

    Abstract HIV stigma remains high globally. Although there is a selection of HIV stigma reduction interventions discussed in the literature, there is a paucity of research about the effectiveness of these interventions. This study aimed at gaining a deeper understanding of the experiences of people living with HIV (PLWH) and people living close to them from six designated groups during and after having undergone a comprehensive HIV stigma reduction community intervention in both an urban and a rural setting. Attention was focused on their expressed experiences of the workshop and projects executed. A qualitative interpretive description approach was used. PLWH as participants were selected through purposive voluntary sampling and through snowball sampling for the people living close to them. Recruitment was from both urban and rural settings in the North West Province, South Africa. Data collection was via in-depth interviews with 23 PLWH and 60 people living close to them from specific designated groups. The data were thematically analysed through manual open coding. The results from the urban and rural settings were pooled, as there were no noteworthy differences in the themes between them. The results indicated that there was an increase in knowledge in all the groups, as well as experiences of enhanced relationships and of being equipped with leadership skills in order to go out into the community and being part of HIV stigma reduction actions. The intervention in its comprehensive nature was found to have been successful and promising for future use in reducing HIV stigma. PMID:25019454

  15. Health Needs of People Living with HIV/AIDS: From the Perspective of Policy Makers, Physicians and Consultants, and People Living with HIV/AIDS

    PubMed Central

    MORADI, Ghobad; MOHRAZ, Minoo; GOUYA, Mohammad Mehdi; DEJMAN, Masoumeh; SEYEDALINAGHI, SeyedAhmad; KHOSHRAVESH, Sahar; MALEKAFZALI ARDAKANI, Hossein

    2014-01-01

    Abstract Background HIV/AIDS has been concentrated among injecting drug users in the country. This study aimed to investigate and identify health and treatment needs of people living with HIV/AIDS in Iran. Methods This qualitative study was conducted in 2012 in Iran. The study groups consisted of experts, practitioners, and consultants working with People Living with HIV/AIDS and their families. Data was collected through Focus Group Discussions and deep interviews. Data were analyzed using content analysis method. Results The findings of this study included the needs of people living with HIV/AIDS, which were classified in three main categories. The first category was prevention and counseling services with several sub-groups such as education and public and available consultation, distribution of condoms to vulnerable groups, increasing counseling centers in urban areas, providing appropriate psychological and supportive counseling, and family planning services. The second category included diagnostic and treatment services and had several sub-groups such as full retroviral treatment, Tuberculosis treatment and continuing care, providing care and treatment for patients with hepatitis, and providing dental services. The third category included rehabilitation services and had some sub-categories such as home care, social and psychological support, nutritional support, and empowering positive clubs. Conclusions This study puts emphasis on making plans based on the priorities to meet the needs of people living with HIV/AIDS in Iran. PMID:26060705

  16. The Economic Lives of People with Disabilities in Vietnam

    PubMed Central

    Palmer, Michael; Groce, Nora; Mont, Daniel; Nguyen, Oanh Hong; Mitra, Sophie

    2015-01-01

    Through a series of focus group discussions conducted in northern and central Vietnam, this study gives voice to the lived economic experience of families with disabilities and how they manage the economic challenges associated with disability. The dynamic of low and unstable income combined with on-going health care and other disability-related costs gives rise to a range of coping mechanisms (borrowing, reducing and foregoing expenditures, drawing upon savings and substituting labour) that helps to maintain living standards in the short-run yet threatens the longer-term welfare of both the individual with disability and their household. Current social protection programs were reported as not accessible to all and while addressing some immediate economic costs of disability, do not successfully meet current needs nor accommodate wider barriers to availing benefits. PMID:26197034

  17. The prevalence of comorbidities among people living with HIV in Brent: a diverse London Borough.

    PubMed

    Lorenc, Ava; Ananthavarathan, Piriyankan; Lorigan, James; Jowata, Mohamade; Brook, Gary; Banarsee, Ricky

    2014-01-01

    Background HIV has changed from a rapidly deteriorating illness to a complex chronic disease, with increasing incidences of comorbidity, including cancer, and liver, lung and cardiovascular diseases. North West London has 6719 individuals living with the human immunodeficiency virus (HIV), 873 of whom reside in the London Borough of Brent. Traditionally, commissioning services have focused on HIV therapy alone without considering how comorbidity affects treatment outcome and total service costs. Setting The setting for the study was NHS Brent Primary Care Trust, London UK. Question What associated comorbidities are present in people in Brent (London, UK) living with HIV, and how common are they? Methods A point-prevalence audit of retrospective data was conducted on all HIV-positive patients in Brent (financial year 2011/12). Data were collected from genito-urinary medicine (GUM) services, community services and general practitioners (GPs) on HIV diagnosis, patient demographics and past/current comorbidities: hepatitis B and C, cardiovascular disease, diabetes and mental health disorders. Results This study identified that 29% of people living with HIV/AIDS (PLWHA) in Brent have at least one comorbidity. The most common was hepatitis, followed by mental health disorders and cardiovascular disease (CVD). Comorbidity was more likely in older male patients (in particular CVD and diabetes) and White patients (except for diabetes which was more common in Asian groups). Discussion/Conclusion Many PLWHA in Brent suffer from a number of other conditions, which appear largely independent of HIV. Findings confirm the need to treat HIV as a long-term condition, including patient education, empowerment and encouraging self-management. The multi-morbidity of many PLWHA suggests a role for both primary care and collaborative, holistic, patient-centred and individualised healthcare. Service providers and commissioners need to consider comorbidities in their treatment of and

  18. The prevalence of comorbidities among people living with HIV in Brent: a diverse London Borough

    PubMed Central

    Lorenc, Ava; Lorigan, James; Jowata, Mohamade; Brook, Gary; Banarsee, Ricky

    2014-01-01

    Background HIV has changed from a rapidly deteriorating illness to a complex chronic disease, with increasing incidences of comorbidity, including cancer, and liver, lung and cardiovascular diseases. North West London has 6719 individuals living with the human immunodeficiency virus (HIV), 873 of whom reside in the London Borough of Brent. Traditionally, commissioning services have focused on HIV therapy alone without considering how comorbidity affects treatment outcome and total service costs. Setting The setting for the study was NHS Brent Primary Care Trust, London UK. Question What associated comorbidities are present in people in Brent (London, UK) living with HIV, and how common are they? Methods A point-prevalence audit of retrospective data was conducted on all HIV-positive patients in Brent (financial year 2011/12). Data were collected from genito-urinary medicine (GUM) services, community services and general practitioners (GPs) on HIV diagnosis, patient demographics and past/current comorbidities: hepatitis B and C, cardiovascular disease, diabetes and mental health disorders. Results This study identified that 29% of people living with HIV/AIDS (PLWHA) in Brent have at least one comorbidity. The most common was hepatitis, followed by mental health disorders and cardiovascular disease (CVD). Comorbidity was more likely in older male patients (in particular CVD and diabetes) and White patients (except for diabetes which was more common in Asian groups). Discussion/Conclusion Many PLWHA in Brent suffer from a number of other conditions, which appear largely independent of HIV. Findings confirm the need to treat HIV as a long-term condition, including patient education, empowerment and encouraging self-management. The multi-morbidity of many PLWHA suggests a role for both primary care and collaborative, holistic, patient-centred and individualised healthcare. Service providers and commissioners need to consider comorbidities in their treatment of and

  19. People with Intellectual Disabilities Living in Generic Residential Services for Older People in the UK

    ERIC Educational Resources Information Center

    Thompson, D. J.; Ryrie, I.; Wright, S.

    2004-01-01

    Background: As part of a UK programme of work focusing on older people with intellectual disabilities, the circumstance of those who reside in generic services for older people were investigated. Materials and methods: Questionnaires were sent to 2570 residential and nursing homes in 53 local authorities across the UK. Results: Five hundred and…

  20. The Prevalence of Behavior Problems among People with Intellectual Disability Living in Community Settings

    ERIC Educational Resources Information Center

    Myrbakk, Even; Von Tetzchner, Stephen

    2008-01-01

    With the desegregation processes of services for people with intellectual disability (ID) that is taking place in most Western countries there is a need for more knowledge related to the prevalence of behavior problems among people living in community settings. This study investigates the prevalence of behavior problems among 140 adolescents and…

  1. New Learning Worlds: The Significance of Nature in the Lives of Marginalised Young People

    ERIC Educational Resources Information Center

    Quinn, Jocey

    2013-01-01

    This article explores a hitherto neglected issue: the significance of nature in the learning lives of marginalised young people. Drawing on both post-human and sociocultural perspectives, it develops a theoretical analysis of this important subject. It uses research with 114 young people in jobs without training in rural South-west England to…

  2. Theorising the Relationship between Older People and Their Immediate Social Living Environment

    ERIC Educational Resources Information Center

    Buffel, Tine; Verte, Dominique; De Donder, Liesbeth; De Witte, Nico; Dury, Sarah; Vanwing, Tom; Bolsenbroek, Anouk

    2012-01-01

    This article presents a theoretical framework for exploring the dynamics between older people and their immediate social living environment. After introducing a gerontological perspective that goes beyond "microfication," a literature review presents findings from studies that have explored the role of place and locality for older people. Next,…

  3. Sustainable Living in Long-Term Care: For People with Dementia/Alzheimer's

    ERIC Educational Resources Information Center

    Simmons, Daniela

    2011-01-01

    Nonhome-based long-term care sustainable living arrangements for elderly people with Alzheimer's is presented. Characteristics contributing to sustainability are discussed. The ultimate goal in sustainable design for older adult communities is a people-centered model of care in environments that improve their quality of life. Without sustainable…

  4. Natural hazards and motivation for mitigation behavior: people cannot predict the affect evoked by a severe flood.

    PubMed

    Siegrist, Michael; Gutscher, Heinz

    2008-06-01

    Past research indicates that personal flood experience is an important factor in motivating mitigation behavior. It is not fully clear, however, why such experience is so important. This study tested the hypothesis that people without flooding experience underestimate the negative affect evoked by such an event. People who were affected by a severe recent flood disaster were compared with people who were not affected, but who also lived in flood-prone areas. Face-to-face interviews with open and closed questions were conducted (n= 201). Results suggest that people without flood experience envisaged the consequences of a flood differently from people who had actually experienced severe losses due to a flood. People who were not affected strongly underestimated the negative affect associated with a flood. Based on the results, it can be concluded that risk communication must not focus solely on technical aspects; in order to trigger motivation for mitigation behavior, successful communication must also help people to envisage the negative emotional consequences of natural disasters. PMID:18643832

  5. Meeting the Health Needs of People with Disability Living in the Community

    ERIC Educational Resources Information Center

    Mott, Sarah; Chau, Andrew; Chan, Jeff

    2007-01-01

    An increasing number of people with disabilities live in the community in Australia and internationally. Many of these individuals live in the family home, on their own, in hostels or in the traditional "group home" model, and receive varying levels of support and care. There is a growing concern that many of the care and support needs of these…

  6. Quality of Life of Poor People Living in Remote Areas in Hong Kong

    ERIC Educational Resources Information Center

    Wong, Hung

    2011-01-01

    Based on three surveys carried out for studying living conditions of youth, women and elderly living in six remote areas (Tuen Mun, Yuen Long, Tin Shui Wai, Sheung Shui, Fan Ling and Tai Po) in the New Territories of Hong Kong, this paper reports the poverty and social exclusion of these three groups of people. The quality of life of youth, women…

  7. The Pursuit of Leisure: Enriching the Lives of People Who Have a Disability. Revised Edition.

    ERIC Educational Resources Information Center

    Gold, Deborah, Ed.; McGill, Judith, Ed.

    The book examines the place of leisure in the lives of disabled people and their families, in 18 articles by parents, counselors, recreation specialists, vocational counselors, researchers, and advocates. Stressed throughout is the potential of leisure when seen as a dimension of and vehicle for community living. Chapters are as follows:…

  8. Saving Lives and Protecting People From Injuries and Violence.

    PubMed

    Houry, Debra

    2016-08-01

    Emergency physicians witness the effects of injury and violence every day. Traumatic brain injury, assault-related trauma, motor vehicle crashes, and opioid overdoses make up only some of these injuries-many of which can be prevented and better understood. The Centers for Disease Control and Prevention's National Center for Injury Prevention and Control (Injury Center) is uniquely poised to measure the toll of injury and violence on the lives of Americans, to communicate this public health burden, and to reduce the factors that increase their risk. Injury is the leading cause of death for persons aged 1 to 44 years in the United States. The Injury Center seeks to prevent violence and injuries and to reduce their consequences. For more than 20 years, Injury Center researchers have investigated factors that put Americans at risk through surveillance and research and translated these findings into evidence-based strategies and interventions. Many of these efforts are directly relevant to emergency medicine through preventing injuries and violence to save lives. PMID:27033143

  9. Culturally Competent Service Provision Issues Experienced By Aboriginal People Living With HIV/AIDS

    PubMed Central

    Barlow, Kevin; Loppie, Charlotte; Jackson, Randy; Akan, Margaret; MacLean, Lynne; Reimer, Gwen

    2010-01-01

    Cultural identity is an important factor in how well Aboriginal people respond to HIV/AIDS prevention or, once diagnosed with HIV or AIDS, how it affects their health care. This study explores the cultural skills among service providers who see Aboriginal people living with HIV/AIDS (APHAs) and the perspectives of APHAs. The purpose is to better understand the wellness needs of APHAs and how culturally competent care affects health service access and use. Data collection included face-to-face semi-structured interviews with APHAs and focus groups/interviews with community-based and primary health professionals in five regions of Canada. Interviews and focus groups were voice-recorded, verbatim transcribed, and coded using Atlas.ti® software. Thirty-five APHAs and fifty-two service providers were reached. Two key themes were noticed: Active addictions are a major obstacle to adherence to HIV drug regimes. Half of APHA participants said addictions are a major factor. A similar portion noted intensified substance use was an initial coping strategy when diagnosed. A slightly smaller portion noted that addictions were dealt with soon after diagnosis in order to begin antiretroviral treatment. Service providers who inform, encourage, and support APHAs’ choices are viewed as “culturally competent.”Addictions and HIV must be “treated together,” reflecting a holistic worldview of Aboriginal people. Programs that integrate addiction treatment with HIV/AIDS and service providers who encourage and support APHA’s choices are viewed as “wise practice” models by both sets of study participants offering some convergence and a set of five wise practices are identified. PMID:20835301

  10. Marital sex among people living with HIV receiving antiretroviral treatment in northern Thailand.

    PubMed

    Le Coeur, Sophie; Bozon, Michel; Lelièvre, Eva; Sirijitraporn, Preecha; Pipustanawong, Narongdate; Cowatcharagul, Worawut; Pattanapornpun, Nopporn

    2014-01-01

    Before the advent of effective antiretroviral treatment (ART), the sexuality of people living with HIV was mostly discussed in terms of risk. To assess the extent to which ART allows people living with HIV to regain a regular sexual life, we surveyed all HIV-infected people treated in four hospitals in Northern Thailand and a control group from the general population matched by sex, age and residence. Data included socio-demographic and health characteristics, frequency of sexual intercourse in the last month and condom use. Our findings indicate that people living with HIV less often live in steady partnership (50% of the HIV-infected people versus 79% of the controls). After adjusting for factors known to influence sexuality, their probability of being sexually active was estimated to be about half that of the controls. When sexually active, men had a reduced sexual activity compared to controls (2.8 intercourse in the last month versus 4.0), while levels of reported sexual activity were similar among women (2.2 versus 2.8, respectively). Consistent condom use was high among people living with HIV (66% for women and 70% for men). PMID:24960032

  11. Resisting and challenging stigma in Uganda: the role of support groups of people living with HIV

    PubMed Central

    Mburu, Gitau; Ram, Mala; Skovdal, Morten; Bitira, David; Hodgson, Ian; Mwai, Grace W; Stegling, Christine; Seeley, Janet

    2013-01-01

    Introduction Global scale up of antiretroviral therapy is changing the context of HIV-related stigma. However, stigma remains an ongoing concern in many countries. Groups of people living with HIV can contribute to the reduction of stigma. However, the pathways through which they do so are not well understood. Methods This paper utilizes data from a qualitative study exploring the impact of networked groups of people living with HIV in Jinja and Mbale districts of Uganda. Participants were people living with HIV (n=40), members of their households (n=10) and their health service providers (n=15). Data were collected via interviews and focus group discussions in 2010, and analyzed inductively to extract key themes related to the approaches and outcomes of the groups’ anti-stigma activities. Results Study participants reported that HIV stigma in their communities had declined as a result of the collective activities of groups of people living with HIV. However, they believed that stigma remained an ongoing challenge. Gender, family relationships, social and economic factors emerged as important drivers of stigma. Challenging stigma collectively transcended individual experiences and united people living with HIV in a process of social renegotiation to achieve change. Groups of people living with HIV provided peer support and improved the confidence of their members, which ultimately reduced self-stigma and improved their ability to deal with external stigma when it was encountered. Conclusions Antiretroviral therapy and group-based approaches in the delivery of HIV services are opening up new avenues for the collective participation of people living with HIV to challenge HIV stigma and act as agents of social change. Interventions for reducing HIV stigma should be expanded beyond those that aim to increase the resilience and coping mechanisms of individuals, to those that build the capacity of groups to collectively cope with and challenge HIV stigma. Such

  12. Music--Their Lives: The Experience of Music and View of Music of a Number of Swedish and English Young People

    ERIC Educational Resources Information Center

    Stalhammar, Borje

    2004-01-01

    Music plays an important part in the lives of people of all ages. It can have symbolic significance for nation-states and regions, can be a source of deep emotional experience for the individual, or can be an expression of life-style, image and social belonging. Music affects, but is itself affected by forces influenced by different purposes and…

  13. Noisy human neighbours affect where urban monkeys live

    PubMed Central

    Duarte, Marina H. L.; Vecci, Marco A.; Hirsch, André; Young, Robert J.

    2011-01-01

    Urban areas and many natural habitats are being dominated by a new selection pressure: anthropogenic noise. The ongoing expansion of urban areas, roads and airports throughout the world makes the noise almost omnipresent. Urbanization and the increase of noise levels form a major threat to living conditions in and around cities. Insight into the behavioural strategies of urban survivors may explain the sensitivity of other species to urban selection pressures. Here, we show that urban black-tufted marmosets (Callithrix penicillata) living in noisy urban areas may select their home-range based primarily on ambient noise level. We have tested the hypothesis that the noise from vehicular traffic and visitors in an urban park in Brazil influences the use of home-range (space) by urban marmosets. Marmosets even avoided noisy areas with high food availability. In addition, they systematically preferred the quieter areas even with dynamic changes in the acoustic landscape of the park between weekdays and Sundays (no observations were made on Saturdays). These data provide evidence that the use of home-range by wild animals can be affected by a potential aversive stimulus such as noise pollution. PMID:21715396

  14. Noisy human neighbours affect where urban monkeys live.

    PubMed

    Duarte, Marina H L; Vecci, Marco A; Hirsch, André; Young, Robert J

    2011-12-23

    Urban areas and many natural habitats are being dominated by a new selection pressure: anthropogenic noise. The ongoing expansion of urban areas, roads and airports throughout the world makes the noise almost omnipresent. Urbanization and the increase of noise levels form a major threat to living conditions in and around cities. Insight into the behavioural strategies of urban survivors may explain the sensitivity of other species to urban selection pressures. Here, we show that urban black-tufted marmosets (Callithrix penicillata) living in noisy urban areas may select their home-range based primarily on ambient noise level. We have tested the hypothesis that the noise from vehicular traffic and visitors in an urban park in Brazil influences the use of home-range (space) by urban marmosets. Marmosets even avoided noisy areas with high food availability. In addition, they systematically preferred the quieter areas even with dynamic changes in the acoustic landscape of the park between weekdays and Sundays (no observations were made on Saturdays). These data provide evidence that the use of home-range by wild animals can be affected by a potential aversive stimulus such as noise pollution. PMID:21715396

  15. The experience of caregivers of people living with serious mental disorders: a study from rural Ghana

    PubMed Central

    Ae-Ngibise, Kenneth Ayuurebobi; Doku, Victor Christian Korley; Asante, Kwaku Poku; Owusu-Agyei, Seth

    2015-01-01

    Background Families and friends who give care to people with mental disorders (MDs) are affected in a variety of ways and degrees. The interplay of caregiving consequences: poverty, discrimination and stigma, lack of support from others, diminished social relationships, depression, emotional trauma, and poor or interrupted sleep are associated caregiver burden. Objective The burden of care on caregivers of people living with MDs was assessed in two districts located in the middle part of Ghana. Coping strategies and available support for caregivers of MDs were also assessed. Design A qualitative study was carried out involving 75 caregivers of participants with MDs registered within the Kintampo Health and Demographic Surveillance Systems. Data were gathered from caregivers about their experiences in providing care for their relations with MDs. Results Caregivers reported various degrees of burden, which included financial, social exclusion, emotional, depression, and inadequate time for other social responsibilities. Responsibilities around caregiving were mostly shared among close relatives but to a varying and limited extent. Religious prayers and the anticipation of cure were the main coping strategies adopted by caregivers, with expectation of new treatments being discovered. Conclusions Emotional distress, stigma, financial burden, lack of support networks, social exclusion, health impact, and absence of decentralised mental health services were experienced by family caregivers. These findings highlight the need for interventions to support people with MDs and their caregivers. This might include policy development and implementation that will decentralise mental health care provision including psychosocial support for caregivers. This will ameliorate families’ financial and emotional burden, facilitate early diagnosis and management, reduce travel time to seek care, and improve the quality of life of family caregivers of persons with MDs. PMID:25967587

  16. Quality of life of people living with HIV and AIDS and antiretroviral therapy.

    PubMed

    Oguntibeju, Oluwafemi O

    2012-01-01

    The development of antiretroviral drugs has significantly changed the perception of HIV/AIDS from a very fatal to a chronic and potentially manageable disease, and the availability and administration of antiretroviral therapy (ART) has significantly reduced mortality and morbidity associated with HIV and AIDS. There is a relationship between ART and quality of life of people living with HIV and AIDS, and several studies have reported a strong positive association between ART and improved quality of life in different domains among people living with HIV and AIDS in both developed and developing countries. However, a few studies have reported on the negative effects of ART, which directly or indirectly relate to the quality of life and longevity of HIV-infected persons. In this review, the effects and benefits of ART on people living with HIV and AIDS based on studies done in developed and developing countries is examined. PMID:22893751

  17. Perceptions of people living with HIV/AIDS regarding access to health care.

    PubMed

    Vaswani, Vina; Vaswani, Ravi

    2014-04-01

    Although the health care is replete with technology in the present day, it is not freely accessible in a developing country. The situation could be even more compromised in the case of people living with HIV/AIDS, with the added dimension of stigma and discrimination. What are the factors that act as barriers to health care? This study was conducted to look into perceptions of people living with HIV/AIDS with regard to access to health care. The study looked into accessibility of general health vis-à-vis access to antiretroviral therapy. Demographic variables like age, gender, income were studied in relation to factors such as counseling, confidentiality, stigma and discrimination, which are known to influence access to health care. People living with HIV/AIDS perceive general health care as more accessible than care for HIV treatment. Discrimination by health care workers causes a barrier to accessibility. PMID:24946513

  18. Sexual health screening in people living with HIV--are we getting the whole story?

    PubMed

    Perez, Katrina; Bassett, Deborah; Lee, Vincent

    2016-04-01

    Patients' notes were audited to evaluate sexual health screening in 385 people living with HIV. A total of 76% were offered sexually transmitted infection (STI) screening; 85% of these accepted; 62% reported regular partners of whom 44% were also people living with HIV. In men who have sex with men (MSM), 64% reported consistent condom use for anal sex; of these, 15% had rectal STIs diagnosed. Of all patients, 62% reported monogamous relationships; in this MSM sub-group, 12% had STIs diagnosed. STIs are still being diagnosed despite continued safe sex messages and significantly in those reporting monogamous relationships and consistent condom use. Sexual history and safe sex education should be integral to routine care and STI screening offered annually regardless of sexual history as recommended by 2013 British HIV Association Standards of Care for People Living with HIV. More frequent STI screening may be required in high-risk patients. PMID:25769889

  19. A day to be lived. Elderly peoples' possessions for everyday life in assisted living.

    PubMed

    Nord, Catharina

    2013-04-01

    This study is a qualitative interview study about the household possessions that elderly women and men brought with them when moving into assisted living. The move implied a substantial reduction of their possessions since, in all cases, they had left a larger dwelling than the one they moved to. The study gives a glimpse into the everyday life of the oldest old in assisted living. The things the elderly participants brought were of three types; cherished objects, representations of who they were, and mundane objects. The most important objects indicated by the elderly often belonged to the third type, and were preferred for the significance they had for the everyday life of the individual. These objects revealed a circumscribed but dignified life in their private bed-sitting room, often in solitude, where the elderly individuals pursued various interests and small-scale activities. However, this life was organized and preferred by the individuals themselves, in accordance with the principles of resident autonomy and individual choice that are promoted in assisted living. The author suggests that these self-engaged pursuits can contribute to bridging the gap between disengagement and activity theories. The study results also contribute to making visible the private life of the oldest old in assisted living. PMID:23561278

  20. Understanding the impact of visual arts interventions for people living with dementia: a realist review protocol

    PubMed Central

    2014-01-01

    Background Arts-based activities are being increasingly suggested as a valuable activity for people living with dementia in terms of countering the negative aspects of their condition. The potential for such programmes to improve a broad range of psychosocial outcomes is suggested in some studies. However, there is largely an absence of rigorous methodology to demonstrate the benefits, and research results are mixed. Practice variability in terms of the content, contexts and implementation of such interventions raises challenges in terms of identifying an optimal arts programme model that could be adopted by other service providers. Understanding how interventions may have the best chance at broad implementation success and uptake is limited. Methods/Design A realist review will be undertaken. This aims to understand how visual arts interventions influence outcomes in people living with dementia. The review will explore how the context, that is the circumstances which enable or constrain, affect outcomes through the activation of mechanisms. An early scoping search and a stakeholder survey formulated the preliminary programme theory. A systematic literature search across a broad range of disciplines (arts, humanities, social sciences, health) will be undertaken to identify journal articles and grey literature. Data will be extracted in relation to the programme theory, contextual factors, mechanisms and outcomes and their configurations, background information about the study design and participant characteristics, detail about the quantity (‘dose’) of an intervention, theoretical perspectives proposed by the authors of the paper and further theorising by the reviewer. Thematic connections/patterns will be sought across the extracted data, identifying patterns amongst contextual factors, the mechanisms they trigger and the associated outcomes. Discussion Along with stakeholder engagement and validation, this review will help inform the development of an optimal

  1. PPACA and Low-Income People Living with HIV: 2014 Qualified Health Plan Enrollment in a Medicaid Nonexpansion State.

    PubMed

    McManus, Kathleen A; McGonigle, Keanan M; Engelhard, Carolyn L; Dillingham, Rebecca

    2016-06-01

    People living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) often are uninsured or underinsured, and they may benefit from the Patient Protection and Affordable Care Act (PL 111-148) and its improved access to medical care. Safety net programs, such as AIDS Drug Assistance Programs (ADAP) funded through the Ryan White HIV/AIDS Program, which serve low-income people living with HIV, are incorporating Patient Protection and Affordable Care Act Marketplace-qualified health plans (QHPs) and helping to fund patients' participation. This changing landscape differs from state to state, and one main element contributing to the differing situations is whether a state elected to expand Medicaid. This review examines QHP enrollment of ADAP clients in Virginia, a Medicaid nonexpansion state, and explores some issues that affect people living with HIV in other Medicaid nonexpansion states. Virginia is a leader in the shift of ADAP healthcare delivery from direct medication provision to purchasing QHPs. Virginia ADAP clients accounted for approximately 2% of ADAP clients nationally, but they represent 17% of ADAP clients enrolled in QHPs nationwide. Ensuring good HIV care of the ADAP population is important to each patient's personal longevity, the public health, and the efficient use of healthcare dollars. As healthcare delivery models shift, the effects on patients and health outcomes achieved should be monitored, particularly for chronic diseases such as HIV. PMID:27255096

  2. The impact of a livelihood program on depressive symptoms among people living with HIV in Cambodia

    PubMed Central

    Shimizu, Mayumi; Yi, Siyan; Tuot, Sovannary; Suong, Samedy; Sron, Samrithea; Shibanuma, Akira; Jimba, Masamine

    2016-01-01

    Background Psychological and social problems are major concerns in this era of successful antiretroviral therapy. Although livelihood programs have been implemented extensively to improve the daily living conditions of people living with HIV in Cambodia, no studies have yet investigated the impacts of these programs on the mental health of this vulnerable population. Therefore, we examined the impact of a livelihood program on depressive symptoms and associated factors among people living with HIV in Cambodia. Design A quasi-experimental, nonequivalent comparison group study was conducted in six provinces of Cambodia in 2014. Data were collected from an intervention group comprising 357 people living with HIV who had participated in the livelihood program and a comparison group comprising 328 people living with HIV who had not participated in this program. Multiple logistic regression analysis was carried out to examine the association between livelihood-program participation and depressive symptoms as measured by the depressive symptoms subscale of the 25-item Cambodian version of the Hopkins Symptom Checklist. A propensity score matching was used to examine the effect of the livelihood program on depressive symptoms while controlling for selection bias. Results Overall, 56.0% and 62.7% of the participants in the intervention and comparison groups, respectively, met the Hopkins Symptom Checklist threshold for depressive symptoms. The multiple logistic regression analysis showed that the participants in the intervention group had significantly lower odds of having depressive symptoms (adjusted odds ratio 0.68, 95% confidence interval 0.52–0.88). The analysis from propensity score matching indicated that the livelihood program helped mitigate depressive symptoms among the participants in the intervention group (T=−1.99). Conclusions The livelihood program appeared to help mitigate the burden of depressive symptoms among people living with HIV in Cambodia. Thus

  3. Development of a Model of Care for Rehabilitation of People Living With HIV in a Semirural Setting in South Africa

    PubMed Central

    Hanass-Hancock, Jill

    2014-01-01

    Background Human immunodeficiency virus continues to challenge health care professionals even after the rollout of antiretroviral therapy. South Africa, among the worst affected countries in the world by the pandemic, has seen the effect of people living longer but facing disabling effects of both the virus and the associated impairments of the antiretroviral therapy. Rehabilitation within the evolving context of the disease has changed its focus from the impairment of the individual to the participation restriction within a person’s daily life. Offering a continuum of coordinated, multilevel, multidiscipline, evidence-based rehabilitation within health care will promote its prominence in health care structures. Objective This study aims to develop a model of care within a health care structure using a semi-rural African setting as an example. Methods The study will employ mixed methods using a Learning in Action Approach into the rehabilitation of people living with HIV (PLHIV) at the study setting. The Delphi technique, a multistage consensus method, will be used to obtain feedback from a number of local experts relevant for the field of rehabilitation of people living with HIV. The study will also involve various stakeholders such as the multidisciplinary health care team (doctors, physiotherapists, occupational therapists, dieticians, speech and language therapists, social workers, midlevel workers, community health care workers); department of health representative(s); site affiliated nongovernmental organization representative(s); and service users at the study setting. Results Once a proposed model of care is derived, the model will be assessed for rigour and piloted at the study setting. Conclusions The development of a model of care in rehabilitation for PLHIV in a health care setting is aimed to provide an example of a continuum of coordinated service throughout the disease trajectory. The assumption is that the burden on the health care system will be

  4. Emotional, physical and financial burdens of stigma against people living with HIV/AIDS in China

    PubMed Central

    Zhang, Chen; Li, Xiaoming; Liu, Yu; Qiao, Shan; Zhang, Liying; Zhou, Yuejiao; Shen, Zhiyong; Tang, Zhengzhu

    2016-01-01

    ABSTRACT Numerous researches have shown pernicious effects of stigma against people living with HIV/AIDS (PLWHA). However, no available studies have reported these negative effects including emotional, physical to financial burdens to PLWHA. In the current study, we aim to explore different types of stigma (e.g., perceived, internalized and enacted) and the relevant consequences among PLWHA in China. A cross-sectional study was conducted from 2012 to 2013 in the Guangxi Autonomous Region in China. The validated Berger HIV Stigma Scale was used to measure various types of stigma. We employed a series of linear, logistic and polytomous regression models to assess the association between stigma and different consequences while accounting for potential confounders for each specific model. Of the total sample, 2987 PLWHA provided valid responses with 63% being male and having an average age of 42.9 years. Perceived, internalized and enacted HIV stigma were prevalent among participants, and resulted in various burdens with different magnitudes in their life contexts. Specially, PLWHA who reported higher perceived and internalized stigma were more likely to be imposed on emotional and physical burdens (p < .05). People who reported higher enacted stigma had heavier financial burden compared to their peers (p < .05). Our findings revealed that devastating consequences of HIV-related stigma in China. The prevalent stigmatizing attitudes have pushed PLWHA to the fringes of society and affected them at multiple aspects in their life context. We call for tailored efforts to overcome stigma and discrimination against PLWHA. PMID:26886415

  5. Emotional, physical and financial burdens of stigma against people living with HIV/AIDS in China.

    PubMed

    Zhang, Chen; Li, Xiaoming; Liu, Yu; Qiao, Shan; Zhang, Liying; Zhou, Yuejiao; Shen, Zhiyong; Tang, Zhengzhu

    2016-01-01

    Numerous researches have shown pernicious effects of stigma against people living with HIV/AIDS (PLWHA). However, no available studies have reported these negative effects including emotional, physical to financial burdens to PLWHA. In the current study, we aim to explore different types of stigma (e.g., perceived, internalized and enacted) and the relevant consequences among PLWHA in China. A cross-sectional study was conducted from 2012 to 2013 in the Guangxi Autonomous Region in China. The validated Berger HIV Stigma Scale was used to measure various types of stigma. We employed a series of linear, logistic and polytomous regression models to assess the association between stigma and different consequences while accounting for potential confounders for each specific model. Of the total sample, 2987 PLWHA provided valid responses with 63% being male and having an average age of 42.9 years. Perceived, internalized and enacted HIV stigma were prevalent among participants, and resulted in various burdens with different magnitudes in their life contexts. Specially, PLWHA who reported higher perceived and internalized stigma were more likely to be imposed on emotional and physical burdens (p < .05). People who reported higher enacted stigma had heavier financial burden compared to their peers (p < .05). Our findings revealed that devastating consequences of HIV-related stigma in China. The prevalent stigmatizing attitudes have pushed PLWHA to the fringes of society and affected them at multiple aspects in their life context. We call for tailored efforts to overcome stigma and discrimination against PLWHA. PMID:26886415

  6. Homosexuality among People with a Mild Intellectual Disability: An Explorative Study on the Lived Experiences of Homosexual People in the Netherlands with a Mild Intellectual Disability

    ERIC Educational Resources Information Center

    Stoffelen, J.; Kok, G.; Hospers, H.; Curfs, L. M. G.

    2013-01-01

    Background: Empirical research on homosexuality among people with an intellectual disability (ID) is limited and, to date, very little is known regarding the personal experiences of gay and lesbian people with an ID. This study set out to answer the question: "What are the lived experiences of a specific cohort of homosexual people with an…

  7. Using Digital Stories to Understand the Lives of Alaska Native Young People

    ERIC Educational Resources Information Center

    Wexler, Lisa; Eglinton, Kristen; Gubrium, Aline

    2014-01-01

    To better understand how young Alaska Native (Inupiaq) people are creatively responding to the tensions of growing up in a world markedly different from that of their parents and grandparents, the pilot study examined youth-produced digital stories as representations of their everyday lives, values, and identities. Two hundred and seventy-one…

  8. Internet-Based Health Information Consumer Skills Intervention for People Living with HIV/AIDS

    ERIC Educational Resources Information Center

    Kalichman, Seth C.; Cherry, Charsey; Cain, Demetria; Pope, Howard; Kalichman, Moira; Eaton, Lisa; Weinhardt, Lance; Benotsch, Eric G.

    2006-01-01

    Medical information can improve health, and there is an enormous amount of health information available on the Internet. A randomized clinical trial tested the effectiveness of an intervention based on social-cognitive theory to improve information use among people living with HIV/AIDS. Men and women (N = 448) were placed in either (a) an…

  9. The Meaning of Learning Piano Keyboard in the Lives of Older Chinese People

    ERIC Educational Resources Information Center

    Li, Sicong; Southcott, Jane

    2015-01-01

    Across the globe populations are ageing and living longer. Older people seek meaningful ways of occupying and enjoying their later years. Frequently, this takes the form of learning a new skill, in this case playing the piano keyboard. From the initial act of commitment to learning comes a raft of related aspects that influence the learner, their…

  10. Process and Outcome Evaluation of an Art Therapy Program for People Living with HIV/AIDS

    ERIC Educational Resources Information Center

    Feldman, Matthew B.; Betts, Donna J.; Blausey, Daniel

    2014-01-01

    Program evaluation offers an opportunity for improving the implementation and impact of art therapy. This article describes a process and outcomes evaluation of an art therapy program within the mental health services unit of a community-based organization for people living with HIV/AIDS. The aims were to assess utilization patterns and program…

  11. Young People Living in Rural Australia in the 1990s. Research Report 16.

    ERIC Educational Resources Information Center

    Wyn, Johanna; Stokes, Helen; Stafford, John

    This report examines the challenges facing young people living in rural Australia in relation to their health and well-being and explores the relevance of personal resilience to offset these challenges. Specifically, the report synthesizes the literature on rural Australian youth and the results of focus groups undertaken in five rural…

  12. The Unintended Consequences of Targeting: Young People's Lived Experiences of Social and Emotional Learning Interventions

    ERIC Educational Resources Information Center

    Evans, Rhiannon; Scourfield, Jonathan; Murphy, Simon

    2015-01-01

    In the past twenty years there has been a proliferation of targeted school-based social and emotional learning (SEL) interventions. However, the lived experience of young peoples' participation is often elided, while the potential for interventions to confer unintended and even adverse effects remains under-theorised and empirically…

  13. The Stories of People's Lives: Thematic Investigations and the Development of a Critical Social Studies

    ERIC Educational Resources Information Center

    Jewett, Sarah

    2007-01-01

    The stories of people's lives are captured in historic and contemporary media. Through these lenses, students and teachers can see into the world of social issues and movements, figures, and events. Ultimately, they yield a range of perspectives across time and space. In this article, the author introduces thematic investigations as a systematic…

  14. What Kind of a Future? Supporting Young People with Down's Syndrome to Lead Full Lives after They Leave School

    ERIC Educational Resources Information Center

    Foundation for People with Learning Disabilities (NJ1), 2007

    2007-01-01

    The Foundation for People with Learning Disabilities was fortunate to receive a legacy to improve the lives of people with Down's syndrome. The foundation looked at recent research and talked to people with Down's syndrome, their family members and professionals. One of their greatest concerns was what happens to young people when they leave…

  15. Pharmacy Student Attitudes and Willingness to Engage in Care with People Living with HIV/AIDS

    PubMed Central

    Furtek, Kari J.; Malladi, Ruthvik; Ng, Eric; Zhou, Maria

    2016-01-01

    Objective. To describe the extent to which pharmacy students hold negative attitudes toward people living with HIV/AIDS (PLWHA) and to determine whether background variables, student knowledge, and professional attitudes may affect willingness to care for PLWHA. Methods. An online survey tool was developed and administered to 150 pharmacy students in their third professional year. Descriptive and stepwise multivariate regressions were performed. Results. While descriptive results showed a majority of respondents had favorable professional attitudes towards caring for PLWHA, most pharmacy students expressed discomfort with specific attitudes about being in close physical contact and receiving selected services from PLWHA. Multivariate results revealed that: (1) being a minority predicted greater knowledge; (2) having received prior HIV instruction and greater HIV knowledge predicted more positive professional attitudes caring for PLWHA; (3) being more socially liberal, having more positive professional attitudes caring for PLWHA, and having greater empathy towards PLWHA predicted student willingness to provide services. Conclusion. Future educational interventions specifically targeted toward socially conservative whites may impact greater student willingness to care for PLWHA. Additional research should also explore the generalizability of the present findings and modeling to pharmacy students in other regions of the country. PMID:27170816

  16. A qualitative study on the sexual behaviour of people living with HIV in Vietnam.

    PubMed

    Nguyen, Nam T; Keithly, Sarah C

    2012-01-01

    Understanding HIV-related behaviours and the factors that influence these behaviours among people living with HIV (PLHIV) is critical to the design of effective HIV-prevention strategies; however, this subject has yet to receive the attention it deserves in Vietnam. Given that greater proportions of new HIV infections in the country stem from heterosexual transmission, it is essential to examine the sexual behaviours of Vietnamese PLHIV. The purpose of this qualitative study was to explore the sexual behaviour of individuals following HIV diagnosis and to gain insight into how and why HIV diagnosis affects sexual practices and relationships. Seventy PLHIV in Thaibinh province participated in semi-structured, in-depth interviews. Qualitative data were supported by a quantitative questionnaire on demographics and sexual and drug use history. Nearly all of the participants reported adopting safer sexual practices following HIV diagnosis by using condoms consistently and reducing the number of sex partners. This was true for injecting drug users, female sex workers, unmarried individuals and participants in both HIV serodiscordant and seroconcordant marriages. Motivations for adopting these preventive measures included avoiding HIV transmission, reinfection or cross-resistance as well as preservation of one's own health. Due to stigma, depression, fear of transmission, health status and/or drug addiction, HIV diagnosis dramatically impacted the sexual health of most participants by reducing sexual desire, pleasure and frequency. Implications for HIV prevention and care programmes and policies in Vietnam are discussed. PMID:22272585

  17. Exploring Sources of Emotional Distress among People Living with Scleroderma: A Focus Group Study

    PubMed Central

    Gumuchian, Stephanie T.; Peláez, Sandra; Delisle, Vanessa C.; Carrier, Marie-Eve; Jewett, Lisa R.; El-Baalbaki, Ghassan; Fortune, Catherine; Hudson, Marie; Impens, Ann; Körner, Annett; Persmann, Jennifer; Kwakkenbos, Linda; Bartlett, Susan J.; Thombs, Brett D.

    2016-01-01

    Background Systemic sclerosis, or scleroderma, is a chronic and rare connective tissue disease with negative physical and psychological implications. Sources of emotional distress and the impact they have on the lives of people with scleroderma are not well understood. Objectives To gain an in-depth understanding of the emotional experiences and sources of emotional distress for women and men living with scleroderma through focus group discussions. Methods Three semi-structured focus group discussions were conducted (two in English, one in French) with a total of 22 people with scleroderma recruited through the Scleroderma Society of Ontario in Hamilton, Ontario and a scleroderma clinic in Montreal, Canada. Interviews were recorded, transcribed, and then coded for emerging themes using thematic inductive analysis. Results Core themes representing sources of emotional distress were identified, including: (a) facing a new reality; (b) the daily struggle of living with scleroderma; (c) handling work, employment and general financial burden; (d) changing family roles; (e) social interactions; and (f) navigating the health care system. Collectively, these themes refer to the stressful journey of living with scleroderma including the obstacles faced and the emotional experiences beginning prior to receiving a diagnosis and continuing throughout the participants’ lives. Conclusion Scleroderma was portrayed as being an unpredictable and overwhelming disease, resulting in many individuals experiencing multiple sources of emotional distress. Interventions and supportive resources need to be developed to help individuals with scleroderma and people close to them manage and cope with the emotional aspects of the disease. PMID:27008209

  18. Television Images: Exploring How They Affect People's View of Self and Others

    ERIC Educational Resources Information Center

    Alexandrin, Julie R.

    2009-01-01

    Through television, many different images of ethnic, cultural, and ability groups are presented. Different people perceive these images in different ways. These perceptions affect how people value themselves and judge and interact with others. This article first summaries research on TV images and people's meaning and reaction to them. Second, it…

  19. Psychological, Social, and Familial Problems of People Living with HIV/AIDS in Iran: A Qualitative Study

    PubMed Central

    Dejman, Masoumeh; Ardakani, Hossein Malekafzali; Malekafzali, Bahareh; Moradi, Ghobad; Gouya, Mohammad Mehdi; Shushtari, Zahra Jorjoran; Alinaghi, Seyed Ahmad Seyed; Mohraz, Minoo

    2015-01-01

    Background: HIV/AIDS is one of the diseases which not only makes threats to physical health, but also, due to the negative attitudes of people and the social stigma, affects the emotional and social health of patients. The aim of this study was to identify the psychological, social, and family problems of people living with HIV/AIDS (PLWHA) in Iran. Methods: In this qualitative study, we used purposive sampling to enroll PLWHA, their families, and physicians and consultants in two cities of Kermanshah and Tehran. Each group of PLWHA, their families, physicians, and consultants participated in two focus group discussions (FGDs), and a total of eight FGDs were conducted. Six interviews were held with all key people, individually. Results: Based on the views and opinions of various groups involved in the study, the main problems of PLWHA were: Ostracism, depression, anxiety, a tendency to get revenge and lack of fear to infect others, frustration, social isolation, relationship problems, and fear due to the social stigma. Their psychological problems included: Marriage problems, family conflict, lack of family support, economic hardships inhibiting marriage, and social rejection of patient's families. Their family problems were: Unemployment, the need for housing, basic needs, homelessness, and lack of social support associations. Conclusions: It seems that the identification and focusing on psychological, social, and family problems of affected people not only is an important factor for disease prevention and control, but also enables patients to have a better response to complications caused by HIV/AIDS. PMID:26900440

  20. The Emotional Experience of People with Intellectual Disability: An Analysis Using the International Affective Pictures System

    ERIC Educational Resources Information Center

    Bermejo, Belen G.; Mateos, Pedro M.; Sanchez-Mateos, Juan Degado

    2014-01-01

    The present study provides information on the emotional experience of people with intellectual disability. To evaluate this emotional experience, we have used the International Affective Pictures System (IAPS). The most important result from this study is that the emotional reaction of people with intellectual disability to affective stimuli is…

  1. Requesting help to understand medical information among people living with HIV and poor health literacy.

    PubMed

    Kalichman, Seth; Pellowski, Jennifer; Chen, Yiyun

    2013-06-01

    Health literacy is known to influence medication adherence among people living with HIV/AIDS. People who experience difficulty reading health information may benefit from asking others to assist them with reading, interpreting, and understanding medical information. We examined medical chart-abstracted HIV viral load, medication adherence assessed by unannounced pill counts, and adherence improvement strategies among 245 individuals with lower-health literacy who do not request assistance, and 229 who do request assistance with reading and understanding health information. Participants were people living with HIV who were taking antiretroviral therapy and scored below 90% correct on a standardized test of functional health literacy. After controlling for health literacy scores, requesting informational assistance was associated with strategies used to improve adherence; individuals who asked for assistance were significantly more likely to use multiple adherence strategies. However, despite requesting informational assistance and using more adherence strategies, participants who requested informational assistance evidenced poorer treatment adherence and poorer suppression of HIV replication. Requesting assistance was more common among those with the poorest health literacy and therefore greatest challenges to adherence. People living with HIV who have poor health literacy skills may benefit from medication adherence programs and requests for assistance afford opportunities for social interventions. PMID:23701199

  2. The support needs of terminally ill people living alone at home: a narrative review

    PubMed Central

    Aoun, Samar M.; Breen, Lauren J.; Howting, Denise

    2014-01-01

    Context: The number of terminally ill people who live alone at home and without a caregiver is growing and exerting pressure on the stretched resources of home-based palliative care services. Objectives: We aimed to highlight the unmet support needs of terminally ill people who live alone at home and have no primary caregiver and identify specific models of care that have been used to address these gaps. Methods: We conducted a narrative review of empirical research published in peer-reviewed journals in English using a systematic approach, searching databases 2002–2013. This review identified 547 abstracts as being potentially relevant. Of these, 95 were retrieved and assessed, with 37 studies finally reviewed. Results: Majority of the studies highlighted the reduced likelihood of this group to be cared for and die at home and the experiences of more psychosocial distress and more hospital admissions than people with a primary caregiver. Few studies reported on the development of models of care but showed that the challenges faced by this group may be mitigated by interventions tailored to meet their specific needs. Conclusion: This is the first review to highlight the growing challenges facing community palliative care services in supporting the increasing number of people living alone who require care. There is a need for more studies to examine the effectiveness of informal support networks and suitable models of care and to provide directions that will inform service planning for this growing and challenging group. PMID:25750828

  3. Anxiety, anxiety symptoms, and associations among older people with dementia in assisted-living facilities.

    PubMed

    Neville, Christine; Teri, Linda

    2011-06-01

    Anxiety is a major cause for distress among older people with dementia, and it impedes care. In order to develop interventions to treat anxiety and identify who might be most likely to benefit, mental health nurses need to understand what clinical and demographic factors are associated with anxiety in dementia. This cross-sectional study is a detailed assessment of anxiety in people living in assisted-living facilities using the Rating Anxiety in Dementia (RAID) scale and the Clinical Anxiety Scale (CAS). One hundred and forty-eight people, with a mean age of 86.2 years, were recruited from 19 assisted-living facilities in the USA. Prevalence rates for anxiety were 11% and 18%, as measured on the RAID and CAS, respectively. One or more symptoms of anxiety were exhibited for 49% (RAID) and 48% (CAS) of participants. Behavioural symptoms and the presence of depression strongly predicted anxiety, as did staff's reaction to behavioural symptoms and their sense of competence to care. These findings demonstrate that anxiety is prominent enough to warrant further investigation and treatment, and that anxiety in older people with dementia is closely associated with staff skill. This study has also identified areas for mental health nurses to target interventions. PMID:21492359

  4. Does regulating others' feelings influence people's own affective well-being?

    PubMed

    Niven, Karen; Totterdell, Peter; Holman, David; Headley, Tara

    2012-01-01

    Individuals in a variety of social contexts try to regulate other people's feelings, but how does this process affect the regulators themselves? This research aimed to establish a relationship between people's use of interpersonal affect regulation and their own affective well-being. In a field study, self- and other-reported data were collected from prisoners and staff members in a therapeutic prison using two surveys separated in time. In a laboratory study, a student sample reported their affect before and after attempting to influence the feelings of talent show contestants in a role-play task. The results of both studies indicated congruent associations between the use of affect-improving and affect-worsening interpersonal affect regulation and strategy agents' affective well-being. Our findings highlight that, when performing interpersonal affect regulation, people may not be immune from the effects of their own actions. PMID:22468424

  5. Alterations in psychosocial health of people affected by asbestos poisoning

    PubMed Central

    Clemente, Miguel; Reig-Botella, Adela; Prados, Juan Carlos

    2015-01-01

    OBJECTIVE To analyze the state of psychosocial and mental health of professionals affected by asbestos. METHODS A cross-sectional study was conducted with 110 professionals working in the Ferrolterra region of Spain, who were affected by asbestos poisoning. This group was compared with a group of 70 shipyard workers with no manifestation of work-related diseases. All the participants were male with a mean age of 67 years. This study was conducted in 2013, between January and June, and used the SCL-90 questionnaire by Derogatis as its primary measure for research. This questionnaire consists of 9 variables that measure psychosomatic symptoms. In addition, an overall index of psychosomatic gravity was calculated. The participants were also asked two questions concerning their overall perception of feeling good. Data were analyzed by ANOVA and logistic regression. RESULTS Participants affected by asbestos poisoning showed high occurrence rates of psychological health variables such as somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism, and global severity index. CONCLUSIONS Social interaction as a differentiating factor between workers affected by work-related chronic syndromes as compared to healthy participants will possibly aid in the development of intervention programs by improving the social network of affected individuals. PMID:25902564

  6. True User Involvement by People Living With HIV is Possible: Description of a User-driven HIV Clinic in Norway.

    PubMed

    Berg, Rigmor C; Gamst, Are; Said, Maryan; Aas, Kristin Bårdsen; Songe, Solveig Helene; Fangen, Kim; Rysstad, Ole

    2015-01-01

    The Greater Involvement of People Living with or Affected by HIV principle highlights the various contributions HIV-infected people can make in HIV program development and implementation. We present a unique example of how service users' involvement led to a complete organizational redesign of an outpatient HIV clinic in Southern Norway. We applied a user-driven, case study method, which showed that establishing a user board laid the foundation for the redesign process, as the board provided a clear infrastructure of user involvement and developed a set of user-defined targets for services. The main targets-optimal health, holistic care and treatment, and empowerment-were operationalized as a set of action points, such as establishing HIV nurse coordinators. While there is no single method for user involvement, we offer useful ideas that can help others develop an involvement project that is effective and sustainable. PMID:26255897

  7. People

    NASA Astrophysics Data System (ADS)

    2001-01-01

    Thrilled at @Bristol Kathy Sykes in conversation with Liz Whitelegg. Kathy Sykes is Senior Science Consultant at @Bristol - a new area on Bristol's Harbourside with a Science Centre Explore, a Wildlife Centre Wildscreen, with sculptures and fountains. Kathy was one of five people in 1999 to be awarded an IOP Public Awareness of Physics award. Dr Kathy Sykes What attracted you to Physics in the first place? It was really when I discovered that Physics was all about making models of the world, because then suddenly the ability to be creative became important. I liked the idea that you could have a picture of the world that might work quite well but you could always replace that with a better one. That was what made science come alive and make it seem like something that I'd really love to be involved in, rather than science as a stale body of facts that I needed to learn. I was much more interested in ideas than in facts. I think that finding out about 'models' happened around the time I was discovering quantum mechanics and how the act of observing something can actually affect the outcome. I found it incredibly exciting - especially how that changed the whole philosophy of science. I also had a fantastic teacher in physics and I owe an awful lot to him. He just swooped in at the last moment when I was considering giving it up so that made an enormous difference. After my degree I went to teach maths and physics A-level in Zimbabwe with the VSO, and it was partly wanting to share my excitement with other people about physics that made me want to go and teach abroad. When I came back and began my PhD in Physics at Bristol University, I missed teaching and thought it was important to get the public more involved in science and debates about science. My supervisor, Pete Barham, was doing lots of this himself, and he helped and encouraged me enormously. I can't thank him enough. Did you consider teaching as a career? Well I like having the carpet whipped away from

  8. Environmental Exposure to Arsenic, Lead, and Cadmium in People Living near Janghang Copper Smelter in Korea.

    PubMed

    Kim, Yong-Dae; Eom, Sang-Yong; Yim, Dong-Hyuk; Kim, In-Soo; Won, Hee-Kwan; Park, Choong-Hee; Kim, Guen-Bae; Yu, Seung-Do; Choi, Byung-Sun; Park, Jung-Duck; Kim, Heon

    2016-04-01

    Concentrations of heavy metals exceed safety thresholds in the soil near Janghang Copper Refinery, a smelter in Korea that operated from 1936 to 1989. This study was conducted to evaluate the level of exposure to toxic metals and the potential effect on health in people living near the smelter. The study included 572 adults living within 4 km of the smelter and compared them with 413 controls group of people living similar lifestyles in a rural area approximately 15 km from the smelter. Urinary arsenic (As) level did not decrease according to the distance from the smelter, regardless of gender and working history in smelters and mines. However, in subjects who had no occupational exposure to toxic metals, blood lead (Pb) and cadmium (Cd) and urinary Cd decreased according to the distance from the smelter, both in men and women. Additionally, the distance from the smelter was a determinant factor for a decrease of As, Pb, and Cd in multiple regression models, respectively. On the other hands, urinary Cd was a risk factor for renal tubular dysfunction in populations living near the smelter. These results suggest that Janghang copper smelter was a main contamination source of As, Pb, and Cd, and populations living near the smelter suffered some adverse health effects as a consequence. The local population should be advised to make efforts to reduce exposure to environmental contaminants, in order to minimize potential health effects, and to pay close attention to any health problems possibly related to toxic metal exposure. PMID:27051230

  9. Environmental Exposure to Arsenic, Lead, and Cadmium in People Living near Janghang Copper Smelter in Korea

    PubMed Central

    2016-01-01

    Concentrations of heavy metals exceed safety thresholds in the soil near Janghang Copper Refinery, a smelter in Korea that operated from 1936 to 1989. This study was conducted to evaluate the level of exposure to toxic metals and the potential effect on health in people living near the smelter. The study included 572 adults living within 4 km of the smelter and compared them with 413 controls group of people living similar lifestyles in a rural area approximately 15 km from the smelter. Urinary arsenic (As) level did not decrease according to the distance from the smelter, regardless of gender and working history in smelters and mines. However, in subjects who had no occupational exposure to toxic metals, blood lead (Pb) and cadmium (Cd) and urinary Cd decreased according to the distance from the smelter, both in men and women. Additionally, the distance from the smelter was a determinant factor for a decrease of As, Pb, and Cd in multiple regression models, respectively. On the other hands, urinary Cd was a risk factor for renal tubular dysfunction in populations living near the smelter. These results suggest that Janghang copper smelter was a main contamination source of As, Pb, and Cd, and populations living near the smelter suffered some adverse health effects as a consequence. The local population should be advised to make efforts to reduce exposure to environmental contaminants, in order to minimize potential health effects, and to pay close attention to any health problems possibly related to toxic metal exposure. PMID:27051230

  10. Significant Improvement in Sleep in People with Intellectual Disabilities Living in Residential Settings by Non-Pharmaceutical Interventions

    ERIC Educational Resources Information Center

    Hylkema, T.; Vlaskamp, C.

    2009-01-01

    Background: Although about 15 to 50 percent of people with intellectual disabilities (ID) living in residential settings suffer from sleep problems, scant attention is paid to these problems. Most available studies focus on pharmaceutical solutions. In this study we focus on improving sleep in people with intellectual disabilities living in…

  11. HIV/AIDS and family support systems: A situation analysis of people living with HIV/AIDS in Lagos State.

    PubMed

    Oluwagbemiga, Adeyemi Ezekiel

    2007-11-01

    Current statistics about the HIV/AIDS epidemic in Nigeria do not reveal the broader social and economic impacts of the disease on the family.The study therefore primarily aimed to address the socio-economic effects of HIV infection on individuals and their families.The study was carried out in Lagos State. In-depth interviews were employed to collect information from 188 people living with HIV/AIDS through support groups in the state, while four focus group discussions were conducted to elicit information from people affected by AIDS about the socio-economic impacts of HIV/AIDS on families in Nigeria. From the survey, among people living with HIV/AIDS, 66% of females and males were in the age group 21-40 years, while 10% were older people above 60 years of age. Findings revealed that as HIV/AIDS strikes at parents, grand parents are assuming responsibility for bringing up the children of the infected persons and the orphans of those killed by the virus. It was striking that some of the older caregivers could not meet the requirement of these children.They are often forced to work more than they would have, or borrow in order to cope with the needs of these extra mouths. Some of the infected people have sold their properties to enable them to cope with the economic effects of the virus, while their children have had to drop out of school, since they could not afford the school fees and other related expenses. It was suggested that PLWHA should be economically empowered with adequate medical treatment, in order to reduce the impact of the disease on the family. PMID:18185894

  12. The impact of flooding on people living with HIV: a case study from the Ohangwena Region, Namibia

    PubMed Central

    Anthonj, Carmen; Nkongolo, Odon T.; Schmitz, Peter; Hango, Johannes N.; Kistemann, Thomas

    2015-01-01

    Background Floods are a disaster situation for all affected populations and especially for vulnerable groups within communities such as children, orphans, women, and people with chronic diseases such as HIV and AIDS. They need functioning health care, sanitation and hygiene, safe water, and healthy food supply, and are critically dependent on their social care and support networks. A study carried out in the Ohangwena region, Namibia, where HIV prevalence is high and extensive flooding frequently occurs, aims to provide a deeper understanding of the impact that flooding has on people living with HIV (PLWHIV) as well as on HIV service providers in the region. Design The qualitative research applying grounded theory included semi-structured interviews with PLWHIV, focus group discussions with HIV service providers, and a national feedback meeting. The findings were interpreted using the sustainable livelihoods framework, the natural hazard research approach, and health behaviour theories. Results The study reveals that flooding poses major problems to PLWHIV in terms of their everyday lives, affecting livelihoods, work, income, and living conditions. The factors threatening them under normal conditions – poverty, malnutrition, unsafe water, sanitation and hygiene, limited access to health facilities, a weak health status, and stigma – are intensified by flood-related breakdown of infrastructure, insecurity, malnutrition, and diseases evolving over the course of a flood. A potential dual risk exists for their health: the increased risk both of infection and disease due to the inaccessibility of health services and antiretroviral treatment. A HIV and Flooding Framework was developed to display the results. Conclusions This study demonstrates that vulnerabilities and health risks of PLWHIV will increase in a disaster situation like flooding if access to HIV prevention, treatment, care and support are not addressed and ensured. The findings and the HIV and Flooding

  13. Optimal Treatment Adherence Counseling Outcomes for People Living with HIV and Limited Health Literacy.

    PubMed

    Pellowski, Jennifer A; Kalichman, Seth C; Grebler, Tamar

    2016-01-01

    Limited health literacy has been shown to contribute to poor adherence to antiretroviral therapy (ART) in people living with HIV/AIDS. Given the mixed results of previous interventions for people with HIV and low health literacy, investigating possible targets for improved adherence is warranted. The present study aims to identify the correlates of optimal and suboptimal outcomes among participants of a recent skills-based medication adherence intervention. This secondary analysis included 188 men and women living with HIV who had low health literacy and who had complete viral load data. Adherence was assessed by unannounced pill count and follow-up viral loads were assessed by blood draw. Results showed that higher levels of health literacy and lower levels of alcohol use were the strongest predictors of achieving HIV viral load optimal outcomes. The interplay between lower health literacy and alcohol use on adherence should be the focus of future research. PMID:25211524

  14. Terms Used for People Living With HIV in the Democratic Republic of the Congo

    PubMed Central

    Mupenda, Bavon; Duvall, Sandra; Maman, Suzanne; Pettifor, Audrey; Holub, Christina; Taylor, Eboni; Rennie, Stuart; Kashosi, Mujalambo; Lema, Mamie; Behets, Frieda

    2015-01-01

    For this study we conducted in-depth interviews with 29 youth living with HIV (YLWH) and key informant interviews with 8 HIV care/support providers. We describe terms used to portray people living with HIV (PLWH) in Kinshasa, Democratic Republic of the Congo. Labels commonly used, mostly derogatory, described PLWH as walking corpses, dangers to others, or people deserving to die before others get infected. Blame and other accusations were directed at PLWH through anchoring or objectification. Being labeled sometimes made these youth suffer in silence, afraid to disclose their status, or avoid performing actions in public, preferring to let others do them. YLWH need psychosocial support to mitigate the harmful effects of these labels and strengthen their coping skills, whereas community, institutional, and national efforts are needed for stigma reduction. PMID:24463633

  15. People

    NASA Astrophysics Data System (ADS)

    2001-01-01

    Thrilled at @Bristol Kathy Sykes in conversation with Liz Whitelegg. Kathy Sykes is Senior Science Consultant at @Bristol - a new area on Bristol's Harbourside with a Science Centre Explore, a Wildlife Centre Wildscreen, with sculptures and fountains. Kathy was one of five people in 1999 to be awarded an IOP Public Awareness of Physics award. Dr Kathy Sykes What attracted you to Physics in the first place? It was really when I discovered that Physics was all about making models of the world, because then suddenly the ability to be creative became important. I liked the idea that you could have a picture of the world that might work quite well but you could always replace that with a better one. That was what made science come alive and make it seem like something that I'd really love to be involved in, rather than science as a stale body of facts that I needed to learn. I was much more interested in ideas than in facts. I think that finding out about 'models' happened around the time I was discovering quantum mechanics and how the act of observing something can actually affect the outcome. I found it incredibly exciting - especially how that changed the whole philosophy of science. I also had a fantastic teacher in physics and I owe an awful lot to him. He just swooped in at the last moment when I was considering giving it up so that made an enormous difference. After my degree I went to teach maths and physics A-level in Zimbabwe with the VSO, and it was partly wanting to share my excitement with other people about physics that made me want to go and teach abroad. When I came back and began my PhD in Physics at Bristol University, I missed teaching and thought it was important to get the public more involved in science and debates about science. My supervisor, Pete Barham, was doing lots of this himself, and he helped and encouraged me enormously. I can't thank him enough. Did you consider teaching as a career? Well I like having the carpet whipped away from

  16. The effects of music relaxation on sleep quality and emotional measures in people living with schizophrenia.

    PubMed

    Bloch, Boaz; Reshef, Alon; Vadas, Limor; Haliba, Yamit; Ziv, Naomi; Kremer, Ilana; Haimov, Iris

    2010-01-01

    The aim of the present study was to examine the effects of music relaxation on insomnia and emotional measures in people living with schizophrenia. Twenty-four people living with schizophrenia participated in the study. The study involved a 7-day running-in no-treatment period, followed by a 7-day experimental period. Treatment consisted of music relaxation played at bedtime. During each of these periods, participants' sleep was continuously monitored with a wrist actigraph, and participants completed a wide spectrum of questionnaires. Results showed an improvement in sleep latency and sleep efficiency after the music relaxation was played. Likewise, music relaxation was shown to improve participants' total psychopathology score (PANSS) as well as their level of depression. Moreover, a significant correlation was found between reduction in level of situational anxiety and improvement in sleep efficiency. The findings suggest the beneficial effect of music relaxation as a treatment both for insomnia and for emotional measures in people living with schizophrenia. PMID:20635522

  17. The Mental Health of People Living with HIV in China, 1998–2014: A Systematic Review

    PubMed Central

    Niu, Lu; Luo, Dan; Liu, Ying; Silenzio, Vincent M. B.; Xiao, Shuiyuan

    2016-01-01

    Background Understanding the mental health burdens faced by people living with HIV in China is instrumental in the development of successful targeted programs for psychological support and care. Methods Using multiple Chinese and English literature databases, we conducted a systematic review of observational research (cross-sectional, case-control, or cohort) published between 1998 and 2014 on the mental health of people living with HIV in China. Results We identified a total of 94 eligible articles. A broad range of instruments were used across studies. Depression was the most widely studied problem; the majority of studies reported prevalence greater than 60% across research settings, with indications of a higher prevalence among women than men. Rates of anxiety tended to be greater than 40%. Findings regarding the rates of suicidality, HIV-related neurocognitive disorders, and substance use were less and varied. Only one study investigated posttraumatic stress disorder and reported a prevalence of 46.2%. Conflicting results about health and treatment related factors of mental health were found across studies. Conclusions Despite limitations, this review confirmed that people living with HIV are vulnerable to mental health problems, and there is substantial need for mental health services among this population. PMID:27082749

  18. Information preferences and practices among people living with HIV/AIDS: results from a nationwide survey

    PubMed Central

    Hogan, Timothy P.; Palmer, Carole L.

    2005-01-01

    Objectives: This study was designed to reach many segments of the diverse HIV/AIDS community and broaden understanding of how information can better assist people living with HIV/AIDS. Methods: Data were collected through a self-administered mail survey distributed nationwide at clinics, drug treatment centers, and other AIDS service organizations. Results: The 662 respondents preferred getting information from people—including health professionals, family, and friends—and considered people the most trustworthy, useful, understandable, and available information sources. Forty-three percent selected doctors as their most preferred source. The Internet was not rated highly overall but was preferred by those with more education or living in metropolitan areas. Seventy-two percent said they actively search for HIV/AIDS-related information, and 80% said they give advice or tell others where to get such information. However, 71% agreed that it is easy to feel overwhelmed by information, and 31% agreed that not seeking information can be beneficial. Conclusions: Overall, information seeking is an important activity for this sample of people living with HIV/AIDS. Many sources are widely available to them but, together, can be overwhelming. They rely on health professionals far more than print or media sources and receive encouragement and support from family and friends. PMID:16239938

  19. Public perceptions about HIV/AIDS and discriminatory attitudes toward people living with acquired immunodeficiency syndrome in Iran.

    PubMed

    Masoudnia, Ebrahim

    2015-01-01

    Negative and discriminatory attitudes towards people living with HIV/AIDS (PLWHA) are one of the biggest experienced challenges by people suffering from HIV, and these attitudes have been regarded as a serious threat to the fundamental rights of all infected people who are affected or associated with this disease in Iran. This study aimed to determine the relationship between public perception about HIV/AIDS and discriminatory attitudes toward PLWHA . The present study was conducted using a descriptive and survey design. Data were collected from 450 patients (236 male and 214 female) in Tehran and Yazd cities. The research instruments were modified HIV-related knowledge/attitude and perception questions about PLWHA, and discriminatory attitudes toward PLWHA. The results showed that prevalence of discriminatory attitudes toward PLWHA in the studied population was 60.0%. There was a significant negative correlation between citizens' awareness about HIV/AIDS, HIV-related attitudes, negative perception toward people with HIV/AIDS symptoms and their discriminatory attitudes toward PLWHA (p < .01). The hierarchical multiple regression analysis showed that components of public perception about HIV/AIDS explained for 23.7% of the variance of discriminatory attitudes toward PLWHA. Negative public perceptions about HIV/AIDS in Iran associated with discriminatory attitudes toward PLWHA and cultural beliefs in Iran tend to stigmatize and discriminate against the LWHA. PMID:26726933

  20. Fertility Desires and Intentions among People Living with HIV/AIDS (PLWHA) in Southern India

    PubMed Central

    Jose, Hyma; Chowta, Nithyananda; Ramapuram, John; Bhaskaran, Unnikrishnan; Achappa, Basavaprabhu; Chandran, Vishnu

    2016-01-01

    Introduction The desire of people living with HIV/AIDS (PLWHA) to have children can have significant public health implications. Combination Antiretroviral Therapy (cART) has increased the life expectancy of PLWHA as a result of which they may consider child bearing. There are hardly any studies from India addressing the fertility desires among PLWHA. Aim This study was done to assess the fertility desires of PLWHA in Southern India. Materials and Methods It was a cross-sectional study conducted among 230 HIV-positive men and women who presented to Kasturba Medical College (KMC), Mangalore, India. Study was conducted between October 2012 and October 2014. Statistical analysis was performed using SPSS software version 11.5. Chi-square test, Fisher’s exact test and student t-test was used to find out the association of various factors affecting fertility desire. A p-value of less than 0.05 was considered statistically significant. Results The mean age of our study population was 36.3±5.5 years. The mean age of males was 37.3±6 years and for female 34.9±5 years. In our study 132 (57.4%) were males. Majority were literate 229 (99%). Majority of patients were employed 166 (72%). In our study 195 (84.7%) were on cART. Out of 230 PLWHA 39 (16.95%) were unmarried and 151(65.5%) married PLHIV were living with partners at the time of study. In our study 77 (33.5%) patients had fertility desire. Age, gender, marital status, number of children, partner’s fertility desire and HIV status of partner had an association with fertility desire. Conclusion Providing universal access to cART is the main aim of national programs. It is high time that these programs focus on fertility issues of PLWHA. Reproductive rights of PLWHA need to be respected. Physicians and HIV counselors should proactively discuss and address reproductive issues of PLWHA.

  1. Quality of life and people living with AIDS: relationship with sociodemographic and health aspects1

    PubMed Central

    da Costa, Tadeu Lessa; de Oliveira, Denize Cristina; Gomes, Antonio Marcos Tosoli; Formozo, Gláucia Alexandre

    2014-01-01

    OBJECTIVE: to analyze the relationship of sociodemographic and health dimensions with the quality of life of people living with the human immunodeficiency virus. METHOD: descriptive and quantitative study. The subjects were 131 seropositive people treated in a specialized center of the Norte-Fluminense municipality, Brazil. A form with sociodemographic and health data was applied, as well as the World Health Organization instrument for the assessment of the quality of life of people with the human immunodeficiency virus. RESULTS: the statistical analysis revealed a significant difference in the assessment of the various dimensions of quality of life by the subjects for gender, education, employment, personal income, medical condition, self-perception of sickness, history of hospitalizations, and bodily alterations due to the antiretroviral drugs. CONCLUSION: professional nursing and health care, as well as public policies in the area, should valorize the quality of life approach, considering the conditions related to its configuration. PMID:25296141

  2. Narratives Reflecting the Lived Experiences of People with Brain Disorders: Common Psychosocial Difficulties and Determinants

    PubMed Central

    Hartley, Sally; McArthur, Maggie; Coenen, Michaela; Cabello, Maria; Covelli, Venusia; Roszczynska-Michta, Joanna; Pitkänen, Tuuli; Bickenbach, Jerome; Cieza, Alarcos

    2014-01-01

    Background People with brain disorders - defined as both, mental disorders and neurological disorders experience a wide range of psychosocial difficulties (PSDs) (e.g., concentrating, maintaining energy levels, and maintaining relationships). Research evidence is required to show that these PSDs are common across brain disorders. Objectives To explore and gain deeper understanding of the experiences of people with seven brain disorders (alcohol dependency, depression, epilepsy, multiple sclerosis, Parkinson’s disease, schizophrenia, stroke). It examines the common PSDs and their influencing factors. Methods Seventy seven qualitative studies identified in a systematic literature review and qualitative data derived from six focus groups are used to generate first-person narratives representing seven brain disorders. A theory-driven thematic analysis of these narratives identifies the PSDs and their influencing factors for comparison between the seven disorders. Results First-person narratives illustrate realities for people with brain disorders facilitating a deeper understanding of their every-day life experiences. Thematic analysis serves to highlight the commonalities, both of PSDs, such as loneliness, anger, uncertainty about the future and problems with work activities, and their determinants, such as work opportunities, trusting relationships and access to self-help groups. Conclusions The strength of the methodology and the narratives is that they provide the opportunity for the reader to empathise with people with brain disorders and facilitate deeper levels of understanding of the complexity of the relationship of PSDs, determinants and facilitators. The latter reflect positive aspects of the lives of people with brain disorders. The result that many PSDs and their influencing factors are common to people with different brain disorders opens up the door to the possibility of using cross-cutting interventions involving different sectors. This strengthens

  3. My Imagination versus Your Feelings: Can Personal Affective Forecasts Be Improved by Knowing Other Peoples' Emotions?

    ERIC Educational Resources Information Center

    Walsh, Emma; Ayton, Peter

    2009-01-01

    A proposed remedy for biased affective forecasts is to base judgments on the actual feelings of people (surrogates) currently experiencing the event, rather than using imagination which conjures an inaccurate vision of the future. Gilbert et al. (2009) forced people to use surrogate reports by withholding all event information, resulting in better…

  4. Factors Affecting Work Force Development in the People's Republic of China.

    ERIC Educational Resources Information Center

    Sredl, Henry J.

    Work force development in the Peoples' Republic of China (PRC) is affected by sundry but interrelated factors. Included among these are the following: (1) the PRC's population of one billion people; (2) a recent history of political turmoil and violence, resulting in profound changes in national leadership and vacillation in national policy; (3)…

  5. A Look at Recent Legal Developments Affecting Residential Living.

    ERIC Educational Resources Information Center

    Miller, Thomas E.; And Others

    1979-01-01

    Reviews court decisions concerning search and seizure, intervisitation between sexes, canvassing and solicitation, and damage assessments. College administrators must rely on fairness, ethics and sound educational philosophies in the design of policies affecting residence halls. (JAC)

  6. How Many People Are Affected by or at Risk for Endometriosis?

    MedlinePlus

    ... people are affected by or at risk for endometriosis? Skip sharing on social media links Share this: ... menstruates. Factors that May Increase the Risk of Endometriosis Studies show that women are at higher risk ...

  7. How Many People Are Affected by or at Risk for Down Syndrome?

    MedlinePlus

    ... people are affected by or at risk for Down syndrome? Skip sharing on social media links Share this: ... ethnicity. 4 , 5 Maternal Age and Risk for Down Syndrome Because the likelihood that an egg will contain ...

  8. The Living Astronomy and People of the Mayan World Today: Engaging Hispanic Populations in Science

    NASA Astrophysics Data System (ADS)

    Hawkins, I.; Tapia, F.

    2008-06-01

    From long ago, the Maya civilizations of Mesoamerica have been keenly attuned to the cycles of nature. The Maya have always been careful observers, and more than a thousand years ago, they recorded the motion of the planets, the Sun, and the Moon, and predicted eclipses. These observations were used to create a complex calendar to organize the events of their world. The Maya built great cities containing buildings aligned with the Sun, Moon, and the stars to mark important times of the year. Many astronomical traditions are still practiced today by the Maya of the Yucatán peninsula, Southern states in México, and other areas in Mesoamerica. Traditional farming communities time the cultivation of corn by observing the sky. The living culture of the Mayan people in the Yucatan integrates science and astronomy with every other aspect of their culture. Yucatec Maya, the language spoken by more than 1 million people in the Yucatán today, still carries through oral histories the ancient knowledge of nature. Our hope is that you'll increase your interest and knowledge of the Mayan people and of the enduring wisdom reflected in the daily lives of Mayan families. We present the results of education and public outreach efforts that position astronomy within its cultural context as an effective means of capturing the interest and enabling authentic participation of under-represented populations in science.

  9. Imposing options on people in poverty: the harm of a live donor organ market.

    PubMed

    Rippon, Simon

    2014-03-01

    A prominent defence of a market in organs from living donors says that if we truly care about people in poverty, we should allow them to sell their organs. The argument is that if poor vendors would have voluntarily decided to sell their organs in a free market, then prohibiting them from selling makes them even worse off, at least from their own perspective, and that it would be unconscionably paternalistic to substitute our judgements for individuals' own judgements about what would be best for them. The author shows that this 'Laissez-Choisir Argument' for organ selling rests on a mistake. This is because the claim that it would be better for people in poverty to sell their organs if given the option is consistent with the claim that it would be even better for them to not have the option at all. The upshot is that objections to an organ market need not be at all paternalistic, since we need not accept that the absence of a market makes those in poverty any worse off, even from their own point of view. The author goes on to argue that there are strong theoretical and empirical reasons for believing that people in poverty would in fact be harmed by the introduction of a market for live donor organs and that the harm constitutes sufficient grounds for prohibiting a market. PMID:22745109

  10. Undulation frequency affects burial performance in living and model flatfishes.

    PubMed

    McKee, Amberle; MacDonald, Ian; Farina, Stacy C; Summers, Adam P

    2016-04-01

    Flatfishes bury themselves under a thin layer of sand to hide from predators or to ambush prey. We investigated the role of undulation frequency of the body in burial in five species of flatfishes (Isopsetta isolepis, Lepidopsetta bilineata, Hippoglossoides elassodon, Parophrys vetulus, and Psettichthys melanostictus). High-speed videos show that undulations begin cranially and pass caudally while burying, as in forward swimming in many other fishes. The flatfishes also flick the posterior edge of their dorsal and anal fins during burial, which may increase the total surface area covered by substrate. We built a simple physical model - a flexible, oval silicone plate with a motorized, variable-speed actuator - to isolate the effect of undulation frequency on burial. In both the model and actuated dead flatfish, increased undulation frequency resulted in an increase in the area of sand coverage. Complete coverage required an undulation frequency of no more than 10Hz for our models, and that was also sufficient for live flatfishes. The model shows that undulation is sufficient to bury the animal, but live flatfishes showed a superior ability to bury, which we attribute to the action of the median fins. PMID:26763759

  11. Liminal homes: Older people, loss of capacities, and the present future of living spaces.

    PubMed

    Leibing, Annette; Guberman, Nancy; Wiles, Janine

    2016-04-01

    There are many studies that have examined the meaning of home for older people. In this article, our aim is to add the concept of 'liminal homes' to the existing discussion: While the concept of liminal homes can be applied to a number of 'interim spaces', we focus in our study, on those older people who have to consider, or are concretely confronted with, the need to move into another living space, because of declining health. Based on interviews and photo-elicitation with 26 older lower-income seniors living in Montreal, Québec, this article demonstrates the complexity of liminality and analyzes the dynamics of this process, composed of a web of interrelated and often dichotomous elements. These include the idealized home in contrast to (sometimes imagined) institutions; declining health as opposed to the ideals of active aging and third age; and the widely promoted concept of aging in place versus the reality of being 'stuck in place' due to limited resources. The strategies employed by these older Quebeckers to remain in this state and resist a move to another living space, are the often arduous construction of a 'patchwork of care'. PMID:27131274

  12. Everyday living with diabetes described by family members of adult people with type 1 diabetes.

    PubMed

    Rintala, Tuula-Maria; Paavilainen, Eija; Astedt-Kurki, Päivi

    2013-01-01

    The aim of this study was to explore family members' experiences of everyday life in families with adult people living with type 1 diabetes. The grounded theory method was used to gather and analyse data from the interviews of nineteen family members. Six concepts describing the family members' views on everyday living with diabetes were generated on the basis of the data. Everyday life with diabetes is described as being intertwined with hypoglycemia. Becoming acquainted with diabetes takes place little by little. Being involved in the management and watching self-management from the sidelines are concepts describing family members' participation in the daily management of diabetes. The family members are also integrating diabetes into everyday life. Living on an emotional roller-coaster tells about the thoughts and feelings that family members experience. Family members of adult people with diabetes are involved in the management of the diabetes in many ways and experience many concerns. The family members' point of view is important to take into consideration when developing education for adults with diabetes. PMID:24455251

  13. Social marketing strategies for reaching older people with disabilities: findings from a survey of centers for independent living participants.

    PubMed

    Moone, Rajean Paul; Lightfoot, Elizabeth

    2009-01-01

    Centers for independent living (CILs) provide critical supports, services, and advocacy for assisting people with disabilities in living independently. As there is a rapidly increasing population of older people with disabilities, many CILs are now considering how to actively engage older adults in their organizations. This study utilized a survey of older people with disabilities to help identify social marketing techniques that community organizations like CILs can use to effectively reach older people with disabilities. Utilizing the components of the social marketing mix in designing outreach efforts, including a critical examination of product, place, price, participants, and partnering, CILs and other community agencies can better reach older adults with disabilities. PMID:19459127

  14. A Discourse of "Abnormality": Exploring Discussions of People Living in Australia With Deafness or Hearing Loss.

    PubMed

    Ferndale, Danielle; Munro, Louise; Watson, Bernadette

    2016-01-01

    Adopting a social constructionist framework, the authors conducted a synthetic discourse analysis to explore how people living in Australia with deafness construct their experience of deafness. An online forum facilitated access and communication between the lead author and 24 widely dispersed and linguistically diverse forum contributors. The authors discuss the productive and restrictive effects of the emergent discourse of deafness as abnormal and the rhetorical strategies mobilized in people's accounts: fitting in, acceptance as permission to be different, and the need to prove normality. Using these strategies was productive in that the forum respondents were enabled to reposition deafness as a positive, socially valued identity position. However, the need to manage deafness was reproduced as an individual concern, disallowing any exploration of how deafness could be reconstructed as socially valued. The article concludes with a discussion of the implications of the deafness as abnormal discourse. PMID:26853067

  15. Vision based assistive technology for people with dementia performing activities of daily living (ADLs): an overview

    NASA Astrophysics Data System (ADS)

    As'ari, M. A.; Sheikh, U. U.

    2012-04-01

    The rapid development of intelligent assistive technology for replacing a human caregiver in assisting people with dementia performing activities of daily living (ADLs) promises in the reduction of care cost especially in training and hiring human caregiver. The main problem however, is the various kinds of sensing agents used in such system and is dependent on the intent (types of ADLs) and environment where the activity is performed. In this paper on overview of the potential of computer vision based sensing agent in assistive system and how it can be generalized and be invariant to various kind of ADLs and environment. We find that there exists a gap from the existing vision based human action recognition method in designing such system due to cognitive and physical impairment of people with dementia.

  16. Promoting ethical research with American Indian and Alaska Native people living in urban areas.

    PubMed

    Yuan, Nicole P; Bartgis, Jami; Demers, Deirdre

    2014-11-01

    Most health research with American Indian and Alaska Native (AI/AN) people has focused on tribal communities on reservation lands. Few studies have been conducted with AI/AN people living in urban settings despite their documented health disparities compared with other urban populations. There are unique considerations for working with this population. Engaging key stakeholders, including urban Indian health organization leaders, tribal leaders, research scientists and administrators, and policymakers, is critical to promoting ethical research and enhancing capacity of urban AI/AN communities. Recommendations for their involvement may facilitate an open dialogue and promote the development of implementation strategies. Future collaborations are also necessary for establishing research policies aimed at improving the health of the urban AI/AN population. PMID:25211730

  17. Number of people in the United States experiencing ambulatory and independent living difficulties.

    PubMed

    Siordia, Carlos

    2014-01-01

    Estimating the characteristics of the "disabled" population is necessary for some governments and of interest to health researchers concerned with producing disability prevalence rates. Because generating easy-to-understand estimates of disability in the population is important, this article provides U.S. population estimates for two disability-related measures by using the 2009 to 2011 American Community Survey Public Use Microdata Sample file. The number of people who have "independent living" and "ambulatory" difficulties is calculated from a sample of 9,204,437 (representing >309 million people). The percentage for "disabled" is found to vary by racial and ethnic category, sex, age, citizenship status, educational attainment, and state-level regions divided by weather. PMID:24816336

  18. Promoting Ethical Research With American Indian and Alaska Native People Living in Urban Areas

    PubMed Central

    Bartgis, Jami; Demers, Deirdre

    2014-01-01

    Most health research with American Indian and Alaska Native (AI/AN) people has focused on tribal communities on reservation lands. Few studies have been conducted with AI/AN people living in urban settings despite their documented health disparities compared with other urban populations. There are unique considerations for working with this population. Engaging key stakeholders, including urban Indian health organization leaders, tribal leaders, research scientists and administrators, and policymakers, is critical to promoting ethical research and enhancing capacity of urban AI/AN communities. Recommendations for their involvement may facilitate an open dialogue and promote the development of implementation strategies. Future collaborations are also necessary for establishing research policies aimed at improving the health of the urban AI/AN population. PMID:25211730

  19. A mixed-methods study into ballet for people living with Parkinson's1

    PubMed Central

    Houston, Sara; McGill, Ashley

    2012-01-01

    Background: Parkinson's is a neurological disease that is physically debilitating and can be socially isolating. Dance is growing in popularity for people with Parkinson's and claims have been made for its benefits. The paper details a mixed-methods study that examined a 12-week dance project for people with Parkinson's, led by English National Ballet. Methods: The effects on balance, stability and posture were measured through the Fullerton Advanced Balance Scale and a plumb-line analysis. The value of participation and movement quality were interpreted through ethnographic methods, grounded theory and Effort analysis. Results: Triangulation of results indicates that people were highly motivated, with 100% adherence, and valued the classes as an important part of their lives. Additionally, results indicated an improvement in balance and stability, although not in posture. Conclusions: Dancing may offer benefit to people with Parkinson's through its intellectual, artistic, social and physical aspects. The paper suggests that a range of research methods is fundamental to capture the importance of multifaceted activity, such as dance, to those with Parkinson's. PMID:23805165

  20. [Social support and living conditions in poor elderly people in urban Mexico].

    PubMed

    Pelcastre-Villafuerte, Blanca Estela; Treviño-Siller, Sandra; González-Vázquez, Tonatiuh; Márquez-Serrano, Margarita

    2011-03-01

    The aim of this paper was to analyze social support and living conditions among poor elderly people in Mexican cities. A qualitative study with eight focus groups was carried out in Guadalajara, Cuernavaca, Chilpancingo, and Culiacan, Mexico, in 2005. Forty men and 63 women participated in the study. The main support for the elderly in daily living came from their immediate family and in some cases from neighbors. Social support was basically material and economic, in addition to providing company and transportation for medical appointments. Daily emotional support, companionship, and social inclusion were minimal or absent. The study identified a significant lack of support from government and religious or civil society organizations. The family is still the main source of support for the elderly. Increased government collaboration is dramatically needed to combat the misconception that the needs of the elderly are the individual family's responsibility rather than a collaborative effort by society. PMID:21519697

  1. Prevalence of human herpesvirus 8 infection in people living with HIV/AIDS in Pernambuco, Brazil.

    PubMed

    de Oliveira Mendes Cahú, Georgea Gertrudes; Morais, Viviane Martha Santos; Lopes, Thaisa Regina Rocha; da Silva, Dayvson Maurício; Tozetto-Mendoza, Tania Regina; Pannuti, Claudio Sergio; Cunha Duarte Coêlho, Maria Rosângela

    2016-11-01

    This cross-sectional study aimed to estimate the seroprevalence and risk factors for Human herpesvirus 8 (HHV-8) infection among people living with HIV/AIDS in Recife, Pernambuco, Brazil. A total of 500 individuals were tested for antibodies against HHV-8 using the whole-virus ELISA. The prevalence of anti-HHV-8 was 28.6% and the frequency among 140 men who have sex with men (MSM) was 38.6%. In the univariate model, there were significant associations with male gender, detectable HIV load, travel abroad, bissexual, and homossexual orientation. The first HHV-8 seroepidemiologic study, in northeast Brazil, documents a highly prevalent HHV-8 infection among MSM living with HIV/AIDS. J. Med. Virol. 88:2016-2020, 2016. © 2016 Wiley Periodicals, Inc. PMID:27089548

  2. Dignity and care for people with dementia living in nursing homes.

    PubMed

    Heggestad, Anne Kari Tolo; Nortvedt, Per; Slettebø, Åshild

    2015-11-01

    This article presents and discusses findings from a qualitative study on how the dignity of patients with dementia is preserved or harmed when they live in a nursing home. The results build on participant observation in two nursing home wards, combined with qualitative interviews with seven relatives of patients with dementia. The most important issue for relatives was that their family member with dementia was confirmed as a relational human being. However, relatives experienced lack of resources and task-centred care as threats to confirming, relational care and to patients' dignity. Findings from participant observations confirmed this. In this article, we argue that care which focuses on the residents' personhood, combined with a relational focus, is of great importance in maintaining the dignity of people with dementia living in nursing homes. PMID:24381212

  3. Missed opportunities for religious organizations to support people living with HIV/AIDS: findings from Tanzania.

    PubMed

    Watt, Melissa H; Maman, Suzanne; Jacobson, Mark; Laiser, John; John, Muze

    2009-05-01

    Religious beliefs play an important role in the lives of Tanzanians, but little is known about the influence of religion for people living with HIV/AIDS (PLWHA). This study shares perspectives of PLWHA and identifies opportunities for religious organizations to support the psychological well-being of this group. Data were collected in 2006 and 2007 through semistructured interviews with 36 clients (8 Muslims and 28 Christians) receiving free antiretrovirals (ARVs) in Arusha, Tanzania. Swahili-speaking interviewers asked about participation in religion, change in religious engagement since HIV diagnosis, and what role faith plays in living with HIV and taking ARVs. Interviews were audiotaped, transcribed, translated, and analyzed using Atlas t.i. The findings revealed that patients' personal faith positively influenced their experiences living with HIV, but that religious organizations had neutral or negative influences. On the positive side, prayer gave hope to live with HIV, and religious faith increased after diagnosis. Some respondents said that prayer supported their adherence to medications. On the other hand, few disclosed their HIV status in their religious communities, expressing fear of stigma. Most had heard that prayer can cure HIV, and two expected to be cured. While it was common to hear messages about HIV prevention from churches or mosques, few had heard messages about living with HIV. The findings point to missed opportunities by religious organizations to support PLWHA, particularly the need to ensure that messages about HIV are not stigmatizing; share information about HIV treatment; introduce role models of PLWHA; and emphasize that prayers and medical care go hand-in-hand. PMID:19335171

  4. Missed Opportunities for Religious Organizations to Support People Living with HIV/AIDS: Findings from Tanzania

    PubMed Central

    Maman, Suzanne; Jacobson, Mark; Laiser, John; John, Muze

    2009-01-01

    Abstract Religious beliefs play an important role in the lives of Tanzanians, but little is known about the influence of religion for people living with HIV/AIDS (PLWHA). This study shares perspectives of PLWHA and identifies opportunities for religious organizations to support the psychological well-being of this group. Data were collected in 2006 and 2007 through semistructured interviews with 36 clients (8 Muslims and 28 Christians) receiving free antiretrovirals (ARVs) in Arusha, Tanzania. Swahili-speaking interviewers asked about participation in religion, change in religious engagement since HIV diagnosis, and what role faith plays in living with HIV and taking ARVs. Interviews were audiotaped, transcribed, translated, and analyzed using Atlas t.i. The findings revealed that patients' personal faith positively influenced their experiences living with HIV, but that religious organizations had neutral or negative influences. On the positive side, prayer gave hope to live with HIV, and religious faith increased after diagnosis. Some respondents said that prayer supported their adherence to medications. On the other hand, few disclosed their HIV status in their religious communities, expressing fear of stigma. Most had heard that prayer can cure HIV, and two expected to be cured. While it was common to hear messages about HIV prevention from churches or mosques, few had heard messages about living with HIV. The findings point to missed opportunities by religious organizations to support PLWHA, particularly the need to ensure that messages about HIV are not stigmatizing; share information about HIV treatment; introduce role models of PLWHA; and emphasize that prayers and medical care go hand-in-hand. PMID:19335171

  5. Problems Faced by Complete Denture-Wearing Elderly People Living in Jammu District

    PubMed Central

    Sharma, Sumeet; Singh, Sarbjeet; Wazir, Nikhil; Raina, Rajiv

    2014-01-01

    Context: Poor oral health is increasing dramatically among old people especially those living in rural and remote areas. Various factors such as low education background, low income, poor living conditions, unhealthy lifestyle, inadequate oral hygiene and tobacco use lead to poor oral health among older people which in turn lead to risks to their general health. The older people especially from rural areas are apprehensive about seeing a dentist and do not visit them regularly. This may lead to various problems which may have a detrimental influence on their quality of life. Aim: To know the problems faced by complete denture wearers in rural areas in Jammu district. Materials and Methods: Fifty patients from rural area Bishna, initially treated with a complete denture in the maxilla or mandibles were examined. The data were collected with the help of a questionnaire. Results: The results revealed that majority of respondents were in the age – group of 65-70 y. Majority of respondents complained of "difficulty chewing", "sore spots”, “painful and swollen gums". Majority of respondents had difficulty in speech, it was difficult for them to interact and communicate with their dentures on. Most of the respondents had lost confidence and had low self esteem. Clinical observations revealed that the commonest condition associated with denture wearing was Oral Stomatitis/ Burning mouth Syndrome, Superimposed infection and Angular cheilitis. Conclusion: Older people should Communicate and visit dentists, regularly, so that the dentists can adjust the treatment and pace according to their needs. Behavioural therapy techniques can make dental visits relatively anxiety and pain-free. PMID:25654025

  6. An exploratory survey measuring stigma and discrimination experienced by people living with HIV/AIDS in South Africa: the People Living with HIV Stigma Index

    PubMed Central

    2014-01-01

    Background The continued presence of stigma and its persistence even in areas where HIV prevalence is high makes it an extraordinarily important, yet difficult, issue to eradicate. The study aimed to assess current and emerging HIV/AIDS stigma and discrimination trends in South Africa as experienced by people living with HIV/AIDS (PLHIV). Methods The PLHIV Stigma Index, a questionnaire that measures and detects changing trends in relation to stigma and discrimination experienced by PLHIV, was used as the survey tool. The study was conducted in 10 clinics in four provinces supported by the Foundation for Professional Development (FPD), with an interview total of 486 PLHIV. A cross-sectional design was implemented in the study, and both descriptive and inferential analysis was conducted on the data. Results Findings suggest that PLHIV in this population experience significant levels of stigma and discrimination that negatively impact on their health, working and family life, as well as their access to health services. Internalised stigma was prominent, with many participants blaming themselves for their status. Conclusion The findings can be used to develop and inform programmes and interventions to reduce stigma experienced by PLHIV. The current measures for dealing with stigma should be expanded to incorporate the issues related to health, education and discrimination experienced in the workplace, that were highlighted by the study. PMID:24461042

  7. Determinants of unequal HIV care access among people living with HIV in Peru

    PubMed Central

    2013-01-01

    Background Equity in access to health care among people living with HIV (PLHA) has not been extensively studied in Peru despite the fact there is significant social diversity within this group. We aimed to assess the extent to which health care provision to PLHA, including ARVT, was equitable and, if appropriate, identify factors associated with lower access. Methods We conducted a survey among adult PLHA in four cities in Peru, recruited through respondent-driven sampling (RDS), to collect information on socio-demographic characteristics, social network size, household welfare, economic activity, use of HIV-related services including ARV treatment, and health-related out-of-pocket expenses. Results Between September 2008 and January 2009, 863 individuals from PLHA organizations in four cities of Peru were enrolled. Median age was 35 (IQR = 29–41), and mostly male (62%). Overall, 25% reported to be gay, 11% bisexual and 3% transgender. Most PLHA (96%) reported access to some kind of HIV-related health service, and 84% were receiving those services at a public facility. Approximately 85% of those reporting access to care were receiving antiretroviral treatment (ARV), and 17% of those not in treatment already had indication to start treatment. Among those currently on ARV, 36% percent reported out-of-pocket expenses within the last month. Transgender identity and age younger than 35 years old, were associated with lower access to health care. Conclusions Our findings contribute to a better social and demographic characterization of the situation of PLHAs, their access to HIV care and their source of care, and provide an assessment of equity in access. In the long term, it is expected that HIV care access, as well as its social determinants, will impact on the morbidity and mortality rates among those affected by the HIV/AIDS epidemic. HIV care providers and program managers should further characterize the barriers to healthcare access and develop strategies to

  8. Caregiver Burden among Adults Caring for People Living with HIV/AIDS (PLWHA) in Southern India

    PubMed Central

    Chandran, Vishnu; Chowta, Nithyananda; Ramapuram, John; Bhaskaran, Unnikrishnan; Achappa, Basavaprabhu; Jose, Hyma

    2016-01-01

    Introduction In India, family caregivers provide bulk of care to People Living With HIV/AIDS (PLWHA). Caregiver burden refers to the physical, emotional and financial hardships associated with providing care to a diseased individual. Attending to the needs of PLWHA can place a significant burden on family members. This may adversely affect their Quality of Life (QOL). Aim The main aim of our study was to assess the caregiver burden and QOL among the family members of PLWHA in Southern India. We also determined the impact of caregiver burden on QOL. Materials and Methods This facility based cross-sectional study was carried out at Kasturba Medical College (KMC) Mangalore. The study was conducted over a period of 18 months starting from October 2013. A total of 360 caregivers participated in our study. The data were collected by face-to-face interview. Caregiver burden was assessed using the Zarit Burden scale & WHOQOL-BREF scale was used to assess the QOL of caregivers. The collected data was entered and analysed using SPSS version 11.5. A p-value of less than 0.05 was considered statistically significant. Results The mean age of caregivers was 36.09± 10.18 years. Most of the caregivers were females 279 (77.5%). Majority of caregivers 184 (51.1%) belonged to Middle/Lower Middle socioeconomic class (Kuppuswamy class III). Majority of PLWHA 155 (43.1%) had Stage 2 disease. Mean CD4 count of the patients was 405.2± 240 cells/μL. In our study 88(24.4%) caregivers had moderate to severe burden and 36(10%) had very severe burden. Physical domain of QOL showed maximum score of 60.28±13.08, while a minimum score of 51.88 ± 14.20 was seen in social domain. With increase in caregiver burden, the mean QOL scores decreased which was statistically significant. Conclusion Our study highlights the need to counsel the caregivers on how to deal with PLWHA in the family. Family care plays a major role in the general wellbeing of PLWHA. Majority of national HIV programmes all

  9. Increased risk of preterm delivery among people living near the three oil refineries in Taiwan.

    PubMed

    Yang, Chun-Yuh; Chang, Chih-Ching; Chuang, Hung-Yi; Ho, Chi-Kung; Wu, Trong-Neng; Chang, Po-Ya

    2004-05-01

    The petrochemical and petroleum industries are two of the main sources of industrial air pollution in Taiwan. Data used in this study concern outdoor air pollution and the health of individuals living in communities in close proximity to oil refinery plants. The prevalence of delivery of preterm birth infants was significantly higher in mothers living near the oil refinery plants than in control mothers in Taiwan. After controlling for several possible confounders (including maternal age, season, marital status, maternal education, and infant sex), the adjusted odds ratio was 1.14 (95% CI=1.01-1.28) for delivery of preterm infants for mothers living near oil refinery plants. These data provide further support for the hypothesis that air pollution can affect the outcome of pregnancies. PMID:14987863

  10. Incidence and prevalence of Parkinson's disease among Navajo people living in the Navajo nation.

    PubMed

    Gordon, Paul H; Mehal, Jason M; Holman, Robert C; Bartholomew, Michael L; Cheek, James E; Rowland, Andrew S

    2015-04-15

    Parkinson's disease (PD) is largely unstudied among American Indians. Unique populations might harbor clues to elusive causes. We describe the incidence and prevalence of PD among Navajo people residing in the Navajo Nation, home to the largest American Indian tribe in the United States. We analyzed 2001-2011 inpatient and outpatient visit data for Navajo people obtained from the Indian Health Service, which provides health care to American Indian people living on the Navajo Reservation. Cases were defined by at least two inpatient or outpatient visits with the diagnosis of PD. Crude and age-adjusted incidence and prevalence rates were calculated overall as well as by age, sex, region of residence, and time period. Five hundred twenty-four Navajo people with median age-at-onset of 74.0 years were diagnosed with PD during the study period, yielding an average annual crude incidence rate of 22.5/100,000. Age-specific incidence was 232.0 for patients 65 years of age or older and 302.0 for 80 years of age or older. Age-adjusted incidence was 35.9 overall (238.1 for ≥65 years), was higher in men than in women (47.5 vs. 27.7; P<0.001), varied by region (P=0.03), and was similar between time periods (2002-2004 vs. 2009-2011). The age-adjusted point prevalence rate was 261.0. The rate of PD among Navajo People appears to be as high as or higher than rates reported in many other populations. Rates increased to the highest age group, consistent with population-based studies. Further investigation is warranted to examine risk factors for PD in this remote population. PMID:25649219

  11. Palliative and end of life care for people living with dementia in care homes: part 1.

    PubMed

    Mitchell, Gary; Agnelli, Joanne; McGreevy, Jessie; Diamond, Monica; Roble, Herlindina; McShane, Elaine; Strain, Joanne

    2016-06-22

    The terms palliative and end of life care are often used interchangeably and healthcare practitioners may perceive that palliative care is only appropriate during the terminal stages of an illness. This article, the first of two parts, provides healthcare practitioners with an overview of the concept of palliative care. It explains how this can be differentiated from end of life care and how it should be commenced in a timely manner, so that people who are living with dementia can contribute to the planning of their future care and death. The policies and tools used in the provision of palliative and end of life care are discussed, including advance care planning and The Gold Standards Framework. The article is framed in a care home context; there is little research about how to optimise palliative care for people living with dementia in care homes. The second part of this article will discuss end of life care and the best practices for providing end of life care, including nutrition and hydration, oral hygiene, pain management and spiritual care. PMID:27332611

  12. Predictive factors for the Nursing Diagnoses in people living with Acquired Immune Deficiency Syndrome 1

    PubMed Central

    da Silva, Richardson Augusto Rosendo; Costa, Romanniny Hévillyn Silva; Nelson, Ana Raquel Cortês; Duarte, Fernando Hiago da Silva; Prado, Nanete Caroline da Costa; Rodrigues, Eduardo Henrique Fagundes

    2016-01-01

    Abstract Objective: to identify the predictive factors for the nursing diagnoses in people living with Acquired Immune Deficiency Syndrome. Method: a cross-sectional study, undertaken with 113 people living with AIDS. The data were collected using an interview script and physical examination. Logistic regression was used for the data analysis, considering a level of significance of 10%. Results: the predictive factors identified were: for the nursing diagnosis of knowledge deficit-inadequate following of instructions and verbalization of the problem; for the nursing diagnosis of failure to adhere - years of study, behavior indicative of failure to adhere, participation in the treatment and forgetfulness; for the nursing diagnosis of sexual dysfunction - family income, reduced frequency of sexual practice, perceived deficit in sexual desire, perceived limitations imposed by the disease and altered body function. Conclusion: the predictive factors for these nursing diagnoses involved sociodemographic and clinical characteristics, defining characteristics, and related factors, which must be taken into consideration during the assistance provided by the nurse. PMID:27384466

  13. Intuitive wireless control of a robotic arm for people living with an upper body disability.

    PubMed

    Fall, C L; Turgeon, P; Campeau-Lecours, A; Maheu, V; Boukadoum, M; Roy, S; Massicotte, D; Gosselin, C; Gosselin, B

    2015-08-01

    Assistive Technologies (ATs) also called extrinsic enablers are useful tools for people living with various disabilities. The key points when designing such useful devices not only concern their intended goal, but also the most suitable human-machine interface (HMI) that should be provided to users. This paper describes the design of a highly intuitive wireless controller for people living with upper body disabilities with a residual or complete control of their neck and their shoulders. Tested with JACO, a six-degree-of-freedom (6-DOF) assistive robotic arm with 3 flexible fingers on its end-effector, the system described in this article is made of low-cost commercial off-the-shelf components and allows a full emulation of JACO's standard controller, a 3 axis joystick with 7 user buttons. To do so, three nine-degree-of-freedom (9-DOF) inertial measurement units (IMUs) are connected to a microcontroller and help measuring the user's head and shoulders position, using a complementary filter approach. The results are then transmitted to a base-station via a 2.4-GHz low-power wireless transceiver and interpreted by the control algorithm running on a PC host. A dedicated software interface allows the user to quickly calibrate the controller, and translates the information into suitable commands for JACO. The proposed controller is thoroughly described, from the electronic design to implemented algorithms and user interfaces. Its performance and future improvements are discussed as well. PMID:26737270

  14. The social positioning of older people living with Alzheimer's disease who scream in long-term care homes.

    PubMed

    Bourbonnais, Anne; Ducharme, Francine

    2015-11-01

    This article describes the social positioning of older people living with Alzheimer's disease who scream in a long-term care home. Few studies have focused on the social positions taken by older people, their family and formal caregivers during interaction and their effects on screams. A secondary data analysis was conducted using Harré and Van Langenhove's positioning theory. The results show that older people are capable of positioning and repositioning themselves in relational patterns. Family and formal caregivers position older people who scream according to their beliefs about their lived experience. They also react emotionally to older people and try to influence their behaviors. Understanding the social positioning of older people with Alzheimer's disease brought out their capacities and their caregivers' concerns for their well-being. Interventions should focus on these strengths and on promoting healthy relations in the triads to enhance quality of care in long-term care homes. PMID:24339123

  15. Randomised factorial trial of falls prevention among older people living in their own homes

    PubMed Central

    Day, Lesley; Fildes, Brian; Gordon, Ian; Fitzharris, Michael; Flamer, Harold; Lord, Stephen

    2002-01-01

    Objective To test the effectiveness of, and explore interactions between, three interventions to prevent falls among older people. Design A randomised controlled trial with a full factorial design. Setting Urban community in Melbourne, Australia. Participants 1090 aged 70 years and over and living at home. Most were Australian born and rated their health as good to excellent; just over half lived alone. Interventions Three interventions (group based exercise, home hazard management, and vision improvement) delivered to eight groups defined by the presence or absence of each intervention. Main outcome measure Time to first fall ascertained by an 18 month falls calendar and analysed with survival analysis techniques. Changes to targeted risk factors were assessed by using measures of quadriceps strength, balance, vision, and number of hazards in the home. Results The rate ratio for exercise was 0.82 (95% confidence interval 0.70 to 0.97, P=0.02), and a significant effect (P<0.05) was observed for the combinations of interventions that involved exercise. Balance measures improved significantly among the exercise group. Neither home hazard management nor treatment of poor vision showed a significant effect. The strongest effect was observed for all three interventions combined (rate ratio 0.67 (0.51 to 0.88, P=0.004)), producing an estimated 14.0% reduction in the annual fall rate. The number of people needed to be treated to prevent one fall a year ranged from 32 for home hazard management to 7 for all three interventions combined. Conclusions Group based exercise was the most potent single intervention tested, and the reduction in falls among this group seems to have been associated with improved balance. Falls were further reduced by the addition of home hazard management or reduced vision management, or both of these. Cost effectiveness is yet to be examined. These findings are most applicable to Australian born adults aged 70-84 years living at home who rate their

  16. Learning to (Dis)Engage? The Socialising Experiences of Young People Living in Areas of Socio-Economic Disadvantage

    ERIC Educational Resources Information Center

    Mason, Carolynne; Cremin, Hilary; Warwick, Paul; Harrison, Tom

    2011-01-01

    Young people are increasingly required to demonstrate civic engagement in their communities and help deliver the aspirations of localism and Big Society. Using an ecological systems approach this paper explores the experiences of different groups of young people living in areas of socio-economic disadvantage. Using volunteering as an example of…

  17. Assessing the Mental Health Needs of Young People Living in State Care Using the Strengths and Difficulties Questionnaire

    ERIC Educational Resources Information Center

    McCrystal, Patrick; McAloney, Kareena

    2010-01-01

    Young people living in the state care system are often reported to experience poorer levels of mental health and wellbeing. Government policy encourages a holistic approach to the assessment of all aspects of health and wellbeing of these young people. The Strengths and Difficulties Questionnaire (SDQ), a mental health screener for young people…

  18. University Students' Perception of People Living with HIV/AIDS: Discomfort, Fear, Knowledge and a Willingness to Care

    ERIC Educational Resources Information Center

    Houtsonen, Jarmo; Kylmä, Jari; Korhonen, Teija; Välimäki, Maritta; Suominen, Tarja

    2014-01-01

    People living with HIV/AIDS (PLWHA) are often subject to blame, fear and avoidance, particularly if they are perceived as personally responsible for their infection due to their risky behaviour or life style choices. Some people however, react to PLWHA with sympathy and a willingness to care. This paper explores how university students (n = 282)…

  19. Educational Issues for Children and Young People in Families Living in Emergency Accommodation--An Irish Perspective

    ERIC Educational Resources Information Center

    Keogh, Anna Fiona; Halpenny, Ann Marie; Gilligan, Robbie

    2006-01-01

    The article explores how homelessness may impact on the educational participation of children and young people in families living in emergency accommodation in Dublin. Many difficulties arise in terms of maintaining consistent schooling for children when they are part of a homeless family, including problems getting to and from school if living at…

  20. Cognitive Impairment and Risk Factors in Elderly People Living in Fluorosis Areas in China.

    PubMed

    Li, Mang; Gao, Yanhui; Cui, Jing; Li, Yuanyuan; Li, Bingyun; Liu, Yang; Sun, Jing; Liu, Xiaona; Liu, Hongxu; Zhao, Lijun; Sun, Dianjun

    2016-07-01

    Residents living in fluorosis areas generally experienced long-term exposure to excessive fluoride in drinking water. The adverse effects of high fluoride levels on the nervous system have been studied; however, the effect of fluoride exposure on cognitive functions of elderly people in fluorosis areas is rarely reported. This study was aimed to find out the potential risk factors of cognitive impairment among elderly people who lived in fluorosis areas of China. A total of 511 subjects, aged 60 years or above, were investigated in fluorosis areas of Heilongjiang Province, Inner Mongolia Autonomous Region, Qinghai Province, and Xinjiang Uygur Autonomous Region. The Mini-Mental State Examination (MMSE) was used to examine cognitive functions of the study subjects. Based on the MMSE scores, the study subjects were divided into normal group and cognitive impairment group that consisted of mild, moderate, and severe groups. Multivariable logistic regression showed that a higher risk of cognitive impairment was associated with increased age and decreased education levels. Multiple linear regression analysis revealed that MMSE scores were negatively associated with serum homocysteine (Hcy) levels. However, both urinary fluoride and serum Hcy levels in the normal group were not the lowest among the four groups. Spearman's correlation analysis showed that urinary fluoride levels were positively correlated with serum Hcy (r s = 0.209, P < 0.01). Our study suggests that people with cognitive impairment in fluorosis areas have elevated serum Hcy levels, which was positively correlated with urinary fluoride concentrations. A certain low dose of fluoride intake may play a potential protective rather than harmful role in cognitive functions; however, high fluoride exposure is a potential risk factor for cognitive impairment. PMID:26606914

  1. Indices of body fat distribution for assessment of lipodysthrophy in people living with HIV/AIDS

    PubMed Central

    2012-01-01

    Background Metabolic and morphological changes associated with excessive abdominal fat, after the introduction of Antiretroviral Therapy, increase the risk of cardiovascular disease in people living with HIV/AIDS(PLWHA). Accurate methods for body composition analysis are expensive and the use of anthropometric indices is an alternative. However the investigations about this subject in PLWHA are rare, making this research very important for clinical purpose and to advance scientific knowledge. The aim of this study is to correlate results of anthropometric indices of evaluation of body fat distribution with the results obtained by Dual-energy X-Ray Absorptiometry(DEXA), in people living with HIV/AIDS. Methods The sample was of 67 PLWHA(39 male and 28 female), aged 43.6+7.9 years. Body mass index, conicity index, waist/hip ratio, waist/height ratio and waist/thigh were calculated. Separated by sex, each index/ratio was plotted in a scatter chart with linear regression fit and their respective Pearson correlation coefficients. Analyses were performed using Prism statistical program and significance was set at 5%. Results The waist/height ratio presented the highest correlation coefficient, for both male (r=0.80, p<0.001) and female (r=0.87, p <001), while the lowest were in the waist/thigh also for both: male group (r=0.58, p<0.001) and female group (r=0.03, p=0.86). The other indices also showed significant positive correlation with DEXA. Conclusion Anthropometric indices, especially waist/height ratio may be a good alternative way to be used for evaluating the distribution of fat in the abdominal region of adults living with HIV/ADIS. PMID:23031203

  2. August 2003 heat wave in France: risk factors for death of elderly people living at home.

    PubMed

    Vandentorren, S; Bretin, P; Zeghnoun, A; Mandereau-Bruno, L; Croisier, A; Cochet, C; Ribéron, J; Siberan, I; Declercq, B; Ledrans, M

    2006-12-01

    The August 2003 heat wave in France resulted in many thousands of excess deaths particularly of elderly people. Individual and environmental risk factors for death among the community-dwelling elderly were identified. We conducted a case-control survey and defined cases as people aged 65 years and older who lived at home and died from August 8 through August 13 from causes other than accident, suicide, or surgical complications. Controls were matched with cases for age, sex, and residential area. Interviewers used questionnaires to collect data. Satellite pictures provided profiles of the heat island characteristics around the homes. Lack of mobility was a major risk factor along with some pre-existing medical conditions. Housing characteristics associated with death were lack of thermal insulation and sleeping on the top floor, right under the roof. The temperature around the building was a major risk factor. Behaviour such as dressing lightly and use of cooling techniques and devices were protective factors. These findings suggest people with pre-existing medical conditions were likely to be vulnerable during heat waves and need information on how to adjust daily routines to heat waves. In the long term, building insulation and urban planning must be adapted to provide protection from possible heat waves. PMID:17028103

  3. Quality of life, clinical characteristics and treatment adherence of people living with HIV/AIDS1

    PubMed Central

    Silva, Ana Cristina de Oliveira e; Reis, Renata Karina; Nogueira, Jordana Almeida; Gir, Elucir

    2014-01-01

    OBJECTIVES: to assess the quality of life of people living with HIV/AIDS and verify its association with clinical characteristics and treatment adherence. METHOD: cross-sectional study conducted in a hospital in the state of Paraíba, Brazil. A questionnaire was used to collect socio-demographic and clinical data. The quality of life scale proposed by the World Health Organization and a questionnaire to measure treatment adherence were used. RESULTS: of the 314 interviewees, 190 (60.5%) were male, aged 43 years on average, 121 (38.5%) had attended up to five years of schooling, 108 (34.4%) received up to two times the minimum wage, and 112 (35.7%) were on sick leave. In regard to clinical variables, individuals with an undetectable viral load scored higher in all the domains concerning quality of life, with statistically significant differences in three domains. Regarding treatment adherence, 235 (73.8%) presented poor adherence and those who strictly adhered to treatment obtained better scores in quality of life. The results show that quality of life is better among individuals adherent to ART. Supporting people to adhere to the antiretroviral treatment should be a persistent task of healthcare workers and other people participating in the treatment, such as family members and friends. PMID:25591095

  4. Can a lot more people live to one hundred and what if they did?

    PubMed

    Olshansky, S Jay

    2013-12-01

    In the 21st century humanity will witness unprecedented, increases in the number of older people, especially centenarians, in both the developed and developing world. From a public policy standpoint, the aging of our populations and the longer lives we experience will change, the fabric of our modern world - from the funding of age entitlement programs, to the rising cost of health care, to the new ways in which we transport ourselves in increasingly more urban environments. If it becomes possible for biomedical advances to manufacture a form of biological plasticity among the new generations reaching 85 and older in the future, much like that which now exists for the recent middle-aged classes of people aged 65-85, then the future of aging will be bright. If we fail to marshal resources to confront the biological processes of aging, then it is possible that the more destructive side of senescence will emerge. In this paper, I explore the various perspectives on the future course of longevity, examine the prospects for significant increases in the number of very old people - especially centenarians - and present a general view of the demographic aging of our changing society. PMID:23910247

  5. The effect of probiotics on CD4 counts among people living with HIV: a systematic review.

    PubMed

    Miller, H; Ferris, R; Phelps, B R

    2016-06-01

    Probiotics are defined by the WHO as 'live microorganisms which when administered in adequate amounts confer a health benefit on the host'. Ongoing research has shown probiotics provide benefits to humans, including protection and restoration of the gastrointestinal and other mucosal tracts. As human immunodeficiency virus (HIV) activates gut-associated lymphoid tissue (GALT), several studies have investigated the effect of probiotics on CD4 cell count and related outcomes among those living with HIV. These studies are summarised here. Manuscripts were identified using the search terms 'probiotics', 'synbiotics', 'HIV', and 'CD4', and were reviewed for relevance and inclusion of CD4 count as an immunologic endpoint. Bibliographies of relevant manuscripts were also reviewed for additional studies matching inclusion and exclusion criteria. The search yielded 91 results; 13 included relevant outcomes. Seven of these studies produced beneficial CD4 outcomes, while the remaining 6 reported on insignificant beneficial or negative CD4 outcomes. The studies summarised here collectively suggest that daily consumption of probiotics over a prolonged period of time may improve CD4 count in people living with HIV. PMID:27013461

  6. Physiotherapy intervention as a complementary treatment for people living with HIV/AIDS

    PubMed Central

    Pullen, Sara D; Chigbo, Nnenna Nina; Nwigwe, Emmanuel Chukwudi; Chukwuka, Chinwe J; Amah, Christopher Chim; Idu, Stanley C

    2014-01-01

    Background The advent of highly active antiretroviral therapy has dramatically extended the life expectancy of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome. Despite this increased longevity, HIV disease and its pharmacological treatment can cause long-term and acute health complications, many of which can be treated successfully by physiotherapy. The purpose of this paper is to report the effect of a 12-week rehabilitation program on several health-related markers in a 43-year-old woman living with HIV. Methods This case study examined the effect of a 12-week exercise and manual therapy intervention on morphology, pain, cardiopulmonary fitness, strength, neurological balance, immune markers (CD4 cell count), and quality of life in a 43-year-old woman living with HIV. Results The results showed complete elimination of pain and shortness of breath on exertion. There was also a reduction in resting heart rate, waist circumference, exercise duration, muscle strength, and endurance. The patient showed an increase in peak expiratory flow rate, maximal heart rate attained, upper arm, forearm, and thigh circumference, and CD4+ cell count. The patient also showed improvements in the quality of life domains of general health, pain, energy/fatigue, social and physical functioning, and emotional well-being. Conclusion Physiotherapy interventions consisting of exercise and manual therapy appear beneficial in several areas as an adjunct therapy in HIV management. PMID:24936132

  7. Pattern and determinants of morbidity among people living with HIV/AIDS in North Central Nigeria.

    PubMed

    Olaleye, Adeniyi; Ogwumike, F O

    2013-02-01

    The study investigated the nature of self-reported morbidity and determinants of health status among people living with HIV/AIDS (PLWHA) in North Central Nigeria. A multi-stage cluster sampling method was used to select 1,056 adult PLWHA from 60 community-based support groups as respondents to a structured questionnaire. Based on health production function, health status was specified as a function of individual/household characteristics, health-related behaviours and genetic endowment. Descriptive statistics showed that more than half (52.8%, n=558) of the PLWHA reported illness in the last four weeks. The poor, widows and divorcees, and those living in rural areas reported illness more than their non-poor, married and urban counterparts. Logistic regression results indicated that self reported mobility was associated with rural residence (p=.005), greater use of condom (p=.013), and lower CD4 count (p=.007). Programs to promote positive living and access to health care services among PLWHA in Nigeria, especially in rural areas, are recommended. PMID:23377732

  8. Life situation and identity among single older home-living people: A phenomenological–hermeneutic study

    PubMed Central

    Söderhamn, Ulrika; Söderhamn, Olle

    2012-01-01

    Being able to continue living in their own home as long as possible is the general preference for many older people, and this is also in line with the public policy in the Nordic countries. The aim of this study was to elucidate the meaning of self-care and health for perception of life situation and identity among single-living older individuals in rural areas in southern Norway. Eleven older persons with a mean age of 78 years were interviewed and encouraged to narrate their self-care and health experiences. The interviews were audio taped, transcribed verbatim and analysed using a phenomenological–hermeneutic method inspired by the philosophy of Ricoeur. The findings are presented as a naïve reading, an inductive structural analysis characterized by two main themes; i.e., “being able to do” and “being able to be”, and a comprehensive interpretation. The life situation of the interviewed single-living older individuals in rural areas in southern Norway was interpreted as inevitable, appropriate and meaningful. Their identity was constituted by their freedom and self-chosen actions in their personal contexts. The overall impression was that independence and the ability to control and govern their own life in accordance with needs and preferences were ultimate goals for the study participants. PMID:22848230

  9. Life situation and identity among single older home-living people: a phenomenological-hermeneutic study.

    PubMed

    Dale, Bjørg; Söderhamn, Ulrika; Söderhamn, Olle

    2012-01-01

    Being able to continue living in their own home as long as possible is the general preference for many older people, and this is also in line with the public policy in the Nordic countries. The aim of this study was to elucidate the meaning of self-care and health for perception of life situation and identity among single-living older individuals in rural areas in southern Norway. Eleven older persons with a mean age of 78 years were interviewed and encouraged to narrate their self-care and health experiences. The interviews were audio taped, transcribed verbatim and analysed using a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur. The findings are presented as a naïve reading, an inductive structural analysis characterized by two main themes; i.e., "being able to do" and "being able to be", and a comprehensive interpretation. The life situation of the interviewed single-living older individuals in rural areas in southern Norway was interpreted as inevitable, appropriate and meaningful. Their identity was constituted by their freedom and self-chosen actions in their personal contexts. The overall impression was that independence and the ability to control and govern their own life in accordance with needs and preferences were ultimate goals for the study participants. PMID:22848230

  10. Incarceration of people living with HIV/AIDS: Implications for Treatment-As-Prevention

    PubMed Central

    Milloy, M-J; Montaner, Julio S.G.; Wood, Evan

    2015-01-01

    Contact with the criminal justice system, including incarceration, is a common experience for many people living with HIV/AIDS. Optimism has recently been expressed that correctional facilities could be important locations for Treatment-as-Prevention (TasP)-based initiatives. We review recent findings regarding the effect of incarceration on patterns of HIV transmission, testing, treatment initiation and retention. We found that the prevalence of HIV infection among incarcerated individuals remains higher than analogous non-incarcerated populations. Recent studies have shown that voluntary HIV/AIDS testing is feasible in many correctional facilities, although the number of previously undiagnosed individuals identified has been modest. Studies have implied enhanced linkage to HIV/AIDS treatment and care in jails in the United States was associated with improvements in the HIV cascade of care. However, for many individuals living with HIV/AIDS, exposure to the correctional system remains an important barrier to retention in HIV/AIDS treatment and care. Future research should evaluate structural interventions to address these barriers and facilitate the scale-up of TasP-based efforts among individuals living in correctional settings. PMID:24962285

  11. Factors associated with psychological and behavioral functioning in people with type 2 diabetes living in France

    PubMed Central

    2010-01-01

    Background To identify demographic and clinical factors associated with psychological and behavioral functioning (PBF) in people with type 2 diabetes living in France. Methods In March 2002, approximately 10,000 adults, who had been reimbursed for at least one hypoglycemic treatment or insulin dose during the last quarter of 2001, received a questionnaire about their health status and PBF (3,646 responders). For this analysis, the 3,090 persons with type 2 diabetes, aged 18-85 years old were selected. PBF was measured with the adapted version of the Diabetes Health Profile for people with type 2 diabetes. This permitted the calculation of three functional scores - psychological distress (PD), barriers to activity (BA), and disinhibited eating (DE) - from 0 (worst) to 100 (best). Results Major negative associations were observed with PBF for microvascular complications (a difference of 6.7 in the BA score between persons with and without microvascular complications) and severe hypoglycemia (difference of 7.9 in the BA score), insulin treatment (-8.5 & -9.5 in the PD & BA scores respectively, as compared to treatment with oral hypoglycemic agents), non-adherence to treatment (-12.3 in the DE score for persons forgetting their weekly treatment), increasing weight (-8.5 & -9.7 in the PD & DE scores respectively, as compared to stable weight), at least one psychiatrist visit in 2001 (-8.9 in the DE score), and universal medical insurance coverage (-7.9 in the PD score) (due to low income). Conclusion Prevention and management of microvascular complications or adherence to treatment (modifiable factors) could be essential to preserving or improving PBF among people with type 2 diabetes. A specific approach to type 2 diabetes management may be required in groups with a low socioeconomic profile (particularly people with universal medical insurance coverage), or other non modifiable factors. PMID:21044345

  12. Safety of live attenuated influenza vaccine in young people with egg allergy: multicentre prospective cohort study

    PubMed Central

    Southern, Jo; Andrews, Nick J; Miller, Elizabeth; Erlewyn-Lajeunesse, Michel

    2015-01-01

    Study question How safe is live attenuated influenza vaccine (LAIV), which contains egg protein, in young people with egg allergy? Methods In this open label, phase IV intervention study, 779 young people (2-18 years) with egg allergy were recruited from 30 UK allergy centres and immunised with LAIV. The cohort included 270 (34.7%) young people with previous anaphylaxis to egg, of whom 157 (20.1%) had experienced respiratory and/or cardiovascular symptoms. 445 (57.1%) had doctor diagnosed asthma or recurrent wheeze. Participants were observed for at least 30 minutes after vaccination and followed-up by telephone 72 hours later. Participants with a history of recurrent wheeze or asthma underwent further follow-up four weeks later. The main outcome measure was incidence of an adverse event within two hours of vaccination in young people with egg allergy. Study answer and limitations No systemic allergic reactions occurred (upper 95% confidence interval for population 0.47% and in participants with anaphylaxis to egg 1.36%). Nine participants (1.2%, 95% CI 0.5% to 2.2%) experienced mild symptoms, potentially consistent with a local, IgE mediated allergic reaction. Delayed events potentially related to the vaccine were reported in 221 participants. 62 participants (8.1%, 95% CI for population 6.3% to 10.3%) experienced lower respiratory tract symptoms within 72 hours, including 29 with parent reported wheeze. No participants were admitted to hospital. No increase in lower respiratory tract symptoms occurred in the four weeks after vaccination (assessed with asthma control test). The study cohort may represent young people with more severe allergy requiring specialist input, since they were recruited from secondary and tertiary allergy centres. What this study adds LAIV is associated with a low risk of systemic allergic reactions in young people with egg allergy. The vaccine seems to be well tolerated in those with well controlled asthma or recurrent wheeze. Funding

  13. Electric and magnetic field exposures for people living near a 735-Kilovolt power line

    SciTech Connect

    Levallois, P.; Gauvin, D.; St. Laurent, J.

    1995-09-01

    The purpose of this study was to assess the effect of a 735-kV transmission line on the electric and magnetic field exposures of people living at the edge of the line`s right of way. Exposure of 18 adults, mostly white-collar workers, living in different bungalows located 190-240 feet from the line (exposed subjects) was compared to that of 17 adults living in similar residences far away from any transmission line. Each subject carried a Positron meter for 24 hr during 1 workday, which measured 60-Hz electric and magnetic fields every minute. All measurements were carried out in parallel for exposed and unexposed subjects during the same weeks between September and December. During measurements the average loading on the line varied between 600 and 1100 A. The average magnetic field intensity while at home was 4.4 times higher among exposed subjects than unexposed (7.1 versus 1.6 Mg, p=0.0001) and 6.2 times higher when considering only the sleeping period (6.8 versus 1.1 mG, p=0.0001). Based on the 24-hr measurement, average magnetic field exposure was three times higher among the exposed was positively correlated with the loading on the line (r=0.8, p+0.001). Percentage of time above a magnetic field threshold F(2 mG or 7.8 mG) was a good indicator to distinguish the two types of exposure. Percentage of time above 20 V/m was significantly different, but percentage of time above 78 V/m was rare and comparable for the two groups. Variability of exposure was very low. This study demonstrates that a 735-kV line contributes significantly to residential 60-Hz magnetic field exposure and, to a lesser extent, electric fields for people living at the edge of the right way. Because of the limited size of our sample, caution is recommended before generalizing these results. Nevertheless, due to the uncertainty on the risks associated with such an unusual high residential exposure, research is needed on its possible effects. 30 refs., 1 fig., 7 tabs.

  14. The use and impact of a computer-based support system for people living with AIDS and HIV infection.

    PubMed

    Gustafson, D H; Hawkins, R P; Boberg, E W; Bricker, E; Pingree, S; Chan, C L

    1994-01-01

    CHESS (the Comprehensive Health Enhancement Support System) is an interactive, computer-based system to support people facing AIDS/HIV Infection and other health-related crises or concerns. CHESS provides information, referral to service providers, support in making tough decisions and networking to experts and others facing the same concerns. CHESS is designed to improve access to health and human services for people who would otherwise face psychological, social, economic or geographic barriers to receiving services. CHESS has been evaluated in a random-assignment study with over 200 men and women living with AIDS and HIV infection. When CHESS was placed in subjects' homes for 3-6 months, use of CHESS was extremely heavy, with the average subject using CHESS 138 times for 39 hours. Compared with a control group which did not receive CHESS, subjects who used CHESS reported significantly higher quality of life in several dimensions, including social support and cognitive functioning. Users also reported significant reductions in some types of health care costs, especially inpatient services (hospitalizations). All segments of the study population used and benefited from CHESS, including women, minorities and those subjects with lower levels of education. Thus, CHESS appears to be an effective means of delivering education and support to the diverse populations which are affected by AIDS and HIV infection. PMID:7949999

  15. 'Many people know the law, but also many people violate it': discrimination experienced by people living with HIV/AIDS in Vietnam--results of a national study.

    PubMed

    Messersmith, Lisa J; Semrau, Katherine; Hammett, Theodore M; Phong, Nguyen Tuan; Tung, Nguyen Duy; Nguyen, Ha; Glandon, Douglas; Huong, Nguyen Mai; Anh, Hoang Tu

    2013-01-01

    In Vietnam, discrimination against people living with HIV/AIDS (PLHIV) is defined within and prohibited by the 2007 national HIV/AIDS law. Despite the law, PLHIV face discrimination in health care, employment, education and other spheres. This study presents the first national estimates of the levels and types of discrimination that are defined in Vietnamese law and experienced by PLHIV in Vietnam. A nationally representative sample of 1200 PLHIV was surveyed, and 129 PLHIV participated in focus group discussions (FGDs). In the last 12 months, nearly half of the survey population experienced at least one form of discrimination and many experienced up to six different types of discrimination. The most common forms of discrimination included disclosure of HIV status without consent; denial of access to education for children; loss of employment; advice, primarily from health care providers, to abstain from sex; and physical and emotional harm. In logistic regression analysis, the experience of discrimination differed by gender, region of residence and membership status in a PLHIV support group. The logistic regression and FGD results indicate that disclosure of HIV status without consent was associated with experiencing other forms of discrimination. Key programme and policy recommendations are discussed. PMID:22974225

  16. Depression and Apathy Among People Living with HIV: Implications for Treatment of HIV Associated Neurocognitive Disorders

    PubMed Central

    Whitehead, Nicole E.; Burrell, Larry E.; Dotson, Vonetta M.; Cook, Robert L.; Malloy, Paul; Devlin, Kathryn; Cohen, Ronald A.

    2015-01-01

    Depression and apathy are common among people living with HIV (PLWH). However, in PLWH, it is unclear whether depression and apathy are distinct conditions, which contribute to different patterns of disruption to cognitive processing and brain systems. Understanding these conditions may enable the development of prognostic indicators for HIV associated neurocognitive disorders (HAND). The present study examined substance use behavior and cognitive deficits, associated with depression and apathy, in 120 PLWH, using hierarchical regression analyses. Higher levels of depression were associated with a history of alcohol dependence and greater deficits in processing speed, motor and global cognitive functioning. Higher levels of apathy were associated with a history of cocaine dependence. It is recommended that PLWH get screened appropriately for apathy and depression, in order to receive the appropriate treatment, considering the comorbidities associated with each condition. Future research should examine the neurological correlates of apathy and depression in PLWH. PMID:25533921

  17. Learning about Barriers to Care for People Living with HIV in Egypt: A Qualitative Exploratory Study.

    PubMed

    Abdelrahman, Ihab; Lohiniva, Anna Leena; Kandeel, Amr; Benkirane, Manal; Atta, Hossam; Saleh, Hanan; El Sayed, Nasr; Talaat, Maha

    2015-01-01

    The purpose of this study was to identify obstacles health care workers face in providing care for people living with HIV and AIDS (PLWHA). Based on these findings, health authorities can design interventions to support health care workers in providing better medical care for PLWHA. Thirty in-depth interviews were conducted with physicians and nurses in one 300-bed tertiary care public hospital in Giza, Egypt. Thematic analysis was conducted by 2 investigators. Five main themes were identified (1) fear of infection; (2) disbelief in effectiveness of infection control measures to protect against HIV; (3) misconceptions regarding medical care for PLWHA; (4) fear of secondary stigma; and (5) moral judgments toward PLWHA and negative connotations related to HIV. Interventions targeting health care workers should be multidimensional, including knowledge and skills building as well as value and attitude change. Reducing stigma among health care workers will improve access to care for PLWHA. PMID:23792709

  18. Ethnic differences in the links between benefit finding and psychological adjustment in people living with HIV.

    PubMed

    Fekete, Erin M; Chatterton, Michael; Skinta, Matthew D; Williams, Stacey L

    2016-06-01

    Experiencing growth after the diagnosis of a life threatening illness is commonly reported among people living with HIV (PLWH). The links between benefit finding and better adjustment in PLWH have been identified, but it is less clear whether these links vary by ethnicity. Minority stress theory suggests that individuals from minority populations may have unique stress experiences, which can have negative health implications but may also provide opportunity for growth. We hypothesized that the association between benefit finding and psychological adjustment would be stronger for Black (n = 80) than White (n = 87) PLWH. Contrary to predictions, the relationship between benefit finding and better adjustment was significant for White but not Black PLWH. Post-hoc analyses suggested that sexual orientation played role in this relationship. The relationship between benefit finding and psychological adjustment may be complex for Black PLWH, or they may achieve adjustment using other resources. PMID:26782813

  19. Menthol cigarettes and the cardiovascular risks of people living with HIV

    PubMed Central

    Míguez-Burbano, María José; Vargas, Mayra; Quiros, Clery; Lewis, John E.; Espinoza, Luis; Asthana, Deshratan

    2014-01-01

    The possibility that menthol cigarettes add to the deleterious cardiovascular effects of smoking has been barely discussed. Although cardiovascular diseases (CVD) are at the forefront of medical concerns of people living with HIV (PLWH), an important, yet unknown, issue for clinicians and public health authorities is whether use of menthol-flavored cigarettes heightens CVD risk factors. Our study aims to assess traditional (10-year risk using the Framingham Risk Model) and nontraditional CVD risk factors and to contrast the effects of menthol-flavored versus non-menthol flavored cigarettes on these risk factors. Compared to controls, menthol smokers were twice as likely to have hypertension. Users of menthol-flavored cigarettes had higher body mass index values, and increased risk of abdominal obesity. Multivariate analyses indicated that menthol smokers doubled the odds of having moderate to high CVD risk. This finding is highly significant given the widespread use of menthol-flavored cigarettes, particularly among women, minorities, and PLWH. PMID:24581861

  20. Human papillomavirus-related cancers among people living with AIDS in Puerto Rico.

    PubMed

    Ortiz, Ana Patricia; Pérez-Irizarry, Javier; Soto-Salgado, Marievelisse; Suárez, Erick; Pérez, Naydi; Cruz, Maritza; Palefsky, Joel; Tortolero-Luna, Guillermo; Miranda, Sandra; Colón-López, Vivian

    2014-01-01

    The objective of this study was to estimate the incidence of cancer and human papillomavirus (HPV)-related cancers and the risk of death (by cancer status) among people living with AIDS (PLWA) in Puerto Rico. We used data from the Puerto Rico AIDS Surveillance Program and Central Cancer Registry (1985-2005). Cancers with highest incidence were cervix (299.6/100,000) for women and oral cavity/oropharynx for men (150.0/100,000); the greatest excess of cancer incidence for men (standardized incidence ratio, 86.8) and women (standardized incidence ratio, 52.8) was for anal cancer. PLWA who developed a cancer had decreased survival and increased risk of death compared with those who did not have cancer. Cancer control strategies for PLWA will be essential for improving their disease survival. PMID:24831284

  1. Medication management concerns of ethnic minority family caregivers of people living with dementia.

    PubMed

    Gillespie, Robyn J; Harrison, Lindsey; Mullan, Judy

    2015-01-01

    This qualitative study explored the medication management experiences of Australian ethnic minority family caregivers of people living with dementia. From the perspective of this group of caregivers, medication management was a source of stress resulting from the progressive loss of ability of care recipients to manage their own medications; the complexity of the medication regime and the caregiver's lack of trust of the care recipient to safely and effectively manage medications. Caregivers used various strategies to manage medications and avoid conflict with care recipients including being watchful and involving other family members in medication management tasks. Family caregivers indicated that a lack of information and access to support to inform their medication management role added to their stress, which was exacerbated in some cases by limited English proficiency. Supportive factors noted by caregivers included a well-established relationship with a community pharmacist, involvement of a geriatrician, family support and caregiver support group participation. PMID:24339089

  2. Complementary medicine use by people living with HIV in Australia - a national survey.

    PubMed

    Braun, Lesley A; Forrester, Catherine A; Rawlins, Matthew Dm; Levy, Russell W; Penm, Jonathan; Graham, Marissa M; Mackie, Kathryn F; Aran, Sohileh; Bridle, Sylvia; Bailey, Michael J; Duncan, Alison J

    2016-01-01

    Little is known about the use of complementary medicines by people living with HIV in Australia since the advent of more effective combination antiretroviral therapy. We conducted an anonymous survey of 1211 adult patients receiving combination antiretroviral therapy from one of eight specialist HIV clinics across Australia, aiming to identify the current patterns of use of ingestible complementary medicines. Data collected included reasons for use, information sources and rates of disclosure of use of complementary medicines to medical practitioners and pharmacists. Ingestible complementary medicine was used by up to 53% of the 1037 patients returning a survey. Complementary medicine was commonly used for general health, to boost immune function and, to a lesser extent, to address co-morbidities. Disclosure of complementary medicines use to doctors was far higher than to pharmacists. Given the potential for interactions, pharmacists should be more aware of patients' complementary medicines use. PMID:25681264

  3. Treating Posttraumatic Stress Symptoms Among People Living with HIV: a Critical Review of Intervention Trials.

    PubMed

    McLean, Carmen P; Fitzgerald, Hayley

    2016-09-01

    The prevalence rate of posttraumatic stress disorder (PTSD) among people living with HIV (PLWH) is significantly higher than the rate among the general population. Moreover, PTS symptoms have been linked with numerous negative health-related outcomes in PLWH. While these findings suggest that studies evaluating the efficacy of treatments for PTS symptoms among PLWH are sorely needed, according to prior reviews, such studies are lacking. The purpose of the present systematic review was to provide an updated critical evaluation of treatment studies that targeted PTS among PLWH. Following PRIMSA guidelines, we searched PubMed and PsycINFO and identified eight articles (representing seven studies) evaluating the impact of various individual and group treatments on PTS symptoms. The limited evidence base to date precludes clinical recommendations for this population. Future studies should examine the efficacy of existing evidence-based treatments for PTSD among PLWH and then, if necessary, evaluate the impact of any treatment modifications for this population. PMID:27439305

  4. Predictors of HIV-related Stigma among Young People Living with HIV

    PubMed Central

    Swendeman, Dallas; Rotheram-Borus, Mary Jane; Comulada, Scott; Weiss, Robert; Ramos, Maria Elena

    2008-01-01

    Enacted and perceived HIV-stigma was examined among substance using young people living with HIV (YPLH) in Los Angeles, San Francisco, and New York City (N = 147). Almost all YPLH (89%) reported perceived stigma and 31% report enacted experiences in the past three months; 64% reported experiences during their lifetime. The HIV-stigma questions were characterized by factors of avoidance, social rejections, abuse and shame. In multivariate models enacted stigma was associated with gay/bisexual identity, symptomatic HIV or AIDS, and bartering sex. Perceived stigma was associated with female gender, symptomatic HIV or AIDS, bartering sex, lower injection drug use, and fewer friends and family knowing serostatus. Gay/bisexual YPLH who were also HIV symptomatic or AIDS diagnosed experienced more HIV-stigma than their heterosexual peers. PMID:16846325

  5. Self-compassion and Risk Behavior among People Living with HIV/AIDS

    PubMed Central

    Webel, Allison; Sullivan, Kathleen M.; Cuca, Yvette P.; Wantland, Dean; Johnson, Mallory O.; Brion, John; Portillo, Carmen J.; Corless, Inge B.; Voss, Joachim; Chen, Wei-Ti; Phillips, J. Craig; Tyer-Viola, Lynda; Rivero-Méndez, Marta; Nicholas, Patrice K.; Nokes, Kathleen; Kemppainen, Jeanne; Sefcik, Elizabeth; Eller, Lucille Sanzero; Iipinge, Scholastika; Kirksey, Kenn; Chaiphibalsarisdi, Puangtip; Davila, Nancy; Hamilton, Mary Jane; Hickey, Dorothy; Maryland, Mary; Reid, Paula; Holzemer, William L.

    2014-01-01

    Sexual risk behavior and illicit drug use among people living with HIV/AIDS (PLWHA) contribute to poor health and onward transmission of HIV. The aim of this collaborative multi-site nursing research study was to explore the association between self-compassion and risk behaviors in PLWHA. Nurse researchers in Canada, China, Namibia, Puerto Rico, Thailand and the U.S. enrolled 2,182 PLWHA using convenience sampling. Over half of study participants were sexually active in the past three months. Participants with higher self-compassion were less likely to report sexual risk behavior. However, if a person also used illicit drugs, the relationship with self-compassion was reduced. Self-compassion may be a novel area for behavioral intervention development for PLWHA. PMID:24510757

  6. Self-compassion and risk behavior among people living with HIV/AIDS.

    PubMed

    Dawson Rose, Carol; Webel, Allison; Sullivan, Kathleen M; Cuca, Yvette P; Wantland, Dean; Johnson, Mallory O; Brion, John; Portillo, Carmen J; Corless, Inge B; Voss, Joachim; Chen, Wei-Ti; Phillips, J Craig; Tyer-Viola, Lynda; Rivero-Méndez, Marta; Nicholas, Patrice K; Nokes, Kathleen; Kemppainen, Jeanne; Sefcik, Elizabeth; Eller, Lucille Sanzero; Iipinge, Scholastika; Kirksey, Kenn; Chaiphibalsarisdi, Puangtip; Davila, Nancy; Hamilton, Mary Jane; Hickey, Dorothy; Maryland, Mary; Reid, Paula; Holzemer, William L

    2014-04-01

    Sexual risk behavior and illicit drug use among people living with HIV/AIDS (PLWHA) contribute to poor health and onward transmission of HIV. The aim of this collaborative multi-site nursing research study was to explore the association between self-compassion and risk behaviors in PLWHA. As part of a larger project, nurse researchers in Canada, China, Namibia, Puerto Rico, Thailand and the US enrolled 1211 sexually active PLWHA using convenience sampling. The majority of the sample was male, middle-aged, and from the US. Illicit drug use was strongly associated with sexual risk behavior, but participants with higher self-compassion were less likely to report sexual risk behavior, even in the presence of illicit drug use. Self-compassion may be a novel area for behavioral intervention development for PLWHA. PMID:24510757

  7. To protect and to support: How citizenship and self-determination are legally constructed and managed in practice for people living with dementia in Sweden.

    PubMed

    Nedlund, Ann-Charlotte; Taghizadeh Larsson, Annika

    2016-05-01

    Since living with dementia implies increasing difficulties in taking charge of rights due to cognitive as well as communicative impairments, many people with dementia are vulnerable and in need of support in order to realize full citizenship. In Sweden, all adults right to self-determination is strongly emphasized in law, regulations, and policies. Further, and in contrast to the situation in many other countries, people living with dementia cannot be declared as incompetent of making decisions concerning social care and their right to self-determination cannot legally be taken away. The article shows that in the Swedish welfare system, the focus is more on protecting the self-determination of citizens than on supporting people in making decisions and exercising citizenship. Subsequently, this causes legally constructed zones of inclusion and exclusion. This article examines and problematizes how different institutional contexts, legal constructions, norms, and practices in Sweden affect the management of issues concerning guardianship, supported decision-making and self-determination, and outline the implications for people living with dementia. PMID:27170586

  8. State of Australia's Young People: A Report on the Social, Economic, Health and Family Lives of Young People

    ERIC Educational Resources Information Center

    Muir, Kristy; Mullan, Killian; Powell, Abigail; Flaxman, Saul; Thompson, Denise; Griffiths, Megan

    2009-01-01

    This report presents a comprehensive picture of how young Australians are faring by bringing together data from a variety of sources and drawing on the comments of young people themselves. Overall the report presents a positive picture, showing how important young people are to this country and why it makes good economic and social sense for…

  9. Stress and Burnout among Health-Care Staff Working with People Affected by HIV.

    ERIC Educational Resources Information Center

    Miller, David

    1995-01-01

    The nature, causes, consequences, and symptoms of stress and burnout among health-care staff working with people affected by HIV are identified. The extent to which these characteristics are specific to HIV/AIDS workers is discussed. Some options for prevention and management of burnout are presented. (Author)

  10. The association between cognitive impairment and community service use patterns in older people living in Australia.

    PubMed

    Vecchio, Nerina; Fitzgerald, Janna A; Radford, Katrina; Fisher, Ron

    2016-05-01

    Family plays a vital role in supporting individuals with dementia to reside in the community, thus delaying institutionalisation. Existing research indicates that the burden of care-giving is particularly high for those caring for a person with dementia. Yet, little is known about the uptake of community services by people with a diagnosis of dementia. Therefore, this study aims to better understand the relationship between cognitive impairment and the receipt of community care services. In order to examine the relationship, secondary data collected across Queensland, Australia, from 59,352 home-care clients aged 65 and over during 2007-2008 are analysed. This cross-sectional study uses regression analyses to estimate the relationship between cognitive impairment and service mix, while controlling for socio-demographic characteristics. The dependent variables include formal services, informal care and total home-care service hours during a 12-month period. The findings of this study demonstrate that cognitive impairment is associated with accessing more hours of respite and day centre care but fewer hours of other formal care services. Additionally, the likelihood of support from an informal caregiver increases when a client becomes cognitively impaired. Therefore, this study demonstrates that there is an increased need for respite programmes to support informal caregivers in the future, as the population of people living with dementia increases. These findings support the need for investigations of new and innovative respite models in the future. PMID:25754586

  11. People

    NASA Astrophysics Data System (ADS)

    2001-11-01

    the war Hoyle returned to Cambridge, but kept in close contact with his collaborators. Fred Hoyle was a canny and media-savvy scientist, 40 years before such things were recognized. Martin Rees said after his death '[He] also had other dimensions to his career, his inventiveness and skill as a communicator'. It is hard to realize now the impact that Hoyle's broadcasts had in post-war Britain. His programmes for the BBC on The Nature of the Universe won greater audiences than such unlikely rivals as Bertrand Russell and Tommy Handley. Even today many people recall how they were affected by listening to these broadcasts. Hoyle used one of his broadcasts to ridicule the hot explosion theory. He referred to the idea of a 'big bang as fanciful'. Unfortunately the name stuck, much to Hoyle's chagrin. In the 1950s Hoyle began a fruitful collaboration with Willy Fowler of the California Institute of Technology in Pasadena. Hoyle was interested in the origin of the chemical elements. Hans Bethe, Charles Critchfield and Karl-Frederich von Weizsäcker had calculated in 1939 how stars could turn protons into helium nuclei by nuclear fusion. Part of the Vela supernova remmant, the debris left after the type of massive explosion in which Hoyle predicted that heavy nuclei were formed. (© Royal Observatory, Edinburgh, Anglo-Australian Observatory.) Building on earlier collaboration with Ed Saltpeter, Hoyle used data supplied by Geoffrey and Margaret Burbidge and, working with Fowler, began to piece together how the elements were formed. By looking at very large stars near the end of their lives and examining their chemical composition, they noticed that the abundances of elements almost exactly corresponded to those with a low nuclear capture cross section. Hoyle argued that all of the elements in our bodies had been formed in stars that had been and gone before our solar system had even formed. In their classic paper the elements are produced by three basic methods. The

  12. Caring for Ethnic Older People Living with Dementia - Experiences of Nursing Staff.

    PubMed

    Söderman, Mirkka; Rosendahl, Sirpa Pietilä

    2016-09-01

    The total number of persons living with dementia is estimated to double every 20 years and ageing migrant populations are growing in several countries. There are gaps in the health and social care of people from other countries, regardless of the efforts made when someone has a dementia diagnosis; similarly, receiving care in sheltered accommodation is less common. The aim of this study was to explore and describe the nursing staff's experiences of caring for non-Swedish speaking persons living with dementia in a Finnish speaking group home in relation to a Swedish speaking group home in Sweden. 27 qualitative semi-structured interviews were analysed using qualitative content analyses. The first main category, "communication", concentrated on language abilities and deficiencies, non-verbal language, highlighting the consequences of not understanding and the benefits of a common language. The second main category, "culturally oriented activities", focused on being served traditional food, celebrating holidays at the group home, the importance of traditions and the importance of familiar music as cultural elements. The Swedish speaking nursing staff could provide qualitative and equitable care, but the challenge was greater for them than for the bilingual nursing staff who spoke the same language as the residents. PMID:27287438

  13. Managing and resisting stigma: a qualitative study among people living with HIV in South Africa

    PubMed Central

    Abrahams, Naeemah; Jewkes, Rachel

    2012-01-01

    Background Living with HIV is of daily concern for many South Africans and poses challenges including adapting to a chronic illness and continuing to achieve and meet social expectations. This study explored experiences of being HIV-positive and how people manage stigma in their daily social interactions. Methods Using qualitative methods we did repeat interviewed with 42 HIV-positive men and women in Cape Town and Mthatha resulting in 71 interviews. Results HIV was ubiquitous in our informants’ lives, and almost all participants reported fear of stigma (perceived stigma), but this fear did not disrupt them completely. The most common stigma experiences were gossips and insults where HIV status was used as a tool, but these were often resisted. Many feared the possibility of stigma, but very few had experiences that resulted in discrimination or loss of social status. Stigma experiences were intertwined with other daily conflicts and together created tensions, particularly in gender relations, which interfered with attempts to regain normality. Evidence of support and resistance to stigma was common, and most encouraging was the evidence of how structural interventions such as de-stigmatizing policies impacted on experiences and transference into active resistance. Conclusions The study showed the complex and shifting nature of stigma experiences. These differences must be considered when we intensify stigma reduction with context- and gender-specific strategies focussing on those not yet on ARV programmes. PMID:22905361

  14. We are all people living with AIDS: myths and realities of AIDS in Brazil.

    PubMed

    Daniel, H

    1991-01-01

    Although AIDS was expected in Brazil, no serious efforts were undertaken to prevent AIDS from taking root. Irresponsible press and media coverage highlighted the spread of AIDS within the gay community of the United States, creating an aura of immunity in Brazil to what was characterized as a "foreign" disorder. When AIDS did surface in 1983, the official response was to adopt an abstract, inappropriate, and ideological "Western" model, in which only stigmatized "others" and "minorities" were at risk of HIV infection. Brazilian health authorities subsequently downplayed the significance of the sale of contaminated blood in HIV transmission, and likewise ignored the rising rates of AIDS among Brazil's one unarguable majority group: the poor. An analysis of efforts to force the "facts" of AIDS to fit a false model's predictions leads to a clearer definition of the broader context of the Brazilian epidemic: we all are people living with AIDS, precisely because we live in this age of AIDS; it is sheer folly to discriminate against persons infected by HIV and to obstruct their participation in efforts to curtail the epidemic's spread; and the necessary response to AIDS is solidarity, not because it is poetic, but because no other response will suffice. PMID:1917212

  15. Housing Status and the Health of People Living with HIV/AIDS

    PubMed Central

    Milloy, M-J; Marshall, Brandon DL; Montaner, Julio; Wood, Evan

    2012-01-01

    Individuals who are homeless or living in marginal conditions have an elevated burden of infection with HIV. Existing research suggests the HIV/AIDS pandemic in resource-rich settings is increasingly concentrated among members of vulnerable and marginalized populations, including homeless/marginally-housed individuals, who have yet to benefit fully from recent advances in highly-active antiretroviral therapy (HAART). We reviewed the scientific evidence investigating the relationships between inferior housing and the health status, HAART access and adherence and HIV treatment outcomes of people living with HIV/AIDS (PLWHA.) Studies indicate being homeless/marginally-housed is common among PLWHA and associated with poorer levels of HAART access and sub-optimal treatment outcomes. Among homeless/marginally-housed PLWHA, determinants of poorer HAART access/adherence or treatment outcomes include depression, illicit drug use and medication insurance status. Future research should consider possible social- and structural-level determinants of HAART access and HV treatment outcomes that have been shown to increase vulnerability to HIV infection among homeless/marginally-housed individuals. As evidence indicates homeless/marginally-housed PLWHA with adequate levels of adherence can benefit from HAART at similar rates to housed PLWHA, and given the individual and community benefits of expanding HAART use, interventions to identify HIV-seropositive homeless/marginally-housed individuals and engage them in HIV care including comprehensive support for HAART adherence are urgently needed. PMID:22968432

  16. Electric and magnetic field exposures for people living near a 735-kilovolt power line.

    PubMed Central

    Levallois, P; Gauvin, D; St-Laurent, J; Gingras, S; Deadman, J E

    1995-01-01

    The purpose of this study was to assess the effect of a 735-kV transmission line on the electric and magnetic field exposures of people living at the edge of the line's right of way. Exposure of 18 adults, mostly white-collar workers, living in different bungalows located 190-240 feet from the line (exposed subjects) was compared to that of 17 adults living in similar residences far away from any transmission line. Each subject carried a Positron meter for 24 hr during 1 workday, which measured 60-Hz electric and magnetic fields every minute. All measurements were carried out in parallel for exposed and unexposed subjects during the same weeks between September and December. During measurements the average loading on the line varied between 600 and 1100 A. The average magnetic field intensity while at home was 4.4 times higher among exposed subjects than unexposed (7.1 versus 1.6 mG, p = 0.0001) and 6.2 times higher when considering only the sleeping period (6.8 versus 1.1 mG, p = 0.0001). Based on the 24-hr measurement, average magnetic field exposure was three times higher among the exposed. Electric field intensity was also higher among the exposed while at home (26.3 versus 14.0 V/m, p = 0.03). Magnetic field intensity among the exposed was positively correlated with the loading on the line (r = 0.8, p = 0.001). Percentage of time above a magnetic field threshold (2 mG or 7.8 mG) was a good indicator to distinguish the two types of exposure.(ABSTRACT TRUNCATED AT 250 WORDS) Images Figure 1. PMID:7498095

  17. [Sexual-affective trajectories of people with chronic leg ulcers: aspects of therapeutic listening].

    PubMed

    Carvalho, Evanilda Souza de Santana; Paiva, Mirian Santos; Aparício, Elena Casado; Rodrigues, Gilmara Ribeiro Santos

    2013-09-01

    This is a qualitative study that aims to discuss the trajectories of people with chronic sores on the lower limbs,focusing on their affective and sexual experiences. Fifty-one adult outpatients participated and they received care at the infirmary of a public hospital in Salvador-Bahia, between 2008 and 2009. Data was collected through techniques that included themed-story drawings and in-depth interviews, during therapeutic listening sessions,followed by an analysis of the content and an analysis of the drawing contents. Three categories emerged solitary sexual-affective trajectory, fragmented sexual-affective trajectory, and continuous or linear sexual-affective trajectory. It was concluded that the limitations imposed by sores influence the subjectivity of these people, leading them to processes of loss of self-confidence, self-deprecation and fear of sexual- affective demands. It becomes clear, therefore, for the need to promote, not only curative interventions for the body, but also to include therapeutic listening and psychological support in the assistance offered to these people. PMID:24344599

  18. What matters to older people with assisted living needs? A phenomenological analysis of the use and non-use of telehealth and telecare.

    PubMed

    Greenhalgh, Trisha; Wherton, Joe; Sugarhood, Paul; Hinder, Sue; Procter, Rob; Stones, Rob

    2013-09-01

    Telehealth and telecare research has been dominated by efficacy trials. The field lacks a sophisticated theorisation of [a] what matters to older people with assisted living needs; [b] how illness affects people's capacity to use technologies; and [c] the materiality of assistive technologies. We sought to develop a phenomenologically and socio-materially informed theoretical model of assistive technology use. Forty people aged 60-98 (recruited via NHS, social care and third sector) were visited at home several times in 2011-13. Using ethnographic methods, we built a detailed picture of participants' lives, illness experiences and use (or non-use) of technologies. Data were analysed phenomenologically, drawing on the work of Heidegger, and contextualised using a structuration approach with reference to Bourdieu's notions of habitus and field. We found that participants' needs were diverse and unique. Each had multiple, mutually reinforcing impairments (e.g. tremor and visual loss and stiff hands) that were steadily worsening, culturally framed and bound up with the prospect of decline and death. They managed these conditions subjectively and experientially, appropriating or adapting technologies so as to enhance their capacity to sense and act on their world. Installed assistive technologies met few participants' needs; some devices had been abandoned and a few deliberately disabled. Successful technology arrangements were often characterised by 'bricolage' (pragmatic customisation, combining new with legacy devices) by the participant or someone who knew and cared about them. With few exceptions, the current generation of so-called 'assisted living technologies' does not assist people to live with illness. To overcome this irony, technology providers need to move beyond the goal of representing technology users informationally (e.g. as biometric data) to providing flexible components from which individuals and their carers can 'think with things' to improve the

  19. How do people judge risks: availability heuristic, affect heuristic, or both?

    PubMed

    Pachur, Thorsten; Hertwig, Ralph; Steinmann, Florian

    2012-09-01

    How does the public reckon which risks to be concerned about? The availability heuristic and the affect heuristic are key accounts of how laypeople judge risks. Yet, these two accounts have never been systematically tested against each other, nor have their predictive powers been examined across different measures of the public's risk perception. In two studies, we gauged risk perception in student samples by employing three measures (frequency, value of a statistical life, and perceived risk) and by using a homogeneous (cancer) and a classic set of heterogeneous causes of death. Based on these judgments of risk, we tested precise models of the availability heuristic and the affect heuristic and different definitions of availability and affect. Overall, availability-by-recall, a heuristic that exploits people's direct experience of occurrences of risks in their social network, conformed to people's responses best. We also found direct experience to carry a high degree of ecological validity (and one that clearly surpasses that of affective information). However, the relative impact of affective information (as compared to availability) proved more pronounced in value-of-a-statistical-life and perceived-risk judgments than in risk-frequency judgments. Encounters with risks in the media, in contrast, played a negligible role in people's judgments. Going beyond the assumption of exclusive reliance on either availability or affect, we also found evidence for mechanisms that combine both, either sequentially or in a composite fashion. We conclude with a discussion of policy implications of our results, including how to foster people's risk calibration and the success of education campaigns. PMID:22564084

  20. People living under threat of volcanic hazard in southern Iceland: vulnerability and risk perception

    NASA Astrophysics Data System (ADS)

    Jóhannesdóttir, G.; Gísladóttir, G.

    2010-02-01

    Residents in the village of Vík and in the farming community of Álftaver in southern Iceland are living with the threat of volcanic hazards. The highly active subglacial volcano Katla has erupted approximately twice per century since the beginning of settlement around 874 AD. The last major eruption was in 1918 and Katla has recently entered an agitated stage. The purpose of this research was to (1) review residents' responses in relation to vulnerability, (2) examine their risk perception, preparedness and mitigation in relation to an eruption of Katla, and (3) investigate the public and the representative of the local authorities and emergency manager's knowledge of the official evacuation plan. In 2004, we conducted in-depth, face-to-face interviews with local residents using a snowball sample technique. All participants were permanent residents of the two communities, between the ages of 25-95 and most had lived in the area their entire lives. Regardless of the residents' knowledge about past volcanic activity of Katla and the associated future risk, many residents were doubtful about the imminent eruption forecast by scientists and they believed that the volcano is no longer active. In both communities, different social, cultural and economic factors played a central role in how people perceived natural hazards and how they dealt with the fact that their lives and livelihoods could be at risk. The participants had good knowledge about the existing evacuation plan and had participated in evacuation exercises. However, they had not made personal mitigation or preparedness plans in the event of a future eruption. In contrast to the residents of Vík, the inhabitants in Álftaver are concerned about the evacuation process and found it very confusing; they neither found the emergency plan nor the proposed methods for risk communication relevant for their farming community. The perception of the inhabitants, especially in Álftaver, does not correspond to those

  1. Personalization, self-advocacy and inclusion: An evaluation of parent-initiated supported living schemes for people with intellectual and developmental disabilities in the Netherlands.

    PubMed

    Reindl, Marie-Sol; Waltz, Mitzi; Schippers, Alice

    2016-06-01

    This study focused on parent-initiated supported living schemes in the South of the Netherlands and the ability of these living schemes to enhance participation, choice, autonomy and self-advocacy for people with intellectual or developmental disabilities through personalized planning, support and care. Based on in-depth interviews with tenants, parents and caregivers, findings included that parent-initiated supported housing schemes made steps towards stimulating self-advocacy and autonomy for tenants. However, overprotective and paternalistic attitudes expressed by a significant number of parents, as well as structural constraints affecting the living schemes, created obstacles to tenants' personal development. The study calls for consideration of interdependence as a model for the relationship of parents and adult offspring with disabilities. The benefits and tensions inherent within this relationship must be taken into consideration during inclusive community building. PMID:26864287

  2. People

    NASA Astrophysics Data System (ADS)

    2001-11-01

    the war Hoyle returned to Cambridge, but kept in close contact with his collaborators. Fred Hoyle was a canny and media-savvy scientist, 40 years before such things were recognized. Martin Rees said after his death '[He] also had other dimensions to his career, his inventiveness and skill as a communicator'. It is hard to realize now the impact that Hoyle's broadcasts had in post-war Britain. His programmes for the BBC on The Nature of the Universe won greater audiences than such unlikely rivals as Bertrand Russell and Tommy Handley. Even today many people recall how they were affected by listening to these broadcasts. Hoyle used one of his broadcasts to ridicule the hot explosion theory. He referred to the idea of a 'big bang as fanciful'. Unfortunately the name stuck, much to Hoyle's chagrin. In the 1950s Hoyle began a fruitful collaboration with Willy Fowler of the California Institute of Technology in Pasadena. Hoyle was interested in the origin of the chemical elements. Hans Bethe, Charles Critchfield and Karl-Frederich von Weizsäcker had calculated in 1939 how stars could turn protons into helium nuclei by nuclear fusion. Part of the Vela supernova remmant, the debris left after the type of massive explosion in which Hoyle predicted that heavy nuclei were formed. (© Royal Observatory, Edinburgh, Anglo-Australian Observatory.) Building on earlier collaboration with Ed Saltpeter, Hoyle used data supplied by Geoffrey and Margaret Burbidge and, working with Fowler, began to piece together how the elements were formed. By looking at very large stars near the end of their lives and examining their chemical composition, they noticed that the abundances of elements almost exactly corresponded to those with a low nuclear capture cross section. Hoyle argued that all of the elements in our bodies had been formed in stars that had been and gone before our solar system had even formed. In their classic paper the elements are produced by three basic methods. The

  3. Estimate of HIV prevalence and number of people living with HIV in India 2008–2009

    PubMed Central

    Pandey, Arvind; Sahu, Damodar; Bakkali, Taoufi; Reddy, DCS; Venkatesh, S; Kant, Shashi; Bhattacharya, M; Raj, Yujwal; Haldar, Partha; Bhardwaj, Deepak; Chandra, Nalini

    2012-01-01

    Objectives To update the estimation of the adult HIV prevalence and number of people living with HIV (PLHIV) in India for the year 2008−2009 with the combination of improved data and methods. Design Based on HIV sentinel surveillance (HSS) data and a set of epidemiological assumptions, estimates of HIV prevalence and burden in India have been derived. Setting HSS sites spread over all the States of India. Participants Secondary data from HSS sites which include attendees of antenatal clinics and sites under targeted interventions of high-risk groups, namely, female sex workers (FSW), intravenous drug users (IDU) and men having sex with men (MSM). Primary and secondary outcome measures Estimates of adult HIV prevalence and PLHIV in India and its states. Results The adult HIV prevalence in India has declined to an estimated 0.31% (0.25–0.39%) in 2009 against 0.36% (0.29–0.45%) in 2006. Among the high prevalence states, the HIV prevalence has declined in Tamil Nadu to 0.33% in 2009 and other states show either a plateau or a slightly declining trend over the time period 2006–2009. There are states in the low prevalence states where the adult HIV prevalence has risen over the last 4 years. The estimated number of PLHIV in India is 2.4 million (1.93–3.04 million) in 2009. Of which, 39% are women, children under 15 years of age account for 4.4% of all infections, while people aged 15–49 years account for 82.4% of all infections. Conclusions The estimated adult prevalence has declined in few states, a plateau or a slightly declining trend over the time. In future, efforts may be made to examine the implications of the emerging trend of the HIV prevalence on the recent infections in the study population. PMID:23028110

  4. Influence of a persuasive strategy on nursing students' beliefs and attitudes toward provision of care to people living with HIV/AIDS.

    PubMed

    Valois, P; Turgeon, H; Godin, G; Blondeau, D; Cote, F

    2001-11-01

    Based on the theory of planned behavior and the elaboration likelihood model, the aim of this study was to verify the effect of persuasive messages on nursing students' beliefs and attitudes regarding provision of care to people living with HIV/AIDS. The assumption was that a persuasive communication strategy induces a constructive change in beliefs and attitudes regarding provision of care. Baseline data collection was performed among a group of 74 nursing students (experimental group = 27; control group = 47). The questionnaire assessed the variables of the theory of planned behavior (i.e., beliefs, attitudes, perceived behavioral control). The results confirmed that persuasive messages generated a change in beliefs and attitudes of the nursing students concerning providing care to people living with HIV/AIDS. It appears that this strategy of modifying behavioral predispositions is effective and generates cognitive and affective changes. Therefore, educational programs should take these observations into consideration to ensure that future nurses are better prepared to provide appropriate care to people living with HIV/AIDS. PMID:11725993

  5. Rethinking how we understand individual healthcare needs for people living with long-term conditions: a qualitative study.

    PubMed

    Reeve, Joanne; Cooper, Lucy

    2016-01-01

    It has been suggested that we need to 'Think Differently' about how we organise care for people with long-term conditions. Current approaches prioritise reducing population disease burden, meaning health need is defined predominantly in terms of disease status, or even risk of disease. However, the result is care which overburdens some individuals. The World Health Organisation has described the need to view health as a 'resource for living' and not an end in itself. This study considers whether this view of health offers an alternative view of healthcare need in people living with long-term conditions. We know that chronic disease can be disruptive for some people; but not all. Our research question asked: Why do people experience long-term conditions differently, and what are the implications for understanding healthcare need? Our phenomenographic study involved qualitative interviews with 24 people living with at least one of the three conditions (diabetes, depression and chronic pain) and explored resources for and demands on daily living. Interviews all took place during 2012 and 2013. A narrative form analysis identified three patterns of illness experience (Gliding Swan, Stormy Seas and Stuck Adrift). Narrative content analysis revealed four factors explaining the variation: personalising care, existence of meaningful anchors, partnership and excess demands. We thus propose three new categories of healthcare need described by a consideration of health as a resource for living: Resilient, Vulnerable and Disconnected. We discuss how the emerging findings may offer scope to develop new needs assessment and patient-reported outcome measure tools. And so, offer a different way of thinking about the organisation for care for people with long-term conditions. PMID:25470421

  6. Ready to give up on life: The lived experience of elderly people who feel life is completed and no longer worth living.

    PubMed

    van Wijngaarden, Els; Leget, Carlo; Goossensen, Anne

    2015-08-01

    In the Netherlands, there has been much debate on the question whether elderly people over 70 who are tired of life and who consider their life to be completed, should have legal options to ask for assisted dying. So far there has been little research into the experiences of these elderly people. In order to develop deliberate policy and care that targets this group of elderly people, it is necessary to understand their lifeworld. The aim of this paper is to describe the phenomenon 'life is completed and no longer worth living' from a lifeworld perspective, as it is lived and experienced by elderly people. Between April to December 2013, we conducted 25 in-depth interviews. A reflective lifeworld research design, drawing on the phenomenological tradition, was used during the data gathering and data analysis. The essential meaning of the phenomenon is understood as 'a tangle of inability and unwillingness to connect to one's actual life', characterized by a permanently lived tension: daily experiences seem incompatible with people's expectations of life and their idea of whom they are. While feeling more and more disconnected to life, a yearning desire to end life is strengthened. The experience is further explicated in its five constituents: 1) a sense of aching loneliness; 2) the pain of not mattering; 3) the inability to express oneself; 4) multidimensional tiredness; and 5) a sense of aversion towards feared dependence. This article provides evocative and empathic lifeworld descriptions contributing to a deeper understanding of these elderly people and raises questions about a close association between death wishes and depression in this sample. PMID:25982088

  7. FRAILTY, FOOD INSECURITY, AND NUTRITIONAL STATUS IN PEOPLE LIVING WITH HIV

    PubMed Central

    SMIT, E.; WANKE, C.; DONG, K.; GROTHEER, A.; HANSEN, S.; SKINNER, S.; TANG, A.M.

    2015-01-01

    Background Nutritional status and food insecurity are associated with frailty in the general U.S. population, yet little is known about this in the aging population of people living with HIV (PLWH). Objectives Given the potential importance of nutrition and the amenability to intervention, we examined the association between nutritional status, food insecurity, and frailty in PLWH. Design Cross sectional study. Setting Boston, Massachusetts, U.S.A. Participants 50 PLWH, age ≥45 years, recruited from a cohort study examining risk factors for cardiovascular disease. Measurements Frailty, duration of HIV, use of antiretroviral therapy, disease history, food insecurity, physical function, and physical activity were assessed by questionnaire. Dietary intake was assessed using 3-day food records. Blood was drawn for CD4+ cell count, hemoglobin, hematocrit, and lipid levels. Physical measurements included height, weight, and skinfold thickness. Results The prevalence of frailty was 16% (n=8), 44% were pre-frail (n=22) and 40% were not frail (n=20). The number of reported difficulties with 20 activities of daily living was highest in frail (mean 10.4±3.9 SD), followed by pre-frail (6.5±4.6), and lowest in not frail participants (2.0±2.3). Seven (88%) of the frail PLWH lost weight with an average weight loss of 22.9 pounds; 6 (75%) reported unintentional weight loss, and all 6 of these met the frailty criteria for weight loss of 10 or more pounds. Nine (45%) of the not frail PLWH reported losing weight with an average weight loss of 6.2 pounds; 5 (23%) reported unintentional weight loss of <10 pounds. Frail PLWH were more likely to report being food insecure than not frail PLWH (63% vs. 10%, p=0.02), and tended to have lower energy intake than not frail PLWH. Conclusion Research is needed on targeted interventions to improve food security and activities of daily living in PLWH for both the prevention and improvement of frailty. PMID:26689809

  8. The relationship between sleep-wake cycle and cognitive functioning in young people with affective disorders.

    PubMed

    Carpenter, Joanne S; Robillard, Rébecca; Lee, Rico S C; Hermens, Daniel F; Naismith, Sharon L; White, Django; Whitwell, Bradley; Scott, Elizabeth M; Hickie, Ian B

    2015-01-01

    Although early-stage affective disorders are associated with both cognitive dysfunction and sleep-wake disruptions, relationships between these factors have not been specifically examined in young adults. Sleep and circadian rhythm disturbances in those with affective disorders are considerably heterogeneous, and may not relate to cognitive dysfunction in a simple linear fashion. This study aimed to characterise profiles of sleep and circadian disturbance in young people with affective disorders and examine associations between these profiles and cognitive performance. Actigraphy monitoring was completed in 152 young people (16-30 years; 66% female) with primary diagnoses of affective disorders, and 69 healthy controls (18-30 years; 57% female). Patients also underwent detailed neuropsychological assessment. Actigraphy data were processed to estimate both sleep and circadian parameters. Overall neuropsychological performance in patients was poor on tasks relating to mental flexibility and visual memory. Two hierarchical cluster analyses identified three distinct patient groups based on sleep variables and three based on circadian variables. Sleep clusters included a 'long sleep' cluster, a 'disrupted sleep' cluster, and a 'delayed and disrupted sleep' cluster. Circadian clusters included a 'strong circadian' cluster, a 'weak circadian' cluster, and a 'delayed circadian' cluster. Medication use differed between clusters. The 'long sleep' cluster displayed significantly worse visual memory performance compared to the 'disrupted sleep' cluster. No other cognitive functions differed between clusters. These results highlight the heterogeneity of sleep and circadian profiles in young people with affective disorders, and provide preliminary evidence in support of a relationship between sleep and visual memory, which may be mediated by use of antipsychotic medication. These findings have implications for the personalisation of treatments and improvement of functioning in

  9. The Relationship between Sleep-Wake Cycle and Cognitive Functioning in Young People with Affective Disorders

    PubMed Central

    Carpenter, Joanne S.; Robillard, Rébecca; Lee, Rico S. C.; Hermens, Daniel F.; Naismith, Sharon L.; White, Django; Whitwell, Bradley; Scott, Elizabeth M.; Hickie, Ian B.

    2015-01-01

    Although early-stage affective disorders are associated with both cognitive dysfunction and sleep-wake disruptions, relationships between these factors have not been specifically examined in young adults. Sleep and circadian rhythm disturbances in those with affective disorders are considerably heterogeneous, and may not relate to cognitive dysfunction in a simple linear fashion. This study aimed to characterise profiles of sleep and circadian disturbance in young people with affective disorders and examine associations between these profiles and cognitive performance. Actigraphy monitoring was completed in 152 young people (16–30 years; 66% female) with primary diagnoses of affective disorders, and 69 healthy controls (18–30 years; 57% female). Patients also underwent detailed neuropsychological assessment. Actigraphy data were processed to estimate both sleep and circadian parameters. Overall neuropsychological performance in patients was poor on tasks relating to mental flexibility and visual memory. Two hierarchical cluster analyses identified three distinct patient groups based on sleep variables and three based on circadian variables. Sleep clusters included a ‘long sleep’ cluster, a ‘disrupted sleep’ cluster, and a ‘delayed and disrupted sleep’ cluster. Circadian clusters included a ‘strong circadian’ cluster, a ‘weak circadian’ cluster, and a ‘delayed circadian’ cluster. Medication use differed between clusters. The ‘long sleep’ cluster displayed significantly worse visual memory performance compared to the ‘disrupted sleep’ cluster. No other cognitive functions differed between clusters. These results highlight the heterogeneity of sleep and circadian profiles in young people with affective disorders, and provide preliminary evidence in support of a relationship between sleep and visual memory, which may be mediated by use of antipsychotic medication. These findings have implications for the personalisation of treatments

  10. Examining the Role of Serostatus Disclosure on Unprotected Sex Among People Living with HIV

    PubMed Central

    Golin, Carol; Widman, Laura; Grodensky, Catherine; Earp, Jo Anne; Suchindran, Chirayath

    2014-01-01

    Abstract Given the increasing prevalence of HIV, it is important to identify factors associated with safer sex behaviors between people living with HIV and their partners. Utilizing a diverse sample of 242 HIV-infected adults [n=69 men who have sex with men (MSM); n=68 men who have sex with women (MSW); n=105 women who have sex with men (WSM)], we examined the association between serostatus disclosure and unprotected anal or vaginal intercourse (UAVI) and the moderating effect of sexual behavior group on this association. Overall, 88.7% disclosed to their current partner. Approximately 18.8% of MSM, 17.7% of MSW, and 29.5% of WSM reported UAVI. Controlling for age, time since diagnosis, and partner serostatus, we found main effects on UAVI for disclosure and sexual behavior group; specifically, disclosure was inversely related to unprotected sex [AOR=0.09, 95% CI (0.02, 0.43), p<0.001], and MSM were less likely to engage in UAVI relative to WSM [AOR=0.11, 95% CI (0.17, 0.82), p<0.05]. However, the relationship between disclosure and UAVI was not moderated by sexual behavior group. Future strategies that aim to increase disclosure to partners may consider focusing on its value as a means by which to reduce sexual risk behavior. PMID:25397358

  11. Hepatotoxicity during Treatment for Tuberculosis in People Living with HIV/AIDS

    PubMed Central

    Araújo-Mariz, Carolline; Lopes, Edmundo Pessoa; Acioli-Santos, Bartolomeu; Maruza, Magda; Montarroyos, Ulisses Ramos; Ximenes, Ricardo Arraes de Alencar; Lacerda, Heloísa Ramos; Miranda-Filho, Demócrito de Barros; de Albuquerque, Maria de Fátima P. Militão

    2016-01-01

    Hepatotoxicity is frequently reported as an adverse reaction during the treatment of tuberculosis. The aim of this study was to determine the incidence of hepatotoxicity and to identify predictive factors for developing hepatotoxicity after people living with HIV/AIDS (PLWHA) start treatment for tuberculosis. This was a prospective cohort study with PLWHA who were monitored during the first 60 days of tuberculosis treatment in Pernambuco, Brazil. Hepatotoxicity was considered increased levels of aminotransferase, namely those that rose to three times higher than the level before initiating tuberculosis treatment, these levels being associated with symptoms of hepatitis. We conducted a multivariate logistic regression analysis and the magnitude of the associations was expressed by the odds ratio with a confidence interval of 95%. Hepatotoxicity was observed in 53 (30.6%) of the 173 patients who started tuberculosis treatment. The final multivariate logistic regression model demonstrated that the use of fluconazole, malnutrition and the subject being classified as a phenotypically slow acetylator increased the risk of hepatotoxicity significantly. The incidence of hepatotoxicity during treatment for tuberculosis in PLWHA was high. Those classified as phenotypically slow acetylators and as malnourished should be targeted for specific care to reduce the risk of hepatotoxicity during treatment for tuberculosis. The use of fluconazole should be avoided during tuberculosis treatment in PLWHA. PMID:27332812

  12. Increasing access to oral health care for people living with HIV/AIDS in rural Oregon.

    PubMed

    Jones, Jill; Mofidi, Mahyar; Bednarsh, Helene; Gambrell, Alan; Tobias, Carol R

    2012-05-01

    Access to oral health care for people living with HIV/AIDS is a severe problem. This article describes the design and impact of an Innovations in Oral Health Care Initiative program, funded through the Health Resources and Services Administration HIV/AIDS Bureau's Special Projects of National Significance (SPNS) program, that expanded oral health-care services for these individuals in rural Oregon. From April 2007 to August 2010, 473 patients received dental care (exceeding the target goal of 410 patients) and 153 dental hygiene students were trained to deliver oral health care to HIV-positive patients. The proportion of patients receiving oral health care increased from 10% to 65%, while the no-show rate declined from 40% to 10%. Key implementation components were leveraging SPNS funding and services to create an integrated delivery system, collaborations that resulted in improved service delivery systems, using dental hygiene students to deliver oral health care, enhanced care coordination through the services of a dental case manager, and program capacity to adjust to unanticipated needs. PMID:22547878

  13. Mortality among People Living with HIV and AIDS in China: Implications for Enhancing Linkage

    PubMed Central

    Li, Meng; Tang, Weiming; Bu, Kai; Mahapatra, Tanmay; Zhang, Xiayan; Feng, Yibing; Chen, Fangfang; Guo, Wei; Wang, Liyan; Ding, Zhengwei; Qin, Qianqian; Liu, Shiliang; Tucker, Joseph D.; Wang, Lu; Wang, Ning

    2016-01-01

    To assess the patterns and predictors of AIDS-related mortality and identify its correlates among adult people living with HIV/AIDS (PLWHA) in China, a retrospective record-based cohort study was conducted among 18 years or older PLWHA, who had at least one follow up reported to the national database between January-1989 and June-2012. Cumulative Incidence Function was used to calculate AIDS-related mortality rate. Gray’s test was used to determine the variation in cumulative incidence across strata. The Fine and Gray model was used to measure the burden of cumulative incidence of AIDS-related mortality and strength of its association with potential correlates. Among 375,629 patients, 107,634 died during study period, of which 54,759 (50.87%) deaths were AIDS-related. Cumulative mortality rates of AIDS-related death at one, two, five, 10 and 15 years post-diagnosis were 5.7%, 8.2%, 14.3%, 22.9% and 30.9%, respectively. Among PLWHA, male gender, ethnic minority and having AIDS were associated with significantly higher mortality. Further, homosexual transmission, being on ART and increasing CD4-testing frequency were associated with lower mortality. To reduce mortality among PLWHA, efficient interventions targeting males, ethnic minority, heterosexually infected and AIDS patients should be combined with immunologic monitoring, enhancement of coverage of HIV-testing and ART. PMID:27324204

  14. Condom Use Determinants and Practices Among People Living with HIV in Kisii County, Kenya

    PubMed Central

    Emmanuel, Wamalwa; Edward, Neyole; Moses, Poipoi; William, Ringera; Geoffrey, Otomu; Monicah, Bitok; Rosemary, Mbaluka

    2015-01-01

    The male condom remains the single, most efficient and available technology to reduce sexual transmission of HIV as well as sexually transmitted infections. This study sought to establish condom use determinants and practices among people living with HIV (PLHIVs) in Kisii County, Kenya. We interviewed 340 PLHIVs and 6 health workers. Although most PLHIVs had correct knowledge and approved condoms as effective for HIV prevention, consistent use and condom use at last sex were notably low especially among PLHIVs aged 18 – 24, those who depended on remittances from kin as main source of income, as well as during sex with secondary and casual partners. This study notes that knowledge on various benefits of using condoms is associated with enhanced condom use practices. Non-disclosure of HIV status to secondary and casual partners remains a key barrier to condom use among PLHIVs Our observations highlight the need to further promote condom use among specific PLHIVs socio-demographic groups who continue to exhibit low condom use rates. PMID:26668671

  15. TB screening among people living with HIV/AIDS in resource-limited settings.

    PubMed

    Date, Anand; Modi, Surbhi

    2015-04-15

    Tuberculosis (TB) continues to be the leading cause of morbidity and mortality among people living with HIV (PLHIV), making improved prevention and treatment of HIV-associated TB critical to ensuring long-term survival of PLHIV. TB screening among PLHIV is central to implementation of the World Health Organization's 3 I's interventions for reducing the impact of the TB and HIV syndemics. Effective TB screening will result in the identification of PLHIV with presumptive TB disease (ie, those with a positive symptom screen who require appropriate evaluation, including the use of diagnostic tools such as the Xpert MTB/RIF assay) and those eligible for isoniazid preventive therapy (ie, those who have a negative clinical symptom screen or who have a positive screen but are found not to have TB disease). Identification of PLHIV with presumptive TB also facilitates implementation of basic administrative measures for TB infection control, including fast tracking of coughing patients and separation from noncoughing PLHIV to reduce TB transmission. By contributing to the early diagnosis of TB disease among PLHIV, TB screening is also critical to facilitate early initiation of antiretroviral treatment among PLHIV diagnosed with TB disease who might not otherwise be eligible for antiretroviral treatment based on CD4 count or clinical staging. TB screening thus serves as a gateway for multiple TB/HIV interventions and is an integral part of routine clinical services for PLHIV at each clinic visit. PMID:25768866

  16. Perceived discrimination, social support, and perceived stress among people living with HIV/AIDS in China.

    PubMed

    Su, Xiaoyou; Lau, Joseph T F; Mak, Winnie W S; Chen, Lin; Choi, K C; Song, Junmin; Zhang, Yan; Zhao, Guanglu; Feng, Tiejian; Chen, Xi; Liu, Chuliang; Liu, Jun; Liu, De; Cheng, Jinquan

    2013-01-01

    Perceived stress among people living with HIV/AIDS (PLWH) was associated with severe mental health problems and risk behaviors. Discrimination toward PLWH in China is prevalent. Both perceived discrimination and social supports are determinants of the stress level among PLWH. Psychological support services for PLWH in China are scarce. It is unknown whether social support is a buffer between the perceived discrimination and perceived stress. With written consent, this study surveyed 258 PLWH recruited from multiple sources in two cities in China. Instruments were validated in previous or the present study, including the perceived stress scale for PLWH (PSSHIV), the perceived social support scale (PSSS), and the perceived discrimination scale for PLWH (PDSHIV). Pearson correlations and multiple regression models were fit. PDSHIV was associated with the Overall Scale and all subscales of PSSHIV, whilst lower socioeconomic status in general and lower scores of PSSS were associated with various subscales of PSSHIV. The interaction item (PSSS×PSDHIV) was nonsignificant in modeling PSSHIV, hence no significant moderating effect was detected. Whilst perceived discrimination is a major source of stress and social support can reduce stress among PLWH in China, improved social support cannot buffer the stressful consequences due to perceived discrimination. The results highlight the importance to reduce discrimination toward PLWH and the difficulty to alleviate its negative consequences. It is warranted to improve mental health among PLWH in China and it is still important to foster social support among PLWH as it has direct effects on perceived stress. PMID:22835331

  17. Condom Use Determinants and Practices Among People Living with HIV in Kisii County, Kenya.

    PubMed

    Emmanuel, Wamalwa; Edward, Neyole; Moses, Poipoi; William, Ringera; Geoffrey, Otomu; Monicah, Bitok; Rosemary, Mbaluka

    2015-01-01

    The male condom remains the single, most efficient and available technology to reduce sexual transmission of HIV as well as sexually transmitted infections. This study sought to establish condom use determinants and practices among people living with HIV (PLHIVs) in Kisii County, Kenya. We interviewed 340 PLHIVs and 6 health workers. Although most PLHIVs had correct knowledge and approved condoms as effective for HIV prevention, consistent use and condom use at last sex were notably low especially among PLHIVs aged 18 - 24, those who depended on remittances from kin as main source of income, as well as during sex with secondary and casual partners. This study notes that knowledge on various benefits of using condoms is associated with enhanced condom use practices. Non-disclosure of HIV status to secondary and casual partners remains a key barrier to condom use among PLHIVs Our observations highlight the need to further promote condom use among specific PLHIVs socio-demographic groups who continue to exhibit low condom use rates. PMID:26668671

  18. HIV stigma among substance abusing people living with HIV/AIDS: implications for HIV treatment.

    PubMed

    Levi-Minzi, Maria A; Surratt, Hilary L

    2014-08-01

    HIV-related stigma has a major impact on quality of life and health among people living with HIV and AIDS (PLWHA). This study examines demographic, mental health, behavioral, contextual, and HIV care-related correlates of HIV stigma among 503 substance abusing PLWHA. Stigma was measured with the HIV Internalized Stigma Measure which has four subscales: stereotypes about HIV, self-acceptance, disclosure concerns, and social relationships. Severe substance dependence (55.3%) and depression (54.7%) were associated with higher HIV stigma across all domains. 49.9% of the sample reported antiretroviral (ARV) medication diversion (the unlawful sale and trading of ARV medications); diverters endorsed significantly higher stigma related to disclosure. 54.1% of the sample reported ≥95% ARV adherence; these individuals reported significantly lower stigma for self-acceptance, disclosure, and social relationships. Multivariate linear regression showed that depression and social support demonstrated significant main effects across stigma domains. Findings suggest that interventions to decrease HIV related stigma may be an important component of initiatives to increase engagement in HIV care. PMID:24983302

  19. With health comes work? People living with HIV/AIDS consider returning to work.

    PubMed

    Ferrier, S E; Lavis, J N

    2003-06-01

    Many people living with HIV/AIDS (PHAs) ham experienced significant improvements in their health over the last few years, to the point that many are considering returning to work. The objectives of this study were to develop a model of return to work which could apply to chronic illnesses with a fluctuating or uncertain course. Issues related to health, work and return to work were explored using in-depth interviews with 20 PHAs in Toronto, Canada, who had been on long-term disability for at least five years. Data were analyzed using a grounded theory approach. Contextual factors like the approach of disability and health (drug) insurance plans and intervening conditions like PHAs' current activities influenced their consideration of returning to work and the strategies they employed as a result of considering such a return. More than two-thirds of the sample had undertaken more activities as their health improved. The three study participants who had returned to work either had an opportunity for a low-risk trial of work or could return to their old job. Employers and disability compensation plan administrators, assisted by AIDS service organizations and governments, can facilitate return to work for PHAs by reducing the risks of and removing the barriers to returning to work. PMID:12828149

  20. Mortality among People Living with HIV and AIDS in China: Implications for Enhancing Linkage.

    PubMed

    Li, Meng; Tang, Weiming; Bu, Kai; Mahapatra, Tanmay; Zhang, Xiayan; Feng, Yibing; Chen, Fangfang; Guo, Wei; Wang, Liyan; Ding, Zhengwei; Qin, Qianqian; Liu, Shiliang; Tucker, Joseph D; Wang, Lu; Wang, Ning

    2016-01-01

    To assess the patterns and predictors of AIDS-related mortality and identify its correlates among adult people living with HIV/AIDS (PLWHA) in China, a retrospective record-based cohort study was conducted among 18 years or older PLWHA, who had at least one follow up reported to the national database between January-1989 and June-2012. Cumulative Incidence Function was used to calculate AIDS-related mortality rate. Gray's test was used to determine the variation in cumulative incidence across strata. The Fine and Gray model was used to measure the burden of cumulative incidence of AIDS-related mortality and strength of its association with potential correlates. Among 375,629 patients, 107,634 died during study period, of which 54,759 (50.87%) deaths were AIDS-related. Cumulative mortality rates of AIDS-related death at one, two, five, 10 and 15 years post-diagnosis were 5.7%, 8.2%, 14.3%, 22.9% and 30.9%, respectively. Among PLWHA, male gender, ethnic minority and having AIDS were associated with significantly higher mortality. Further, homosexual transmission, being on ART and increasing CD4-testing frequency were associated with lower mortality. To reduce mortality among PLWHA, efficient interventions targeting males, ethnic minority, heterosexually infected and AIDS patients should be combined with immunologic monitoring, enhancement of coverage of HIV-testing and ART. PMID:27324204

  1. Autonomous motivation is associated with the maintenance stage of behaviour change in people with affective disorders.

    PubMed

    Vancampfort, Davy; Moens, Herman; Madou, Tomas; De Backer, Tanja; Vallons, Veerle; Bruyninx, Peter; Vanheuverzwijn, Sarah; Mota, Cindy Teixeira; Soundy, Andy; Probst, Michel

    2016-06-30

    The present study examined whether in people with affective disorders motives for adopting and maintaining physical activity recommendations (as formulated by the self-determination theory) differed across the stages of behaviour change (identified by the transtheoretical model). A total of 165 (105♀) persons (45.6±14.2years) with affective disorders [major depressive disorder (n=96) or bipolar disorder (n=69)] completed the Behavioural Regulation in Exercise Questionnaire-2 and the Patient-centred Assessment and Counselling for Exercise questionnaire. Discriminant and multivariate analyses demonstrated that persons with affective disorders at the early stages of change have less autonomous and more controlled physical activity motives than those at the later stages. Our results suggest that autonomous motivation may have an important role to play in the maintenance of health recommendations in persons with affective disorders. Longitudinal and intervention studies should be designed in people with affective disorders to identify the causal pathways between motives for maintaining health recommendations, effective changes in health behaviour and physical and mental health outcomes. PMID:27131627

  2. Do Social Networks Differ? Comparison of the Social Networks of People with Intellectual Disabilities, People with Autism Spectrum Disorders and Other People Living in the Community

    ERIC Educational Resources Information Center

    van Asselt-Goverts, A. E.; Embregts, P. J. C. M.; Hendriks, A. H. C.; Wegman, K. M.; Teunisse, J. P.

    2015-01-01

    The aim of this study was to determine the similarities and differences in social network characteristics, satisfaction and wishes with respect to the social network between people with mild or borderline intellectual disabilities (ID), people with autism spectrum disorders (ASD) and a reference group. Data were gathered from 105 young adults…

  3. Listening to Bodies and Watching Machines: Developing Health Information Skills, Tools and Services for People Living with Chronic Kidney Disease

    ERIC Educational Resources Information Center

    Godbold, Natalya

    2013-01-01

    When patients need information, they may visit a doctor, ask a nurse, or look online. But these are not the only sources of information used by patients. This paper examines discussion threads in online renal support groups to describe how people living with kidney failure conceive of help, information and support. I use Actor Network Theory to…

  4. Using Personal Goal Setting to Promote the Social Inclusion of People with Intellectual Disability Living in Supported Accommodation

    ERIC Educational Resources Information Center

    McConkey, R.; Collins, S.

    2010-01-01

    Background: The social exclusion of persons with intellectual disability is more marked in congregated than in individualised supported accommodation. Goal setting was used as a means of increasing individuals' choices and engaging support staff in personalised planning. Method: People living in four different housing and support options were…

  5. As We Tell Our Stories. Living Traditions and the Algonkian Peoples of Indian New England: A New Exhibit.

    ERIC Educational Resources Information Center

    Williamson, Lynne

    1990-01-01

    Describes a new exhibit initiative at the American Indian Archeological Institute (Washington, Connecticut), which seeks to relate Algonkian peoples' historical and contemporary art forms to each other and to the ongoing cultural context from which they spring. Describes exhibit sections: land, exchange, clay, living spaces, corn, deer, and…

  6. The Place and Meaning of the Field of PE in Turkish Young People's Lives: A Study Using Bourdieu's Conceptual Tools

    ERIC Educational Resources Information Center

    Koca, Canan; Atencio, Matthew; Demirhan, Giyasettin

    2009-01-01

    This paper draws on Bourdieu's notions of habitus, social field, and capital to provide a more complex examination of the place and meaning of physical education in Turkish young people's lives. Two secondary schools comprised of students from quite distinctive social, cultural, and geographical locations were involved in the study. Collected data…

  7. Factors Associated with Perceived Stigma among People Living with HIV/AIDS in Post-Conflict Northern Uganda

    ERIC Educational Resources Information Center

    Nattabi, Barbara; Li, Jianghong; Thompson, Sandra C.; Orach, Christopher G.; Earnest, Jaya

    2011-01-01

    HIV-related stigma continues to persist in several African countries including Uganda. This study quantified the burden of stigma and examined factors associated with stigma among 476 people living with HIV (PLHTV) in Gulu, northern Uganda. Data were collected between February and May 2009 using the HIV/AIDS Stigma Instrument-PLWA. Females more…

  8. Musical Meaning in the Lives of Those Affected by the Holocaust: Implications for Music Education

    ERIC Educational Resources Information Center

    Cunningham, Deborah A.

    2014-01-01

    This qualitative study investigated the role of music in the lives of those affected by the Holocaust. Participants were identified through purposeful and snowball sampling techniques, and a total of five were selected based on their connection to the Holocaust. Participants included those incarcerated in camps and ghettos, those who escaped…

  9. Oral health associated with quality of life of people living with HIV/AIDS in Brazil

    PubMed Central

    2014-01-01

    Background The epidemic of HIV/AIDS enters into its fourth decade and is still considered an important public health problem in developed and developing countries. The purpose is verify the oral health and other factors that influence the quality of life of people living with HIV/AIDS attending a public service reference in Brazil. Methods The participants answered the questionnaire on socio-demographic conditions, issues related to HIV and daily habits. The quality of life was analyzed by the HIV/AIDS Targeted Quality of Life (HAT-QoL) instrument with 42 items divided into nine domains: General Activity, Sexual Activity, Confidentiality concerns, Health Concerns, Financial Concern, HIV Awareness, Satisfaction with Life Issues related to medication and Trust in the physician. The oral health data were collected by means of the DMFT index, use and need of dentures and the Community Periodontal Index, according to the criteria proposed by the World Health Organization, by a calibrated researcher. Bivariate and multiple linear regressions were performed. Results Of the participants, 53.1% were women and had a mean age of 42 years, 53.1% had eight years or less of schooling and 20.3% were not employed. In analyzing the quality of life domain of the HAT-QoL, with a lower average there was: Financial concern (39.4), followed by Confidentiality concern (43.2), Sexual activities (55.2) and Health concerns (62. 88). There was an association between the variables: do not have link to employment (p <0.001), is brown or black (p = 0.045), alcohol consumption (p = 0.041), did not make use of antiretroviral therapy (p = 0.006), high levels of viral load (p = 0.035) and need for dentures (p = 0.025), with the worse quality of life scores. Conclusion Socioeconomic and inadequate health conditions had a negative impact on the quality of life of people with HIV/AIDS. PMID:24581005

  10. Improving outcomes for caregivers through treatment of young people affected by war: a randomized controlled trial in Sierra Leone

    PubMed Central

    Salhi, Carmel; Hann, Katrina; Kellie, Jim; Kamara, Alimamy; Salomon, Joshua A; Kim, Jane J; Betancourt, Theresa S

    2015-01-01

    Abstract Objective To measure the benefits to household caregivers of a psychotherapeutic intervention for adolescents and young adults living in a war-affected area. Methods Between July 2012 and July 2013, we carried out a randomized controlled trial of the Youth Readiness Intervention – a cognitive–behavioural intervention for war-affected young people who exhibit depressive and anxiety symptoms and conduct problems – in Freetown, Sierra Leone. Overall, 436 participants aged 15–24 years were randomized to receive the intervention (n = 222) or care as usual (n = 214). Household caregivers for the participants in the intervention arm (n = 101) or control arm (n = 103) were interviewed during a baseline survey and again, if available (n = 155), 12 weeks later in a follow-up survey. We used a burden assessment scale to evaluate the burden of care placed on caregivers in terms of emotional distress and functional impairment. The caregivers’ mental health – i.e. internalizing, externalizing and prosocial behaviour – was evaluated using the Oxford Measure of Psychosocial Adjustment. Difference-in-differences multiple regression analyses were used, within an intention-to-treat framework, to estimate the treatment effects. Findings Compared with the caregivers of participants of the control group, the caregivers of participants of the intervention group reported greater reductions in emotional distress (scale difference: 0.252; 95% confidence interval, CI: 0.026–0.4782) and greater improvements in prosocial behaviour (scale difference: 0.249; 95% CI: 0.012–0.486) between the two surveys. Conclusion A psychotherapeutic intervention for war-affected young people can improve the mental health of their caregivers. PMID:26668435

  11. Perspectives of People Living with HIV on Access to Health Care: Protocol for a Scoping Review

    PubMed Central

    Maybank, Allison; Hurley, Oliver; Modir, Hilary; Farrell, Alison; Marshall, Zack; Kendall, Claire; Johnston, Sharon; Hogel, Matthew; Rourke, Sean B; Liddy, Clare

    2016-01-01

    Background Strategies to improve access to health care for people living with human immunodeficiency virus (PLHIV) have demonstrated limited success. Whereas previous approaches have been informed by the views of health providers and decision-makers, it is believed that incorporating patient perspectives into the design and evaluations of health care programs will lead to improved access to health care services. Objective We aim to map the literature on the perspectives of PLHIV concerning access to health care services, to identify gaps in evidence, and to produce an evidence-informed research action plan to guide the Living with HIV program of research. Methods This scoping review includes peer-reviewed and grey literature from 1946 to May 2014 using double data extraction. Variations of the search terms “HIV”, “patient satisfaction”, and “health services accessibility” are used to identify relevant literature. The search strategy is being developed in consultation with content experts, review methodologists, and a librarian, and validated using gold standard studies identified by those stakeholders. The inclusion criteria are (1) the study includes the perspectives of PLHIV, (2) study design includes qualitative, quantitative, or mixed methods, and (3) outcome measures are limited to patient satisfaction, their implied needs, beliefs, and desires in relation to access to health care. The papers are extracted by two independent reviewers, including quality assessment. Data is then collated, summarized, and thematically analyzed. Results A total of 12,857 references were retrieved, of which 326 documents were identified as eligible in pre-screening, and 64 articles met the inclusion criteria (56% qualitative studies, 38% quantitative studies and 6% mixed-method studies). Only four studies were conducted in Canada. Data synthesis is in progress and full results are expected in June, 2016. Conclusions This scoping review will record and characterize the

  12. People

    NASA Astrophysics Data System (ADS)

    2001-09-01

    teachers in Iceland and on Friday to teachers in Ireland. Fred and Frances from Southgate College showed great team spirit in the world's most chaotic quiz, then sang in harmony with Dave from Barnsley and Yoji from Japan amongst others. Kirsten from across the Atlantic shared her research on children and museums on Friday and later I discovered how much I didn't know about global warming from a chemist and a set of unreadable graphs in a computer lab. What a pleasure to see Tom and Seamus from Ireland again. The day closed with a barn dance fling where I managed to boogie on down with some teachers from Turkey. A final 'strip the willow' with Pete and Allison finished me off. Saturday started with breakfast with Ken from Greenwich offering me some part-time work. The exhibitions called and amongst others I hugged Sue from Cardiff, Barry and Leila from London, Pauline from Scotland and an unknown but very friendly lady from Holland. I met a lady from Scotland who lived in Iceland but who taught in Norway and of course Catherine was everywhere. I had tea with Jean from Edinburgh, Janet from London, Gordon from Aberdeen. I laughed with Mick from Sheffield and the same friendly lady from Holland. I ate posh food with Susie from Ayr and applauded big names from America and Australia. I shared a lump in my throat for John and for Wynne and nodded and smiled at countless people whose names I had forgotten but our paths had crossed sometime in the past. There are more than 20 000 members in the ASE and countless thousands of science teachers across the globe. The world is indeed expansive but for three days in Guildford it seemed that the very best speakers and the very cheeriest folk had magically converged on one place. If ever there were confirmation that science and science teaching were alive and well it was there and it was then. If you were there you will know exactly what I mean. If you weren't there then don't miss it next January in Liverpool.www.ase.org.uk

  13. Social defeat or social resistance? Reaction to fear of crime and violence among people with severe mental illness living in urban 'recovery communities'.

    PubMed

    Whitley, Rob

    2011-12-01

    This article is propelled by recent theory positing that 'social defeat' is a common experience for people with severe mental illness, potentially affecting course and outcome. The primary objective is to investigate how far fear of crime and violence contributes toward 'social defeat' among people with mental illness. This is done through examining 6 years of ethnographic data collected from a sample of urban-dwelling people with severe mental illness, all securely-housed in apartments located in small scale "recovery communities." Findings suggest that many participants living in the highest crime neighborhoods report that they deliberately restrict their temporal and spatial movement as a consequence of such crime. This hinders aspects of their recovery. Nevertheless, participants actively confront the nefarious affects of neighborhood crime by engaging in various empowering strategies of resistance. These include confronting disruptive people, fortifying homes, moving around the neighborhood in small groups and carrying objects such as umbrellas and canes that can be used in self-defense. Some reported that fear of crime directly contributed to the development of a rich and gratifying domestic life, centered on hospitality and religion. I conclude that participants partake in valiant and durable "social resistance," and may better be perceived as imaginative and resourceful resistors, rather than passive victims of "social defeat." An influential factor fostering such resistance is the "recovery community' itself, which creates secure and reliable housing within a micro-community in which participants could thrive. PMID:21701942

  14. Testing the efficiency of Markov chain Monte Carlo with People using facial affect categories.

    PubMed

    Martin, Jay B; Griffiths, Thomas L; Sanborn, Adam N

    2012-01-01

    Exploring how people represent natural categories is a key step toward developing a better understanding of how people learn, form memories, and make decisions. Much research on categorization has focused on artificial categories that are created in the laboratory, since studying natural categories defined on high-dimensional stimuli such as images is methodologically challenging. Recent work has produced methods for identifying these representations from observed behavior, such as reverse correlation (RC). We compare RC against an alternative method for inferring the structure of natural categories called Markov chain Monte Carlo with People (MCMCP). Based on an algorithm used in computer science and statistics, MCMCP provides a way to sample from the set of stimuli associated with a natural category. We apply MCMCP and RC to the problem of recovering natural categories that correspond to two kinds of facial affect (happy and sad) from realistic images of faces. Our results show that MCMCP requires fewer trials to obtain a higher quality estimate of people's mental representations of these two categories. PMID:21972923

  15. Ordinary Lives: An Ethnographic Study of Young People Attending Entry to Employment Programmes

    ERIC Educational Resources Information Center

    Russell, Lisa; Simmons, Robin; Thompson, Ron

    2011-01-01

    This paper discusses the findings from a one-year ethnographic study of young people attending Entry to Employment (E2E) programmes in two local authorities in the north of England. The paper locates E2E within the broader context of provision for low-achieving young people and of UK government policy on reducing the proportion of young people who…

  16. Does the informal caregiver notice HIV associated mild cognitive impairment in people living with HIV?

    PubMed

    Murray, Kenneth J; Cummins, Denise; Batterham, Marijka; Trotter, Garry; Healey, Loretta; O'Connor, Catherine C

    2016-01-01

    HIV associated minor neurocognitive disorder (MND) may be difficult to identify as key signs and symptoms (S & S) may be due to other clinical conditions. Using a self-assessment booklet "HIV and associated MND" we recruited 123 people living with HIV (PLHIV) from three sites: two hospital HIV clinics and a sexual health clinic in Sydney, Australia. Patients may down play S & S. Caregivers may notice subtle changes. By including caregivers, we aimed to find whether the caregivers noticed S & S undetected by the PLHIV. This is a sub-study of a prospective observational multi-site study aimed to validate the usefulness of a patient self-assessment tool (HIV-associated MND booklet). Using the booklet, participants and their caregivers subsequently identified S & S of MND. Sixty-four per cent (79) did not nominate a caregiver to be contacted. Participants from 2 sites 44 (36%) nominated caregivers to be contacted. Twenty-five caregivers identified more than four S & S of MND. S & S reported most by caregivers related to participants being more tired at the end of the day (76%). Participants agreed (77%). Participants also reported that they found it more difficult to remember things such as taking medications or attending medical appointments (67%). The most agreed on symptom was the requirement for increased concentration to get the same things done (Kappa P 0.599 <0.001 and McNemar 0.289). For each question at least one caregiver identified a symptom when the PLHIV did not. Caregivers were more likely than participants to report irritability and communication difficulties. It is important to include caregivers when investigating PLHIV for MND, as caregivers may validate the experience of the patient, and may also be uniquely placed to identify S & S not otherwise identified. PMID:26489931

  17. Stigma, activism, and well-being among people living with HIV.

    PubMed

    Earnshaw, Valerie A; Rosenthal, Lisa; Lang, Shawn M

    2016-06-01

    Evidence demonstrates that HIV stigma undermines the psychological and physical health of people living with HIV (PLWH). Yet, PLWH describe engaging in HIV activism to challenge stigma, and research suggests that individuals may benefit from activism. We examine associations between experiences of HIV stigma and HIV activism, and test whether HIV activists benefit from greater well-being than non-activists. Participants include 93 PLWH recruited from drop-in centers, housing programs, and other organizations providing services to PLWH in the Northeastern USA between 2012 and 2013 (mean age = 50 years; 56% Black, 20% White, 18% Other; 61% non-Latino(a), 39% Latino(a); 59% male, 38% female, 3% transgender; 82% heterosexual, 15% sexual minority). Participants completed a cross-sectional written survey. Results of regression analyses suggest that PLWH who experienced greater enacted stigma engaged in greater HIV activism. Anticipated, internalized, and perceived public stigma, however, were unrelated to HIV activism. Moreover, results of a multivariate analysis of variance suggest that HIV activists reported greater social network integration, greater social well-being, greater engagement in active coping with discrimination, and greater meaning in life than non-activists. Yet, HIV activists also reported somewhat greater depressive symptoms than non-activists, suggesting that the association between HIV activism and well-being is complex. By differentiating between HIV stigma mechanisms, the current study provides a more nuanced understanding of which experiences of HIV stigma may be associated with HIV activism. It further suggests that engagement in activism may offer benefits to PLWH, while raising the possibility that activists could experience greater depressive symptoms than non-activists. Given the preliminary nature of this study, future research should continue to examine these complex associations between HIV stigma, activism, and well-being among PLWH

  18. Estimating the number of people living with HIV/AIDS in China: 2003–09

    PubMed Central

    Wang, Ning; Wang, Lu; Wu, Zunyou; Guo, Wei; Sun, Xinhua; Poundstone, Katharine; Wang, Yu

    2010-01-01

    Background Before 2003, little was known about the scale of China’s HIV/AIDS epidemic. In 2003, the Chinese government produced national estimates with support from the Joint United Nations Programme on HIV/AIDS, the World Health Organization and the United States Centers for Disease Control and Prevention. Subsequent national estimation exercises were carried out in 2005, 2007 and 2009. We describe these estimation processes and present the results of China’s HIV/AIDS estimation exercises from 2003 to 2009. Methods The Workbook Method was used to generate national HIV/AIDS estimates. Data from the provincial level were used in 2003, data from the prefecture level were used in 2005 and data from the county level were used in 2007 and 2009. Data at the lowest level of aggregation were used to estimate risk group population size and HIV prevalence. Data from lower levels were combined into national estimates. Results At the end of 2003, 2005, 2007 and 2009, there were an estimated 0.84, 0.65, 0.70 and 0.74 million people living with HIV/AIDS in China, respectively, with an overall HIV prevalence of 0.05–0.06%. The number of new HIV infections decreased from 70 000 in 2005, to 50 000 in 2007, to 48 000 in 2009. Data quality improvements have increased the precision of China’s HIV estimates. Conclusion Repeated estimates have improved understanding of the HIV/AIDS epidemic in China. HIV estimates are a valuable tool for guiding national AIDS policies evaluating HIV prevention and control programmes. PMID:21113033

  19. Chronic disease, risk factors and disability in adults aged 50 and above living with and without HIV: findings from the Wellbeing of Older People Study in Uganda

    PubMed Central

    Mugisha, Joseph O.; Schatz, Enid J.; Randell, Madeleine; Kuteesa, Monica; Kowal, Paul; Negin, Joel; Seeley, Janet

    2016-01-01

    Background Data on the prevalence of chronic conditions, their risk factors, and their associations with disability in older people living with and without HIV are scarce in sub-Saharan Africa. Objectives In older people living with and without HIV in sub-Saharan Africa: 1) to describe the prevalence of chronic conditions and their risk factors and 2) to draw attention to associations between chronic conditions and disability. Methods Cross-sectional individual-level survey data from people aged 50 years and over living with and without HIV were analyzed from three study sites in Uganda. Diagnoses of chronic conditions were made through self-report, and disability was determined using the WHO Disability Assessment Schedule (WHODAS). We used ordered logistic regression and calculated predicted probabilities to show differences in the prevalence of multiple chronic conditions across HIV status, age groups, and locality. We used linear regression to determine associations between chronic conditions and the WHODAS. Results In total, 471 participants were surveyed; about half the respondents were living with HIV. The prevalence of chronic obstructive pulmonary disease and eye problems (except for those aged 60–69 years) was higher in the HIV-positive participants and increased with age. The prevalence of diabetes and angina was higher in HIV-negative participants. The odds of having one or more compared with no chronic conditions were higher in women (OR 1.6, 95% CI 1.1–2.3) and in those aged 70 years and above (OR 2.1, 95% CI 1.2–3.6). Sleep problems (coefficient 14.2, 95% CI 7.3–21.0) and depression (coefficient 9.4, 95% CI 1.2–17.0) were strongly associated with higher disability scores. Conclusion Chronic conditions are common in older adults and affect their functioning. Many of these conditions are not currently addressed by health services in Uganda. There is a need to revise health care policy and practice in Uganda to consider the health needs of

  20. The perspectives of children and young people living with cleft lip and palate: a review of qualitative literature.

    PubMed

    Sharif, Mohammad Owaise; Callery, Peter; Tierney, Stephanie

    2013-05-01

    Objective :  To explore the experiences of children and young people with cleft lip and/or palate (CL/P) in relation to being treated for and living with this condition. Design :  A systematic review of qualitative research. Electronic databases and hand-searching were employed to identify relevant studies. The review centered on studies examining the views or experiences of young patients first-hand. Any study using a qualitative/mixed method design was eligible for inclusion. Results :  From 184 potential references, 38 papers were read in full, from which only two studies of young people met all the review's inclusion criteria. Common reasons for exclusion were not being a qualitative study, not focusing on CL/P, or data coming from parents only. A further two papers provided a retrospective account of childhood with CL/P from interviews with adults. Their suitability for the review's aims was limited, but they were discussed. Conclusions :  This review demonstrates that there is a paucity of evidence about the experiences of young people living with CL/P. No studies of children and only two studies of young people met all inclusion criteria. Identified papers implied that more attention is needed within families and services to help young people manage everyday difficulties such as bullying and self-consciousness due to facial difference. PMID:23030697

  1. Problems of providing services to people affected by HIV/AIDS: service providers and recipients perspectives.

    PubMed

    Moradi, G; Mohraz, M; Gouya, M M; Dejman, M; Alinaghi, S S; Rahmani, K; Malekafzali-Ardakani, H

    2015-01-01

    This qualitative study aimed to identify the health-care problems of people living with HIV (PLHIV) in 2 large cities: Tehran and Kermanshah. Two main groups of stakeholders - service providers (policy-makers, managers, physicians and counsellors) and service recipients (PLHIV and their relatives) - participated in focus group discussions and in-depth interviews. We identified 24 themes covering the major health problems of PLHIV, including: incomplete and inadequate coverage of health-care services; patients' substance abuse; patients' fear of stigma; occupational burnout of certain service providers; patients' dissatisfaction with some of the services provided by counselling centres/clinics; medical staff's failure to observe confidentiality; and patients' lack of access to required specialized services. The problems and needs identified can inform the design and implementation of health programmes in our country and elsewhere in the Eastern Mediterranean Region. PMID:25907189

  2. Health of people working/living in the vicinity of an oil-polluted beach near Karachi, Pakistan.

    PubMed

    Khurshid, R; Sheikh, M A; Iqbal, S

    2008-01-01

    A short-term study was conducted after the oil spillage from the tanker Tasman Spirit to analyse seawater and sand samples taken from Karachi beach for hydrocarbon/organic contents. Blood samples were collected from people who were working or living in the vicinity of the beach. Lymphocyte and eosinophil levels were slightly increased. About 11 people had raised serum glutamic pyruvic transaminase, but this was not significant. Such steps are vital to ensure that there are no long-term hazardous effects of oil on human health. PMID:18557466

  3. 'I am doing fine only because I have not told anyone': the necessity of concealment in the lives of people living with HIV in India.

    PubMed

    George, Mathew Sunil; Lambert, Helen

    2015-01-01

    In HIV prevention and care programmes, disclosure of status by HIV-positive individuals is generally encouraged to contain the infection and provide adequate support to the person concerned. Lack of disclosure is generally framed as a barrier to preventive behaviours and accessing support. The assumption that disclosure is beneficial is also reflected in studies that aim to identify determinants of disclosure and recommend individual-level measures to promote disclosure. However, in contexts where HIV infection is stigmatised and there is fear of rejection and discrimination among those living with HIV, concealment of status becomes a way to try and regain as much as possible the life that was disrupted by the discovery of HIV infection. In this study of HIV-positive women and children in India, concealment was considered essential by individuals and families of those living with HIV to re-establish and maintain their normal lives in an environment where stigma and discrimination were prevalent. This paper describes why women and care givers of children felt the need to conceal HIV status, the various ways in which people tried to do so and the implications for treatment of people living with HIV. We found that while women were generally willing to disclose their status to their husband or partner, they were very keen to conceal their status from all others, including family members. Parents and carers with an HIV-positive child were not willing to disclose this status to the child or to others. Understanding the different rationales for concealment would help policy makers and programme managers to develop more appropriate care management strategies and train care providers to assist clients in accessing care and support without disrupting their lives. PMID:25706959

  4. ‘I am doing fine only because I have not told anyone’: the necessity of concealment in the lives of people living with HIV in India

    PubMed Central

    George, Mathew Sunil; Lambert, Helen

    2015-01-01

    In HIV prevention and care programmes, disclosure of status by HIV-positive individuals is generally encouraged to contain the infection and provide adequate support to the person concerned. Lack of disclosure is generally framed as a barrier to preventive behaviours and accessing support. The assumption that disclosure is beneficial is also reflected in studies that aim to identify determinants of disclosure and recommend individual-level measures to promote disclosure. However, in contexts where HIV infection is stigmatised and there is fear of rejection and discrimination among those living with HIV, concealment of status becomes a way to try and regain as much as possible the life that was disrupted by the discovery of HIV infection. In this study of HIV-positive women and children in India, concealment was considered essential by individuals and families of those living with HIV to re-establish and maintain their normal lives in an environment where stigma and discrimination were prevalent. This paper describes why women and care givers of children felt the need to conceal HIV status, the various ways in which people tried to do so and the implications for treatment of people living with HIV. We found that while women were generally willing to disclose their status to their husband or partner, they were very keen to conceal their status from all others, including family members. Parents and carers with an HIV-positive child were not willing to disclose this status to the child or to others. Understanding the different rationales for concealment would help policy makers and programme managers to develop more appropriate care management strategies and train care providers to assist clients in accessing care and support without disrupting their lives. PMID:25706959

  5. Thirty-day prevalence of delirium among very old people: a population-based study of very old people living at home and in institutions.

    PubMed

    Mathillas, Johan; Olofsson, Birgitta; Lövheim, Hugo; Gustafson, Yngve

    2013-01-01

    Delirium has mainly been studied in various patient samples and in people living in institutions. The present study investigates the 30-day prevalence of delirium in a population-based sample of very old people in northern Sweden and Finland. Seven hundred and eight persons aged 85 years and older from the GErontological Regional DAtabase (GERDA) were assessed. Information was also collected from relatives, carers and medical records. Assessments performed were among others the Organic Brain Syndrome (OBS) scale, the Mini Mental State Examination (MMSE), and the Geriatric Depression Scale-15 (GDS-15). Delirium, depression and dementia diagnoses were based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. The prevalence of delirium was 17% among 85 year-olds, 21% among 90 year-olds and 39% among participants aged 95 years and older (p<0.001). Delirium prevalence among individuals without dementia was lower than among those with dementia (5% vs. 52%, p<0.001). Factors independently associated with delirium superimposed on dementia in a multivariate logistic regression model were depression (Odds Ratio (OR)=2.0, 95% Confidence Interval (CI)=1.2-3.3), heart failure (OR=2.1, 95% CI=1.2-3.7), institutional living (OR 4.4, 95% CI=2.4-8.2) and prescribed antipsychotics (OR=3.0, 95% CI=1.5-6.0). Delirium is highly prevalent among very old people with dementia. Depression, heart failure, institutional living and prescribed antipsychotic medication seem to be associated with delirium. PMID:23711428

  6. Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/AIDS: A Systematic Review

    PubMed Central

    Wilson, Michael G.; Shubert, Virginia; Gogolishvili, David; Globerman, Jason; Rueda, Sergio; Bozack, Anne K.; Caban, Maria; Rourke, Sean B.

    2016-01-01

    Background. Accumulating evidence suggests responses to HIV that combine individual-level interventions with those that address structural or contextual factors that influence risks and health outcomes of infection. Housing is such a factor. Housing occupies a strategic position as an intermediate structural factor, linking “upstream” economic, social, and cultural determinants to the more immediate physical and social environments in which everyday life is lived. The importance of housing status for HIV prevention and care has been recognized, but much of this attention has focused on homeless individuals as a special risk group. Analyses have less often addressed community housing availability and conditions as factors influencing population health or unstable, inadequate, or unaffordable housing as a situation or temporary state. A focus on individual-level characteristics associated with literal homelessness glosses over social, economic, and policy drivers operating largely outside any specific individual’s control that affect housing and residential environments and the health resources or risk exposures such contexts provide. Objectives. We examined the available empirical evidence on the association between housing status (broadly defined), medical care, and health outcomes among people with HIV and analyzed results to inform future research, program development, and policy implementation. Search methods. We searched 8 electronic health and social science databases from January 1, 1996, through March 31, 2014, using search terms related to housing, dwelling, and living arrangements and HIV and AIDS. We contacted experts for additional literature. Selection criteria. We selected articles if they were quantitative analyses published in English, French, or Spanish that included at least 1 measure of housing status as an independent variable and at least 1 health status, health care, treatment adherence, or risk behavior outcome among people with HIV in

  7. Cost-effectiveness of community vegetable gardens for people living with HIV in Zimbabwe

    PubMed Central

    2014-01-01

    Background There is little evidence to date of the potential impact of vegetable gardens on people living with HIV (PLHIV), who often suffer from social and economic losses due to the disease. From 2008 through 2011, Action Contre la Faim France (ACF) implemented a project in Chipinge District, eastern Zimbabwe, providing low-input vegetable gardens (LIGs) to households of PLHIV. Program partners included Médecins du Monde, which provided medical support, and Zimbabwe's Agricultural Extension Service, which supported vegetable cultivation. A survey conducted at the end of the program found LIG participants to have higher Food Consumption Scores (FCS) and Household Dietary Diversity Scores (HDDS) relative to comparator households of PLHIV receiving other support programs. This study assessed the incremental cost-effectiveness of LIGs to improve FCS and HDDS of PLHIV compared to other support programs. Methods This analysis used an activity-based cost model, and combined ACF accounting data with estimates of partner and beneficiary costs derived using an ingredients approach to build an estimate of total program resource use. A societal perspective was adopted to encompass costs to beneficiary households, including their opportunity costs and an estimate of their income earned from vegetable sales. Qualitative methods were used to assess program benefits to beneficiary households. Effectiveness data was taken from a previously-conducted survey. Results Providing LIGs to PLHIV cost an additional 8,299 EUR per household with adequate FCS and 12,456 EUR per household with HDDS in the upper tertile, relative to comparator households of PLHIV receiving other support programs. Beneficiaries cited multiple tangible and intangible benefits from LIGs, and over 80% of gardens observed were still functioning more than one year after the program had finished. Conclusions Cost outcomes were 20–30 times Zimbabwe's per capita GDP, and unlikely to be affordable within government

  8. "We have to try and have this child before it is too late": missed opportunities in client-provider communication on reproductive intentions of people living with HIV.

    PubMed

    Mindry, D L; Crankshaw, T L; Maharaj, P; Munthree, C; Letsoalo, T; Milford, C; Greener, R M; Rambally, L; Carpenter, S; Smit, J A

    2015-01-01

    Men and women living with HIV with access to ARVs are living longer, healthier lives that can and often do include bearing children. Children occupy a key space in men and women's personal and social lives and often play a fundamental role in maintaining these relationships, irrespective of illness concerns. Couples living with HIV need to balance prevention needs and ill-health while trying to maintain healthy relationships. Health-care providers serving the reproductive needs of HIV-affected couples need to consider the social and relational factors shaping reproductive decisions associated with periconception risk behaviors. This paper based on qualitative research at three hospital sites in eThekwini District, South Africa, investigates the childbearing intentions and needs of people living with HIV (PLHIV), and the attitudes and experiences of health-care providers serving the reproductive needs of PLHIV, and client and provider views and knowledge of safer conception. This research revealed that personal, social, and relationship dynamics shape the reproductive decisions of PLHIV, and "unplanned" pregnancies are not always unintended. Additionally, conception desires are not driven by the number of living children; rather clients are motivated by whether or not they have had any children with their current partner/spouse. Providers should consider the relationship status of clients in discussions about childbearing desires and intentions. Although many providers recognize the complex social realities shaping their clients' reproductive decisions, they have outdated information on serving their reproductive needs. Appropriate training to enable providers to better understand the relationship and social realities surrounding their clients' childbearing intentions is required and should be used as a platform for couples to work together with providers toward safer conception. The adoption of a more participatory approach should be employed to equalize client

  9. Knowledge about epilepsy and attitudes towards affected people among teachers in training in the Czech Republic.

    PubMed

    Brabcová, Dana; Kohout, Jiří; Kršek, Pavel

    2016-01-01

    The aim of this study was to compare knowledge about, confidence with, and attitudes towards epilepsy and affected people between groups of freshmen and senior teachers in training (preservice teachers) at the Faculty of Education in Pilsen, Czech Republic. Two hundred thirty-six freshmen and 138 seniors completed the 21-item Scale of Attitudes Towards People with Epilepsy (ATPE), an 18-item multiple-choice test measuring their knowledge about epilepsy, and a 5-item questionnaire focused on confidence with epilepsy in a school environment. We found that despite a higher level of knowledge about epilepsy among seniors (mean score of 9.6 points compared with 8.48 points for freshmen, p<0.001), attitudes towards epilepsy, and also confidence in how to manage children affected with this disease did not differ significantly. The presented findings suggest that epilepsy-related training of preservice teachers should be more effective especially with respect to their ability to resolve problems that may happen to children with epilepsy in a class. PMID:26687292

  10. Blocks, Ovals, or People? Icon Type Affects Risk Perceptions and Recall of Pictographs

    PubMed Central

    Zikmund-Fisher, Brian J.; Witteman, Holly O.; Dickson, Mark; Fuhrel-Forbis, Andrea; Kahn, Valerie C.; Exe, Nicole L.; Valerio, Melissa; Holtzman, Lisa G.; Scherer, Laura D.; Fagerlin, Angela

    2013-01-01

    Background Numerous research studies have demonstrated that icon arrays (also called “pictographs”) are an effective method of communicating risk statistics and appear particularly useful to less numerate and less graphically literate people. Yet research is very limited regarding whether icon type affects how people interpret and remember these graphs. Methods 1504 people age 35 to 75 from a demographically-diverse online panel completed a cardiovascular risk calculator based on Framingham data using their actual age, weight, and other health data. Participants received their risk estimate in an icon array graphic that used one of 6 types of icons: rectangular blocks, filled ovals, smile/frown faces, an outline of a person’s head and shoulders, male/female “restroom” person icons (gender matched), or actual head-and-shoulder photographs of people of varied races (gender matched). In each icon array, blue icons represented cardiovascular events and grey icons represented those who would not experience an event. We measured perceived risk magnitude, approximate recall, and opinions about the icon arrays, as well as subjective numeracy and an abbreviated measure of graphical literacy. Results Risk recall was significantly higher with more anthropomorphic icons (restroom icons, head outlines, and photos) than with other icon types, and participants rated restroom icons as most preferred. However, while restroom icons resulted in the highest correlations between perceived and actual risk among more numerate and more graphically literate participants, they performed no better than other icon types among less numerate/graphically literate participants. Conclusions Icon type influences both risk perceptions and risk recall, with restroom icons in particular resulting in improved outcomes. However, optimal icon types may depend on numeracy and/or graphical literacy skills. PMID:24246564

  11. Living in the NOW: Young People from Refugee Backgrounds Pursuing Respect, Risk and Fun

    ERIC Educational Resources Information Center

    Ramirez, Marcela; Matthews, Julie

    2008-01-01

    Narrating Our World (NOW) was an arts-based project that attempted to understand the educational experience of refugee young people. This article reflects on understandings generated during the course of the project. Rather than seeking a direct and explicit means of discussing young people's experience, the project made a deliberate effort to…

  12. Self-Harm among People with Intellectual Disabilities Living in Secure Service Provision: A Qualitative Exploration

    ERIC Educational Resources Information Center

    Brown, Jessica; Beail, Nigel

    2009-01-01

    Background: Research into self-harm among people with intellectual disabilities has focused predominantly on high frequency internally maladaptive behaviour among people whose disability is severe or profound. Research into different forms of self-harm, such as cutting or burning the skin, found in those with mild intellectual disabilities;…

  13. Prevention of Dehydration in Independently Living Elderly People at Risk: A Study Protocol of a Randomized Controlled Trial

    PubMed Central

    Konings, Francis J. C. M.; Mathijssen, Jolanda J. P.; Schellingerhout, Jasper M.; Kroesbergen, Ike H. T.; Goede de, Joyce; Goor de, Ien A. M.

    2015-01-01

    Background: Dehydration of elderly people living independently is a very important public health issue. This study compares two interventions to prevent dehydration in elderly people at risk: an educational intervention and an educational intervention in combination with a drink reminder device. Methods: This is an experimental two-armed parallel study. A Public Health Service develops the interventions and will be partnering with a general practice and a university to evaluate the effects. Two groups – all people aged 80 years and older, and people of 65 years and older who have cardiovascular disease – receive a letter from the general practice in which they are asked whether they want to participate in the study and if so to return the form. People who want to participate and whose daily fluid intake is insufficient are randomized to receive either the educational intervention or the educational intervention in combination with a drink reminder device. The participants are asked to fill in a questionnaire before the intervention, 6 weeks after the start of the intervention and 6 months after the start (or after the end) of the intervention. Changes between the two groups in fluid intake, knowledge, awareness of the risks of dehydration, and quality-of-life will be tested by Linear Mixed Model analyses. Conclusions: This study will improve the knowledge of the effectiveness of interventions designed to prevent dehydration in elderly people. PMID:26644904

  14. The impact of representative payee services on medication adherence among unstably housed people living with HIV/AIDS.

    PubMed

    Hawk, Mary; McLaughlin, Jamie; Farmartino, Christina; King, Miranda; Davis, Dana

    2016-01-01

    Rates of viral suppression among people living with HIV/AIDS remain low, especially within marginalized populations such as people who are unstably housed. Representative payee is a service in which the US Social Security Administration appoints an individual or an organization to provide financial management for vulnerable individuals who are unable to manage their finances including housing payments. Little or no published research examines the association between financial management services such as representative payee and HIV clinical adherence. We conducted a pilot study with 18 unstably housed participants living with HIV/AIDS to examine the impact of representative payee services on viral suppression. Of the 11 participants who were not virally suppressed at baseline, 9 (81.8%) of them had achieved viral suppression at six-month follow-up (p = .004). Our findings suggest that providing unstably housed people living with HIV/AIDS with representative payee services may help them to improve their housing stability and clinical adherence. Additional research is needed to fully explore correlations between representative payee services and viral suppression. PMID:26444847

  15. Anxiety and Depressive Symptoms Among People Living with HIV and Childhood Sexual Abuse: The Role of Shame and Posttraumatic Growth.

    PubMed

    Willie, Tiara C; Overstreet, Nicole M; Peasant, Courtney; Kershaw, Trace; Sikkema, Kathleen J; Hansen, Nathan B

    2016-08-01

    There is a critical need to examine protective and risk factors of anxiety and depressive symptoms among people living with HIV in order to improve quality of life. Structural equation modeling was used to examine the associations between HIV-related shame, sexual abuse-related shame, posttraumatic growth, and anxiety and depressive symptoms among a cohort of 225 heterosexual women and men who have sex with men (MSM) living with HIV who have experienced childhood sexual abuse (CSA). Higher sexual abuse-related shame was related to more anxiety and depressive symptoms for heterosexual women. Higher posttraumatic growth predicted less anxiety symptoms for only heterosexual women. Higher posttraumatic growth predicted less depressive symptoms for heterosexual women and MSM, but the magnitude of this effect was stronger for heterosexual women than MSM. Psychosocial interventions may need to be tailored to meet the specific needs of heterosexual women and MSM living with HIV and CSA. PMID:26837633

  16. AIDS awareness and attitudes among Yemeni young people living in high-risk areas.

    PubMed

    Al-Serouri, A W; Anaam, M; Al-Iryani, B; Al Deram, A; Ramaroson, S

    2010-03-01

    Despite te low rate of infection in Yemen, there are concerns about the possible spread of HIV among high-risk and vulnerable groups. A community-based study was made in 2005 of AIDS awareness and attitudes among 601 young people aged 15-24 years from low-income, high-risk neighbourhoods in Aden. Young people lacked proper information about HIV/AIDS. Although 89% had heard of AIDS, fewer (46%) could name 3 ways of transmission or 3 ways to avoid infection (28%). Misconceptions about modes of transmissions were prevalent and many young people believed that they faced little or no risk. There were intolerant attitudes towards AIDS patients. About half the young people knew that prostitution and homosexuality existed in their area. PMID:20795436

  17. Living within stories: Exploring the experiences of people with transient ischemic attack.

    PubMed

    Crowfoot, Gary Mitchell; van der Riet, Pamela Jane; Maguire, Jane Margaret

    2016-03-01

    A transient ischemic attack (TIA) significantly increases a person's risk of ischemic stroke. However, little is known about the experiences of these people or what influences their decision to access care. This article explores the stories of three people who experienced a TIA. All participants were interviewed after receiving a diagnosis of TIA by a specialist neurologist. By utilizing a framework of narrative inquiry, several storylines were revealed across temporal, social, and geographical landscapes. The main storylines include: bodily disruption, time stasis, altered temporal perceptions, the roles of others, and help-seeking behavior. The primary author also reflects upon his own origin and explores how this inquiry has influenced his perceptions, career, and nursing practice. This inquiry may assist healthcare workers to gain insight into the experiences of people with TIA and suggests how involvement of significant others is beneficial when educating people at risk of TIA. PMID:26275055

  18. [Implementation of a continuum of care for people living with HIV/AIDS in Hanoi (Vietnam)].

    PubMed

    de Loenzien, Myriam

    2009-01-01

    Caring for people living with HIV/AIDS (PLWHA) encompasses various tasks, from prevention to palliative care. It involves a set of consistent and coordinated actions. This article presents the first free-of-charge management programme including antiretroviral treatment in Vietnam (as opposed to research and evaluation programmes). It was launched in 2004 in Hanoi. Our study was conducted in 2003-2004 as part of a collaborative research programme led by IRD (Research Institute for Development) and the National Economic University in Hanoi and was funded by ESTHER (Together for a Therapeutic Solidarity in Hospital Network) group. Data collection included 68 qualitative interviews with patients, members of their families and members of the hospital staff, observations of outpatient consultations, and analysis of inpatient files. The results show that patients, their families and hospital staff members all perceive a comprehensive care and treatment programme as very important and consider that it should include social and psychological care as well as an integrated set of actions involving various types of participants. Outpatient and inpatient care are closely linked: they take place in the same hospital department, they involve patients with similar social and demographic characteristics marked by multiple risk behaviours and recourse to several kinds of healthcare services. The observation of outpatient consultations showed the limitations of strictly biomedical care to which social and psychological care were added only lately. One of the principal difficulties is patients' difficulties in keeping their outpatient appointments. Overall, patients consider themselves lucky to able to receive care and treatment with antiretroviral drugs. They nevertheless complain about the lack of social and psychological support, which they expect should help them to tolerate and adapt to their biomedical treatment and to include counselling and information about this treatment and

  19. Working Together to Improve the Lives of People Affected by Epilepsy in Zambia

    ERIC Educational Resources Information Center

    Birbeck, Gretchen L.

    2012-01-01

    Epilepsy is a neurologic disorder that results in recurrent, unprovoked seizures. The biomedical burden of epilepsy can be substantial, but for many the social consequences may be just as extreme, with epilepsy victims suffering from social abandonment as well as economic and physical vulnerabilities. Since its founding in 2000, the Chikankata…

  20. Do Physical Therapy Interventions Affect Urinary Incontinence and Quality of Life in People with Multiple Sclerosis?

    PubMed Central

    Rivera, Monica; Melnick, Marsha; Allen, Diane D.

    2015-01-01

    Background: Multiple sclerosis (MS) presents with many debilitating symptoms, including urinary incontinence (UI), that physical therapy (PT) may address; UI is widely prevalent, but PT management of symptoms lacks consensus. A meta-analysis of long-term nonsurgical and nonpharmaceutical treatment options may supply this deficiency. We analyzed the current evidence for effectiveness of PT to decrease UI and improve quality of life (QOL) in people with MS. Methods: An electronic search conducted through November 26, 2013, included the following search terms: incontinence, bladder dysfunction, urinary incontinence, multiple sclerosis, MS, physical therapy, physiotherapy, therapy, and rehabilitation. Criteria for inclusion were as follows: MS diagnosis, intervention involved PT for UI or bladder dysfunction, outcomes assessed QOL or UI, and at least a 4 of 10 on the Physiotherapy Evidence Database scale or a 2b level of evidence. Outcomes were combined across studies, and effect sizes are depicted in forest plots. Results: Six studies met the inclusion criteria. Between-group analysis revealed statistically significant differences in incontinence episodes and QOL, but did not reach significance for functional control mechanisms (eg, electromyography data on strength of contraction, relaxation, and endurance). Incontinence leakage episodes and QOL participation improved within groups. Conclusions: Meta-analysis indicates support for PT for minimizing incontinence compared with pretreatment and affecting incontinence and QOL more than control in people with MS. Protocols were heterogeneous regarding duration and type of PT intervention and were applied in different types of MS. Further research may reveal the most effective combination and variety of PT interventions for people with MS. PMID:26300703

  1. The prevalence, impact and management of musculoskeletal disorders in older people living in care homes: a systematic review.

    PubMed

    Smith, Toby O; Purdy, Rachel; Latham, Sarah K; Kingsbury, Sarah R; Mulley, Graham; Conaghan, Philip G

    2016-01-01

    The aim was to systematically review the literature describing the prevalence, impact and current management of musculoskeletal pain in older people living in care homes. Published literature (AMED, CINAHL, EMBASE, psycINFO, MEDLINE, Cochrane Library) and unpublished literature (OpenGrey, the WHO International Clinical Trials Registry Platform, Current Controlled Trials, UK National Research Register Archive) were searched on 1 March 2015. All studies assessing the prevalence, impact and management of musculoskeletal disorders in older people living in care homes were included. Literature was appraised using the CASP cohort and qualitative critical appraisal tools. Data were analysed using descriptive statistical approaches, meta-analysis and meta-ethnography techniques. Twenty-four papers reporting the results of 263,775 care home residents in 12 countries were identified. The evidence base was moderate in quality. Prevalence of musculoskeletal pain for people in care homes was 30.2 % (95 % confidence intervals 29.9-30.5 %; n = 105,463). Care home residents reported that musculoskeletal pain had a significant impact on their perceived independence and overall ability to participate in everyday activities of daily living. Three papers which presented data on interventions demonstrated that whilst multi-component assessment and management packages did not significantly change clinical outcomes, these empowered care home staff to feel more confident in managing these patients. Musculoskeletal pain is a common problem in care homes worldwide, and residents report significant impact on their lives. However, there is uncertainty regarding how to assess and manage such pain. PROSPERO Registration Number: CRD42014009824. PMID:26245357

  2. Understanding sociocultural and psychological factors affecting transgender people of color in San Francisco.

    PubMed

    Bith-Melander, Pollie; Sheoran, Bhupendra; Sheth, Lina; Bermudez, Carlos; Drone, Jennifer; Wood, Woo; Schroeder, Kurt

    2010-01-01

    This ethnographic qualitative study explored the needs of transgender people of color, including biological transitioning issues, gender and group membership identity formation, HIV, and other health issues. The sample consisted of transgender youth and adults of color in San Francisco (N = 43). Data were collected from in-depth interviews with 20 youth and adults and focus groups with 23 individuals. The study focused on perspectives of racial and ethnic minorities from Asian/Pacific Islander, African American, and Latino backgrounds. The medical decision-making perspective was used to gain a deeper understanding of sociocultural and psychological factors affecting transgender individuals of color in San Francisco. The major themes that emerged were gender identity, group membership, transitioning and related issues, sex work, alcohol and drug use, mental health and health care, sense of community, HIV, resources, and other support. Key clinical considerations that health providers can use to improve care of transgender individuals of color are included. PMID:20416495

  3. 'What really annoys me is people take it like it's a disability', epilepsy, disability and identity among people of Pakistani origin living in the UK.

    PubMed

    Rhodes, Penny J; Small, Neil A; Ismail, Hanif; Wright, John P

    2008-01-01

    This paper reports on a study of Pakistani people with epilepsy. It explores their attitudes towards their condition, others' attitudes, its impact on their lives, and the extent to which they considered themselves as disabled. Epilepsy was variously interpreted within biomedical, folk and religious paradigms. In line with popular understandings, participants associated disability with stable, permanent and visible physical impairments and did not consider themselves as disabled. However, they also recognised a social dimension to their experience. Much of the distress and disadvantage they experienced was socially determined, both through direct prejudice and discrimination, and indirectly through a fear of others' negative reactions. However, the invisible and unpredictable nature of epilepsy meant that they could conceal their condition and thereby mitigate its social effects. 'Disability' was not experienced as a static and permanent state but as a potential identity that was both contingent and contested. The literature portrays people moving from biomedical to social interpretations of disability. However, the tensions experienced by people in the study were more between competing religious interpretations of their condition and, to some extent, between religious and medical approaches. Conceptions of disability, which are presented in the literature as antagonistic and mutually exclusive, were experienced as different dimensions reflecting the complexity of experience. The paper concludes by suggesting that for many people, for whom disability is an ambiguous, contingent and contested identity, public self-identification as disabled is an unrealistic goal. Rather than conceiving of disability as primarily physical or primarily social, it would be better construed as a complex interweaving of multiple factors--physical, environmental, socio-cultural and psychological factors. PMID:18066735

  4. [Deficiency and BPC: what changes in the lives of people assisted?].

    PubMed

    dos Santos, Wederson Rufino

    2011-01-01

    The aim of this article is to analyze the impact of well-being provoked in the life of the disabled people after the Cash Benefit to Disabled People (BPC). The BPC is a social assistance benefit consisting in an unconditional and monthly transference of the equivalent of a minimum wage, to poor people with deficiency and elders with more than 65 years. The methodology used was a case study with qualitative and quantitative techniques of data collection and analysis. BPC performed interviews guided by a semi-structuralized questionnaire with 30 people with deficiency. The results showed that: (1) BPC is an important mechanism of security of income in the consumption of basic goods of feeding, health treatments and expenses with housing of deficient and its families; (2) disabled people had related the concession of the benefit to the increase of social and financial independence in relation to their families, contributing to expand the idea of autonomy and citizenship; (3) it is an instrument capable of protecting the benefited ones and their families of the situation of social vulnerability result of the poverty, although the mothers of the deficient children leave the work market to take care of their children and do not receive any kind of social protection from the State. PMID:21503425

  5. Knowledge of HIV/AIDS and attitudes towards people living with HIV among the general staff of a public university in Malaysia.

    PubMed

    Tee, Yvonne; Huang, Mary

    2009-12-01

    Stigma and discrimination towards people living with HIV have been widely documented, and have extended their impact into the workplace. Stigmatising attitudes towards people living with HIV (PLHIV) in the workplace significantly hinder HIV prevention efforts and indirectly affect national development. This cross-sectional study was designed to determine the level of knowledge about HIV and AIDS and assess attitudes towards PLHIV among the general staff of Universiti Putra Malaysia (UPM), as well as to identify factors that are associated with it. Self-administered questionnaires were posted to a total of 344 general staff from six randomly selected faculties, and they were a given a week to return the questionnaires. The response rate was 38%. Data were analysed using Pearson's correlation, independent t-test and multiple linear regression. The respondents showed a considerably high level of knowledge about HIV/AIDS (mean knowledge score of 15.57+/-1.93 out of 18 points) although there were some misconceptions (N=129). Likert scale responses to 20 attitude statements revealed that respondents generally had moderately positive attitudes toward PLHIV (average score of 69.65+/-10.08 out of 100 points). Attitudes were inconsistent when it involved direct contact and interaction with PLHIV. Factors significantly associated with level of knowledge and attitudes included age, education and income. There was no difference in mean score for knowledge and attitudes by gender. Further efforts are necessary to improve attitudes of the general staff towards PLHIV, particularly in areas of direct contact with PLHIV. PMID:20485857

  6. Turning points and protective processes in the lives of people with chronic disabilities.

    PubMed

    King, Gillian; Cathers, Tamzin; Brown, Elizabeth; Specht, Jacqueline A; Willoughby, Colleen; Polgar, Janice Miller; MacKinnon, Elizabeth; Smith, Linda K; Havens, Lisa

    2003-02-01

    In this qualitative study, the authors examined the nature of resilience in people with chronic disabilities. Fifteen people with disabilities identified the factors that helped or hindered them at major turning points, and the triggers and resolutions to these turning points. Turning points were emotionally compelling experiences and realizations that involved meaning acquired through the routes of belonging, doing, or understanding the self or the world. The major protective factors were social support, traits such as perseverance and determination, and spiritual beliefs. Three new protective processes were identified: replacing a loss with a gain (transcending), recognizing new things about oneself (self-understanding), and making decisions about relinquishing something in life (accommodating). These protective factors, processes, and ways in which people with disabilities draw sense and meaning in life have important implications for service delivery. PMID:12643028

  7. The Impact of Living in a Care Home on the Health and Wellbeing of Spinal Cord Injured People

    PubMed Central

    Smith, Brett; Caddick, Nick

    2015-01-01

    In the UK, 20% of people with spinal cord injury (SCI) are discharged from rehabilitation into an elderly care home. Despite this, and knowledge that the home is central to health and wellbeing, little research has examined the impact of being in care homes on the health and wellbeing of people with SCI. The purpose of this study was to address this gap. Twenty adults who lived in care homes or had done so recently for over two years were interviewed in-depth. Qualitative data were analyzed using inductive thematic analysis. Analyses revealed that living in a care home environment severely damages quality of life, physical health and psychological wellbeing in the short and long-term. Reasons why quality of life, health, and wellbeing were damaged are identified. These included a lack of freedom, control, and flexibility, inability to participate in community life, inability to sustain relationships, safety problems, restricted participation in work and leisure time physical activity, lack of meaning, self-expression, and a future, loneliness, difficulties with the re-housing process, depression, and suicidal thoughts and actions. It is concluded that for people with SCI, the care home environment violates social dignity, is oppressive, and denies human rights. Implications for housing and health care policies are also offered. PMID:25884273

  8. The impact of living in a care home on the health and wellbeing of spinal cord injured people.

    PubMed

    Smith, Brett; Caddick, Nick

    2015-04-01

    In the UK, 20% of people with spinal cord injury (SCI) are discharged from rehabilitation into an elderly care home. Despite this, and knowledge that the home is central to health and wellbeing, little research has examined the impact of being in care homes on the health and wellbeing of people with SCI. The purpose of this study was to address this gap. Twenty adults who lived in care homes or had done so recently for over two years were interviewed in-depth. Qualitative data were analyzed using inductive thematic analysis. Analyses revealed that living in a care home environment severely damages quality of life, physical health and psychological wellbeing in the short and long-term. Reasons why quality of life, health, and wellbeing were damaged are identified. These included a lack of freedom, control, and flexibility, inability to participate in community life, inability to sustain relationships, safety problems, restricted participation in work and leisure time physical activity, lack of meaning, self-expression, and a future, loneliness, difficulties with the re-housing process, depression, and suicidal thoughts and actions. It is concluded that for people with SCI, the care home environment violates social dignity, is oppressive, and denies human rights. Implications for housing and health care policies are also offered. PMID:25884273

  9. Laughing it off? Humour, affect and emotion work in communities living with nuclear risk.

    PubMed

    Parkhill, K A; Henwood, K L; Pidgeon, N F; Simmons, P

    2011-06-01

    Over the past two decades, an increasing number of risk researchers have recognized that risks are not simply objective hazards but that the meanings of risk are discursively negotiated, dynamic and embedded within the wider social relations that constitute everyday life. A growing interest in the complexity and nuances of risk subjectivities has alerted sociocultural researchers not only to what is said in a risk situation, but also to how it is said and to what is unsaid and even, in a particular context, unsayable; to the intangible qualities of discourse that communicate additional meanings. Humour is both an intangible and marks such intangible meanings, yet it has largely been ignored and insufficiently theorized by risk researchers. In this paper, we draw upon insights from the humour literature - suspending the belief that humour is inherently good - to analyse and theorize humour as a way of examining the meanings and functions of risk. We show how humour can both mask and carefully reveal affectively charged states about living with nuclear risk. As such, it helps risk subjects to live with risk by suppressing vulnerabilities, enabling the negotiation of what constitutes a threat, and engendering a sense of empowerment. We conclude that humorous talk can be serious talk which can enrich our understandings of the lived experience of risk and of risk subjectivities. PMID:21631461

  10. Characteristics of the Activity-Affect Association in Inactive People: An Ambulatory Assessment Study in Daily Life

    PubMed Central

    von Haaren, Birte; Loeffler, Simone Nadine; Haertel, Sascha; Anastasopoulou, Panagiota; Stumpp, Juergen; Hey, Stefan; Boes, Klaus

    2013-01-01

    Acute and regular exercise as well as physical activity (PA) is related to well-being and positive affect. Recent studies have shown that even daily, unstructured physical activities increase positive affect. However, the attempt to achieve adherence to PA or exercise in inactive people through public health interventions has often been unsuccessful. Most studies analyzing the activity-affect association in daily life, did not report participants’ habitual activity behavior. Thus, samples included active and inactive people, but they did not necessarily exhibit the same affective reactions to PA in daily life. Therefore the present study investigated whether the association between PA and subsequent affective state in daily life can also be observed in inactive individuals. We conducted a pilot study with 29 inactive university students (mean age 21.3 ± 1.7 years) using the method of ambulatory assessment. Affect was assessed via electronic diary and PA was measured with accelerometers. Participants had to rate affect every 2 h on a six item bipolar scale reflecting the three basic mood dimensions energetic arousal, valence, and calmness. We calculated activity intensity level [mean Metabolic Equivalent (MET) value] and the amount of time spent in light activity over the last 15 min before every diary prompt and conducted within-subject correlations. We did not find significant associations between activity intensity and the three mood dimensions. Due to the high variability in within-subject correlations we conclude that not all inactive people show the same affective reactions to PA in daily life. Analyzing the PA-affect association of inactive people was difficult due to little variance and distribution of the assessed variables. Interactive assessment and randomized controlled trials might help solving these problems. Future studies should examine characteristics of affective responses of inactive people to PA in daily life. General assumptions

  11. Assistance with Integrity: The Search for Accountability and the Lives of People with Developmental Disabilities.

    ERIC Educational Resources Information Center

    O'Brien, John; O'Brien, Connie Lyle

    This report discusses basic issues in the provision of residential services for people with developmental disabilities. Main points of the discussion include: (1) the service system for this population is in a crisis of accountability as meeting safety and quality requirements threatens to become counterproductive; (2) the current system is well…

  12. Appreciating Diversity through Stories about the Lives of Deaf People of Color

    ERIC Educational Resources Information Center

    Anderson, Glenn B.; Miller, Katrina R.

    2005-01-01

    One way of enhancing appreciation of cultural diversity within the American Deaf community is by collecting and analyzing stories about Deaf people of color. The authors examined biographical profiles in national print and visual media published since 1988. The materials focused on life stories of individuals identified as Deaf persons of color…

  13. Poetics, Power, Possibilities, and Playfulness: Zombies, Performance, and Making Meaning in Young People's Lives

    ERIC Educational Resources Information Center

    Wright, Peter

    2015-01-01

    This article considers drama/theater education as a form of constructivism where popular culture is both accessed and employed to engage young people and animate education. Using the familiar cultural trope of zombies, and in reference to three separate performance projects, attention is drawn to why projects such as these matter and why they…

  14. Self-Management Abilities of Diabetes in People with an Intellectual Disability Living in New Zealand

    ERIC Educational Resources Information Center

    Hale, Leigh A.; Trip, Henrietta T.; Whitehead, Lisa; Conder, Jenny

    2011-01-01

    Self-management of diabetes is encouraged; however, it is not an easy task and requires a good understanding of the disease. To determine how to improve the self-management abilities of diabetes in people with an intellectual disability (ID), this study explored the knowledge and understanding of diabetes held by a select group of adults with…

  15. The Multilingual Mind: Issues Discussed by, for, and about People Living with Many Languages.

    ERIC Educational Resources Information Center

    Tokuhama-Espinosa, Tracey, Ed.

    This collection of 21 essays focuses on people who experience the world with multiple languages: (1) "Myths about Multilingualism" (Tracey Tokuhama-Espinosa); (2) "Teaching Languages using the Multiple Intelligences and the Senses" (Tracey Tokuhama-Espinosa); (3) "The Role of the Sense of Smell in Language Learning" (Sara Ackerman Aoyana); (4)…

  16. Negotiating Identities: The Lives of Pakistani and Bangladeshi Young Disabled People

    ERIC Educational Resources Information Center

    Islam, Zoebia

    2008-01-01

    Research has generally amalgamated minority ethnic (all called "Asian" or "black") disabled young people's experiences and failed to acknowledge the multiple aspects of Asian and black disabled identities, for example how the combined attributes of race, ethnicity, religion, gender, culture, class and disability shape their perspectives and…

  17. Social Aspects of Eating Events among People with Intellectual Disability in Community Living

    ERIC Educational Resources Information Center

    Adolfsson, Paivi; Sydner, Ylva Mattsson; Fjellstrom, Christina

    2010-01-01

    Background: In Sweden, a process involving the deinstitutionalisation of services and the establishment of community-based settings for people with intellectual disability has meant changes in meal arrangements. In the present study, we focus on the social arrangements of meals in community-based settings. Method: Participant observations were…

  18. Reported School Experiences of Young People Living with Sickle Cell Disorder in England

    ERIC Educational Resources Information Center

    Dyson, Simon Martin; Abuateya, Hala; Atkin, Karl; Culley, Lorraine; Dyson, Sue Elizabeth; Rowley, Dave

    2010-01-01

    A survey of 569 young people with sickle cell disorder (SCD) in England has found such pupils miss considerable periods of time from school, typically in short periods of two or three days. One in eight has school absences equating to government-defined "persistent absence". Students with SCD report that they are not helped to catch up after these…

  19. Citizenship in Young People's Daily Lives: Differences in Citizenship Competences of Adolescents in the Netherlands

    ERIC Educational Resources Information Center

    Geijsel, Femke; Ledoux, Guuske; Reumerman, Rene; ten Dam, Geert

    2012-01-01

    The results of a nationwide study of the citizenship competences of adolescents in the Netherlands are presented from the perspective of democratic citizenship in this article. Citizenship competences are defined as the knowledge, skills, attitudes and reflection needed by young people in a democratic and multicultural society to adequately fulfil…

  20. The Impact of Education in Shaping Lives: Reflections of Young People with Disabilities in Ghana

    ERIC Educational Resources Information Center

    Singal, Nidhi; Mahama Salifu, Edward; Iddrisu, Khadijatu; Casely-Hayford, Leslie; Lundebye, Helen

    2015-01-01

    There is increasing recognition of the importance of focusing on people with disabilities (PWDs) in international efforts aimed at poverty alleviation. While universal education has been central to these efforts, the specific and additional needs of children with disabilities are often overlooked in policies and programmes. In order to gain a…

  1. Household Living Arrangements and Transition to Sexual Debut among Young People in Ghana

    ERIC Educational Resources Information Center

    Tenkorang, Eric Y.; Adjei, Jones K.

    2015-01-01

    There is abundant research on the links between family and household structure and young people's sexual risk-taking behaviours, but this scholarship although emerging in sub-Saharan Africa is largely limited to the West. Using data from the 2004 National Adolescent Survey conducted among 12-19 year olds in Ghana, and applying discrete time…

  2. Tobacco Cessation Intervention for People with Disabilities: Survey of Center for Independent Living Directors

    ERIC Educational Resources Information Center

    Moorhouse, Michael D.; Pomeranz, Jamie L.; Barnett, Tracey E.; Yu, Nami S.; Curbow, Barbara A.

    2011-01-01

    People with disabilities (PWD) are 50% more likely to smoke compared with the general population, yet interventions tailored to the needs of PWD remain limited. The authors surveyed directors from a leading disability service organization to assess their delivery of tobacco cessation interventions. Although tobacco cessation was identified as a…

  3. Building Society: Young People's Experiences and Outcomes in the Technologies. Transforming Lives through Learning

    ERIC Educational Resources Information Center

    Education Scotland, 2014

    2014-01-01

    This report continues the series in which Education Scotland evaluates the quality of young people's learning and achievements, in this case in the technologies. The report contributes to the overall picture of what it is like to be a learner in a Scottish early learning or childcare setting or school in this second decade of the 21st Century. The…

  4. Disempowerment and Psychological Distress in the Lives of Young People in Eastern Cape, South Africa

    ERIC Educational Resources Information Center

    Nduna, Mzikazi; Jewkes, Rachel

    2012-01-01

    A qualitative study was conducted in Butterworth, in the rural Eastern Cape Province of South Africa, to explore sources of distress for young people. Semi-structured, individual in-depth interviews were conducted with 16 men and 24 women aged 16-22 years. The findings revealed interconnections between structural factors such as death, poverty,…

  5. The Power of Stories: Learning from the Lives of Young People.

    ERIC Educational Resources Information Center

    Udall, Denis

    1991-01-01

    A "speak-out tour" of five New York City high schools allowed refugee and inner-city young people to share their experiences of war, violence, and mistreatment. Their stories taught their teacher and their audiences about empathy and moral knowledge. (KS)

  6. A Study of Stairs in the Housing of Independently-Living Elderly People.

    ERIC Educational Resources Information Center

    Smith, David W. E.; And Others

    1994-01-01

    This study examines elderly (60+ years) residents of a community dominated by multistory homes and apartments with stairs. Although stairs presented problems for a substantial minority of residents, most occupants expressed satisfaction with their homes. However, a majority of residents, when questioned further, desired stair-free living in a next…

  7. What People Living with Aphasia Think about the Availability of Aphasia Resources

    ERIC Educational Resources Information Center

    Hinckley, Jacqueline J.; Hasselkus, Amy; Ganzfried, Ellayne

    2013-01-01

    Purpose: Obtaining health information and resources can influence an individual's (a) access to services, (b) interactions with health care providers, and (c) ability to manage one's own health needs. The purpose of this study was to gather the perceptions of consumers living with aphasia about resource availability and information needs. Method:…

  8. Western health practitioners' view about African traditional health practitioners' treatment and care of people living with HIV/AIDS.

    PubMed

    Summerton, J V

    2006-08-01

    African traditional health practitioners are an important source of health care for many South Africans. Thus, they are a health resource in this society. However, the integration of traditional health practitioners into the mainstream of health care is a complex process. Various factors contribute to this complexity, including the skepticism and reservation with which some western health practitioners view traditional health practitioners. This paper highlights the perceived strengths and weaknesses of the traditional healing system for people living with HIV/AIDS, as perceived by western health practitioners. The use of traditional practitioners as a choice of health care is attributed to both the strengths and weaknesses of this system of health care. The strength of the traditional healing system is in its sharing of the worldview and belief system of its users, it being an alternative to an inefficient western health care system (official system), privacy and absence of time limitations per consultation, treating patients psychologically, and scientifically unexplained physiological relief of the symptoms of specific illnesses. The perceived weaknesses of the traditional healing system include harmful treatment regimens, especially for people living with HIV/AIDS; prolonging the seeking of appropriate health care when traditional remedies fail to produce the desired effect; destroying interpersonal relationships of people living with HIV/AIDS through witchcraft accusations; psychological torment caused by the belief that HIV/AIDS can be cured by traditional remedies/intervention; and increasing the workload of western practitioners who are requested by patients to conduct multiple HIV tests after undergoing various traditional treatment regimens to cure HIV/AIDS. It is recommended that traditional practitioners be encouraged to adapt harmful traditional healing practices to the benefit of their patients in a non-judgemental and non-critical manner. In addition

  9. Sexual Behaviors and Transmission Risks Among People Living with HIV: Beliefs, Perceptions, and Challenges to Using Treatments as Prevention.

    PubMed

    Kalichman, Seth C; Cherry, Chauncey; Kalichman, Moira O; Washington, Christopher; Grebler, Tamar; Hoyt, Ginger; Merely, Cindy; Welles, Brandi

    2016-08-01

    Antiretroviral therapy (ART) improves the health of people living with HIV and can reduce infectiousness, preventing HIV transmission. The potential preventive benefits of ART are undermined by beliefs that it is safe to have condomless sex when viral load is below levels of detection (infectiousness beliefs and risk perceptions). In this study, we hypothesized that infectiousness beliefs and HIV transmission risk perceptions would prospectively predict people living with HIV engaging in more condomless sex with HIV-negative and unknown HIV status sex partners. Sexually active HIV-positive men (n = 538, 76 %) and women (n = 166, 24 %) completed computerized interviews of sexually transmitted infection (STI) symptoms and diagnoses, unannounced pill counts for medication adherence, medical chart-abstracted HIV viral load, and 28 daily cell-phone-delivered prospective sexual behavior assessments. Results showed that a total of 313 (44 %) participants had engaged in condomless sex with HIV-negative/unknown status sex partners, and these individuals demonstrated higher rates of STI symptoms and diagnoses. Two-thirds of participants who had condomless sex with HIV-negative/unknown status partners had not disclosed their HIV status. Multivariable logistic regression models showed that beliefs regarding viral load and HIV infectiousness and perceptions of lower risk of HIV transmission resulting from HIV viral suppression predicted condomless sex with potentially uninfected partners over and above sex behaviors with HIV-positive partners and STI symptoms/diagnoses. Interventions that address HIV status disclosure and aggressively treat STI in sexually active people living with HIV should routinely accompany the use of HIV treatments as prevention. PMID:26292837

  10. Internet use and the network composition of people living with HIV/AIDS in an urban area in Peru.

    PubMed

    Busse, Peter; Curioso, Walter H

    2010-12-01

    This study examines the association between Internet use and (1) the number of close ties (people with whom a person is closely acquainted), and (2) the percentage of HIV-positive individuals in the personal network of people living with HIV/AIDS (PLHA) in an urban area of Peru. Ninety-four PLHA responded to a survey; 72% were male, and the average age was 36.65 (SD = 7.92). Internet use was not associated with the number of close ties or with a greater number of close ties who are HIV-positive in one's personal network. Internet use was higher among those with greater than a high school education and females reported more social ties than males. PMID:19488849

  11. Impact of caring for people living with HIV on the psychosocial well-being of palliative caregivers.

    PubMed

    Valjee, Lavashni; van Dyk, Alta C

    2014-01-01

    Acquired immunodeficiency syndrome (AIDS) continues to be a serious public health issue, and it is often the caregivers who carry the brunt of the epidemic. Caregivers of people with AIDS face distinctive demands that could make them more prone to occupational stress, with serious consequences for their psychosocial well-being. The impact of caring for people living with HIV infection on the psychosocial well-being of palliative caregivers was investigated using in-depth interviews and questionnaires in 28 participants. The results indicated no burnout, but occupational stress was prevalent. Factors impacting negatively on well-being were stressors inherent in AIDS care, such as suffering and dying of the persons being cared for, work-related stressors such as heavy workload, lack of support and ineffective coping mechanisms. Positive aspects of caring such as job satisfaction, holistic palliative care, effective coping mechanisms and psychosocial support were identified. Recommendations to curb the negative effects of caregiving are provided. PMID:25686108

  12. Who knows, who cares? Dementia knowledge among nurses, care workers, and family members of people living with dementia.

    PubMed

    Robinson, Andrew; Eccleston, Claire; Annear, Michael; Elliott, Kate-Ellen; Andrews, Sharon; Stirling, Christine; Ashby, Michael; Donohue, Catherine; Banks, Susan; Toye, Christine; McInerney, Fran

    2014-01-01

    The number of people with dementia is increasing rapidly worldwide. Commensurate with population ageing, the use of nursing homes in Australia (known as residential aged care facilities) for individuals with dementia is growing. As a terminal condition, dementia is best managed by instituting a palliative approach to care. A good knowledge of dementia, including its progression and management, among staff and families of people living with dementia is essential for clear decision making and the provision of appropriate care. Yet there is limited information regarding relative levels of dementia knowledge. This paper reports the results of a study that assessed dementia knowledge among these two cohorts using the Dementia Knowledge Assessment Tool; the study surveyed 279 staff members and 164 family members of residents with dementia. Dementia knowledge deficits were evident in both cohorts across a range of areas. It is critical that dementia knowledge deficits are identified and addressed in order to support evidence-based dementia care. PMID:25265739

  13. A review of contemporary work on the ethics of ambient assisted living technologies for people with dementia.

    PubMed

    Novitzky, Peter; Smeaton, Alan F; Chen, Cynthia; Irving, Kate; Jacquemard, Tim; O'Brolcháin, Fiachra; O'Mathúna, Dónal; Gordijn, Bert

    2015-06-01

    Ambient assisted living (AAL) technologies can provide assistance and support to persons with dementia. They might allow them the possibility of living at home for longer whilst maintaining their comfort and security as well as offering a way towards reducing the huge economic and personal costs forecast as the incidence of dementia increases worldwide over coming decades. However, the development, introduction and use of AAL technologies also trigger serious ethical issues. This paper is a systematic literature review of the on-going scholarly debate about these issues. More specifically, we look at the ethical issues involved in research and development, clinical experimentation, and clinical application of AAL technologies for people with dementia and related stakeholders. In the discussion we focus on: (1) the value of the goals of AAL technologies, (2) the special vulnerability of persons with dementia in their private homes, (3) the complex question of informed consent for the usage of AAL technologies. PMID:24942810

  14. Palliative and end-of-life care for people living with dementia in care homes: part 2.

    PubMed

    Mitchell, Gary; Agnelli, Joanne; McGreevy, Jessie; Diamond, Monica; Roble, Herlindina; McShane, Elaine; Strain, Joanne

    2016-06-29

    This article, the second of two, provides healthcare practitioners with an overview of best practice in palliative and end-of-life care, including nutrition, hydration, oral hygiene and pain management. Communication and spiritual care are discussed, as well as care after death. Providing support and education for families is an important aspect of palliative and end-of-life care. Care home nurses should ensure that the person living with dementia is at the centre of decision making, and provide care that is inclusive of their needs and wishes. The article is framed in a care home context; there is little research about how to optimise palliative care for people living with dementia in care homes. PMID:27353937

  15. HIV serostatus disclosure: Experiences and perceptions of people living with HIV/AIDS and their service providers in Gujarat, India

    PubMed Central

    Patel, Sangita V.; Patel, Shilpa N.; Baxi, Rajendra K.; Golin, Carol E.; Mehta, Mansi; Shringarpure, Kalpita; Bakshi, Harsh; Modi, Ekta; Coonor, Priyanka; Mehta, Kedar

    2012-01-01

    Background: Human immunodeficiency virus (HIV) disclosure offers important benefits to people living with HIV/AIDS. However, fear of discrimination, blame, and disruption of family relationships can make disclosure a difficult decision. Barriers to HIV disclosure are influenced by the particular culture within which the individuals live. Although many studies have assessed such barriers in the U.S., very few studies have explored the factors that facilitate or prevent HIV disclosure in India. Understanding these factors is critical to the refinement, development, and implementation of a counseling intervention to facilitate disclosure. Materials and Methods: To explore these factors, we conducted 30 in-depth interviews in the local language with HIV- positive individuals from the Integrated Counselling and Testing Centre in Gujarat, India, assessing the experiences, perceived barriers, and facilitators to disclosure. To triangulate the findings, we conducted two focus group discussions with HIV medical and non-medical service providers, respectively. Results: Perceived HIV-associated stigma, fear of discrimination, and fear of family breakdown acted as barriers to HIV disclosure. Most people living with HIV/AIDS came to know of their HIV status due to poor physical health, spousal HIV-positive status, or a positive HIV test during pregnancy. Some wives only learned of their husbands’ HIV positive status after their husbands died. The focus group participants confirmed similar findings. Disclosure had serious implications for individuals living with HIV, such as divorce, maltreatment, ostracism, and decisions regarding child bearing. Interpretation and Conclusion: The identified barriers and facilitators in the present study can be used to augment training of HIV service providers working in voluntary counseling and testing centers in India. PMID:24250046

  16. Increasing the provision of mental health care for vulnerable, disaster-affected people in Bangladesh

    PubMed Central

    2014-01-01

    Background Bangladesh has the highest natural disaster mortality rate in the world, with over half a million people lost to disaster events since 1970. Most of these people have died during floods or cyclones, both of which are likely to become more frequent due to global climate change. To date, the government’s post-disaster response strategy has focused, increasingly effectively, on the physical needs of survivors, through the provision of shelter, food and medical care. However, the serious and widespread mental health consequences of natural disasters in Bangladesh have not yet received the attention that they deserve. This Debate article proposes a practical model that will facilitate the provision of comprehensive and effective post-disaster mental health services for vulnerable Bangladeshis on a sustainable basis. Discussion A series of socially determined factors render the women and the poor of Bangladesh particularly vulnerable to dying in natural disasters; and, for those who survive, to suffering from some sort of disaster-related mental health illness. For women, this is largely due to the enforced gender separation, or purdah, that they endure; while for the poor, it is the fact that they are, by definition, only able to afford to live in the most climatically dangerous, and under-served parts of the country. Although the disasters themselves are brought by nature, therefore, social determinants increase the vulnerability of particular groups to mental illness as a result of them. While deeply entrenched, these determinants are at least partially amenable to change through policy and action. Summary In response to the 2004 Indian Ocean tsunami, the World Health Organisation developed a framework for providing mental health and psychosocial support after major disasters, which, we argue, could be adapted to Bangladeshi post-cyclone and post-flood contexts. The framework is community-based, it includes both medical and non-clinical components, and it

  17. An assisted-living home architecture with integrated healthcare services for elderly people.

    PubMed

    Marsh, Andy; Biniaris, Christos; Vergados, Dimitrios; Eppler, Arnold; Kavvadias, Christoforos; Bigalke, Olaf; Robert, Eric; Jerabek, Boro; Alevizos, Alevizos; Caragiozidis, Michael

    2008-01-01

    Since the population of elderly people grows absolutely and in relation to the overall population in the world, the improvement of the quality of life of elderly people at home is of a great importance. This can be achieved through the development of generic technologies for managing their domestic ambient environment consisting of medical sensors, entertainment equipment, home automation systems and white goods, increasing their autonomy and safety. In this context, the provision intelligent interactive healthcare services will improve their daily life and allowing at the same time the continuous monitoring of their health and their effective treatment. This work is supported by the INHOME Project EU IST-045061-STP, http://www.ist-inhome.eu. PMID:18560072

  18. Number of People in the United States Experiencing Ambulatory and Independent Living Difficulties

    PubMed Central

    Siordia, Carlos

    2014-01-01

    Estimating the characteristics of the “disabled” population is necessary for some governments and of interest to health researchers concerned with producing disability prevalence rates. Because generating easy-to-understand estimates of disability in the population is important, this article provides US population estimates for two disability-related measures by using the 2009 to 2011 American Community Survey Public Use Microdata Sample file. The number of people who have “independent living” and “ambulatory” difficulties is calculated from a sample of 9,204,437 (representing > 309 million people). The percentage for “disabled” is found to vary by: racial-ethnic category, sex, age, citizenship status, educational attainment, and state-level regions divided by weather. PMID:24816336

  19. Citizenship and people living with dementia: A case for the ethics of care.

    PubMed

    Brannelly, Tula

    2016-05-01

    The ethics of care is an emerging field of interest in many disciplines, including care for people with dementia. The ethics of care as proposed by Joan Tronto is a political argument for care together with a set of principles, the integrity of care, to guide and critique practice. This two-pronged approach enables on one hand, a political, complex and situated examination of inequality, and on the other hand the integrity of care provides a set of principles to guide inclusive citizenship practices. This approach has the significant advantage of recognition of the fight that people with dementia face to achieve rights and citizenship as an issue of social justice. In this paper, three challenges to citizenship are discussed in relation to people with dementia using an ethics of care lens: (a) citizenship as a relationship between the individual and the state; (b) citizenship as a practice and (c) citizenship as identity and belonging. I propose that citizenship can be achieved by promoting inclusion in defining and creating policy, research and practice. PMID:27170583

  20. The influence of egocentrism and focalism on people's optimism in competitions: when what affects us equally affects me more.

    PubMed

    Windschitl, Paul D; Kruger, Justin; Simms, Ericka Nus

    2003-09-01

    Six experiments investigated people's optimism in competitions. The studies involved hypothetical and real competitions (course grades in Experiments 1 and 2, a trivia game in Experiments 3-5, and a poker game in Experiment 6) in which the presence of shared adversities and benefits (factors that would generally hinder or help the absolute performance of all competitors) was manipulated. Shared adversities tended to reduce people's subjective likelihoods of winning, whereas shared benefits tended to increase them. The findings suggest that when people judge their likelihood of winning, their assessments of their own strengths and weaknesses have greater impact than their assessments of their competitors' strengths and weaknesses. We identify egocentrism and focalism as two causes of the bias. The experiments revealed moderators of this bias, but also illustrated its robust nature across a variety of conditions. PMID:14498778

  1. Life memories and the ability to act: the meaning of autonomy and participation for older people when living with chronic illness.

    PubMed

    Hedman, Maria; Pöder, Ulrika; Mamhidir, Anna-Greta; Nilsson, Annika; Kristofferzon, Marja-Leena; Häggström, Elisabeth

    2015-12-01

    There is a lack of knowledge about how older people living with chronic illness describe the meaning of autonomy and participation, indicating a risk for reduced autonomy and participation in their everyday life. The purpose of this study was to describe the meaning of autonomy and participation among older people living with chronic illness in accordance with their lived experience. The design was descriptive with a phenomenological approach guided by Giorgi's descriptive phenomenological psychological method. Purposive sampling was used, and 16 older people living with chronic illness who lived in an ordinary home participated in individual interviews. The findings showed that the meaning of autonomy and participation among the older people emerged when it was challenged and evoked emotional considerations of the lived experience of having a chronic illness. It involved living a life apart, yet still being someone who is able, trustworthy and given responsibility--still being seen and acknowledged. The meaning of autonomy and participation was derived through life memories and used by the older people in everyday life for adjustment or adaption to the present life and the future. Our conclusion is that autonomy and participation were considered in relation to older people's life memories in the past, in their present situation and also their future wishes. Ability or disability is of less importance than the meaning of everyday life among older people. We suggest using fewer labels for limitations in everyday life when caring for older people and more use of the phrase 'ability to act' in different ways, based on older people's descriptions of the meaning of autonomy and participation. PMID:25856656

  2. ICRP Publication 111 - Application of the Commission's recommendations to the protection of people living in long-term contaminated areas after a nuclear accident or a radiation emergency.

    PubMed

    Lochard, J; Bogdevitch, I; Gallego, E; Hedemann-Jensen, P; McEwan, A; Nisbet, A; Oudiz, A; Oudiz, T; Strand, P; Janssens, A; Lazo, T; Carr, Z; Sugier, A; Burns, P; Carboneras, P; Cool, D; Cooper, J; Kai, M; Lecomte, J-F; Liu, H; Massera, G; McGarry, A; Mrabit, K; Mrabit, M; Sjöblom, K-L; Tsela, A; Weiss, W

    2009-06-01

    In this report, the Commission provides guidance for the protection of people living in long-term contaminated areas resulting from either a nuclear accident or a radiation emergency. The report considers the effects of such events on the affected population. This includes the pathways of human exposure, the types of exposed populations, and the characteristics of exposures. Although the focus is on radiation protection considerations, the report also recognises the complexity of post-accident situations, which cannot be managed without addressing all the affected domains of daily life, i.e. environmental, health, economic, social, psychological, cultural, ethical, political, etc. The report explains how the 2007 Recommendations apply to this type of existing exposure situation, including consideration of the justification and optimisation of protection strategies, and the introduction and application of a reference level to drive the optimisation process. The report also considers practical aspects of the implementation of protection strategies, both by authorities and the affected population. It emphasises the effectiveness of directly involving the affected population and local professionals in the management of the situation, and the responsibility of authorities at both national and local levels to create the conditions and provide the means favouring the involvement and empowerment of the population. The role of radiation monitoring, health surveillance, and the management of contaminated foodstuffs and other commodities is described in this perspective. The Annex summarises past experience of longterm contaminated areas resulting from radiation emergencies and nuclear accidents, including radiological criteria followed in carrying out remediation measures. PMID:20472181

  3. People

    NASA Astrophysics Data System (ADS)

    2001-05-01

    microscopes, chemical analyses etc. The NHM has big labs—like a university—in the basement. I write papers, give talks... For the public galleries of the NHM my group provides expert input to exhibitions-when the meteorite pavilion was recently refurbished we suggested a layout, wrote text and selected samples, but this was then 'edited' by the exhibition designers. I'm also working on a new website with virtual meteorite specimens. As an expert on Martian meteorites I often get interviewed by the media: for example, I am on a new Channel 4 programme called Destination Mars. I have also just finished a general interest book—it's called Search for Life; the NHM have just published it (in March). And do you get to go to exciting places? As a researcher I go to conferences I am just off to the States this week. I went to Antarctica ten years ago meteorite collecting and I am hoping to go to Australia this year. It is good fun but they really do need an expert who can recognise a meteorite. I'll be going to the Nullarbor region of Australia for 2 3 weeks depending on the weather if it's too green there is too much grass, so you can't see the meteorites. How do you find people respond to meteorites? People love touching rocks from outer space, especially primary school children. You can see how they are burnt on the outside. When you feel the weight of them it really brings it home: iron meteorites are heavy! They'll often say 'Wow, it fell from the sky' as they glance upwards, half expecting another one to come crashing through the ceiling. Everyone finds it amazing that a solid object has come as if from nowhere. And they are so old. They can't believe how old they are. We want to know where we come from. There is always lots of media coverage about what is happening in the sky (eclipses and the like). It's there and it's a bit of a mystery. If we can get to grips with how our planets and how our own Sun formed it can put us in the picture as to where we have come from and

  4. Rehabilitation living lab in the mall community of practice: learning together to improve rehabilitation, participation and social inclusion for people living with disabilities.

    PubMed

    Mazer, Barbara; Kairy, Dahlia; Guindon, Andréanne; Girard, Michel; Swaine, Bonnie; Kehayia, Eva; Labbé, Delphine

    2015-04-01

    Communities of practice (CoP) can facilitate collaboration between people who share a common interest, but do not usually work together. A CoP was initiated and developed including stakeholders from clinical, research, community and governmental backgrounds involved in a large multidisciplinary and multi-sectorial project: the Rehabilitation Living Lab in a Mall (RehabMaLL). This study aimed to evaluate the structure, process and outcomes of this CoP. A single case-study, using mixed-methods, evaluated the RehabMaLL CoP initiative after one year, based on Donabedian's conceptual evaluation model. Forty-three participants took part in the RehabMaLL CoP with 60.5% (n = 26) participating at least once on the online platform where 234 comments were posted. Four in-person meetings were held. Members expressed satisfaction regarding the opportunity to share knowledge with people from diverse backgrounds and the usefulness of the CoP for the RehabMaLL project. Collaboration led to concrete outcomes, such as a sensitization activity and a research project. Common challenges included lack of time and difficulty finding common objectives. A CoP can be a useful strategy to facilitate knowledge sharing on disability issues. Future research is necessary to determine strategies of increasing knowledge creation between members. PMID:25913187

  5. Rehabilitation Living Lab in the Mall Community of Practice: Learning Together to Improve Rehabilitation, Participation and Social Inclusion for People Living with Disabilities

    PubMed Central

    Mazer, Barbara; Kairy, Dahlia; Guindon, Andréanne; Girard, Michel; Swaine, Bonnie; Kehayia, Eva; Labbé, Delphine

    2015-01-01

    Communities of practice (CoP) can facilitate collaboration between people who share a common interest, but do not usually work together. A CoP was initiated and developed including stakeholders from clinical, research, community and governmental backgrounds involved in a large multidisciplinary and multi-sectorial project: the Rehabilitation Living Lab in a Mall (RehabMaLL). This study aimed to evaluate the structure, process and outcomes of this CoP. A single case-study, using mixed-methods, evaluated the RehabMaLL CoP initiative after one year, based on Donabedian’s conceptual evaluation model. Forty-three participants took part in the RehabMaLL CoP with 60.5% (n = 26) participating at least once on the online platform where 234 comments were posted. Four in-person meetings were held. Members expressed satisfaction regarding the opportunity to share knowledge with people from diverse backgrounds and the usefulness of the CoP for the RehabMaLL project. Collaboration led to concrete outcomes, such as a sensitization activity and a research project. Common challenges included lack of time and difficulty finding common objectives. A CoP can be a useful strategy to facilitate knowledge sharing on disability issues. Future research is necessary to determine strategies of increasing knowledge creation between members. PMID:25913187

  6. Risk factors for lower respiratory complications of rhinovirus infections in elderly people living in the community: prospective cohort study.

    PubMed Central

    Nicholson, K. G.; Kent, J.; Hammersley, V.; Cancio, E.

    1996-01-01

    OBJECTIVE: To assess the role of rhinoviruses in elderly people living in the community. DESIGN: Prospective community based surveillance of elderly people, without intervention. Subjects were telephoned weekly to identify symptomatic upper respiratory tract infections. Symptoms and impact of illnesses were monitored, and specimens were collected for diagnostic serology and human rhinovirus polymerase chain reaction. SETTING: Leicestershire, England. SUBJECTS: 533 subjects aged 60 to 90. MAIN OUTCOME MEASURES: Symptoms, restriction of activity, medical consultations, and antibiotic use during 96 rhinovirus infections. Adjusted odds ratios for lower respiratory syndromes with respect to smoking and health status. RESULTS: A viral cause was established in 211 (43%) of 497 respiratory illnesses; rhinoviruses were identified in 121 (24%) and as single pathogens in 107. The median duration of the first or only rhinovirus infection in the 96 people with 107 rhinovirus infections was 16 days; 18 of the 96 patients were confined to bed and 25 were unable to cope with routine household activities. Overall, 60 patients with rhinovirus infections had lower respiratory tract syndromes; 41 patients consulted their doctor, 31 of them (76%) receiving antibiotics. One patient died. Logistic regression analysis showed that chronic medical conditions increased the estimated probability of lower respiratory rhinovirus illness by 40% (95% confidence interval 17% to 68%) and smoking by 47% (14% to 90%). There were almost six times as many symptomatic rhinovirus infections as influenza A and B infections. CONCLUSIONS: Rhinoviruses are an important cause of debility and lower respiratory illness among elderly people in the community. Chronic ill health and smoking increase the likelihood of lower respiratory complications from such infections. The overall burden of rhinovirus infections in elderly people may approach that of influenza. PMID:8916700

  7. Sociodemographic and lifestyle statistics of oldest old people (>80 years) living in ikaria island: the ikaria study.

    PubMed

    Panagiotakos, Demosthenes B; Chrysohoou, Christina; Siasos, Gerasimos; Zisimos, Konstantinos; Skoumas, John; Pitsavos, Christos; Stefanadis, Christodoulos

    2011-01-01

    Background. There are places around the world where people live longer and they are active past the age of 100 years, sharing common behavioral characteristics; these places (i.e., Sardinia in Italy, Okinawa in Japan, Loma Linda in California and Nicoya Peninsula in Costa Rica) have been named the "Blue Zones". Recently it was reported that people in Ikaria Island, Greece, have also one of the highest life expectancies in the world, and joined the "Blue Zones". The aim of this work work was to evaluate various demographic, lifestyle and psychological characteristics of very old (>80 years) people participated in Ikaria Study. Methods. During 2009, 1420 people (aged 30+) men and women from Ikaria Island, Greece, were voluntarily enrolled in the study. For this work, 89 males and 98 females over the age of 80 yrs were studied (13% of the sample). Socio-demographic, clinical, psychological and lifestyle characteristics were assessed using standard questionnaires and procedures. Results. A large proportion of the Ikaria Study's sample was over the age of 80; moreover, the percent of people over 90 were much higher than the European population average. The majority of the oldest old participants reported daily physical activities, healthy eating habits, avoidance of smoking, frequent socializing, mid-day naps and extremely low rates of depression. Conclusion. Modifiable risk factors, such as physical activity, diet, smoking cessation and mid-day naps, might depict the "secrets" of the long-livers; these findings suggest that the interaction of environmental, behavioral together with clinical characteristics may determine longevity. This concept must be further explored in order to understand how these factors relate and which are the most important in shaping prolonged life. PMID:21403883

  8. Sociodemographic and Lifestyle Statistics of Oldest Old People (>80 Years) Living in Ikaria Island: The Ikaria Study

    PubMed Central

    Panagiotakos, Demosthenes B.; Chrysohoou, Christina; Siasos, Gerasimos; Zisimos, Konstantinos; Skoumas, John; Pitsavos, Christos; Stefanadis, Christodoulos

    2011-01-01

    Background. There are places around the world where people live longer and they are active past the age of 100 years, sharing common behavioral characteristics; these places (i.e., Sardinia in Italy, Okinawa in Japan, Loma Linda in California and Nicoya Peninsula in Costa Rica) have been named the “Blue Zones”. Recently it was reported that people in Ikaria Island, Greece, have also one of the highest life expectancies in the world, and joined the “Blue Zones”. The aim of this work work was to evaluate various demographic, lifestyle and psychological characteristics of very old (>80 years) people participated in Ikaria Study. Methods. During 2009, 1420 people (aged 30+) men and women from Ikaria Island, Greece, were voluntarily enrolled in the study. For this work, 89 males and 98 females over the age of 80 yrs were studied (13% of the sample). Socio-demographic, clinical, psychological and lifestyle characteristics were assessed using standard questionnaires and procedures. Results. A large proportion of the Ikaria Study's sample was over the age of 80; moreover, the percent of people over 90 were much higher than the European population average. The majority of the oldest old participants reported daily physical activities, healthy eating habits, avoidance of smoking, frequent socializing, mid-day naps and extremely low rates of depression. Conclusion. Modifiable risk factors, such as physical activity, diet, smoking cessation and mid-day naps, might depict the “secrets” of the long-livers; these findings suggest that the interaction of environmental, behavioral together with clinical characteristics may determine longevity. This concept must be further explored in order to understand how these factors relate and which are the most important in shaping prolonged life. PMID:21403883

  9. Mediators of the relationship between nicotine replacement therapy and smoking abstinence among people living with HIV/AIDS.

    PubMed

    Stanton, Cassandra A; Lloyd-Richardson, Elizabeth E; Papandonatos, George D; de Dios, Marcel A; Niaura, Raymond

    2009-06-01

    Cigarette smoking is highly prevalent among people living with HIV/AIDS and poses unique health risks. Smoking cessation programs tailored to this population have documented improved smoking outcomes with nicotine replacement therapy (NRT). The current study examined 6-month abstinence rates from a randomized clinical trial targeting 412 HIV-positive adult current smokers (51% European American, 19% African American, and 17% Hispanic American) and tested whether psychosocial variables, such as self-efficacy and decisional balance, mediated the relationship between NRT and long-term abstinence. Meeting criteria for complete mediation, 6-month smoking abstinence rates improved significantly with increases in these mediators, and the association of NRT and smoking abstinence was no longer significant once changes in self-efficacy and decisional balance were taken into account . Failure to translate gains in self-efficacy among African Americans into improved abstinence rates accounted for racial/ethnic differences among participants. Specific psychosocial factors, such as self-efficacy, may be particularly amenable to change in cessation interventions and should be addressed with greater awareness of how cultural and social contextual factors impact treatment response among people living with HIV/AIDS. PMID:19537955

  10. Do government brochures affect physical activity cognition? A pilot study of Canada's physical activity guide to healthy active living.

    PubMed

    Kliman, Aviva M; Rhodes, Ryan

    2008-08-01

    Health Canada has published national physical activity (PA) guidelines, which are included in their 26-page Physical Activity Guide to Healthy Active Living (CPAG). To date, the use of CPAG as a motivational instrument for PA promotion has not been evaluated. The purpose of this study was to determine whether reading CPAG 1) increased motivational antecedents to engage in regular PA, and 2) increased regular PA intention and behaviour over 1 month. Participants included 130 randomly sampled Canadian adults (18 years or older) who were randomly mailed pack ages consisting of either 1) a questionnaire and a copy of CPAG, or 2) a questionnaire. Questionnaire items pertained to participants' sociodemographics, previous PA behaviours (Godin Leisure-Time Questionnaire) and PA motivation (theory of planned behaviour). Participants were then sent a follow-up questionnaire pertaining to their PA behaviours throughout the previous month. Results revealed significant interactions between the guide condition and previous activity status on instrumental behavioural beliefs about strength activities and subjective norms about endurance activities (p < 0.05), but all other factors were not significantly different. It was concluded that among previously inactive people, receiving this guide may change some informational/motivational constructs, but key motivational antecedents (affective attitude, perceived behavioural control) and outcomes (intention, behaviour) seem unaffected. PMID:18825580

  11. The Effectiveness of Healthy Physical Fitness Programs on People with Intellectual Disabilities Living in a Disability Institution: Six-Month Short-Term Effect

    ERIC Educational Resources Information Center

    Wu, Chia-Ling; Lin, Jin-Ding; Hu, Jung; Yen, Chia-Feng; Yen, Cheng-Tung; Chou, Yu-Lan; Wu, Po-Hsun

    2010-01-01

    Little information is available on the provision of physical fitness and intervention program among people with intellectual disabilities. The aim of this study is to provide information of examining the effectiveness of healthy physical fitness programs on people with intellectual disabilities living in a disability institution. There were 146…

  12. Stigma Related Avoidance in People Living with Severe Mental Illness (SMI): Findings of an Integrative Review.

    PubMed

    Abiri, Sadat; Oakley, Linda Denise; Hitchcock, Mary E; Hall, Amanda

    2016-04-01

    The purpose of this integrative review is to synthesize primary evidence of the impact of internalized stigma on avoidance in adult community treatment patients living with SMI. A keyword database search of articles published through 2015 yielded 21 papers and a total of 4256 patients. Our analyses found that stigmatizing beliefs associated with avoidance are related to significant loss of self-esteem. Factors generally thought to reduce stigma internalized as self-stigmatizing beliefs, such as improved insight, increased self-awareness, and psycho-education to improve stigma coping skills, do not appear to improve self-esteem. PMID:26668008

  13. The use of everyday technology by people with dementia living alone: mapping out the difficulties.

    PubMed

    Nygård, L; Starkhammar, S

    2007-03-01

    While the technological development available to society is taking quantum leaps, we have little knowledge of how people with mild dementia manage to cope with familiar technology at home, such as television and electronic household machines, or new technology, such as remote controls, cell phones and computers. As this technology represents a potential problem area, the aim of this qualitative, exploratory study was to identify and characterize difficulties with and hindrances to using everyday technology, as they appeared in data, for persons with early stage dementia. Eight participants with dementia were included in an extensive data collection consisting of repeated interviews and observations made in the home; the data were analyzed adopting a constant comparative approach. The results exhibit a taxonomy of difficulties in four domains, encompassing conditions that interfere with the use of the technology, deficiencies in knowledge and in the communication between users and their technology, and limitations in the use of instructions. Typically, difficulties appeared in complex combinations. They arose when familiar technology was being used, and not only when new technology was to be used. This raised concerns about the need these people have for support in home and in society. Further research is needed to validate the findings. PMID:17453547

  14. Fear of falling in elderly people living in a nursing home -- perspective from Manisa.

    PubMed

    Tavsanli, Nurgul Gungor; Turkmen, Sevgi Nehir

    2015-04-01

    Our study aimed to determine the level of fear of falling in elderly nursing home residents. The research population consisted of all the elderly residents of Manisa Municipal Nursing Home between November 2011 and February 2012. The 76 elderly people who agreed to participate were included in the study. A demographics form and the Tinetti Falls Efficacy Scale were used in data collection. The statistical analysis of the data was performed using SPSS 15.0, using percentage calculations, the t-test and Cronbach's alpha. The mean score on the Tinetti Falls Efficacy Scale for elderly individuals was found to be 4.57 ± 3.80. 57.9% of the old people feared falling while taking a bath, 59.2% while going to bed or getting up, and 53.6% while sitting down or getting up from a chair. It was found that mean fear of falling scores were significantly higher in elderly individuals with chronic diseases, sleep problems and urinary incontinence. PMID:25976579

  15. Food availability affects onset of reproduction in a long-lived seabird

    PubMed Central

    Vincenzi, Simone; Hatch, Scott; Mangel, Marc; Kitaysky, Alexander

    2013-01-01

    Life-history theory predicts that suboptimal developmental conditions may lead to faster life histories (younger age at recruitment and higher reproductive investment), but experimental testing of this prediction is still scarce in long-lived species. We report the effects of an experimental manipulation of food availability during early development and at recruitment on the onset of reproduction and reproductive performance (productivity at first breeding) in a long-lived seabird, the black-legged kittiwake Rissa tridactyla, breeding on Middleton Island, Alaska. Birds were born and raised in nests with supplemented food (‘fed’) or unsupplemented control nests (‘unfed’), and later recruited into either fed or unfed nests. Fed chicks grew faster than unfed chicks, and males grew faster than females. Birds were more likely to reproduce at younger ages when recruiting into fed nests. Faster growth during development tended to increase age at recruitment in all individuals. Social rank of individuals also affected age at recruitment: B-chicks recruited earlier than A-chicks and singletons recruited later than A- and B-chicks. Productivity increased with the age at recruitment and growth rate as chick, but much of the variability remained unexplained. We conclude that results of this study at least partially support predictions of life-history theory: younger age at first breeding for kittiwakes that experienced suboptimal natal conditions, as well as greater productivity of early recruiting kittiwakes that grew in control nests compared with those that grew in food-supplemented nests. PMID:23576791

  16. Factors Affecting Graft Survival among Patients Receiving Kidneys from Live Donors: A Single-Center Experience

    PubMed Central

    Ghoneim, Mohamed A.; Bakr, Mohamed A.; Refaie, Ayman F.; Akl, Ahmed I.; Shokeir, Ahmed A.; Shehab El-Dein, Ahmed B.; Ammar, Hesham M.; Ismail, Amani M.; Sheashaa, Hussein A.; El-Baz, Mahmoud A.

    2013-01-01

    Introduction. The aim of this report is to study the graft and patient survival in a large cohort of recipients with an analysis of factors that may affect the final outcomes. Methods. Between March 1976 and March 2008, 1967 consecutive live-donor renal transplants were carried out. Various variables that may have an impact on patients and/or graft survival were studied in two steps. Initially, a univariate analysis was carried out. Thereafter, significant variables were embedded in a stepwise regression analysis. Results. The overall graft survival was 86.7% and 65.5%, at 5 and 10 years, respectively. The projected half-life for grafts was 17.5 years and for patients was 22 years. Five factors had an independent negative impact on graft survival: donor's age, genetic considerations, the type of primary immunosuppression, number of acute rejection episodes, and total steroid dose during the first 3 months after transplantation. Conclusions. Despite refinements in tissue matching techniques and improvements in immunosuppression protocols, an important proportion of grafts is still lost following living donor kidney transplantation, presumably due to chronic allograft nephropathy. PMID:23878820

  17. Predictors of mortality among elderly people living in a south Indian urban community; a 10/66 Dementia Research Group prospective population-based cohort study

    PubMed Central

    2010-01-01

    Background Eighty percent of deaths occur in low and middle income countries (LMIC), where chronic diseases are the leading cause. Most of these deaths are of older people, but there is little information on the extent, pattern and predictors of their mortality. We studied these among people aged 65 years and over living in urban catchment areas in Chennai, south India. Methods In a prospective population cohort study, 1005 participants were followed-up after three years. Baseline assessment included sociodemographic and socioeconomic characteristics, health behaviours, physical, mental and cognitive disorders, disability and subjective global health. Results At follow-up, 257 (25.6%) were not traced. Baseline characteristics were similar to the 748 whose vital status was ascertained; 154 (20.6%) had died. The mortality rate was 92.5/1000 per annum for men and 51.0/1000 per annum for women. Adjusting for age and sex, mortality was associated with older age, male sex, having no friends, physical inactivity, smaller arm circumference, dementia, depression, poor self-rated health and disability. A parsimonious model included, in order of aetiologic force, male sex, smaller arm circumference, age, disability, and dementia. The total population attributable risk fraction was 0.90. Conclusion A balanced approach to prevention of chronic disease deaths requires some attention to proximal risk factors in older people. Smoking and obesity seem much less relevant than in younger people. Undernutrition is preventable. While dementia makes the largest contribution to disability and dependency, comorbidity is the rule, and more attention should be given to the chronic care needs of those affected, and their carers. PMID:20573243

  18. Employment discrimination and HIV stigma: survey results from civil society organisations and people living with HIV in Africa.

    PubMed

    Sprague, Laurel; Simon, Sara; Sprague, Courtenay

    2011-01-01

    The article presents findings from three surveys of people living with HIV (PLHIV) and civil society organisations about the experience of employment discrimination and stigma in the workplace. The work seeks to contribute to efforts by businesses and other organisations to effectively respond to the HIV epidemic within the world of work, and to deepen our understanding of the ways in which HIV stigma and employment discrimination persist in the workplace. The findings of global and regional surveys indicate the existence of high levels of employment discrimination based on HIV status worldwide, including forced disclosure of HIV status, exclusion in the workplace, refusals to hire or promote, and terminations of people known to be living with HIV. The survey findings show that employment discrimination based on HIV status is experienced in all African subregions. Country-level surveys conducted in Kenya and Zambia indicated that PLHIV face marked barriers to employment, including discrimination in hiring, loss of promotions, and termination because of HIV status. Additionally, large variances were found in the degree of support versus discrimination that employees living with HIV in those two countries received following their disclosure. The discussion emphasises the importance of the workplace as a site for intervention and behaviour change. To address this, we introduce a conceptual framework - the employment continuum - that maps multiple points of entry within the workplace to address HIV-related stigma and discrimination. Additional recommendations include: actions to ensure equal opportunity in hiring for PLHIV; ensuring that HIV testing is voluntary, never mandatory, and that disclosure is not necessary for employment; ensuring confidentiality of HIV status; communicating and enforcing HIV-related antidiscrimination policies; establishing support groups in the workplace; providing safe and confidential processes for resolving complaints of employment

  19. Effects of Nurse-Led Multifactorial Care to Prevent Disability in Community-Living Older People: Cluster Randomized Trial

    PubMed Central

    Buurman, Bianca M.; ter Riet, Gerben; Moll van Charante, Eric P.; de Rooij, Sophia E.

    2016-01-01

    Background To evaluate the effects of nurse-led multifactorial care to prevent disability in community-living older people. Methods In a cluster randomized trail, 11 practices (n = 1,209 participants) were randomized to the intervention group, and 13 practices (n = 1,074 participants) were randomized to the control group. Participants aged ≥ 70 years were at increased risk of functional decline based on a score ≥ 2 points on the Identification of Seniors at Risk- Primary Care, ISAR-PC. Participants in the intervention group received a systematic comprehensive geriatric assessment, and individually tailored multifactorial interventions coordinated by a trained community-care registered nurse (CCRN) with multiple follow-up home visits. The primary outcome was the participant’s disability as measured by the modified Katz activities of daily living (ADL) index score (range 0–15) at one year follow-up. Secondary outcomes were health-related quality of life, hospitalization, and mortality. Results At baseline, the median age was 82.7 years (IQR 77.0–87.1), the median modified Katz-ADL index score was 2 (IQR 1–5) points in the intervention group and 3 (IQR 1–5) points in the control group. The follow-up rate was 76.8% (n = 1753) after one year and was similar in both trial groups. The adjusted intervention effect on disability was -0.07 (95% confidence interval -0.22 to 0.07; p = 0.33). No intervention effects were found for the secondary outcomes. Conclusions We found no evidence that a one-year individualized multifactorial intervention program with nurse-led care coordination was better than the current primary care in community-living older people at increased risk of functional decline in The Netherlands. Trial Registration Netherlands Trial Register NTR2653 PMID:27459349

  20. The role of social support among people living with HIV in rural Mozambique.

    PubMed

    Cummings, Beverley; Gutin, Sarah A; Jaiantilal, Prafulta; Correia, Della; Malimane, Inacio; Rose, Carol Dawson

    2014-11-01

    A Positive Health, Dignity, and Prevention framework is being implemented in Mozambique to maintain the health of persons living with HIV (PLHIV) and prevent onward HIV transmission. An important intervention component is psycho-social support. However, coordinating support services has been challenging. Seventy in-depth individual interviews were conducted with PLHIV between January and June 2010 in three rural provinces to clarify the receipt and provision of support by PLHIV. Thematic coding and analysis were conducted to identify salient responses. PLHIV reported that the majority of social support received was instrumental, followed by emotional and informational support. Instrumental support included material, medical, and financial assistance. Emotional support was mentioned less frequently and was supplied most by family and friends. PLHIV also received informational support from a variety of sources, the most common being family members. Informational support from health providers was rarely mentioned, but this advice was valued and used to educate others. Although most participants described receiving social support from many sources, there were consistently identified needs. This study revealed that social support is central in the lives of PLHIV and identified areas where social support can be improved to better respond to the needs of PLHIV in the Mozambican context. PMID:25290317

  1. The text telephone as an empowering technology in the daily lives of deaf people-A qualitative study.

    PubMed

    Roos, Carin; Wengelin, Åsa

    2016-01-01

    Text-telephone technology (TTY) has been used for communication between deaf people since 1964. There is a gap in the scientific knowledge about the influence this may have had especially in relation to effective participation in society as well as the feeling of capability, confidence and collective meaningfulness. The aim of the present paper is, first, to disentangle the different aspects of TTY as an empowering artifact; and, second, to explore the role of TTY in their lives. To provide a framework for the empirical analysis, the paper draws on Empowerment Theory: personal control, a proactive approach to life, and a critical awareness of one's socio-political environment. Twenty-four people aged 16-64 with Swedish Sign Language (SSL) as their first language were interviewed. The findings indicate that the introduction of the TTY was of great importance for self-esteem, equality and independence. The findings show that feelings of empowerment are closely linked to language use and contextually driven, and it is in interaction between deaf and hearing that such feelings arise (or not). The results indicate the need for further research into Deaf people's use of other means of interacting, using modern technique for example in social digital media and interactive platforms. PMID:26479953

  2. Food Insecurity and Other Poverty Indicators among People Living with HIV/AIDS: Effects on Treatment and Health Outcomes

    PubMed Central

    Kalichman, Seth C.; Hernandez, Dominica; Cherry, Chauncey; Kalichman, Moira O.; Grebler, Tamar

    2014-01-01

    Health disparities in access to antiretroviral therapy (ART) as well as the demands of long-term medication adherence have meant the full benefits of HIV treatment are often not realized. In particular, food insecurity has emerged as a robust predictor of ART non-adherence. However, research is limited in determining whether food insecurity uniquely impedes HIV treatment or if food insecurity is merely a marker for poverty that interferes more broadly with treatment. This study examined indicators of poverty at multiple levels in a sample of 364 men and 157 women living with HIV recruited through an offering of a free holiday food basket. Results showed that 61% (N = 321) of participants had experienced at least one indicator of food insecurity in the previous month. Multivariate analyses showed that food insecurity was closely tied to lack of transportation. In addition, food insecurity was associated with lacking access to ART and poor ART adherence after adjusting for neighbourhood poverty, living in an area without a supermarket (food desert), education, stable housing, and reliable transportation. Results therefore affirm previous research that has suggested food insecurity is uniquely associated with poor ART adherence and calls for structural interventions that address basic survival needs among people living with HIV, especially food security. PMID:24705680

  3. Design and feasibility of a social self-value intervention package to empower people living with HIV.

    PubMed

    Bhatta, Dharma Nand; Liabsuetrakul, Tippawan

    2016-09-01

    Human immunodeficiency virus (HIV) infection affects the quality of life of infected people. It is well known that empowerment is important for appropriate access to health care and quality of care. However, there is currently limited availability of explicit methods to increase the empowerment of HIV-infected people. This study aimed to develop and test the feasibility of a social self-value package as an empowerment intervention method for HIV-infected people. One group included 8-10 participants and each session lasted for one and half hours. Six sessions in total were developed and one session was conducted in one week. A total of 66 participants were randomly selected for participating in the package, assessed its feasibility both quantitatively and qualitatively. Attitudes towards HIV-related issues significantly and positively changed after each session. Client satisfaction and acceptability of the intervention was very high indicating high feasibility with good design. The qualitative findings also supported the quantitative findings where both participants and counselors accepted and were satisfied with the structure and contents of the package. This study revealed that providing an inclusive six-week social self-value package for HIV-infected Nepali people appears to be feasible. Its effect on empowerment intervention will be measured by a randomized controlled trial. PMID:27008991

  4. Health behavior predictors of medication adherence among low health literacy people living with HIV/AIDS.

    PubMed

    Pellowski, Jennifer A; Kalichman, Seth C

    2016-09-01

    One particularly vulnerable population for HIV treatment non-adherence is persons with poor health literacy skills. For these individuals, it is important to simplify medication taking as much as possible by integrating medication adherence into other routine health behaviors. This study aims to ascertain the relationship between medication adherence and other health behaviors. Adults living with HIV (N = 422) completed intake measures and 3 months of unannounced pill counts. Endorsement of diet and exercise behaviors at intake predicted higher medication adherence, over and above other known predictors of medication adherence such as HIV symptoms, depression, social support, and stress. These results support integrating strategies for medication management into a constellation of routine health practices. PMID:25706334

  5. Cancer Mortality Among People Living in Areas With Various Levels of Natural Background Radiation

    PubMed Central

    Fornalski, Krzysztof W.; Feinendegen, Ludwig E.

    2015-01-01

    There are many places on the earth, where natural background radiation exposures are elevated significantly above about 2.5 mSv/year. The studies of health effects on populations living in such places are crucially important for understanding the impact of low doses of ionizing radiation. This article critically reviews some recent representative literature that addresses the likelihood of radiation-induced cancer and early childhood death in regions with high natural background radiation. The comparative and Bayesian analysis of the published data shows that the linear no-threshold hypothesis does not likely explain the results of these recent studies, whereas they favor the model of threshold or hormesis. Neither cancers nor early childhood deaths positively correlate with dose rates in regions with elevated natural background radiation. PMID:26674931

  6. Helping people live between office visits: An interview with Bernie Siegel, MD. Interview by Sheldon Lewis.

    PubMed

    Siegel, Bernie

    2008-01-01

    Bernie Siegel, MD, was born in Brooklyn, New York, and attended Colgate University and Cornell University Medical College. Dr Siegel trained as a surgeon at Yale New Haven Hospital, West Haven Veteran's Hospital, and the Children's Hospital of Pittsburgh. He was an assistant clinical professor of surgery in general and pediatric surgery at Yale University School of Medicine. In 1978, Dr Siegel founded Exceptional Cancer Patients (ECaP) using a group therapy approach aimed at personal empowerment, transformation, and lifestyle changes. He is the best-selling author of Love, Medicine and Miracles (HarperCollins, 1986); Peace, Love, and Healing: Bodymind Communication and the Path to Self-Healing (HarperCollins, 1989); and How to Live Between Office Visits (HarperCollins, 1992), among others. He retired from Yale in 1989 to continue to write and speak to patients and their caregivers. Dr Siegel recently spoke with the editor in chief of Advances, Sheldon Lewis. PMID:20664138

  7. Investigating the Lived Experience of Recovery in People Who Hear Voices.

    PubMed

    de Jager, Adèle; Rhodes, Paul; Beavan, Vanessa; Holmes, Douglas; McCabe, Kathryn; Thomas, Neil; McCarthy-Jones, Simon; Lampshire, Debra; Hayward, Mark

    2016-08-01

    Although there is evidence of both clinical and personal recovery from distressing voices, the process of recovery over time is unclear. Narrative inquiry was used to investigate 11 voice-hearers' lived experience of recovery. After a period of despair/exhaustion, two recovery typologies emerged: (a) turning toward/empowerment, which involved developing a normalized account of voices, building voice-specific skills, integration of voices into daily life, and a transformation of identity, and (b) turning away/protective hibernation, which involved harnessing all available resources to survive the experience, with the importance of medication in recovery being emphasized. Results indicated the importance of services being sensitive and responsive to a person's recovery style at any given time and their readiness for change. Coming to hold a normalized account of voice-hearing and the self and witnessing of preferred narratives by others were essential in the more robust turning toward recovery typology. PMID:25896792

  8. Comparative Yield of Different Diagnostic Tests for Tuberculosis among People Living with HIV in Western Kenya

    PubMed Central

    Cavanaugh, Joseph S.; Modi, Surbhi; Musau, Susan; McCarthy, Kimberly; Alexander, Heather; Burmen, Barbara; Heilig, Charles M.; Shiraishi, Ray W.; Cain, Kevin

    2016-01-01

    Background Diagnosis followed by effective treatment of tuberculosis (TB) reduces transmission and saves lives in persons living with HIV (PLHIV). Sputum smear microscopy is widely used for diagnosis, despite limited sensitivity in PLHIV. Evidence is needed to determine the optimal diagnostic approach for these patients. Methods From May 2011 through June 2012, we recruited PLHIV from 15 HIV treatment centers in western Kenya. We collected up to three sputum specimens for Ziehl-Neelsen (ZN) and fluorescence microscopy (FM), GeneXpert MTB/RIF (Xpert), and culture, regardless of symptoms. We calculated the incremental yield of each test, stratifying results by CD4 cell count and specimen type; data were analyzed to account for complex sampling. Results From 778 enrolled patients, we identified 88 (11.3%) laboratory-confirmed TB cases. Of the 74 cases who submitted 2 specimens for microscopy and Xpert testing, ZN microscopy identified 25 (33.6%); Xpert identified those plus an additional 18 (incremental yield = 24.4%). Xpert testing of spot specimens identified 48 (57.0%) of 84 cases; whereas Xpert testing of morning specimens identified 50 (66.0%) of 76 cases. Two Xpert tests detected 22/24 (92.0%) TB cases with CD4 counts <100 cells/μL and 30/45 (67.0%) of cases with CD4 counts ≥100 cells/μl. Conclusions In PLHIV, Xpert substantially increased diagnostic yield compared to smear microscopy and had the highest yield when used to test morning specimens and specimens from PLHIV with CD4 count <100 cells/μL. TB programs unable to replace smear microscopy with Xpert for all symptomatic PLHIV should consider targeted replacement and using morning specimens. PMID:27023213

  9. How many people are living with undiagnosed HIV infection? An estimate for Italy, based on surveillance data

    PubMed Central

    Mammone, Alessia; Pezzotti, Patrizio; Regine, Vincenza; Camoni, Laura; Puro, Vincenzo; Ippolito, Giuseppe; Suligoi, Barbara; Girardi, Enrico

    2016-01-01

    Objective: To estimate the size and characteristics of the undiagnosed HIV population in Italy in 2012 applying a method that does not require surveillance data from the beginning of the HIV epidemic. Methods: We adapted the method known as ‘London method 2’; the undiagnosed population is estimated as the ratio between the estimated annual number of simultaneous HIV/clinical AIDS diagnoses and the expected annual progression rate to clinical AIDS in the undiagnosed HIV population; the latter is estimated using the CD4+ cell count distribution of asymptomatic patients reported to surveillance. Under-reporting/ascertainment of new diagnoses was also considered. Also, the total number of people living with HIV was estimated. Results: The undiagnosed HIV population in 2012 was 13 729 (95% confidence interval: 12 152–15 592), 15 102 (13 366–17 151) and 16 475 (14 581–18 710), assuming no under-reporting/ascertainment, 10 and 20% of under-reporting/ascertainment, respectively. The percentage of undiagnosed cases was higher among HIV people aged below 25 years (25–28%), MSM (16–19%) and people born abroad (16–19%), whereas it was small among injection drug users (3%). Conclusion: The estimate of people in Italy with undiagnosed HIV in 2012 was in a plausible range of 12 000–18 000 cases, corresponding to 11–13% of the overall prevalence. The method is straightforward to implement only requiring annual information from the HIV surveillance system about CD4+ cell count and clinical stage at HIV diagnosis. Thus, it could be used to monitor if a certain prevention initiative lead to the reduction of the undiagnosed HIV population over time. It can also be easily implemented in other countries collecting the same basic information from the HIV surveillance system. PMID:26807973

  10. Foreclosure and Health in Southern Europe: Results from the Platform for People Affected by Mortgages.

    PubMed

    Vásquez-Vera, Hugo; Rodríguez-Sanz, Maica; Palència, Laia; Borrell, Carme

    2016-04-01

    Housing instability has been shown to be related to poorer health outcomes in various studies, mainly in the USA and UK. Affected individuals are more prone to psychiatric (e.g., major depression, anxiety) and physical disorders (e.g., hypertension). This situation has deteriorated with the onset of the economic crisis. One of the most affected countries is Spain, which has high rates of foreclosure and eviction that continue to rise. In response, a civil movement, The Platform for People Affected by Mortgages (PAH), works to provide solutions to its members affected by foreclosure and advocates for the right to decent housing. The aims of this study ware to describe and compare the health status of PAH members from Catalonia to a sample of the general population and to analyze the association between health status and mortgage status, foreclosure stage, and other socioeconomic variables, among members of the PAH. We conducted a cross-sectional study using a self-administered online questionnaire (2014) administered to 905 PAH members in Catalonia (>18 years; 559 women and 346 men). Results were compared with health indicators from The Health Survey of Catalonia 2013 (n = 4830). The dependent variables were poor mental health (GHQ 12 ≥ 3), and poor self-reported health (fair or poor). All analyses were stratified by sex. We computed age-standardized prevalence and prevalence ratios of poor mental and self-reported health in both samples. We also analyzed health outcomes among PAH members according to mortgage status (mortgage holders or guarantors), stage of foreclosure, and other socioeconomic variables by computing prevalence ratios from robust Poisson regression models. The prevalence of poor mental health among PAH members was 90.6 % in women and 84.4 % in men, and 15.5 and 10.2 % in the general population, respectively. The prevalence of poor self-reported health was 55.6 % in women and 39.4 % in men from the PAH, and 19.2 and 16.1 % in the general

  11. Association between Food Insecurity and Procurement Methods among People Living with HIV in a High Resource Setting

    PubMed Central

    Anema, Aranka; Fielden, Sarah J.; Shurgold, Susan; Ding, Erin; Messina, Jennifer; Jones, Jennifer E.; Chittock, Brian; Monteith, Ken; Globerman, Jason; Rourke, Sean B.; Hogg, Robert S.

    2016-01-01

    Objective People living with HIV in high-resource settings suffer severe levels of food insecurity; however, limited evidence exists regarding dietary intake and sub-components that characterize food insecurity (i.e. food quantity, quality, safety or procurement) in this population. We examined the prevalence and characteristics of food insecurity among people living with HIV across British Columbia, Canada. Design This cross-sectional analysis was conducted within a national community-based research initiative. Methods Food security was measured using the Health Canada Household Food Security Scale Module. Logistic regression was used to determine key independent predictors of food insecurity, controlling for potential confounders. Results Of 262 participants, 192 (73%) reported food insecurity. Sub-components associated with food insecurity in bivariate analysis included: < RDI consumption of protein (p = 0.046); being sick from spoiled/unsafe food in the past six months (p = 0.010); and procurement of food using non-traditional methods (p <0.05). In multivariable analyses, factors significantly associated with food insecurity included: procurement of food using non-traditional methods [AOR = 11.11, 95% CI: 4.79–25.68, p = <0.001]; younger age [AOR = 0.92, 95% CI: 0.86–0.96, p = <0.001]; unstable housing [AOR = 4.46, 95% CI: 1.15–17.36, p = 0.031]; household gross annual income [AOR = 4.49, 95% CI: 1.74–11.60, p = 0.002]; and symptoms of depression [AOR = 2.73, 95% CI: 1.25–5.96, p = 0.012]. Conclusions Food insecurity among people living with HIV in British Columbia is characterized by poor dietary quality and food procurement methods. Notably, participants who reported procuring in non-traditional manners were over 10 times more likely to be food insecure. These findings suggest a need for tailored food security and social support interventions in this setting. PMID:27487041

  12. Testing the Efficiency of Markov Chain Monte Carlo with People Using Facial Affect Categories

    ERIC Educational Resources Information Center

    Martin, Jay B.; Griffiths, Thomas L.; Sanborn, Adam N.

    2012-01-01

    Exploring how people represent natural categories is a key step toward developing a better understanding of how people learn, form memories, and make decisions. Much research on categorization has focused on artificial categories that are created in the laboratory, since studying natural categories defined on high-dimensional stimuli such as…

  13. Individual and Service Factors Affecting Deinstitutionalization and Community Use of People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Baker, Peter A.

    2007-01-01

    Background: The aim was to evaluate the effect of the closure of a small intellectual disability hospital on the community use of those people involved. In addition, the study sought to identify those factors that might influence the community use of people with intellectual disabilities. Methods: The impact of resettlement was investigated using…

  14. The Role of Attention in the Affective Life of People with Severe or Profound Intellectual Disabilities

    ERIC Educational Resources Information Center

    Vos, Pieter; De Cock, Paul; Munde, Vera; Neerinckx, Heleen; Petry, Katja; Van Den Noortgate, Wim; Maes, Bea

    2013-01-01

    Although it is shown that attention plays an important role both in the onset and in the regulation of emotions in people without disabilities there is no information about how attention is related to emotions in people with severe or profound intellectual disability (ID). Therefore, in our study, we investigated the role of attention in the onset…

  15. Stigma against People Living with HIV/AIDS in China: Does the Route of Infection Matter?

    PubMed Central

    Zhang, Chen; Li, Xiaoming; Liu, Yu; Qiao, Shan; Zhang, Liying; Zhou, Yuejiao; Tang, Zhenzhu; Shen, Zhiyong; Chen, Yi

    2016-01-01

    In the current study, we tested the hypothesis that people who contracted HIV from “blameless” routes (e.g., blood transfusion, sex with stable partners) are less stigmatized compared to people who contracted HIV from “blamable” routes (e.g., injection drug use, sex with sex workers). A cross-sectional study was conducted among 2,987 participants in Guangxi province, China, between 2012 and 2013. We employed both explanatory and predictive modeling strategy by using multivariate linear regression models. In the explanatory models, we assessed the association between routes of infection and three types of stigma (perceived, internalized, and enacted). From identified routes of infection that significantly contributed to higher stigma, we employed predictive modeling to explore predictors for the specific type of stigma. Multiple-imputation was employed for sensitivity analyses. Of the total sample, 63% were male and the average age was 42.9 years (ranged between 18 and 88). Multivariate regression models revealed that contraction from commercial sex increased the perceived (β = 0.46, 95%CI = 0.02, 0.90) and internalized stigma (β = 0.60, 95%CI = 0.09, 1.10), while injecting drug use increased the perceived (β = 0.65, 95%CI = 0.07, 1.22) and enacted stigma (β = 0.09, 95%CI = 0.02, 0.16) after controlling for confounders. Among PLWHA who were infected via commercial sex partners, social support was negatively associated with perceived (β = -0.47, 95%CI = -0.79, -0.14) and internalized stigma (β = -0.80, 95%CI = -1.24, -0.35). Among PLWHA who were infected via injecting drugs, no adherence to antiretroviral treatment (β = 0.41, 95%CI = 0.01, 0.82) was positively associated with perceived stigma, and disclosure of serostatus to others was negatively associated with enacted stigma (β = -0.20, 95%CI = -0.34, -0.05). Knowledge of the association between routes of infection and stigma can guide health professionals and policy makers to develop tailored

  16. Stigma against People Living with HIV/AIDS in China: Does the Route of Infection Matter?

    PubMed

    Zhang, Chen; Li, Xiaoming; Liu, Yu; Qiao, Shan; Zhang, Liying; Zhou, Yuejiao; Tang, Zhenzhu; Shen, Zhiyong; Chen, Yi

    2016-01-01

    In the current study, we tested the hypothesis that people who contracted HIV from "blameless" routes (e.g., blood transfusion, sex with stable partners) are less stigmatized compared to people who contracted HIV from "blamable" routes (e.g., injection drug use, sex with sex workers). A cross-sectional study was conducted among 2,987 participants in Guangxi province, China, between 2012 and 2013. We employed both explanatory and predictive modeling strategy by using multivariate linear regression models. In the explanatory models, we assessed the association between routes of infection and three types of stigma (perceived, internalized, and enacted). From identified routes of infection that significantly contributed to higher stigma, we employed predictive modeling to explore predictors for the specific type of stigma. Multiple-imputation was employed for sensitivity analyses. Of the total sample, 63% were male and the average age was 42.9 years (ranged between 18 and 88). Multivariate regression models revealed that contraction from commercial sex increased the perceived (β = 0.46, 95%CI = 0.02, 0.90) and internalized stigma (β = 0.60, 95%CI = 0.09, 1.10), while injecting drug use increased the perceived (β = 0.65, 95%CI = 0.07, 1.22) and enacted stigma (β = 0.09, 95%CI = 0.02, 0.16) after controlling for confounders. Among PLWHA who were infected via commercial sex partners, social support was negatively associated with perceived (β = -0.47, 95%CI = -0.79, -0.14) and internalized stigma (β = -0.80, 95%CI = -1.24, -0.35). Among PLWHA who were infected via injecting drugs, no adherence to antiretroviral treatment (β = 0.41, 95%CI = 0.01, 0.82) was positively associated with perceived stigma, and disclosure of serostatus to others was negatively associated with enacted stigma (β = -0.20, 95%CI = -0.34, -0.05). Knowledge of the association between routes of infection and stigma can guide health professionals and policy makers to develop tailored intervention

  17. People

    NASA Astrophysics Data System (ADS)

    2001-07-01

    design of the BepiColombo Mercury Surface Element (lander) ©ESA. Conceptual image of the BepiColombo spacecraft at Mercury ©ESA. As well as being interesting in its own right, the regolith also interacts with almost all other aspects of the Mercurian environment. By analysing the regolith we will be able to find out about Mercury's thin atmosphere and also (because the magnetosphere affects the amount of solar wind hitting the planet's surface) changes in the magnetosphere. Planets like the Earth and Jupiter rely on an electrically conductive ionosphere to close the current systems generated by the magnetosphere. Some researchers believe that on Mercury these currents could flow through, or very close to, the surface itself! Designing and building instruments to work in an environment like the surface of Mercury is one of the major challenges I face. Not only must they be capable of surviving extremes of temperature and vibration they must also be small enough to fit into a total lander payload mass of just 7 kg and complete their investigations within the one week expected lifetime of the MSE. In order to take measurements in more than one place, the lander must be equipped with some limited form of mobility. A 'micro-rover' will be carried and deployed after landing, a miniature tracked vehicle that will carry instruments (probably an alpha x-ray spectrometer) to specific target rocks and areas around the lander. To keep things simple the rover will be physically and electronically connected to the lander by a flexible tether. The lander will also carry a 'mole', a slender cylinder (currently being developed for the Beagle-2 Mars lander) with an internal hammering mechanism. Once pushed into the top layer of soil the mole will be able to drive itself down, pushing aside or breaking small rocks, to a depth of several metres, taking measurements as it goes. Over the past few months we have been studying some of the instruments which could be carried by the mole

  18. Between a rock and a hard place: stigma and the desire to have children among people living with HIV in northern Uganda

    PubMed Central

    Nattabi, Barbara; Li, Jianghong; Thompson, Sandra C; Orach, Christopher G; Earnest, Jaya

    2012-01-01

    Background HIV-related stigma, among other factors, has been shown to have an impact on the desire to have children among people living with HIV (PLHIV). Our objective was to explore the experiences of HIV-related stigma among PLHIV in post-conflict northern Uganda, a region of high HIV prevalence, high infant and child mortality and low contraception use, and to describe how stigma affected the desires of PLHIV to have children in the future. Methods Semi-structured interviews were conducted with 26 PLHIV in Gulu district, northern Uganda. The interviews, conducted in Luo, the local language, were audio recorded, transcribed and then translated into English. Thematic data analysis was undertaken using NVivo8 and was underpinned by the “Conceptual Model of HIV/AIDS Stigma”. Results HIV-related stigma continues to affect the quality of life of PLHIV in Gulu district, northern Uganda, and also influences PLHIV's desire to have children. PLHIV in northern Uganda continue to experience stigma in various forms, including internal stigma and verbal abuse from community members. While many PLHIV desire to have children and are strongly influenced by several factors including societal and cultural obligations, stigma and discrimination also affect this desire. Several dimensions of stigma, such as types of stigma (received, internal and associated stigma), stigmatizing behaviours (abusing and desertion) and agents of stigmatization (families, communities and health systems), either directly, or indirectly, enhanced or reduced PLHIV's desire to have more children. Conclusion The social-cultural context within which PLHIV continue to desire to have children must be better understood by all health professionals who hope to improve the quality of PLHIV's lives. By delineating the stigma process, the paper proposes interventions for reducing stigmatization of PLHIV in northern Uganda in order to improve the quality of life and health outcomes for PLHIV and their children

  19. Becoming Irreplaceable: How Comparisons to the Partner’s Alternatives Differentially Affect Low and High Self-Esteem People

    PubMed Central

    Murray, Sandra L.; Leder, Sadie; McClellan, Jennifer C. D.; Holmes, John G.; Pinkus, Rebecca T.; Harris, Brianna

    2009-01-01

    It is proposed that people are motivated to feel hard to replace in romantic relationships because feeling irreplaceable fosters trust in a partner’s continued responsiveness. By contrast, feeling replaceable motivates compensatory behavior aimed at strengthening the partner’s commitment to the relationship. A correlational study of dating couples and 2 experiments examined how satiating/thwarting the goal of feeling irreplaceable differentially affects relationship perception and behavior for low and high self-esteem people. The results revealed that satiating the goal of feeling irreplaceable increases trust for people low in self-esteem. In contrast, thwarting the goal of feeling irreplaceable increases compensatory behaviors meant to prove one’s indispensability for people high in self-esteem. PMID:20161401

  20. [Diet quality and mortality in elderly people living in Warsaw Region].

    PubMed

    Frackiewicz, Joanna; Roszkowski, Wojciech; Brzozowska, Anna; Kałuza, Joanna

    2010-01-01

    The aim of this study was to examine the relationship between indicators of diet quality and all-cause mortality in a group of elderly people. The study was carried out among 411 participants aged 75-80 years (190 men and 221 women). During this study 78 men (42%) and 79 women (36.6%) died. Quality of diet was evaluated using following indicators: Greek Mediterranean Diet Score (GMDS), Mediterranean Diet Score (MDS), Healthy Diet Indicator (HDI), Healthy Eating Index (HEI), Diet Quality Index (DQI), and Diet Quality Index-Revised (DQI-R). Among men there were not significant relationships between all-cause mortality and diet quality measured by the indicators. While the risk of all-cause mortality was statistically significantly lower in women with lower HDI (RR = 0.61; 95% CI: 0.37-0.99) and DQI-R (RR = 0.60; 95% CI: 0.37-0.96) compared to women with higher quality of diet. A similar tendency was shown for MDS indicator (RR = 0.65; 95% CI: 0.40-1.05). It was concluded that indicators used to assessment of diet quality were not good predictors of mortality in Polish population. Therefore to continue study in this field it is necessary to create new diet quality indicator more suitable to nutritional habits in Poland. PMID:20499672

  1. Social anxiety and its psychosocial impact on the lives of people with epilepsy.

    PubMed

    Heersink, Michelle; Kocovski, Nancy L; MacKenzie, Meagan B; Denomme, Kyla; Macrodimitris, Sophia

    2015-10-01

    Little is known about social anxiety among people with epilepsy (PWE), although PWE are more likely to be diagnosed with social anxiety disorder than the general population. The purpose of this study was to determine which psychosocial and seizure-related variables are associated with social anxiety. It was hypothesized that social anxiety would be positively correlated with perceived seizure severity, stigma, impact of epilepsy, fear of negative evaluation, and experiential avoidance. Further, social anxiety would be negatively correlated with epilepsy knowledge and disclosure of epilepsy. Finally, if a seizure occurred in public and others were unaware of the epilepsy, participants would report greater judgment, anxiety, and rumination compared with those in a situation where others were aware of the epilepsy. A total of 101 individuals with epilepsy participated in this online study. Social anxiety was found to correlate with both psychosocial and seizure-related variables in the expected directions. Further, social anxiety predicted significant variance in stigma and disclosure beyond known predictors of stigma. Participants in both conditions (disclosed diagnosis of epilepsy versus undisclosed diagnosis of epilepsy) were equally distressed by having a seizure in public. These findings provide an initial basis for discerning how to best assess and support PWE with social anxiety. PMID:26318791

  2. Use of Ethnomedicinal Plants by the People Living around Indus River

    PubMed Central

    Mussarat, Sakina; AbdEl-Salam, Nasser M.; Tariq, Akash; Wazir, Sultan Mehmood; Ullah, Riaz; Adnan, Muhammad

    2014-01-01

    The objective of present study was to document and preserve ethnomedicinal knowledge use to treat different human ailments by traditional healers of Dera Ismail Khan region, Pakistan. Field work was conducted between February 2012 and January 2013 using semistructured questionnaires. Data was collected from 120 traditional healers through questionnaire survey. Traditional healers in the study area use 70 plant species mostly herbs (57%) for ethnomedicinal and other purposes. The highest FIC values (0.80) were obtained each for gastrointestinal and kidney problems followed by respiratory infections (0.72) and skin infections (0.73). There was a significant correlation (r2 = 0.950; p < 0.01) between the age and traditional knowledge of respondent. Direct matrix ranking indicated Morus alba and Dalbergia sissoo as highly multipurpose and threatened species in the study area. The results showed high dependency of local inhabitants on medicinal plants in meeting their primary health care needs. Moreover, the traditional knowledge has been restricted to elder people. Protection measures should be taken in order to conserve precious multipurpose species that are facing overexploitation. Medicinal plants treating major ailments in the region may be subjected to phytochemical and pharmacological investigations for the identification of bioactive compounds. PMID:24778701

  3. When families fail: shifting expectations of care among people living with HIV in Nairobi, Kenya

    PubMed Central

    Moyer, Eileen; Igonya, Emmy Kageha

    2014-01-01

    The availability of free antiretroviral treatment in public health facilities since 2004 has contributed to the increasing biomedicalization of AIDS care in Kenya. This has been accompanied by a reduction of funding for community-based care and support organizations since the 2008 global economic crisis and a consequent donor divestment from HIV projects in Africa. This paper explores the ways that HIV interventions, including support groups, home-based care and antiretroviral treatments have shaped expectations regarding relations of care in the low-income area of Kibera in Nairobi, Kenya, over the last decade. Findings are based on 20 months of ethnographic research conducted in Nairobi between January 2011 and August 2013. By focusing on three eras of HIV treatment – pre-treatment, treatment scale-up, and post-crisis – the authors illustrate how family and community-based care have changed with shifts in funding. Many support groups that previously provided HIV care in Kibera, where the state is largely absent and family networks are thin, have been forced to cut services. Large-scale HIV treatment programmes may allow the urban poor in Nairobi to survive, but they are unlikely to thrive. Many care needs continue to go unmet in the age of treatment, and many economically marginal people who had found work in care-oriented community-based organizations now find themselves jobless or engaged in work not related to HIV. PMID:25175290

  4. Living with constipation—older people's experiences and strategies with constipation before and during hospitalization

    PubMed Central

    Munch, Lene; Tvistholm, Nina; Trosborg, Ingelise; Konradsen, Hanne

    2016-01-01

    Background Constipation is a common problem among older people. This study aimed to explore how older patients experience constipation and which strategies they used in handling the condition before and during hospitalization. Methods A qualitative exploratory research design was used. Fourteen semi-structured interviews were conducted with patients (61–91 years of age) during hospitalization. Data were analyzed by using content analysis. Results Themes concerning experiences were Bodily signs and symptoms of constipation; the participants described severe pain during constipation, as well as pronounced relief after bowel movements, Impact on well-being and social activities; being constipated negatively impacted their mood and limited social activities, Striving for bowel balance; the participants experienced an ongoing strive for balancing between constipation and diarrhea. Themes related to strategies were Struggling to find a solution; they were aware of different strategies to prevent and treat constipation, though the most common solution described was the use of laxatives, Wait and see; the participants were awaiting to take action until they experienced constipation symptoms, Constipation is a private problem being challenged during hospitalization; constipation was considered a private issue rarely discussed with health-care professionals. Conclusion This study illuminates the need for health-care professionals to be attentive to this issue and initiate the conversation with patients in order to advise on the management of constipation. PMID:27121271

  5. [Reproductive options for people living with HIV: 2013 guidelines from the French expert working group].

    PubMed

    Mandelbrot, L; Berrebi, A; Rouzioux, C; Partisani, M; Faucher, P; Tubiana, R; Matheron, S; Bujan, L; Morlat, P

    2014-01-01

    The desire for children is a legitimate aspiration that should be part of multidisciplinary care for all men, women or couples living with HIV. The use of effective antiretroviral therapy has revolutionized the prevention of sexual, as well as mother-to-child HIV transmission. When the HIV plasma viral load is undetectable on long-term antiretroviral therapy, the risk of mother-to-child transmission is <1% and the risk of heterosexual HIV transmission without condom use in a stable relationship is very low (estimated at less than 1/10,000) in the absence of inflammation of the genital tract. In a man with a long-term undetectable viral load, viral shedding in semen is uncommon, but may occur persistently or intermittently. The same appears true of viral shedding in the vaginal tract of women. Reproductive options are: natural conception, self-insemination when the woman is HIV-infected, assisted reproduction. Natural conception is now considered to be an acceptable option when the conditions are met, after exploring four aspects: (1) virological (viral load undetectable sustained for at least 6 months on therapy), (2) genital (absence of genital infections or lesions), (3) fertility (after appropriate evaluation) and (4) detecting the ovulation period to limit intercourse without condoms. Assisted reproduction has two objectives in the context of HIV, to allow the couple to conceive without abandoning condom use and/or to treat infertility. PMID:24969954

  6. Effects of Reiki With Music Compared to Music Only Among People Living With HIV.

    PubMed

    Bremner, Marie N; Blake, Barbara J; Wagner, V Doreen; Pearcey, Sharon M

    2016-01-01

    Persons living with HIV (PLWH) often seek complementary treatments to improve their overall health and well-being. Reiki, an ancient healing practice, has been found to be effective in reducing symptoms of stress, anxiety, pain, and depression. The purpose of this pilot study was to evaluate the effectiveness of Reiki as a complementary treatment for PLWH. Using a two-group mixed-methods experimental design, 37 participants were randomized to either a 6-week Reiki with Music Group or a Music Only Group. Self-reported and physiologic measures were obtained at baseline, 6 weeks, and 10 weeks. Significant improvements in relief of pain and stress in those receiving RMG were found. At the 6-week assessment, semi-structured interviews were conducted with all participants. Qualitative findings indicated that Reiki and music therapy helped reduce stress, anxiety, and depression. Evidence-based data regarding the effectiveness of Reiki will help nurses help patients better manage HIV-related symptoms. PMID:27184735

  7. Stigma, secrecy, and discrimination: ethnic/racial differences in the concerns of people living with HIV/AIDS.

    PubMed

    Rao, Deepa; Pryor, John B; Gaddist, Bambi W; Mayer, Randy

    2008-03-01

    The HIV Stigma Scale is a measure that assesses stigmatization perceived and experienced by people living with HIV/AIDS (PLWHA). Using Item Response Theory (IRT) methodologies, the present study examined HIV Stigma Scale responses from 224 Black and 317 White PLWHA to determine whether cross-cultural differences exist in responses to items of the scale. IRT analysis revealed that eleven out of forty items functioned differently across groups. Black respondents had a higher probability of indicating greater stigmatization on items that described situations in which others discriminated against them, and White respondents had a higher probability of indicating greater stigmatization on items that described a resolve to keep their status a secret and fears of interpersonal rejection. These differences suggest that PLWHA have different experiences of stigma based on their ethnic/racial background, either because of cultural differences or the ways in which the participants interpreted items of the HIV Stigma Scale. PMID:17588146

  8. Technology use and reasons to participate in social networking health websites among people living with HIV in the US.

    PubMed

    Horvath, Keith J; Danilenko, Gene P; Williams, Mark L; Simoni, Jane; Amico, K Rivet; Oakes, J Michael; Simon Rosser, B R

    2012-05-01

    Online social media and mobile technologies hold potential to enhance adherence to antiretroviral therapy (ART), although little is known about the current use of these technologies among people living with HIV (PLWH). To address this gap in understanding, 312 PLWH (84% male, 69% White) US adults completed an online survey in 2009, from which 22 persons accepted an invitation to participate in one of two online focus groups. Results showed that 76% of participants with lower ART adherence used social networking websites/features at least once a week. Their ideal online social networking health websites included one that facilitated socializing with others (45% of participants) and ones with relevant HIV informational content (22%), although privacy was a barrier to use (26%). Texting (81%), and to a lesser extent mobile web-access (51%), was widely used among participants. Results support the potential reach of online social networking and text messaging intervention approaches. PMID:22350832

  9. Technology use and reasons to participate in online social networking websites for people living with HIV in the US

    PubMed Central

    Horvath, Keith J.; Danilenko, Gene P.; Williams, Mark L.; Simoni, Jane; Amico, K. Rivet; Oakes, J. Michael; Rosser, B.R. Simon

    2012-01-01

    It is unknown if online social networking technologies are already highly integrated among some people living with HIV (PLWH) or have yet to be adopted. To fill this gap in understanding, 312 PLWH (84% male, 69% white) residing in the US completed on online survey in 2009 of their patterns of social networking and mobile phone use. Twenty-two persons also participated in one of two online focus groups. Results showed that 76% of participants with lower adherence to HIV medication used social networking websites/features at least once a week. Their ideal online social networking health websites included one that facilitated socializing with others (45% of participants) and relevant informational content (22%), although privacy was a barrier to use (26%). Texting (81%), and to a lesser extent mobile web-access (51%), was widely used among participants. Results support the potential reach of online social networking and text messaging intervention approaches. PMID:22350832

  10. Food Insecurity and Its Relation to Psychological Well-Being Among South Indian People Living with HIV.

    PubMed

    Heylen, Elsa; Panicker, Siju Thomas; Chandy, Sara; Steward, Wayne T; Ekstrand, Maria L

    2015-08-01

    Food insecurity (FI) and its link with depression and quality of life (QOL) among people living with HIV (PLHIV) in India are not well-documented. We analyzed cohort data from 243 male and 129 female PLHIV from Bengaluru, and found 19 % of men and 26 % of women reported moderate or severe FI over a 6-month period. Women reported higher mean depression than men, and lower mean QOL. In multivariate analyses adjusting for HIV stigma and demographic covariates, both male and female PLHIV with moderate to severe FI showed lower mean QOL than those reporting mild to no FI. Male but not female food insecure participants also had higher depression scores in adjusted regression analyses. As ART has improved the physical health of PLHIV, more effort is being invested in improving their psychological well-being. Our results suggest such interventions could benefit from including nutritional support to reduce FI among PLHIV. PMID:25488171

  11. Palliative Care, Hospice, and Advance Care Planning: Views of People Living with HIV and Other Chronic Conditions.

    PubMed

    Slomka, Jacquelyn; Prince-Paul, Maryjo; Webel, Allison; Daly, Barbara J

    2016-01-01

    People living with HIV (PLWH) who survive to older adulthood risk developing multiple chronic medical conditions. Health policymakers recognize the role of early palliative care and advance care planning in improving health quality for at-risk populations, but misperceptions about palliative care, hospice, and advance care planning are common. Before testing a program of early palliative care for PLWH and other chronic conditions, we conducted focus groups to elicit perceptions of palliative care, hospice, and advance care planning in our target population. Overall, participants were unfamiliar with the term palliative care, confused concepts of palliative care and hospice, and/or associated hospice care with dying. Participants misunderstood advance care planning, but valued communication about health care preferences. Accepting palliative care was contingent on distinguishing it from hospice and historical memories of HIV and dying. Provision of high-quality, comprehensive care will require changing public perceptions and individuals' views in this high-risk population. PMID:27053406

  12. Improving Access to Mental Health Services for Racialized Immigrants, Refugees, and Non-Status People Living with HIV/AIDS.

    PubMed

    Chen, Y Y Brandon; Li, Alan Tai; Fung, Kenneth Po; Wong, Josephine Pui

    2015-05-01

    The demographic characteristics of people living with HIV/AIDS (PHAs) in Canada are increasingly diverse. Despite literature suggesting a potentially heightened mental health burden borne by racialized immigrant, refugee, and non-status PHAs (IRN-PHAs), researchers have hitherto paid insufficient attention to whether existing services adequately address this need and how services might be improved. Employing community-based research methodology involving PHAs from five ethnoracial groups in Toronto, Ontario, this study explored IRN-PHAs' mental health service-seeking behaviors, service utilization experiences, and suggestions for service improvements. Results showed that while most IRN-PHAs were proactive in improving their mental health, their attempts to obtain support were commonly undermined by service provider mistreatment, unavailability of appropriate services, and multiple access barriers. A three-pronged approach involving IRN-PHA empowerment, anti-stigma and cultural competence promotion, and greater service integration is proposed for improving IRN-PHAs' mental health service experience. PMID:25913347

  13. FOOD INSECURITY AND ITS RELATION TO PSYCHOLOGICAL WELL-BEING AMONG SOUTH INDIAN PEOPLE LIVING WITH HIV

    PubMed Central

    Heylen, Elsa; Panicker, Siju Thomas; Chandy, Sara; Steward, Wayne T.; Ekstrand, Maria L.

    2015-01-01

    Food insecurity (FI) and its link with depression and quality of life (QOL) among people living with HIV (PLHIV) in India are not well-documented. We analyzed cohort data from 243 male and 129 female PLHIV from Bengaluru, and found 19% of men and 26% of women reported moderate or severe FI over a six-month period. Women reported higher mean depression than men, and lower mean QOL. In multivariate analyses adjusting for HIV stigma and demographic covariates, both male and female PLHIV with moderate to severe FI showed lower mean QOL than those reporting mild to no FI. Male but not female food insecure participants also had higher depression scores in adjusted regression analyses. As ART has improved the physical health of PLHIV, more effort is being invested in improving their psychological well-being. Our results suggest such interventions could benefit from including nutritional support to reduce FI among PLHIV. PMID:25488171

  14. The meaning and perceived value of mind-body practices for people living with HIV: a qualitative synthesis.

    PubMed

    Donald, Graeme; Lawrence, Maggie; Lorimer, Karen; Stringer, Jacqui; Flowers, Paul

    2015-01-01

    Mind-body practices (MBPs) are a subset of complementary medicine that represents a selection of self-care activities that may promote the health of people living with HIV (PLWH). No synthesis of qualitative research in this context, which might inform service provision and research priorities, has yet been published. A systematic search of electronic databases was conducted, identifying papers exploring the experience of MBPs in PLWH. During thematic synthesis, all text under the headings "results" or "findings" was scanned line by line, and discrete, meaningful units of text were extracted as data items. Categories were identified, and second- and third-order constructs were developed. Concerns related to control and self-management appeared in the convergence of participants' worlds with the medical world and in being pragmatic about selecting MBPs and goal setting. The themes developed suggest a desire for more holistic and person-centered care, arguably marginalized as a result of effective antiretroviral therapy. PMID:25769753

  15. Understanding Space Weather influence on earthquake triggering to shield people living in seismic regions

    NASA Astrophysics Data System (ADS)

    Khachikyan, Galina; Inchin, Alexander; Kim, Alexander; Khassanov, Eldar

    2016-07-01

    There is an idea at present that space weather can influence not only the technological infrastructure and people's health, but seismic activity as well. Space weather impact on the Earth results from magnetic reconnection between the Sun's and Earth's magnetic fields. The effectiveness of reconnection depends on sign and magnitude of Z-components in solar wind magnetic field and earth's magnetic field as measured in the geocentric solar magnetosphere (GSM) coordinate system. The more negative value of Zgsm in the solar wind magnetic field, and the more positive value of Zgsm in the geomagnetic field, the more solar wind energy penetrates into the earth's environment due to reconnection. It was found recently by Khachikyan et al. [2012, http://www.scirp.org/journal/ijg] that maximal possible earthquake magnitude in a particular seismic region (seismic potential - Mmax) may be determined, in first approximation, on the base of maximal geomagnetic Zgsm value in this region, namely: Mmax = (5.22 +- 0.17) + (0.78 +- 0.06) x [abs (Zgsm)]. In this report we present statistical results on association between variations in space weather and global seismic activity, and demonstrate that a great Sumatra earthquake (M=9.1, on December 26, 2004, at 00:58:53 GMT) indeed occurred in region where the geomagnetic Zgsm components are largest at the globe. In the time of earthquake occurrence, geomagnetic Zgsm value in the epicenter (3.30N, 95.980E) was equal to ~37147 nT. A range of possible maximal magnitude, as estimated from above relation, could be of 8.8 - 9.2. The recorded magnitude M=9.1 is within this range.

  16. Prevalence of stroke and related burden among older people living in Latin America, India and China

    PubMed Central

    Schoenborn, Claudia; Kalra, Lalit; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Jacob, K S; Llibre Rodriguez, Juan J; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph D; Liu, Zhaorui; Moriyama, Tais; Valhuerdi, Adolfo; Prince, Martin J

    2011-01-01

    Objectives Despite the growing importance of stroke in developing countries, little is known of stroke burden in survivors. The authors investigated the prevalence of self-reported stroke, stroke-related disability, dependence and care-giver strain in Latin America (LA), China and India. Methods Cross-sectional surveys were conducted on individuals aged 65+ (n=15 022) living in specified catchment areas. Self-reported stroke diagnosis, disability, care needs and care giver burden were assessed using a standardised protocol. For those reporting stroke, the correlates of disability, dependence and care-giver burden were estimated at each site using Poisson or linear regression, and combined meta-analytically. Results The prevalence of self-reported stroke ranged between 6% and 9% across most LA sites and urban China, but was much lower in urban India (1.9%), and in rural sites in India (1.1%), China (1.6%) and Peru (2.7%). The proportion of stroke survivors needing care varied between 20% and 39% in LA sites but was higher in rural China (44%), urban China (54%) and rural India (73%). Comorbid dementia and depression were the main correlates of disability and dependence. Conclusion The prevalence of stroke in urban LA and Chinese sites is nearly as high as in industrialised countries. High levels of disability and dependence in the other mainly rural and less-developed sites suggest underascertainment of less severe cases as one likely explanation for the lower prevalence in those settings. As the health transition proceeds, a further increase in numbers of older stroke survivors is to be anticipated. In addition to prevention, stroke rehabilitation and long-term care needs should be addressed. PMID:21402745

  17. Dietary intakes and nutritional status of old people with dementia living at home in Oslo.

    PubMed

    Nes, M; Sem, S W; Rousseau, B; Bjørneboe, G E; Engedal, K; Trygg, K; Pedersen, J I

    1988-07-01

    A nutritional study was carried out of 16 independent-living elderly (9 women, 7 men) suffering from dementia and a control group matched for sex and age. The study consisted of interview (with participants or relatives/home helps), a 3-d weighed dietary record and biochemical determinations of blood components. No significant difference in mean daily energy intake between demented elderly (women 7.2 +/- 2.0 MJ, men 8.6 +/- 1.2 MJ) and controls (women 6.9 +/- 0.7 MJ, men 9.4 +/- 2.0 MJ) was found. The women with dementia had lower dietary intakes of protein (P less than 0.05), thiamin (P less than 0.05) and vitamin C (P less than 0.01) than female controls. For both sexes in both groups the nutrients most lacking were vitamin D and thiamin. Dietary supplements were more frequently used among elderly with dementia (50 per cent) than among controls (13 per cent) (P less than 0.05). Except for vitamin D, supplements did not reduce the number of demented elderly with low intakes (less than two-thirds of the recommendations) because generally those in most need were non-users. The demented elderly had lower levels of haemoglobin and folic acid (blood and plasma) (P less than 0.05) but better thiamin status (alpha-transketolase) than controls (P less than 0.05). No difference in mean levels of protein, 25-hydroxyvitamin D, vitamin E, vitamin B12 in serum was found. Individuals with blood or serum levels of nutrients below reference values were more frequently found among the demented elderly than among controls. In the dementia group 2 individuals with low levels of 25-hydroxyvitamin D also had clinical evidence of osteomalacia. PMID:3265665

  18. Sexuality and intimacy among people living with serious mental illnesses: Factors contributing to sexual activity

    PubMed Central

    Bonfils, Kelsey A.; Firmin, Ruth L.; Salyers, Michelle P.; Wright, Eric R.

    2015-01-01

    Objective Limited research has focused on sexuality for those diagnosed with a severe mental illness. We aimed to extend existing work by exploring relationships between mastery (perception of control of one's life and future), sexual self-esteem (perceptions of one's capacity to engage in healthy sexual behavior), sexual attitudes (permissive ideas about sexuality), and perceived importance of relationships/sexuality and number of sexual partners. Methods A secondary analysis of survey data from adult participants living with a severe mental illness (N=401) in the Indiana Mental Health Services and HIV-Risk Study (Perry & Wright, 2006) was conducted. Analysis of covariance (controlling for marital status) compared those with zero partners, one partner, or multiple partners over the past three months on the dependent variables of mastery, sexual self-esteem, sexual attitudes, and perceived importance. Results Participants with more permissive attitudes, greater perceived importance, and higher mastery were more likely to be sexually active with multiple partners. Self-esteem did not differentiate groups. Conclusions and Implications for Practice Given the key role of sexual satisfaction in quality of life and the high rates of sexual risk behavior in this population, it is important that clinicians systematically assess mastery, perceived importance, and attitudes about sexuality when working with consumers diagnosed with a severe mental illness. Individually tailoring existing interventions based on consumers' levels of mastery, related to self-efficacy for implementing changes in life, could improve long-term outcomes for these programs. Future research should examine other constructs that may account for more variance in sexual activity, such as perceptions of risk, intentions for sexual safety, or romantic relationship functioning. PMID:25664756

  19. Embodiment and biographical disruption in people living with HIV/AIDS (PLWHA).

    PubMed

    Alexias, George; Savvakis, Manos; Stratopoulou, Ιfigenia

    2016-05-01

    This study attempts to provide a concrete understanding to the embodied experience of HIV/AIDS. PLWHA have to cope with physical changes, especially lipodystrophy, caused by HIV and its treatment. These clinical manifestations make the disease socially visible and form a potential source of stigmatization. Visibility seems to transform the personal experience of this particular illness into a collective one. The changing body image and the stigma, which is often internalized by individuals, along with other consequences of chronic illness, such as alteration of life plans and social relationships, constitute new elements that appear in their life after diagnosis. These new experiences can break one's biographical continuity, especially in cases like HIV/AIDS. Semi-structured and in-depth interviews were conducted with 18 HIV-positive individuals (13 men, 5 women) with lipodystrophy. Their ages ranged from 36 to 65 years. The analysis of data revealed three main themes: loss of control over the body, ambivalence about visibility of HIV/AIDS, attributing positive meaning to HIV/AIDS. Physical changes caused by lipodystrophy are a source of dysphoria for PLWHA. This dissatisfaction was closely associated with the absence of control over their own body, due to the virus and the side effects of medication. Furthermore, it became evident that there was ambivalence among participants about the visibility of HIV, as it was in parallel a source of stigmatization, but also a part of their identity and biography. Results indicate that individuals were in search of meaning and constitute strategies in order to "answer" to the disruptive aspects of HIV. These were the normalization of illness, the integration into personal identity and the recognition of positive effects of HIV in their lives (e.g., stopping drug and alcohol abuse). Further research is required to identify the factors that determine the selection of each "answer" by these particular individuals who belong to

  20. Incidence and Risk Factors for Tuberculosis in People Living with HIV: Cohort from HIV Referral Health Centers in Recife, Brazil

    PubMed Central

    Batista, Joanna d’Arc Lyra; de Albuquerque, Maria de Fátima Pessoa Militão; Maruza, Magda; Ximenes, Ricardo Arraes de Alencar; Santos, Marcela Lopes; Montarroyos, Ulisses Ramos; de Barros Miranda-Filho, Demócrito; Lacerda, Heloisa Ramos; Rodrigues, Laura Cunha

    2013-01-01

    Objective To identify the incidence of and risk factors for tuberculosis in people living with HIV (PLHIV). Design Observational, prospective cohort study. Methods A total of 2069 HIV-infected patients was observed between July 2007 and December 2010. The Kaplan-Meier method was used to estimate the probability of survival free of tuberculosis, and Cox regression analysis to identify risk factors associated with the development of tuberculosis. Results Survival free of tuberculosis (TB) was 91%. The incidence rate of tuberculosis was 2.8 per 100 persons/years. Incidence of tuberculosis was higher when subjects had CD4 cell count <200 cells/mm3; were not on antiretroviral therapy; in those who had, a body mass index <18.5 kg/m2, anemia (or were not tested for it), were illiterate or referred previous tuberculosis treatment at entry into the cohort. Those not treated for latent TB infection had a much higher risk (HR = 7.9) of tuberculosis than those with a negative tuberculin skin test (TST). Having a TST≥5 mm but not being treated for latent TB infection increased the risk of incident tuberculosis even in those with a history of previous tuberculosis. Conclusions Preventive actions to reduce the risk of TB in people living with HIV should include an appropriate HAART and treatment for latent TB infection in those with TST≥5 mm. The actions towards enabling rigorous implementation of treatment of latent TB infection and targeting of PLHIV drug users both at the individual and in public health level can reduce substantially the incidence of TB in PLHIV. PMID:23675515

  1. The predictors of psychiatric disorders among people living with epilepsy as seen in a Nigerian Tertiary Health Institution

    PubMed Central

    Ayanda, Kazeem Ayinde; Sulyman, Dauda

    2016-01-01

    Background: Mental disorders may complicate epilepsy which can further impair the quality of life of people living with this chronic neurological condition. The aim of this study was to determine the types of psychiatric disorders in patients with epilepsy and to determine the sociodemographic and clinical factors that may predict these psychiatric illnesses. Materials and Methods: This is a descriptive cross-sectional study carried out over a period of 6 months at Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria. The Mini International Neuropsychiatric Interview was used to determine the psychological health of 74 consecutively recruited adult patients with epilepsy attending the psychiatric outpatients' clinic of the hospital. Psychiatric diagnoses were based on Diagnostic and Statistical Manual for Mental Disorders, 4th Edition criteria, and logistic regression analysis was done to determine variables that predict psychiatric disorder. Results: Majority of the participants were male (67.6%) with their age ranging from 18 to 68 years and the mean age of 30.55 ± 10.91 years. Thirty-three (44.6%) of our study respondents had psychiatric diagnoses that included major depressive disorder (21.6%), schizophrenia (17.6%), generalized anxiety disorder (4.1%), and hypomania (1.4%). Being unemployed (odds ratio [OR] = 3.24. 95% confidence interval [CI] = 1.15–9.10, P = 0.026) and short-term seizure free period (OR = 0.19, 95% CI = 0.04–0.78, P = 0.022) were the variables found to be predictive of psychiatric diagnoses. Conclusions: The study revealed that a large percentage of people living with epilepsy develop mental disorders which can further increase the burden and worsen the quality of life of patients with this chronic debilitating condition. PMID:27185975

  2. A narrative review of cost-effectiveness analysis of people living with HIV treated with HAART: from interventions to outcomes

    PubMed Central

    Tse, Wah Fung; Yang, Weimin; Huang, Wenlong

    2015-01-01

    Background Since its introduction in 1996, highly active antiretroviral therapy (HAART), which involves the combination of antiretroviral drugs, has resulted in significant improvements in the morbidity, mortality, and life expectancy of HIV-infected patients. Numerous studies of the cost-effectiveness of HAART from different perspectives in HIV have been reported. Aim To investigate the economic outcomes and relevance of HAART for people living with HIV. Materials and methods A narrative literature review was conducted on 22 peer-reviewed full economic evaluations of people living with HIV treated with different HAART regimens and published in English between January 2005 and December 2014. Information regarding study details, such as interventions, outcomes, and modeling methods, was extracted. The high heterogeneity of the included studies rendered a meta-analysis inappropriate; therefore, we conducted a comparative analysis of studies grouped according to the similarity of the different intervention types and outcomes. Results Most of the economic evaluations of HAART focused on comparisons between the specific HAART regimens and others from the following perspectives: injecting drug users versus noninjecting drug users, HIV-infected adults without AIDS versus those with AIDS, regimens based on developed world guidelines versus those based on developing world guidelines, self-administered HAART versus directly observed HAART, and “ideal” versus “typical” regimens. Conclusion In general, HAART is more cost-effective than other therapeutic regimens adopted so far. Further investigations, especially head-to-head comparisons of “ideal” and “typical” trials of different regimen combinations, are required to identify the optimal HAART regimens. PMID:26316787

  3. Integrating Prevention Interventions for People Living With HIV Into Care and Treatment Programs: A Systematic Review of the Evidence

    PubMed Central

    Medley, Amy; Bachanas, Pamela; Grillo, Michael; Hasen, Nina; Amanyeiwe, Ugochukwu

    2015-01-01

    Introduction This review assesses the impact of prevention interventions for people living with HIV on HIV-related mortality, morbidity, retention in care, quality of life, and prevention of ongoing HIV transmission in resource-limited settings (RLSs). Methods We conducted a systematic review of studies reporting the results of prevention interventions for people living with HIV in RLS published between January 2000 and August 2014. Standardized methods of searching and data abstraction were used. Results Ninety-two studies met the eligibility criteria: 24 articles related to adherence counseling and support, 13 on risk reduction education and condom provision, 19 on partner HIV testing and counseling, 14 on provision of family planning services, and 22 on assessment and treatment of other sexually transmitted infections. Findings indicate good evidence that adherence counseling and sexually transmitted infection treatment can have a high impact on morbidity, whereas risk reduction education, partner HIV testing and counseling, and family planning counseling can prevent transmission of HIV. More limited evidence was found to support the impact of these interventions on retention in care and quality of life. Most studies did not report cost information, making it difficult to draw conclusions about the cost-effectiveness of these interventions. Conclusions This evidence suggests that these prevention interventions, if brought to sufficient scale and coverage, can help support and optimize the impact of core treatment and prevention interventions in RLS. Further operational research with more rigorous study designs, and ideally with biomarkers and costing information, is needed to determine the best model for providing these interventions in RLS. PMID:25768868

  4. Instrumental Activities of Daily Living Performance and Role Satisfaction in People With and Without Mild Cognitive Impairment: A Pilot Project

    PubMed Central

    Anderson, Michael P.; Hershey, Linda A.; Prodan, Calin I.; Holm, Margo B.

    2015-01-01

    OBJECTIVE. We investigated differences in observed performance of instrumental activities of daily living (IADLs) and self-reported satisfaction with social role performance between people with amnestic mild cognitive impairment (a-MCI) and age- and gender-matched control participants. METHOD. We measured observed performance of 14 IADLs using the Independence, Safety, and Adequacy domains of the Performance Assessment of Self-Care Skills (PASS) and the Patient-Reported Outcomes Measurement Information Systems (PROMIS) to examine satisfaction with social role performance. RESULTS. Total PASS scores were significantly lower in participants with a-MCI (median = 40.6) than in control participants (median = 44.2; p = .006). Adequacy scores were also significantly lower. No significant differences were found between groups on the PROMIS measures. CONCLUSION. IADL differences between groups were related more to errors in adequacy than to safety and independence. Occupational therapy practitioners can play a key role in the diagnosis and treatment of subtle IADL deficits in people with MCI. PMID:25871600

  5. Stigma, discrimination, and sexual (dis)satisfaction among people living with HIV: results from the "AIDES et toi" survey.

    PubMed

    Rojas Castro, D; Le Gall, J M; Andreo, C; Spire, B

    2010-08-01

    The effects of HIV-related stigma and discrimination have been studied in several areas, such as access to testing, quality of care quality, and access to work. Nevertheless, the effects of stigma and discrimination on the sexual life of people living with HIV/AIDS (PLWHA) have not been studied enough. AIDES, a French community-based organization, has developed a biannual survey which assesses several socioeconomical and psychosocial dimensions of the people in contact with this organization. A focus on the results concerning sexual (dis)satisfaction and the factors associated are presented here. A convenience sample of 521 HIV-positive men having sex with men, heterosexual men and women was analyzed. A logistic regression was performed to examine which factors were significantly associated with sexual dissatisfaction. Results showed that being older, not having a full-time job, not having a steady sexual partner, lower frequency of sexual intercourse, discrimination in the sexual relationship setting, and the perception of loneliness were independently associated with sexual dissatisfaction. A quality health approach must include the aspects linked to sexual life and sexual satisfaction. Given the potentially harmful effects that HIV-related stigma and discrimination have on PLWHA's well-being, more specific actions and advocacy in this direction should be developed and implemented. PMID:20552468

  6. Alcohol, Brain Derived Neurotrophic Factor and Obesity among People Living with HIV

    PubMed Central

    Míguez-Burbano, María José; Espinoza, Luis; Cook, Robert L.; Mayra, Mayra; Bueno, Diego; Lewis, John E.; Asthana, Deshratan

    2014-01-01

    Introduction In an expanding HAART era, obesity has become a health problem among persons living with HIV (PLWH). Whereas the rising level of obesity has been largely attributed to poor nutrition and exercise habits, differences in biological factors may explain why some individuals gain more weight than others. Thus, our main goal is to prospectively determine in PLWH whether plasma brain-derived neurotrophic factor (BDNF), and hazardous alcohol use (HAU), two overlooked but highly prevalent conditions among PLWH, correlate with an adverse anthropometric profile. Also to test whether these relationships varied in men and women Methods The Platelets mediating Alcohol and HIV Damage Study (PADS) is an ongoing multiethnic study of 400 PLWH receiving regular medical care in South Florida (37% females and 63% males). Semi-annual visits consisted of a medical exam, including anthropometrics to assess both general (body mass index: BMI) and central obesity (waist and hip circumferences). Participants also completed health history questionnaires, and provided a fasting blood sample to obtain BDNF and immune and biochemical assessments. Results A sizable proportion of participants met the National Institutes of Health definition of overweight (BMI = 25–29.9 kg/m2; 26%) and obese (BMI ≥ 30 kg/m2; 35%). Women were more likely to be obese than men (OR=4.9, 95% CI=2.9–8.2, p=0.0001). Compared to men, women also exhibited the highest mean plasma BDNF levels (9,959 ± 6,578 vs. 7,470 ± 6,068 pg/ml, p=0.0001). Additional analyses indicated that HAU, particularly heavy drinkers, had the smallest waist and hip circumferences if they were males, but the opposite if they were females. High BDNF levels were positively correlated with BMI. Linear regression analysis revealed that gender, BDNF, and HAU were the best predictors of BMI. Conclusion In summary, our findings offer novel insights into the relationships between BDNF, and alcohol use among overweight and obese PLWH. Our

  7. The impact of psychological factors on self-reported sleep disturbance among people living in the vicinity of wind turbines.

    PubMed

    Jalali, Leila; Nezhad-Ahmadi, Mohammad-Reza; Gohari, Mahmood; Bigelow, Philip; McColl, Stephen

    2016-07-01

    Canada's wind energy capacity has grown from approximately 137MW (MW) in 2000 to over 9700MW in 2014, and this progressive development has made Canada the fifth-largest market in the world for the installation of new wind turbines (WTs). Although wind energy is now one of the fastest growing sources of power in Canada and many other countries, the growth in both number and size of WTs has raised questions regarding potential health impacts on individuals who live close to such turbines. This study is the first published research using a prospective cohort design, with noise and sleep measurements obtained before and after installation of WTs to investigate effect of such turbines on self-reported sleep disturbances of nearby residents. Subjective assessment of sleep disturbance was conducted in Ontario, Canada through standard sleep and sleepiness scales, including the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth daytime Sleepiness Scale (ESS). Both audible and infra-sound noises were also measured inside the bedroom. Descriptive and comparison analyses were performed to investigate the effect of WT exposure on sleep data. Results of the analysis show that participants reported poorer sleep quality if they had a negative attitude to WTs, if they had concerns related to property devaluation, and if they could see turbines from their properties. This study provides evidence for the role of individual differences and psychological factors in reports of sleep disturbance by people living in the vicinity of WTs. PMID:27131794

  8. Dimensions of Poverty and Health Outcomes Among People Living with HIV Infection: Limited Resources and Competing Needs.

    PubMed

    Kalichman, Seth C; Hernandez, Dominica; Kegler, Christopher; Cherry, Chauncey; Kalichman, Moira O; Grebler, Tamar

    2015-08-01

    HIV infection is concentrated in populations living in poverty. We examined the overlapping and independent effects of multiple poverty indicators on HIV-related health status. Because substance use can create competing survival needs when resources are limited, we also sought to objectively measure expenditures on food relative to alcohol and tobacco products. To achieve these aims, 459 men and 212 women living with HIV infection in Atlanta, GA completed measures of socio-demographic and heath characteristics as well as multiple indicators of poverty including housing stability, transportation, food insecurity, and substance use. Participants were given a $30 grocery gift card for their participation and we collected receipts which were coded for alcohol (beer, wine, liquors) and tobacco purchases. Results showed that participants with unsuppressed HIV replication were significantly more likely to experience multiple indicators of poverty. In addition, one in four participants purchased alcohol or tobacco products with their gift cards, with as much as one-fourth of money spent on these products. A multivariable logistic regression model showed that food insecurity was independently associated with unsuppressed HIV, and purchasing alcohol or tobacco products did not moderate this association. Results confirm previous research to show the primacy of food insecurity in relation to HIV-related health outcomes. Competing survival needs, including addictive substances, should be addressed in programs that aim to alleviate poverty to enhance the health and well-being of people with HIV infection. PMID:25572901

  9. Gender Differences in Severity and Correlates of Depression Symptoms in People Living with HIV in Ontario, Canada.

    PubMed

    Aljassem, Kinda; Raboud, Janet M; Hart, Trevor A; Benoit, Anita; Su, DeSheng; Margolese, Shari L; Rourke, Sean B; Rueda, Sergio; Burchell, Ann; Cairney, John; Shuper, Paul; Loutfy, Mona R

    2016-01-01

    This study investigates the differences in severity and correlates of depression symptoms among 1069 men and 267 women living with HIV in Ontario, Canada, who completed the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). Women had higher CES-D scores than that of men (median [interquartile range]: 13 [5-26] versus 9 [3-20], P=.0004). More women had total CES-D scores>15 (mild-moderate depression; 44% versus 33%, P=.002) and >21 (severe depression; 31% versus 23%, P=.003). Unlike men, at age 40, women's scores increased yearly (0.4 per increased year, P=.005). The distribution of scores differed by gender: There was no difference in the 10th percentile of depression scores, 0 (95% confidence interval [CI]: 1.0-1.0) but the 75th percentile of depression scores for women was 6 (95% CI: 2.0-10.0) points higher than that of men. Important gender differences exist in depression symptoms and in correlates of symptoms in people living with HIV. PMID:24899261

  10. Dimensions of Poverty and Health Outcomes among People Living with HIV Infection: Limited Resources and Competing Needs

    PubMed Central

    Kalichman, Seth C.; Hernandez, Dominica; Kegler, Christopher; Cherry, Chauncey; Kalichman, Moira O.; Grebler, Tamar

    2015-01-01

    HIV infection is concentrated in populations living in poverty. We examined the overlapping and independent effects of multiple poverty indicators on HIV-related health status. Because substance use can create competing survival needs when resources are limited, we also sought to objectively measure expenditures on food relative to alcohol and tobacco products. To achieve these aims, 459 men and 212 women living with HIV infection in Atlanta, GA completed measures of socio-demographic and heath characteristics as well as multiple indicators of poverty including housing stability, transportation, food insecurity, and substance use. Participants were given a $30 grocery gift card for their participation and we collected receipts which were coded for alcohol (beer, wine, liquors) and tobacco purchases. Results showed that participants with unsuppressed HIV replication were significantly more likely to experience multiple indicators of poverty. In addition, one in four participants purchased alcohol or tobacco products with their gift cards, with as much as one-fourth of money spent on these products. A multivariable logistic regression model showed that food insecurity was independently associated with unsuppressed HIV, and purchasing alcohol or tobacco products did not moderate this association. Results confirm previous research to show the primacy of food insecurity in relation to HIV-related health outcomes. Competing survival needs, including addictive substances, should be addressed in programs that aim to alleviate poverty to enhance the health and well-being of people with HIV infection. PMID:25572901

  11. Improving the prevention, diagnosis and treatment of TB among people living with HIV: the role of operational research

    PubMed Central

    2011-01-01

    Operational research is necessary to improve the access to and delivery of tuberculosis prevention, diagnosis and treatment interventions for people living with HIV. We conducted an extensive review of the literature and reports from recent expert consultations and research-related meetings organized by the World Health Organization and the Stop TB Partnership to identify a TB/HIV operational research agenda. We present critical operational research questions in a series of key areas: optimizing TB prevention by enhancing the uptake of isoniazid preventive therapy and the implementation of infection control measures; assessing the effectiveness of existing diagnostic tools and scaling up new technologies; improving service delivery models; and reducing risk factors for mortality among TB patients living with HIV. We discuss the potential impact that addressing the operational research questions may have on improving programmes’ performance, assessing new strategies or interventions for TB control, or informing global or national policy formulation. Financial resources to implement these operational research questions should be mobilized from existing and new funding mechanisms. National TB and HIV/AIDS programmes should develop their operational research agendas based on these questions, and conduct the research that they consider crucial for improving TB and HIV control in their settings in collaboration with research stakeholders. PMID:21967874

  12. Factors associated with access to antiretroviral therapy among people living with hiv in vientiane capital, lao pdr.

    PubMed

    Chanvilay, Thammachak; Yoshida, Yoshitoku; Reyer, Joshua A; Hamajima, Nobuyuki

    2015-02-01

    Since 2001, antiretroviral therapy (ART) has been available for people living with HIV (PLHIV) in Lao People's Democratic Republic (PDR). Over 10 years of the ART program many HIV patients were found with advanced-stage AIDS in health care service facilities. This study aimed to examine factors associated with delayed access to ART among PLHIV in the capital of Vientiane. A cross-sectional study was conducted with 283 respondents (131 males and 152 females) aged 15 years or over. In this study, delayed access to ART was defined by a CD4 cell count of less than 350 cells/mm(3) at the first screening, or those who presented with advanced AIDS-related symptoms. The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by a logistic model. After adjustment, young people (OR=2.17; 95% CI: 1.00-4.68; p=0.049), low education (OR=0.23; 95% CI: 0.10-0.55; p=0.001) and duration between risk behavior and HIV test (OR=3.83; 95% CI: 1.22-12.00; p=0.021) were significantly associated with delayed access to ART. Low perception of high risk behaviors was one of the obstacles leading to delayed testing and inability to access ART. Almost all reported feeling self-stigma, and only 30.5% of men and 23.7% of women disclosed the HIV status to his/her partner/spouse. In conclusion, delayed access to ART was associated with individual factors and exposure to health care facility. In order to improve early detection HIV infection following access to ART, an improvement in perceptional knowledge of HIV, as well as reduction of HIV/AIDS-related stigma, might be needed. PMID:25797968

  13. Managing the wandering behaviour of people living in a residential aged care facility.

    PubMed

    Hodgkinson, Brent; Koch, Susan; Nay, Rhonda; Lewis, Matthew

    2007-12-01

    Background  Wandering behaviour is frequently seen in older people with cognitive impairment. The prevalence of patients exhibiting wandering behaviour has been estimated to be 11.6% on traditional units and 52.7% on Alzheimer's units. Wandering is one of the core behavioural characteristics that impact on familial carers and is likely to influence the decision to place a family member in an aged care environment. Considering the possible risks associated with wandering behaviour, the successful identification and management of wandering is essential. Wandering is also a problem for caregivers in the institutionalised setting, in terms of containment, usually being addressed by securing the environment. There has been some research conducted to assist in the understanding and management of wandering behaviour; however, the findings have been diverse resulting in a level of confusion about the best approaches to take. Objectives  This review aims to present the best available evidence on the management of wandering in older adults who reside in an aged care facility (both high and low care). Search strategy  An extensive search of keywords contained in the title and abstract, and relevant MeSH headings and descriptor terms was performed on the following databases: MEDLINE, CINAHL, PsychINFO, AGELINE, Cochrane Library, Embase, APAIS Health, Current Contents, Dare, Dissertation Abstracts, Personal Communication, Social Science Index. Selection criteria  Papers were selected if they focused on the treatment of wandering in an institutional setting. Some studies were not specifically examining wanderers over the age of 65 years as per the protocol requirements, but were included as it was felt that their findings could be applied to this age group. Data collection and analysis  Study design and quality were tabulated and relative risks, odds ratios, mean differences and associated 95% confidence intervals were calculated from individual comparative studies

  14. In the mood for love or vice versa? Exploring the relations among sexual activity, physical affection, affect, and stress in the daily lives of mid-aged women.

    PubMed

    Burleson, Mary H; Trevathan, Wenda R; Todd, Michael

    2007-06-01

    How do physical affection, sexual activity, mood, and stress influence one another in the daily lives of mid-aged women? Fifty-eight women (M age, 47.6 yrs) recorded physical affection, several different sexual behaviors, stressful events, and mood ratings every morning for 36 weeks. Using multilevel modeling, we determined that physical affection or sexual behavior with a partner on one day significantly predicted lower negative mood and stress and higher positive mood on the following day. The relation did not hold for orgasm without a partner. Additionally, positive mood on one day predicted more physical affection and sexual activity with a partner, but fewer solo orgasms the following day. Negative mood was mostly unrelated to next-day sexual activity or physical affection. Sexual orientation, living with a partner, and duration of relationship moderated some of these effects. Results support a bidirectional causal model in which dyadic sexual interaction and physical affection improve mood and reduce stress, with improved mood and reduced stress in turn increasing the likelihood of future sex and physical affection. PMID:17109236

  15. [Evaluation of the work-related disability in people affected by Ehlers-Danlos syndrome].

    PubMed

    Bogni, M; Basotti, A; Vigna, L; Brunani, A; Bertazzi, P A; Riboldi, L

    2012-01-01

    The Ehlers-Danlos syndrome (EDS), inherited disorder of connective tissue, frequently leads to impairment of various functional areas, including employment. In 35 subjects with classic type EDS, 14 hypermobile, 3 vascular was administered 7 visual analogical scales (pain, stiffness, activities of daily living, instrumental activities of daily living, work, social relations). An impairment of particular significance in total score and in individual areas emerges is in the hypermobile group, followed by classic, less for the vasculature. Overall there is a significant alteration of the quality of life that deserves proper evaluation to facilitate the definition of fitness and the improvement of job insertion in patients with EDS. PMID:23405630

  16. How Many People Are Affected by or at Risk for Cushing's Syndrome?

    MedlinePlus

    ... Small Business Programs Activities and opportunities geared toward small businesses Peer Review Review of the scientific & technical merit of grant applications Contacts for NICHD Funding Information ... at risk for Cushing’s syndrome? Skip sharing on social media links Share this: Page Content The risk of developing Cushing’s syndrome is small; only two to three people per million are ...

  17. How Are Young People's Experiences of "Home" Affecting Their Engagement with Schooling and Community?

    ERIC Educational Resources Information Center

    Rowe, Paula; Savelsberg, Harry

    2010-01-01

    Little consideration has been given to the influence of housing tenure on young people's developmental pathways. This paper draws on empirical findings from research conducted in the northern suburbs of Adelaide in 2009 to highlight how secure and quality housing tenure, when combined with familial support and positive relationships with teachers…

  18. Education Affects Attitudes of Physical Therapy Providers toward People with Dementia

    ERIC Educational Resources Information Center

    Staples, William H.; Killian, Clyde B.

    2012-01-01

    A survey was sent to every skilled nursing home (N = 495) in Indiana regarding the demographics, education, and whether the severity of dementia impacts the attitudes of people in physical therapy practice. Physical therapists (PTs) and physical therapist assistants (PTAs) practicing in nursing homes spend considerable time (44.0%) working with…

  19. Otoacoustic Emissions, Auditory Evoked Potentials and Self-Reported Gender in People Affected by Disorders of Sex Development (DSD)

    PubMed Central

    Wisniewski, Amy B.; Espinoza-Varas, Blas; Aston, Christopher E.; Edmundson, Shelagh; Champlin, Craig A.; Pasanen, Edward G.; McFadden, Dennis

    2014-01-01

    Both otoacoustic emissions (OAEs) and auditory evoked potentials (AEPs) are sexually dimorphic, and both are believed to be influenced by prenatal androgen exposure. OAEs and AEPs were collected from people affected by 1 of 3 categories of disorders of sex development (DSD) – (1) women with complete androgen insensitivity syndrome (CAIS); (2) women with congenital adrenal hyperplasia (CAH); and (3) individuals with 46, XY DSD including prenatal androgen exposure who developed a male gender despite initial rearing as females (men with DSD). Gender identity (GI) and role (GR) were measured both retrospectively and at the time of study participation, using standardized questionnaires. The main objective of this study was to determine if patterns of OAEs and AEPs correlate with gender in people affected by DSD and in controls. A second objective was to assess if OAE and AEP patterns differed according to degrees of prenatal androgen exposure across groups. Control males, men with DSD, and women with CAH produced fewer spontaneous OAEs (SOAEs) – the male-typical pattern – than control females and women with CAIS. Additionally, the number of SOAEs produced correlated with gender development across all groups tested. Although some sex differences in AEPs were observed between control males and females, AEP measures did not correlate with gender development, nor did they vary according to degrees of prenatal androgen exposure, among people with DSD. Thus, OAEs, but not AEPs, may prove useful as bioassays for assessing early brain exposure to androgens and predicting gender development in people with DSD. PMID:25038289

  20. Otoacoustic emissions, auditory evoked potentials and self-reported gender in people affected by disorders of sex development (DSD).

    PubMed

    Wisniewski, Amy B; Espinoza-Varas, Blas; Aston, Christopher E; Edmundson, Shelagh; Champlin, Craig A; Pasanen, Edward G; McFadden, Dennis

    2014-08-01

    Both otoacoustic emissions (OAEs) and auditory evoked potentials (AEPs) are sexually dimorphic, and both are believed to be influenced by prenatal androgen exposure. OAEs and AEPs were collected from people affected by 1 of 3 categories of disorders of sex development (DSD) - (1) women with complete androgen insensitivity syndrome (CAIS); (2) women with congenital adrenal hyperplasia (CAH); and (3) individuals with 46,XY DSD including prenatal androgen exposure who developed a male gender despite initial rearing as females (men with DSD). Gender identity (GI) and role (GR) were measured both retrospectively and at the time of study participation, using standardized questionnaires. The main objective of this study was to determine if patterns of OAEs and AEPs correlate with gender in people affected by DSD and in controls. A second objective was to assess if OAE and AEP patterns differed according to degrees of prenatal androgen exposure across groups. Control males, men with DSD, and women with CAH produced fewer spontaneous OAEs (SOAEs) - the male-typical pattern - than control females and women with CAIS. Additionally, the number of SOAEs produced correlated with gender development across all groups tested. Although some sex differences in AEPs were observed between control males and females, AEP measures did not correlate with gender development, nor did they vary according to degrees of prenatal androgen exposure, among people with DSD. Thus, OAEs, but not AEPs, may prove useful as bioassays for assessing early brain exposure to androgens and predicting gender development in people with DSD. PMID:25038289

  1. Perception of Lay People Regarding Determinants of Health and Factors Affecting It: An Aggregated Analysis from 29 Countries

    PubMed Central

    ZAHRA, Aqeela; LEE, Eun-Whan; SUN, Li-Yuan; PARK, Jae-Hyun

    2015-01-01

    Background: This study aimed to evaluate the perception of lay people regarding determinants of health at global level and factors affecting it. Methods: Data was collected from International Social Survey Program (ISSP) and World Bank website. Multilevel regression analysis was done and lay people’s perception regarding health behavior, environment, poverty and genes as health determinants was assessed. Various socio demographic factors were used as independent variables. Results: The highest percentage of people agreed environment as determinant of health. An inverse relationship was observed between GNI quartiles and an individual’s agreement with poverty, health behavior, and environment as health determinant. There was a significant negative association of females with health damaging behavior (P<0.05) and positive association with environment and genes (P<0.05) as health determinants. Elderly people agreed with poverty as determinant of health (P<0.05). GNI was negatively related to environment (P<0.05) and poverty (P<0.05) as health determinant. Conclusion: The common public is now becoming aware of a broadened concept of health and people belonging to different backgrounds have different perceptions regarding determinants of health. Our results show that highest percentage of people agreed with environment as determinant of health, which is consistent with scientific view of increased burden of disease, caused by environmental factors. Thus, tailored health programs and policies that address an individual’s specific problems are likely to induce a change in behavior and attitude, hence decreasing the disease burden. PMID:26811813

  2. Out-of-school lives of physically disabled children and young people in the United Kingdom: a qualitative literature review.

    PubMed

    Knight, Kate Helen; Porcellato, Lorna; Tume, Lyvonne

    2014-09-01

    Currently there appears to be few opportunities and little evidence of physically disabled children and young people (C&YP) participating in mainstream social activities. A qualitative review was undertaken to examine the factors affecting physically disabled C&YP (8-15 years) in the United Kingdom participating in out-of-school activities. Views and experiences were explored from the perspective of the service users and providers to assess current provision and to determine the need for future research into factors that may affect participation. Searches were conducted across eight databases, the references of the included studies were checked and the websites were searched. Studies that used a qualitative design that examined the views relating to out-of-school activities were included. Nine papers were identified, which included three peer-reviewed papers and six pieces of grey literature and pertinent government documents to include views and experiences of out-of-school activity provision. The main themes emerging from the review were the need for social inclusion, out-of-school activities run by volunteers and accessibility, with threads throughout, which require further research including parental influence, provision, training and attitudes. This review highlights the absence of the service user's voice and sheds light on the limited provision and barriers affecting participation in out-of-school activities. PMID:23818148

  3. AIDS-Related Stigma and Mental Disorders among People Living with HIV: A Cross-Sectional Study in Cambodia

    PubMed Central

    Yi, Siyan; Chhoun, Pheak; Suong, Samedy; Thin, Kouland; Brody, Carinne; Tuot, Sovannary

    2015-01-01

    Background AIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV). We therefore conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia. Methods A two-stage cluster sampling method was used to select 1,003 adult PLHIV from six provinces. The People Living with HIV Stigma Index was used to measure stigma and discrimination, and a short version of general health questionnaire (GHQ-12) was used to measure mental disorders. Multivariate logistic regression analysis was conducted. Results The reported experiences of discrimination in communities in the past 12 months ranged from 0.8% for reports of being denied health services to 42.3% for being aware of being gossiped about. Internal stigma was also common ranging from 2.8% for avoiding going to a local clinic and/or hospital to 59.6% for deciding not to have (more) children. The proportions of PLHIV who reported fear of stigma and discrimination ranged from 13.9% for fear of being physically assaulted to 34.5% for fear of being gossiped about. The mean score of GHQ-12 was 3.2 (SD = 2.4). After controlling for several potential confounders, higher levels of mental disorders (GHQ-12≥ 4) remained significantly associated with higher levels of experiences of stigma and discrimination in family and communities (AOR = 1.9, 95% CI = 1.4–2.6), higher levels of internal stigma (AOR = 1.7, 95% CI = 1.2–2.3), and higher levels of fear of stigma and discrimination in family and communities (AOR = 1.5, 95% CI = 1.1–2.2). Conclusions AIDS-related stigma and discrimination among PLHIV in Cambodia are common and may have potential impacts on their mental health conditions. These findings indicate a need for community-based interventions to reduce stigma and discrimination in the general public and to help PLHIV to cope with this situation. PMID:25806534

  4. Weight and height of people living with HIV/AIDS attended by the Brazilian National Health System.

    PubMed

    Bassichetto, Katia Cristina; Bergamaschi, Denise Pimentel; Frainer, Deivis Elton Schlickmann; Garcia, Vania Regina Salles; Trovões, Edina Aparecida Tramarin

    2013-09-01

    The nutritional status of people living with HIV/AIDS (PLWHA) is related to morbidity and mortality and its monitoring is important in the maintenance of the health status. This is a cross-sectional study carried out in Brazilian National Health System in the Municipality of São Paulo. It describes anthropometrical characteristics: weight and height; indices of weight for height (W/H), height for age (H/A), body mass index for age (BMI/A) and Z score for height and weight. The study includes 772 participants from all ages: children, adolescents, adults and elderly. The graphical analysis shows that in under-5s and in the 5 to 19 years old group, the W/H, the H/A and the BMI/A curves are similar to the reference population with an exception in the H/A for 5 to 19 years old group which is left-shifted (mean Z = -0.66). In the case of adults, graphics for the study population show median weight apparently lower than in the reference population for most age groups in the case of men, and when age is greater in women. The proportion of people over 20 years old with AIDS on anti-retroviral therapy is lower when coinfection is present (p < 0.001). The findings of the study showed that, for children and adolescents with HIV/AIDS, the average weight and height are lower than the values for non infected population. For adults and elderly, the weight average is lower than the reference population with a worsening among coinfected patients. This underscores the need to direct more effort in nutritional actions thus helping enhance the health status of this group. PMID:24896276

  5. Does social capital travel? Influences on the life satisfaction of young people living in England and Spain

    PubMed Central

    2012-01-01

    Background This study used a social capital framework to examine the relationship between a set of potential protective ('health assets') factors and the wellbeing of 15 year adolescents living in Spain and England. The overall purpose of the study was to compare the consistency of these relationships between countries and to investigate their respective relative importance. Methods Data were drawn from the 2002, English and Spanish components of the WHO Health Behaviour in School-Aged Children (HBSC) survey A total of 3,591 respondents (1884, Spain; 1707, England) aged 15, drawn from random samples of students in 215 and 80 schools respectively were included in the study. A series of univariate, bivariate and multivariate (general linear modelling and decision tree) analyses were used to establish the relationships. Results Results showed that the wellbeing of Spanish and English adolescents is similar and good. Three measures of social capital and 2 measures of social support were found to be important factors in the general linear model. Namely, family autonomy and control; family and school sense of belonging; and social support at home and school. However, there were differences in how the sub components of social capital manifest themselves in each country--feelings of autonomy of control, were more important in England and social support factors in Spain. Conclusions There is some evidence to suggest that social capital (and its related concept of social support) do travel and are applicable to young people living in Spain and England. Given the different constellation of assets found in each country, it is not possible to define exactly the precise formula for applying social capital across cultures. This should more appropriately be defined at the programme planning stage. PMID:22353283

  6. Brain Derived Neurotrophic Factor and Cognitive Status: The Delicate Balance Among People Living with HIV, with and without Alcohol Abuse

    PubMed Central

    Míguez-Burbano, María José; Espinoza, Luis; Whitehead, Nicole Ennis; Bryant, Vaughn E.; Vargas, Mayra; Cook, Robert L.; Quiros, Clery; Lewis, John E.; Deshratan, Asthana

    2015-01-01

    Introduction The advent of combination antiretroviral therapy(cART) has lead to a significant reduction in morbidity and mortality among people living with HIV(PLWH). However, HIV-associated neurocognitive disorders (HAND) still remain a significant problem. One possible mechanism for the persistence of these disorders is through the effect of HIV on brain-derived neurotrophic factor (BDNF). BDNF is influenced by various factors including hazardous alcohol use (HAU), which is prevalent among PLWH. This study attempts to elucidate the relationships between HAU, BDNF and HAND. Methods Cross-sectional analyses were conducted on a sample of 199 hazardous alcohol users and 198 non-HAU living with HIV. Members of each group were matched according to sociodemographic characteristics and CD4 count. Research procedures included validated questionnaires, neuropsychological assessments and a blood sample to obtain BDNF and immune measurements. Results Hazardous alcohol users showed either significantly lower or significantly higher BDNF levels compared to the Non-hazardous (OR=1,4; 95% CI: 1–2.1, p = 0.003). Therefore, for additional analyses, subjects were categorized based on BDNF values in: Group 1 < 4000, Group 2: 4001–7,999 (reference group), and Group 3 for those >8,000 pg/mL. Groups 1 and 3 performed significantly worse than those in Group 2 in the domains of processing speed, auditory-verbal and visuospatial learning and memory. Multivariate analyses confirmed that HAU and BDNF are significant contributors of HAND. Conclusion Our findings offer novel insights into the relationships between BDNF, and alcohol use among PLWH. Our results also lend support to expanding clinical movement to use BDNF as an intervention target for PLWH, in those with evidence of deficiencies, and highlight the importance of including HAU at the inception of clinical trials. PMID:25053366

  7. Social networks and mental health among people living with human immunodeficiency virus (HIV) in Johannesburg, South Africa.

    PubMed

    Odek, Willis Omondi

    2014-01-01

    People living with human immunodeficiency virus (PLHIV) in developing countries can live longer due to improved treatment access, and a deeper understanding of determinants of their quality of life is critical. This study assessed the link between social capital, operationally defined in terms of social networks (group-based and personal social networks) and access to network resources (access to material and non-material resources and social support) and health-related quality of life (HRQoL) among 554 (55% female) adults on HIV treatment through South Africa's public health system. Female study participants were involved with more group-based social networks but had fewer personal social networks in comparison to males. Access to network resources was higher among females and those from larger households but lower among older study participants. Experience of social support significantly increased with household economic status and duration at current residence. Social capital indicators were unrelated to HIV disease status indicators, including duration since diagnosis, CD4 count and viral load. Only a minority (13%) of study participants took part in groups formed by and for predominantly PLHIV (HIV support groups), and participation in such groups was unrelated to their mental or physical health. Personal rather than group-linked social networks and access to network resources were significantly associated with mental but not physical health, after controlling for sociodemographic characteristics. The findings of limited participation in HIV support groups and that the participation in such groups was not significantly associated with physical or mental health may suggest efforts among PLHIV in South Africa to normalise HIV as a chronic illness through broad-based rather than HIV-status bounded social participation, as a strategy for deflecting stigma. Further research is required to examine the effects of HIV treatment on social networking and participation

  8. Disclosure Pattern of Self-Labeled People Living with HIV/AIDS on Chinese Social Networking Site: An Exploratory Study.

    PubMed

    Han, Jin; Tian, Xianyun; Yu, Guang; He, Fang

    2016-08-01

    HIV/AIDS is an important public health issue in China. The number of people living with HIV/AIDS (PLWHA) has been increasing since the introduction of highly active antiretroviral therapy. PLWHA's life quality is becoming an important issue, with lack of research in China. In this study, a group of PLWHA (n = 663) was identified using HIV/AIDS relevant usernames on a Chinese social networking site (Weibo) to study their daily living situations. We found that more than 99.10% of PLWHA were male, among whom 90.80% turned out to be homosexual. They had significantly more fans and followees, but fewer postings compared to the general population. The mean age of the PLWHA was 28.96 (SD = 5.05) years old, and southwest and northwest China had a high prevalence of HIV/AIDS. In addition, PLWHA's postings were coded and we found that more than half of the postings (n = 769, 51.03%) contained strong emotions. Less than one-fifth of the postings were directly related to HIV/AIDS topics (n = 269, 17.85%), while seeking emotional support, such as looking for stable partnership, was ranked as the first priority of support seeking. In summary, we found that the majority of the self-labeled PLWHA were likely to be men who have sex with men. They used Weibo to share their daily life events and seek emotional support. Implications for promoting HIV/AIDS education and prevention through Chinese social networking sites were also discussed. PMID:27494331

  9. College Student Affect and Heavy Drinking: Variable Associations Across Days, Semesters, and People

    PubMed Central

    Howard, Andrea L.; Patrick, Megan E.; Maggs, Jennifer L.

    2014-01-01

    This study tested associations between positive and negative affect and heavy drinking in 734 college students who completed daily diaries in 14-day bursts once per semester over 7 semesters (≤98 days per person). Three-level multilevel models tested whether affect and heavy drinking were linked across days, semesters, and persons. Higher daily, between-semester, and between-person positive affect were each associated with a greater odds of heavy drinking on weekdays and on weekend days. A significant interaction with semester in college showed that the association between daily positive affect and heavy drinking on weekend days became stronger over time. That is, heavy drinking on a weekend day with higher positive affect was more likely in later years of college (OR=2.93, Fall of 4th year), compared to earlier in college (OR=1.80, Fall of 1st year). A similar interaction was found for between-semester positive affect and heavy drinking on weekdays. Higher daily negative affect was associated with a greater odds of heavy drinking on weekdays only for students who first began drinking in 7th grade or earlier (OR=2.36). Results of this study highlight the importance of varied time spans in studying the etiology, consequences, and prevention of heavy drinking. Harm-reduction strategies that target positive affect-related drinking by encouraging protective behaviors during celebratory events may become increasingly important as students transition to later years of college. PMID:25347017

  10. Factors Affecting the Retention of Individuals as Important People for Ex-Offenders in Early Recovery

    PubMed Central

    Jason, Leonard A.; Stone, Ariel; Stevens, Ed; Light, John M.

    2013-01-01

    Objective Few studies consider the retention of the individuals (alters) comprising the social networks of people in recovery. We conducted a longitudinal study exploring several possible factors predicting whether alters were retained six months after participants completed treatment. Method The Important Person Inventory was given to 270 ex-offenders (224 men, 46 women) transitioning from treatment to Oxford House residences, Safe Haven therapeutic communities, or to usual aftercare. A 6-month follow-up was completed by 176 participants (137 men, 39 women). Results We found that alters who were related to the participant, did not use drugs, were embedded in smaller networks, and had more frequent contact with the participant were significantly more likely to be retained as important people over 6 months, but found no effects based on alters’ drinking or criminal history. Conclusions Certain characteristics of important people are related to their retention in a social network. Understanding these relationships is essential for creating effective social interventions for addictions. PMID:24521088

  11. Live substrate positively affects root growth and stolon direction in the woodland strawberry, Fragaria vesca

    PubMed Central

    Waters, Erica M.; Watson, Maxine A.

    2015-01-01

    Studies of clonal plant foraging generally focus on growth responses to patch quality once rooted. Here we explore the possibility of true plant foraging; the ability to detect and respond to patch resource status prior to rooting. Two greenhouse experiments were conducted to investigate the morphological changes that occur when individual daughter ramets of Fragaria vesca (woodland strawberry) were exposed to air above live (non-sterilized) or dead (sterilized) substrates. Contact between daughter ramets and substrate was prohibited. Daughter ramet root biomass was significantly larger over live versus dead substrate. Root:shoot ratio also increased over live substrate, a morphological response we interpret as indicative of active nutrient foraging. Daughter ramet root biomass was positively correlated with mother ramet size over live but not dead substrate. Given the choice between a live versus a dead substrate, primary stolons extended preferentially toward live substrates. We conclude that exposure to live substrate drives positive nutrient foraging responses in F. vesca. We propose that volatiles emitted from the substrates might be effecting the morphological changes that occur during true nutrient foraging. PMID:26483826

  12. More Intense Experiences, Less Intense Forecasts: Why People Overweight Probability Specifications in Affective Forecasts

    PubMed Central

    Buechel, Eva C.; Zhang, Jiao; Morewedge, Carey K.; Vosgerau, Joachim

    2014-01-01

    We propose that affective forecasters overestimate the extent to which experienced hedonic responses to an outcome are influenced by the probability of its occurrence. The experience of an outcome (e.g., winning a gamble) is typically more affectively intense than the simulation of that outcome (e.g., imagining winning a gamble) upon which the affective forecast for it is based. We suggest that, as a result, experiencers allocate a larger share of their attention toward the outcome (e.g., winning the gamble) and less to its probability specifications than do affective forecasters. Consequently, hedonic responses to an outcome are less sensitive to its probability specifications than are affective forecasts for that outcome. The results of 6 experiments provide support for our theory. Affective forecasters overestimated how sensitive experiencers would be to the probability of positive and negative outcomes (Experiments 1 and 2). Consistent with our attentional account, differences in sensitivity to probability specifications disappeared when the attention of forecasters was diverted from probability specifications (Experiment 3) or when the attention of experiencers was drawn toward probability specifications (Experiment 4). Finally, differences in sensitivity to probability specifications between forecasters and experiencers were diminished when the forecasted outcome was more affectively intense (Experiments 5 and 6). PMID:24128184

  13. Health, wellbeing, and disability among older people infected or affected by HIV in Uganda and South Africa

    PubMed Central

    Nyirenda, Makandwe; Newell, Marie-Louise; Mugisha, Joseph; Mutevedzi, Portia C.; Seeley, Janet; Scholten, Francien; Kowal, Paul

    2013-01-01

    Objective To describe and compare the health status, emotional wellbeing, and functional status of older people in Uganda and South Africa who are HIV infected or affected by HIV in their families. Methods Data came from the general population cohort and Entebbe cohort of the Medical Research Council/Uganda Virus Research Institute, and from the Africa Centre Demographic Information System through cross-sectional surveys in 2009/10 using instruments adapted from the World Health Organization (WHO) Study on Global Ageing and adult health (SAGE). Analysis was based on 932 people aged 50 years or older (510 Uganda, 422 South Africa). Results Participants in South Africa were slightly younger (median age − 60 years in South Africa, 63 in Uganda), and more were currently married, had no formal education, were not working, and were residing in a rural area. Adjusting for socio-demographic factors, older people in South Africa were significantly less likely to have good functional ability [adjusted odds ratio (aOR) 0.72, 95% CI 0.53–0.98] than those in Uganda, but were more likely to be in good subjective wellbeing (aOR 2.15, 95% CI 1.60–2.90). South Africans were more likely to be obese (aOR 5.26, 95% CI 3.46–8.00) or to be diagnosed with hypertension (aOR 2.77, 95% CI 2.06–3.73). Discussion and conclusions While older people’s health problems are similar in the two countries, marked socio-demographic differences influence the extent to which older people are affected by poorer health. It is therefore imperative when designing policies to improve the health and wellbeing of older people in sub-Saharan Africa that the region is not treated as a homogenous entity. PMID:23364075

  14. Virological and Immunological Status of the People Living with HIV/AIDS Undergoing ART Treatment in Nepal.

    PubMed

    Ojha, Chet Raj; Shakya, Geeta; Dumre, Shyam Prakash

    2016-01-01

    Antiretroviral therapy (ART) has increased the life span of the people living with HIV (PLHIV), but their virological and immunological outcomes are not well documented in Nepal. The study was conducted at a tertiary care center including 826 HIV-1 seropositive individuals undergoing ART for at least six months. Plasma viral load (HIV-1 RNA) was detected by Real Time PCR and CD4(+) T-lymphocyte (CD4(+)) counts were estimated by flow cytometry. The mean CD4(+) count of patients was 501 (95% CI = 325-579) cells/cumm, but about 35% of patients had CD4(+) T cell counts below 350 cells/cumm. With increasing age, average CD4(+) count was found to be decreasing (p = 0.005). Of the total cases, 82 (9.92%) were found to have virological failure (viral load: >1000 copies/ml). Tenofovir/Lamivudine/Efavirenz (TDF/3TC/EFV), the frequently used ART regimen in Nepal, showed virological failure in 11.34% and immunological failure in 37.17% of patients. Virological failure rate was higher among children < 15 years (14.5%) (p = 0.03); however, no association was observed between ART outcomes and gender or route of transmission. The study suggests there are still some chances of virological and immunological failures despite the success of highly active ART (HAART). PMID:27547761

  15. Antiretroviral Treatment Adherence Rate and Associated Factors among People Living with HIV in Dubti Hospital, Afar Regional State, East Ethiopia

    PubMed Central

    Negus, Rahma

    2015-01-01

    Introduction. Antiretroviral Therapy has transformed HIV infection into a chronic manageable disease; it requires near perfect adherence rates (as high as 95%). In this study, we assessed antiretroviral treatment adherence rate and associated factors among people living with HIV in Dubti Hospital. Methods. A retrospective cross-sectional study design was conducted within February 1–30, 2014. All HIV-infected patients above the age of 18 years who took first line Antiretroviral Therapy were eligible for inclusion of the study. Adherence Scale was used for labeling patients as adherent or nonadherent. All HIV-infected patients record data were collected from the medical records, entered, and analyzed using Epi Info 7 and SPSS Version 20. Multivariable analysis was used to identify the relative effect of explanatory variables on low adherence rate. Results. A total of 370 patients aged 18 years and above, who started ART, were included in this study. The self-reported adherence rate of the patient on ART was 81.1%. Independent predictors of adherence were treatment duration. Conclusion. Adherence rate was associated with time to ART. That is, the longer they were on ART, the lesser they adhered.

  16. Psychosocial factors as predictors of HIV/AIDS risky behaviors among people living with HIV/AIDS

    PubMed Central

    Gerbi, Gemechu B.; Habtemariam, Tsegaye; Robnett, Vinaida; Nganwa, David; Tameru, Berhanu

    2012-01-01

    Infection with the human immunodeficiency virus (HIV) that causes acquired immunodeficiency syndrome (AIDS) is still rising globally. In order to develop effective HIV/AIDS risky behavior reduction intervention strategies and to further decrease the spread of HIV/AIDS, it is important to assess the prevalence of psychosocial problems and HIV/AIDS risky behaviors in people living with HIV/AIDS (PLWHA). The objective of this study is to assess the relationship between psychosocial variables and HIV/AIDS risky behaviors among PLWHA. A total of 341 questionnaires were distributed and 326 were fully completed and returned, 96% response rate. The relationships between the identified psychosocial and HIV/AIDS risky behaviors among PLWHA were analyzed using The Moment Structures software version 17.0 (SPSS Inc.) The results indicate that psychosocial health problems were significant predictors of HIV/AIDS risky behaviors in PLWA. Further cross-disciplinary research that addresses the manner in which psychosocial problems and HIV/AIDS risky behaviors interact with each other among PLWHA is needed. PMID:22374351

  17. Home-based care for people living with HIV/AIDS in Plateau State, Nigeria: findings from qualitative study.

    PubMed

    Agbonyitor, M

    2009-01-01

    As health-care services in Nigeria and other African countries are becoming overstrained with patients, home-based care has increasingly been touted as a possible solution. The faith-based organisation, Gospel Health and Development Services, provides a home-based care programme for people living with HIV/AIDS (PLWHA) residing in Plateau State, Nigeria. This paper assesses the challenges that PLWHA in the programme faced while maintaining their health and livelihoods. The frustrations that volunteers endured in performing their work are also described, as well as the benefits and weaknesses of the programme from the perspective of PLWHA and their volunteer caregivers. Focus groups and interviews were done with 30 PLWHA and 22 volunteers to learn about their experiences with the home-based care programme and possible areas for its improvement. From these discussions three major challenges facing PLWHA emerged: discrimination towards PLWHA; the lack of money, food, and transport to health-care centres; and the desire for closer antiretroviral drug access. PMID:19437217

  18. Rates and predictors of consistent condom-use by people living with HIV/AIDS on antiretroviral treatment in Uganda.

    PubMed

    Ayiga, Natal

    2012-09-01

    Antiretroviral treatment (ART) has been recognized as one of the methods for reducing the risk of HIV transmission, and access to this is being rapidly expanded. However, in a generalized HIV epidemic, ART could increase unprotected sex by people living with HIV/AIDS (PHAs). This paper assessed the rates and predictors of consistent condom-use by sexually-active PHAs after initiating ART. The study used cross-sectional data on sexual behaviour of 269 sexually-active ART-experienced individuals (95 males and 174 females) aged 18 years and above. The results revealed that 65% (70% of men and 61% of women) used condom consistently after initiating ART. Consistent use of condom was more likely if PHAs had secondary- or tertiary-level education and had more than one sex partner in the 12 months preceding the study. However, PHAs were less likely to have used condom consistently if they worked in the informal and formal sectors, belonged to the medium- and high-income groups, and were married. PHAs, who were on ART for less than 1 year and 1-2 year(s), had a good self-perception of health, had a sexual partner who was HIV-negative or a partner with unknown HIV status, and desired to bear children, were also less likely to have used condom consistently. The paper concluded that, although the majority of PHAs consistently used condom, there was potential for unprotected sex by PHAs on ART. PMID:23082629

  19. Gender and ethnicity differences in HIV-related stigma experienced by people living with HIV in Ontario, Canada.

    PubMed

    Loutfy, Mona R; Logie, Carmen H; Zhang, Yimeng; Blitz, Sandra L; Margolese, Shari L; Tharao, Wangari E; Rourke, Sean B; Rueda, Sergio; Raboud, Janet M

    2012-01-01

    This study aimed to understand gender and ethnicity differences in HIV-related stigma experienced by 1026 HIV-positive individuals living in Ontario, Canada that were enrolled in the OHTN Cohort Study. Total and subscale HIV-related stigma scores were measured using the revised HIV-related Stigma Scale. Correlates of total stigma scores were assessed in univariate and multivariate linear regression. Women had significantly higher total and subscale stigma scores than men (total, median = 56.0 vs. 48.0, p<0.0001). Among men and women, Black individuals had the highest, Aboriginal and Asian/Latin-American/Unspecified people intermediate, and White individuals the lowest total stigma scores. The gender-ethnicity interaction term was significant in multivariate analysis: Black women and Asian/Latin-American/Unspecified men reported the highest HIV-related stigma scores. Gender and ethnicity differences in HIV-related stigma were identified in our cohort. Findings suggest differing approaches may be required to address HIV-related stigma based on gender and ethnicity; and such strategies should challenge racist and sexist stereotypes. PMID:23300514

  20. The Framing and Fashioning of Therapeutic Citizenship Among People Living With HIV Taking Antiretroviral Therapy in Uganda.

    PubMed

    Russell, Steve; Namukwaya, Stella; Zalwango, Flavia; Seeley, Janet

    2016-09-01

    In this article, we examine how people living with HIV (PLWH) were able to reconceptualize or "reframe" their understanding of HIV and enhance their capacity to self-manage the condition. Two in-depth interviews were held with 38 PLWH (20 women, 18 men) selected from three government and nongovernment antiretroviral therapy (ART) delivery sites in Wakiso District, and the narratives analyzed. ART providers played an important role in shaping participants' HIV self-management processes. Health workers helped PLWH realize that they could control their condition, provided useful concepts and language for emotional coping, and gave advice about practical self-management tasks, although this could not always be put into practice. ART providers in this setting were spaces for the development of a collective identity and a particular form of therapeutic citizenship that encouraged self-management, including adherence to ART. Positive framing institutions are important for many PLWH in resource-limited settings and the success of ART programs. PMID:26246523

  1. Retrospective evaluation of cotrimoxazole use as preventive therapy in people living with HIV/AIDS in Boru Meda Hospital

    PubMed Central

    2014-01-01

    Background Drug use evaluation is a performance improvement method that focuses on evaluating and improving drug use process to achieve optimal patient outcomes. Drug use evaluation helps in identifying, preventing or resolving actual and potential drug related problems. The objective of the study was to evaluate the use of cotrimoxazole as preventive therapy in people living with HIV/AIDS in Boru Meda Hospital, Northeast Ethiopia. Methods A retrospective drug use evaluation was conducted on patients’ medical history records based on a validated drug use evaluation criteria according to the national guideline. Medical history records of 248 patients were selected using systematic sampling method. Results The result showed that 49.6% of the patients were at WHO clinical stage III at the start of cotrimoxazole preventive therapy. In this study, the use of cotrimoxazole preventive therapy was consistent with the guideline in the rationale for indication (97.98%), dose (96.77%), and its use despite the presence of contraindications (91.93%). Problems regarding drug-drug interaction were identified in 49.59% of cases, and 20.97% of patients discontinued cotrimoxazole preventive therapy due to different reasons. Conclusions In most patients cotrimoxazole preventive therapy was consistent with the national guideline regarding the rationale for indication, dose, discontinuation and its use in the presence of contraindications. PMID:24507658

  2. Gender and Ethnicity Differences in HIV-related Stigma Experienced by People Living with HIV in Ontario, Canada

    PubMed Central

    Loutfy, Mona R.; Logie, Carmen H.; Zhang, Yimeng; Blitz, Sandra L.; Margolese, Shari L.; Tharao, Wangari E.; Rourke, Sean B.; Rueda, Sergio; Raboud, Janet M.

    2012-01-01

    This study aimed to understand gender and ethnicity differences in HIV-related stigma experienced by 1026 HIV-positive individuals living in Ontario, Canada that were enrolled in the OHTN Cohort Study. Total and subscale HIV-related stigma scores were measured using the revised HIV-related Stigma Scale. Correlates of total stigma scores were assessed in univariate and multivariate linear regression. Women had significantly higher total and subscale stigma scores than men (total, median = 56.0 vs. 48.0, p<0.0001). Among men and women, Black individuals had the highest, Aboriginal and Asian/Latin-American/Unspecified people intermediate, and White individuals the lowest total stigma scores. The gender-ethnicity interaction term was significant in multivariate analysis: Black women and Asian/Latin-American/Unspecified men reported the highest HIV-related stigma scores. Gender and ethnicity differences in HIV-related stigma were identified in our cohort. Findings suggest differing approaches may be required to address HIV-related stigma based on gender and ethnicity; and such strategies should challenge racist and sexist stereotypes. PMID:23300514

  3. The Framing and Fashioning of Therapeutic Citizenship Among People Living With HIV Taking Antiretroviral Therapy in Uganda

    PubMed Central

    Russell, Steve; Namukwaya, Stella; Zalwango, Flavia; Seeley, Janet

    2015-01-01

    In this article, we examine how people living with HIV (PLWH) were able to reconceptualize or “reframe” their understanding of HIV and enhance their capacity to self-manage the condition. Two in-depth interviews were held with 38 PLWH (20 women, 18 men) selected from three government and nongovernment antiretroviral therapy (ART) delivery sites in Wakiso District, and the narratives analyzed. ART providers played an important role in shaping participants’ HIV self-management processes. Health workers helped PLWH realize that they could control their condition, provided useful concepts and language for emotional coping, and gave advice about practical self-management tasks, although this could not always be put into practice. ART providers in this setting were spaces for the development of a collective identity and a particular form of therapeutic citizenship that encouraged self-management, including adherence to ART. Positive framing institutions are important for many PLWH in resource-limited settings and the success of ART programs. PMID:26246523

  4. Advancing Behavioral HIV Prevention: Adapting an Evidence-Based Intervention for People Living with HIV and Alcohol Use Disorders

    PubMed Central

    Armstrong, M. L.; LaPlante, A. M.; Altice, F. L.; Copenhaver, M.; Molina, P. E.

    2015-01-01

    Alcohol use disorders (AUDs) are highly prevalent among people living with HIV/AIDS (PLWHA) and are associated with increased HIV risk behaviors, suboptimal treatment adherence, and greater risk for disease progression. We used the ADAPT-ITT strategy to adapt an evidence-based intervention (EBI), the Holistic Health Recovery Program (HHRP+), that focuses on secondary HIV prevention and antiretroviral therapy (ART) adherence and apply it to PLWHA with problematic drinking. Focus groups (FGs) were conducted with PLWHA who consume alcohol and with treatment providers at the largest HIV primary care clinic in New Orleans, LA. Overall themes that emerged from the FGs included the following: (1) negative mood states contribute to heavy alcohol consumption in PLWHA; (2) high levels of psychosocial stress, paired with few adaptive coping strategies, perpetuate the use of harmful alcohol consumption in PLWHA; (3) local cultural norms are related to the permissiveness and pervasiveness of drinking and contribute to heavy alcohol use; (4) healthcare providers unanimously stated that outpatient options for AUD intervention are scarce, (5) misperceptions about the relationships between alcohol and HIV are common; (6) PLWHA are interested in learning about alcohol's impact on ART and HIV disease progression. These data were used to design the adapted EBI. PMID:26697216

  5. Cholesterol as a Mediator of Alcohol-Induced Risks for Respiratory Disease Hospitalizations among People Living With HIV

    PubMed Central

    Míguez, María José; Rosenberg, Rhonda; Burbano, Ximena; Malow, Robert

    2012-01-01

    We analyzed the role of cholesterol as a potential mediator of alcohol-increased risk of respiratory infections that required hospitalization in People Living with HIV (PLWH). Using a longitudinal clinic-based design, 346 PLWH were consecutively admitted and followed at Jackson Memorial Medical Center(enrolled in the study). Following national guidelines, PLWH were stratified according to cholesterol levels: <150 mg/dl (Hypocholesterolemia= HypoCHL), 151-200, and >200 mg/dl Hypercholesterolemia =HyperCHL), and compared on the basis of clinical outcomes, lymphocyte phenotypes and behavioral risks. Analyses indicated that compared to HyperCHL participants, HypoCHL subjects were more likely to be hospitalized, particularly for lower respiratory tract infections (LRTI). Excessive admissions were associated with more deviant lymphocyte profiles, particularly limited NK cells. In logistic regression analyses, smoking (OR=1.5), HypoCHL (OR=7.7), and alcohol (OR=1.2) were predictors of LRTI. These findings warrant further investigation of the potential use of HypoCHL as a risk marker, and the cost-effectiveness of switching prevention gears towards HypoCHL, alcohol and tobacco in PLWH. PMID:23565339

  6. Promoting self-help activities for people living with HIV / AIDS in Ho Chi Minh City, Vietnam.

    PubMed

    Le Truong Giang; Nguyen Huu Luyen; Le Thuy Lan Thao; Narimani, P

    1999-01-01

    The rising epidemic of HIV/AIDS in Ho Chi Minh City presents new challenges for sexually transmitted disease/HIV prevention in Vietnam. Most HIV/AIDS cases are found south of the country and this puts a burden on the Ho Chi Minh City AIDS Committee. Building on experiences from other countries, the AIDS Committee successfully implemented measures such as needle-exchange programs, condom distribution, peer education, and outreach activities. It also established a meeting place, the Cafe Hy Vong, for female sex workers and intravenous drug users. From the beginning, the Committee regarded meeting the special needs of people living with HIV/AIDS (PHA) as important prevention activities, and encouraged PHA to discuss their concerns with the committee. The PHA formed the Friend-to-Friend group in October 1995, where the Ho Chi Minh AIDS Committee gave its full support. The group organizes meetings and social gatherings where they can share their feelings and experiences, as well as get information and counseling. PMID:12349769

  7. Engaging therapeutic citizenship and clientship: Untangling the reasons for therapeutic pacifism among people living with HIV in urban Zambia.

    PubMed

    Patterson, Amy S

    2016-10-01

    This article explores the reasons for therapeutic pacifism among people living with HIV (PLHIVs) in urban Zambia. It contributes to a growing ethnography on global health, biosociality, and patient-provider dynamics. Therapeutic citizenship is a biopolitical citizenship that includes claims and ethical projects that emerge from techniques to control and manage bodies. In some contexts, therapeutic citizenship has included activism and claims-making against local, national, and international power brokers. This article investigates therapeutic citizenship in the specific context of impoverished urban Zambian compounds, sites of food insecurity, unemployment, and political exclusion, as well as targets for donor, NGO, and faith-based organisation projects and PLHIV support group proliferation. The article utilises data from participant observations at two Lusaka AIDS clinics, interviews, and focused discussions with support groups of PLHIVs. It argues that PLHIVs continuously negotiate subjectivities related to kinship, clientship, religious belief, and political citizenship in processes that complicate therapeutic citizenship. Rather than fostering participation in PLHIV support groups or challenging 'politics as usual' through activist claims-making to institutions of biopower, these processes lead to therapeutic pacifism. PMID:26256509

  8. Challenges Faced by People Living with HIV/AIDS in Cape Town, South Africa: Issues for Group Risk Reduction Interventions

    PubMed Central

    Cloete, Allanise; Strebel, Anna; Simbayi, Leickness; van Wyk, Brian; Henda, Nomvo; Nqeketo, Ayanda

    2010-01-01

    This paper presents the findings of an exploratory study to investigate the challenges faced by people living with HIV/AIDS (PLWHA) in communities in Cape Town, South Africa. The primary goal of the study was to gather data to inform the adaptation of a group risk reduction intervention to the South African context. Qualitative methods were used to examine the experiences of PLWHA. Eight focus group discussions (FGDs) were conducted with 83 HIV-positive participants and 14 key informants (KIs) involved in work with PLWHA were interviewed. Findings revealed that AIDS-related stigma was still pervasive in local communities. This was associated with the difficulty of disclosure of their status for fear of rejection. Also notable was the role of risky behaviours such as lack of condom use and that PLWHA considered their HIV/AIDS status as secondary to daily life stressors like poverty, unemployment, and gender-based violence. These findings have implications for the adaptation or development of behavioural risk reduction interventions for PLWHA. PMID:21490904

  9. A qualitative study of stigma and discrimination against people living with HIV in Ho Chi Minh City, Vietnam.

    PubMed

    Thi, Mai Doan Anh; Brickley, Deborah Bain; Vinh, Dang Thi Nhat; Colby, Donn J; Sohn, Annette H; Trung, Nguyen Quang; Giang, Le Truong; Mandel, Jeffrey S

    2008-07-01

    Stigma and discrimination against people living with HIV/AIDS (PLHIV) are a pressing problem in Vietnam, in particular because of propaganda associating HIV with the "social evils" of sex work and drug use. There is little understanding of the causes and sequelae of stigma and discrimination against PLHIV in Vietnam. Fifty-three PLHIV participated in focus group discussions in Ho Chi Minh City. Nearly all participants experienced some form of stigma and discrimination. Causes included exaggerated fears of HIV infection, misperceptions about HIV transmission, and negative representations of PLHIV in the media. Participants faced problems getting a job, perceived unfair treatment in the workplace and experienced discrimination in the healthcare setting. Both discrimination and support were reported in the family environment. There is a need to enforce laws against discrimination and provide education to decrease stigma against PLHIV in Vietnam. Recent public campaigns encouraging compassion toward PLHIV and less discrimination from healthcare providers who work with PLHIV have been encouraging. PMID:18360743

  10. Prevalence and Correlates of Smoking and Readiness to Quit Smoking in People Living with HIV in Austria and Germany.

    PubMed

    Brath, Helmut; Grabovac, Igor; Schalk, Horst; Degen, Olaf; Dorner, Thomas E

    2016-01-01

    We aimed to investigate the prevalence and correlates of smoking in people living with HIV (PLWHIV) in Germany and Austria and their readiness to quit. A total of 447 consecutive patients with confirmed positive HIV status who were treated in different outpatient HIV centres in Austria and Germany were included. Nicotine dependence and stages of change were assessed by standardized questionnaires, and this was confirmed by measuring exhaled carbon monoxide. Prevalence of smoking was 49.4%. According to a multivariate logistic regression analysis, higher age (for each year of life OR = 0.96; 95% CI 0.92-1.00) and tertiary education level (OR = 0.43; 95% CI 0.15-0.79) were associated with a lower chance, and occasional (OR = 3.75; 95% CI 1.74-8.07) and daily smoking of the partner (OR 8.78; 95% CI 4.49-17.17) were significantly associated with a higher chance of smoking. Moderate (OR = 3.41; 95% CI = 1.30-9.05) and higher nicotine dependency level (OR = 3.40; 95% CI 1.46-7.94), were significantly associated with higher chance, and older age (for each year of life OR = 0.95; 95% CI = 0.91-0.99), with lower chance for readiness to quit smoking. Those results may be used to address preventive measures to quit smoking aimed at PLWHIV and the importance of addressing smoking habits. PMID:26919722

  11. Alcohol and Sexual Risk Reduction Interventions among People Living in Russia: A Systematic Review and Meta-Analysis

    PubMed Central

    Lan, Chiao-Wen; Scott-Sheldon, Lori A. J.; Carey, Kate B.; Johnson, Blair T.; Carey, Michael P.

    2013-01-01

    Russia has one of the highest rates of alcohol consumption and is experiencing one of the fastest-growing HIV epidemics in the world. Given these co-occurring health problems, we systematically reviewed combined alcohol and sexual risk interventions to reduce HIV among Russians. We completed comprehensive electronic searches to locate studies that (a) sampled people living in Russia, (b) used a behavioral intervention, and (c) assessed both alcohol and sexual risk behavior. These searches yielded 584 studies, of these, 2 were included. Compared with controls, intervention participants reported increasing their condom use (ds ranged from 0.12 to 0.85). Within-group improvements in sexual behaviors were found for both groups (ds ranged from 0.19 to 1.94); participants reported fewer sexual partners, more condom use, and reduced alcohol or drug use before sex. These findings support the need and potential benefits for alcohol and HIV interventions among Russians, and suggest directions for public policy. PMID:24104461

  12. Modelling level, trend and geographical variations in stigma and discrimination against people living with HIV/AIDS in Nigeria.

    PubMed

    Adebayo, Samson B; Fakolade, Richard; Anyanti, Jennifer; Ekweremadu, Bright; Ladipo, Olaronke; Ankomah, Augustine

    2011-01-01

    People living with HIV and AIDS (PLHA) often face stigma and discrimination. Stigma is a powerful tool for social control and PLHA are to varying degrees stigmatised against. Consequences of stigma and discrimination against PLHA may result in low turn-out for HIV counselling and testing, identity crises, isolation, loneliness, low self-esteem and lack of interest in containing the disease. To achieve the millennium development goal on HIV reduction, efforts should be targeted at measuring impact of HIV preventive interventions. In this paper, effort was made to explore geographical variations in addition to level and trend of accepting attitude towards PLHA using 2003 - 2007 population-based household survey data. Inferences are based on Markov Chain Monte Carlo techniques, while model selection was based on Deviance Information Criteria. Findings revealed significant positive trend and spatial variations on level of accepting attitude towards PLHA. Level of exposure to HIV prevention interventions and perceptions about social support received on HIV are significantly associated with accepting attitude towards PLHA. Findings provide policy makers with tools to discern states where prevention efforts on HIV-related stigma and discrimination should be intensified. This in turn, can enhance an effective utilization of scarce resources that is paramount in developing countries. PMID:23237726

  13. Virological and Immunological Status of the People Living with HIV/AIDS Undergoing ART Treatment in Nepal

    PubMed Central

    Dumre, Shyam Prakash

    2016-01-01

    Antiretroviral therapy (ART) has increased the life span of the people living with HIV (PLHIV), but their virological and immunological outcomes are not well documented in Nepal. The study was conducted at a tertiary care center including 826 HIV-1 seropositive individuals undergoing ART for at least six months. Plasma viral load (HIV-1 RNA) was detected by Real Time PCR and CD4+ T-lymphocyte (CD4+) counts were estimated by flow cytometry. The mean CD4+ count of patients was 501 (95% CI = 325–579) cells/cumm, but about 35% of patients had CD4+ T cell counts below 350 cells/cumm. With increasing age, average CD4+ count was found to be decreasing (p = 0.005). Of the total cases, 82 (9.92%) were found to have virological failure (viral load: >1000 copies/ml). Tenofovir/Lamivudine/Efavirenz (TDF/3TC/EFV), the frequently used ART regimen in Nepal, showed virological failure in 11.34% and immunological failure in 37.17% of patients. Virological failure rate was higher among children < 15 years (14.5%) (p = 0.03); however, no association was observed between ART outcomes and gender or route of transmission. The study suggests there are still some chances of virological and immunological failures despite the success of highly active ART (HAART). PMID:27547761

  14. Personality as a predictor of unprotected sexual behavior among people living with HIV/AIDS: a systematic review.

    PubMed

    Shuper, Paul A; Joharchi, Narges; Rehm, Jürgen

    2014-02-01

    The present investigation involved a systematic literature review to (1) identify associations between personality constructs and unprotected sex among people living with HIV/AIDS (PLWH); (2) assess patterns of direct versus indirect personality-risky sex associations; and (3) explore possible differences in personality-risky sex associations among PLWH versus non-infected populations. Among the 26 studies yielded through the systematic search, sensation seeking and sexual compulsivity were the constructs most frequently examined, with fewer studies investigating traditional personality typologies. Personality constructs that were more conceptually proximal to the sexual act, such as sexual compulsivity and sex-related sub-components of sensation seeking, showed relatively direct associations with unprotected sex, whereas more conceptually distal constructs such as generalized impulsivity demonstrated only weak or indirect associations. Associations were also frequently mediated by other risk factors, including perceived responsibility and substance use. These findings have implications for the development of interventions to reduce high risk sexual behavior among PLWH. PMID:23835736

  15. How Many People Are Affected By or Are at Risk for Neural Tube Defects?

    MedlinePlus

    ... are affected by or are at risk for neural tube defects? Skip sharing on social media links Share this: ... with spina bifida. 1 The other types of neural tube defects are less common. About 340 infants are born ...

  16. A Qualitative Exploration of Motivation to Self-Manage and Styles of Self-Management amongst People Living with Type 2 Diabetes.

    PubMed

    Newton, Paul; Asimakopoulou, Koula; Scambler, Sasha

    2015-01-01

    The study examined the motives that people living with type 2 diabetes (T2D) had for self-managing their condition and ways they used to assess the success of their self-management efforts. Using semistructured interviews (N = 25), focus groups (3 × N = 12 participants), and open-ended questionnaires (N = 6), people living with and self-managing T2D were recruited from a community-based T2D participation group. Most participants were older (aged 60+) and lived in a socioeconomically deprived area in the United Kingdom. Data were analysed thematically using framework analysis. Patients' motives for self-management included (i) concern about the anticipative effects of T2D; (ii) wishing to "stay well"; (iii) maintaining independence; (iv) reducing the need for healthcare professionals; and (v) improving quality of life. Six self-management styles were found and pertained to self-managing: (i) through routinisation; (ii) as a burden; (iii) as maintenance; (iv) through delegation; (v) through comanagement; and (vi) through autonomy. Motivators for self-management shaped the criteria people used to judge the success of their self-management practices and influenced their self-management style. The findings show that styles of T2D self-management are mediated and moderated by sociocontextual issues. Healthcare professionals should take these into account when supporting people living with T2D. PMID:26075285

  17. Reducing Medical Students' Stigmatization of People with Chronic Mental Illness: A Field Intervention at the "Living Museum" State Hospital Art Studio

    ERIC Educational Resources Information Center

    Cutler, Janis L.; Harding, Kelli J.; Hutner, Lucy A.; Cortland, Clarissa; Graham, Mark J.

    2012-01-01

    Objective: The authors designed an intervention to reduce beginning medical students' stigmatization of people with chronic mental illness (CMI). Methods: Pre-clinical medical students visited a state psychiatric facility's "Living Museum," a combination patient art studio/display space, as the intervention. During the visit, students interacted…

  18. Where and How People Live. Language Arts around the World, Volume IV. Cross-Curricular Activities for Grades 4-6.

    ERIC Educational Resources Information Center

    McAllister, Elizabeth A.; Hildebrand, Joan M.; Ericson, Joann H.

    Suggesting that students in the intermediate grades can explore the world around them and practice valuable skills in spelling, reading, writing, communication, and language, this book presents cross-curricular units designed to integrate language-arts activities into the study of where and how people live. The units in the book reach diverse…

  19. Grief and Bereavement Issues and the Loss of a Companion Animal: People Living with a Companion Animal, Owners of Livestock, and Animal Support Workers

    ERIC Educational Resources Information Center

    Chur-Hansen, Anna

    2010-01-01

    Companion animals play various roles in people's lives and these roles can impact on loss, grief, bereavement and mourning when the animal has been lost, whether that is through death, when missing, or when relinquished. This paper considers not only companion animal owners, but also those who own farm animals and those who work in animal service…

  20. Prevalence of Sexually Transmitted Co-Infections in People Living with HIV/AIDS: Systematic Review with Implications for using HIV Treatments for Prevention

    PubMed Central

    Kalichman, Seth C.; Pellowski, Jennifer; Turner, Christina

    2015-01-01

    Background Sexually transmitted co-infections increase HIV infectiousness through local inflammatory processes. The prevalence of STI among people living with HIV/AIDS has implications for containing the spread of HIV in general and the effectiveness of HIV treatments for prevention in particular. Methods A systematic review of studies examining STI co-infections in people living with HIV/AIDS. The review focuses on STI contracted after becoming HIV infected. Electronic database and manual searches located clinical and epidemiological studies of STI that increase HIV infectiousness. Results Thirty seven studies of STI-HIV co-infection prevalence were located. Studies of adults living with HIV/AIDS from developed and developing countries reported STI rates for 46 different samples (33 samples had clinical/laboratory confirmed STI). The overall mean point-prevalence for confirmed STI was16.3% (SD = 16.4), and median 12.4% STI prevalence in people living with HIV/AIDS. The most common STI studied were Syphilis with median 9.5% prevalence, gonorrhea 9.5%, Chlamydia 5%, and Trichamoniasis 18.8% prevalence. STI prevalence was greatest at the time of HIV diagnosis, reflecting the role of STI in HIV transmission. Prevalence of STI among individuals receiving HIV treatment was not appreciably different from untreated persons. Conclusions The prevalence of STI in people infected with HIV suggests that STI co-infections could undermine efforts to use HIV treatments for prevention by increasing genital secretion infectiousness. PMID:21330572

  1. Stigmatizing Attitudes towards People Living with HIV/AIDS among College Students in China: Implications for HIV/AIDS Education and Prevention

    ERIC Educational Resources Information Center

    Zhang, Liying; Li, Xiaoming; Mao, Rong; Stanton, Bonita; Zhao, Qun; Wang, Bo; Mathur, Ambika

    2008-01-01

    Purpose: The purpose of this paper is to show that HIV/AIDS-related stigma has persisted world-wide for decades. However, studies on the linkage between stigmatizing attitudes towards people living with HIV/AIDS (PLWHA) and misconceptions about HIV transmission routes in the general population, especially among youth in China, are sparse--a gap…

  2. "How People Read and Write and They Don't Even Notice": Everyday Lives and Literacies on a Midlands Council Estate

    ERIC Educational Resources Information Center

    Jones, Susan

    2014-01-01

    This article presents data from a British Academy-funded study of the everyday literacy practices of three families living on a predominantly white working-class council housing estate on the edge of a Midlands city. The study explored, as one participant succinctly put it, "how people read and write and they don't even notice".…

  3. Global Epidemiology of HIV Infection and Related Syndemics Affecting Transgender People

    PubMed Central

    Scheim, Ayden; Xavier, Jessica; Reisner, Sari; Baral, Stefan

    2016-01-01

    Introduction: Transgender populations have been underrepresented in HIV epidemiologic studies and consequently in HIV prevention, care, and treatment programs. Since 2012, there has been a dramatic increase in research focused on transgender people. Studies highlight the burden of HIV and risk determinants, including intersecting stigmas, as drivers of syndemics among transgender populations. This review synthesizes the most recent global epidemiology of HIV infection and describes current gaps in research and interventions to inform prioritization of HIV research for transgender populations. Methods: A systematic review was conducted of the medical literature published between January 1, 2012 and November 30, 2015. The data focused on HIV prevalence, determinants of risk, and syndemics among transgender populations. Results: Estimates varied dramatically by location and subpopulation. Transfeminine individuals have some of the highest concentrated HIV epidemics in the world with laboratory-confirmed prevalence up to 40%. Data were sparse among trans masculine individuals; however, they suggest potential increased risk for trans masculine men who have sex with men (MSM). No prevalence data were available for transgender people across Sub-Saharan Africa or Eastern Europe/Central Asia. Emerging data consistently support the association of syndemic conditions with HIV risk in transgender populations. Discussion: Addressing syndemic conditions and gender-specific challenges is critical to ensure engagement and retention in HIV prevention by transgender populations. Future research should prioritize: filling knowledge gaps in HIV epidemiology; elucidating how stigma shapes syndemic factors to produce HIV and other deleterious effects on transgender health; and understanding how to effectively implement HIV interventions for transgender people. PMID:27429185

  4. Vitamin D intake and other risk factors for vitamin D insufficiency in Middle Eastern people living in the UK: a comparison of cultural and ethnic groups.

    PubMed

    Ahmed, Wassan A; Al-Murrani, Waleed; Kuri, Victor; Rees, Gail A

    2013-01-01

    A questionnaire was designed to obtain information about factors affecting vitamin D status in Middle Eastern people living in the UK. A total of 242 questionnaires were returned out of 350 distributed. A total of 85% of the sample was estimated to have a low vitamin D intake (< 5 μg/d). Other risk factors for vitamin D insufficiency included covering skin from sunlight (62% men and 84% women); low use of vitamin D containing supplements (18.5%) and being overweight or obese (49% men and 44% women). Vitamin D intake was lowest in the Kurdish ethnic group (2.18 μg/d) and in those with primary (1.83 μg/d) and secondary school (2.14 μg/d) level education compared to higher education (3.0-3.59 μg/d). Vitamin D intake was highest in those aged 40-49 years (4.0 μg/d), those born in the Levant (4.29 μg/d), and in those who were obese (3.60 μg/d). PMID:23621485

  5. Activating health goals reduces (increases) hedonic evaluation of food brands for people who harbor highly positive (negative) affect toward them.

    PubMed

    Connell, Paul M; Mayor, Lauren F

    2013-06-01

    Associations of pleasure and fun with junk foods have the potential to create considerable challenges for efforts to improve diets. The aim of this research was to determine whether activating health goals had the potential to exploit mixed motivations (i.e., health and pleasure) that people have related to food, and subsequently strip junk foods of the expected pleasure derived from them. In study 1, 98 participants evaluated a soft drink brand after being primed (not primed) for health. In study 2, 93 participants evaluated a presweetened breakfast cereal brand after being primed (not primed) for health. In both studies, participants who harbored highly positive feelings for the food brands devalued their hedonic judgments of them when they were primed for health. However, in an unexpected result, participants in both studies who harbored highly negative feelings for the food brands revalued their hedonic judgments of them (i.e., increased the favorability) when they were primed for health. Thus, increasing health salience is only effective in decreasing expected pleasure derived from junk foods for people who harbor positive affect toward junk food brands, and is likely counterproductive for people who harbor negative affect toward junk food brands. PMID:23428938

  6. Abnormal surround inhibition does not affect asymptomatic limbs in people with cervical dystonia.

    PubMed

    McDougall, Laura; Kiernan, Dovin; Kiss, Zelma H T; Suchowersky, Oksana; Welsh, Timothy N

    2015-09-14

    Surround inhibition is a neural mechanism hypothesized to facilitate goal-directed action by disinhibiting agonist muscle activity while simultaneously inhibiting antagonist and other uninvolved muscle activity. The present study was designed to investigate if abnormalities in surround inhibition are found in asymptomatic body parts (the hand) of people with focal cervical dystonia (neck). Participants with (n=7) and without (n=17) cervical dystonia completed a protocol in which they abducted their index finger while EMG was recorded from the first dorsal interosseous (agonist) and abductor digiti minimi (uninvolved) muscles. Transcranial magnetic stimulation was delivered over the primary motor cortex at intervals ranging from 0 to 950+ms after the onset of agonist muscle activity. Motor-evoked potential (MEP) amplitudes from both muscles were compared. In control participants, MEPs from the uninvolved muscle were significantly lower than agonist MEPs at intervals from 0 to 480ms. Similarly, in the hands of participants with cervical dystonia - the asymptomatic body part - MEPs from the uninvolved muscle were significantly lower than agonist MEPs from 0 to 175ms. These findings suggest that surround inhibition in people with focal dystonia may be intact in asymptomatic hands. In other words, abnormalities in surround inhibition may be restricted to the dystonic limb. PMID:26219986

  7. Effectiveness of interventions that assist caregivers to support people with dementia living in the community: a systematic review.

    PubMed

    Parker, Deborah; Mills, Sandra; Abbey, Jennifer

    2008-06-01

    Objectives  The objective of this review was to assess the effectiveness of interventions that assist caregivers to provide support for people living with dementia in the community. Inclusion criteria  Types of participants  Adult caregivers who provide support for people with dementia living in the community (non-institutional care). Types of interventions  Interventions designed to support caregivers in their role such as skills training, education to assist in caring for a person living with dementia and support groups/programs. Interventions of formal approaches to care designed to support caregivers in their role, care planning, case management and specially designated members of the healthcare team - for example dementia nurse specialist or volunteers trained in caring for someone with dementia. Types of studies  This review considered any meta-analyses, systematic reviews, randomised control trials, quasi-experimental studies, cohort studies, case control studies and observational studies without control groups that addressed the effectiveness of interventions that assist caregivers to provide support for people living with dementia in the community. Search strategy  The search sought to identify published studies from 2000 to 2005 through the use of electronic databases. Only studies in English were considered for inclusion. The initial search was conducted of the databases, CINAHL, MEDLINE and PsychINFO using search strategies adapted from the Cochrane Dementia and Cognitive Improvement Group. A second more extensive search was then conducted using the appropriate Medical Subject Headings (MeSH) and keywords for other available databases. Finally, hand searching of reference lists of articles retrieved and of core dementia, geriatric and psycho geriatric journals was undertaken. Assessment of quality  Methodological quality of each of the articles was assessed by two independent reviewers using appraisal checklist developed by the Joanna

  8. Models of inter professional working for older people living at home: a survey and review of the local strategies of english health and social care statutory organisations

    PubMed Central

    2011-01-01

    Background Most services provided by health and social care organisations for older people living at home rely on interprofessional working (IPW). Although there is research investigating what supports and inhibits how professionals work together, less is known about how different service models deliver care to older people and how effectiveness is measured. The aim of this study was to describe how IPW for older people living at home is delivered, enacted and evaluated in England. Method An online survey of health and social care managers across England directly involved in providing services to older people, and a review of local strategies for older people services produced by primary care organisations and local government adult services organisations in England. Results The online survey achieved a 31% response rate and search strategies identified 50 local strategies that addressed IPW for older people living at home across health and social care organisations. IPW definitions varied, but there was an internal consistency of language informed by budgeting and organisation specific definitions of IPW. Community Services for Older People, Intermediate Care and Re-enablement (rehabilitation) Teams were the services most frequently identified as involving IPW. Other IPW services identified were problem or disease specific and reflected issues highlighted in local strategies. There was limited agreement about what interventions or strategies supported the process of IPW. Older people and their carers were not reported to be involved in the evaluation of the services they received and it was unclear how organisations and managers judged the effectiveness of IPW, particularly for services that had an open-ended commitment to the care of older people. Conclusion Health and social care organisations and their managers recognise the value and importance of IPW. There is a theoretical literature on what supports IPW and what it can achieve. The need for precision may

  9. From potential donor to actual donation: does socioeconomic position affect living kidney donation? A systematic review of the evidence.

    PubMed

    Bailey, Phillippa; Tomson, Charles; Risdale, Saira; Ben-Shlomo, Yoav

    2014-11-15

    Evidence from Europe, Australia and the United States demonstrates that socioeconomically deprived individuals with advanced chronic kidney disease are less likely to receive a living kidney transplant compared with less deprived individuals. This systematic review focuses on how socioeconomic position (SEP) may influence hypothetical and actual living kidney donors and where appropriate, summarizes the quantitative evidence.In the general population, a higher SEP appears to be associated with an increased 'hypothetical' willingness to be a living kidney donor but with marked heterogeneity in the absolute differences (I = 95.9%, P < 0.001). In a commercial setting, lower SEP motivates people to donate. Outside of this setting, there is no evidence of discordance in the SEP of donors and recipients that would suggest undisclosed financial exchange. There is evidence for a complex interaction between SEP and other variables, such as ethnicity, sex, and the national economic climate. Some evidence suggests that measures to remove financial disincentives to donation are associated with an increase in living donation rates. Future research needs to study how SEP impacts the potential donor population from willingness to donate, progression through donor assessment to actual donor nephrectomy. PMID:25250649

  10. Mortality and morbidity among people living close to incinerators: a cohort study based on dispersion modeling for exposure assessment

    PubMed Central

    2011-01-01

    Background Several studies have been conducted on the possible health effects for people living close to incinerators and well-conducted reviews are available. Nevertheless, several uncertainties limit the overall interpretation of the findings. We evaluated the health effects of emissions from two incinerators in a pilot cohort study. Methods The study area was defined as the 3.5 km radius around two incinerators located near Forlì (Italy). People who were residents in 1/1/1990, or subsequently became residents up to 31/12/2003, were enrolled in a longitudinal study (31,347 individuals). All the addresses were geocoded. Follow-up continued until 31/12/2003 by linking the mortality register, cancer registry and hospital admissions databases. Atmospheric Dispersion Model System (ADMS) software was used for exposure assessment; modelled concentration maps of heavy metals (annual average) were considered the indicators of exposure to atmospheric pollution from the incinerators, while concentration maps of nitrogen dioxide (NO2) were considered for exposure to other pollution sources. Age and area-based socioeconomic status adjusted rate ratios and 95% Confidence Intervals were estimated with Poisson regression, using the lowest exposure category to heavy metals as reference. Results The mortality and morbidity experience of the whole cohort did not differ from the regional population. In the internal analysis, no association between pollution exposure from the incinerators and all-cause and cause-specific mortality outcomes was observed in men, with the exception of colon cancer. Exposure to the incinerators was associated with cancer mortality among women, in particular for all cancer sites (RR for the highest exposure level = 1.47, 95% CI: 1.09, 1.99), stomach, colon, liver and breast cancer. No clear trend was detected for cancer incidence. No association was found for hospitalizations related to major diseases. NO2 levels, as a proxy from other pollution sources

  11. Stigma trajectories among people living with HIV (PLHIV) embarking on a life time journey with antiretroviral drugs in Jinja, Uganda

    PubMed Central

    2013-01-01

    Background Stigma is a barrier to HIV prevention and treatment. There is a limited understanding of the types of stigma facing people living with HIV (PLHIV) on antiretroviral therapy (ART). We describe the stigma trajectories of PLHIV over a 5-year period from the time they started ART. Methods Longitudinal qualitative in-depth interviews were conducted with 41 members of The AIDS Support Organisation (TASO) from 2005 to 2008 in Jinja, Uganda, who were part of a pragmatic cluster-randomised trial comparing two different modes of ART delivery (facility and home). Participants were stratified by gender, ART delivery arm and HIV stage (early or advanced) and interviewed at enrolment on to ART and then after 3, 6, 18 and 30 months. Interviews focused on stigma and ART experiences. In 2011, follow-up interviews were conducted with 24 of the participants who could be traced. Transcribed texts were translated, coded and analyzed thematically. Results Stigma was reported to be very high prior to starting ART, explained by visible signs of long-term illnesses and experiences of discrimination and abuse. Early coping strategies included: withdrawal from public life, leaving work due to ill health and moving in with relatives. Starting ART led to a steady decline in stigma and allowed the participants to take control of their illness and manage their social lives. Better health led to resumption of work and having sex but led to reduced disclosure to employers, colleagues and new sexual partners. Some participants mentioned sero-sorting in order to avoid questions around HIV sero-status. A rise in stigma levels during the 18 and 30 month interviews may be correlated with decreased disclosure. By 2011, ART-related stigma was even more pronounced particularly among those who had started new sexual relationships, gained employment and those who had bodily signs from ART side-effects. Conclusion This study has shown that while ART comes with health benefits which help

  12. HIV Status Disclosure Among People Living with HIV in the Era of Combination Antiretroviral Therapy (cART)

    PubMed Central

    Madi, Deepak; Gupta, Parul; Bhaskaran, Unnikrishnan; Ramapuram, John T.; Rao, Satish; Mahalingam, Soundarya

    2015-01-01

    Introduction As patients with HIV live longer due to Combination Anti-Retroviral Therapy (cART) serostatus disclosure becomes an important issue. Disclosure can have both positive and negative outcomes. Disclosure of HIV status has been associated with better adherence to medication and reduction in levels of psychological distress. Stigma and disruption of family relationships are barriers for disclosure. Most studies regarding disclosure status have been conducted in West. There are many cultural differences in Indian society when compared to west. There is a dearth of research in the field of disclosure of HIV infection in India. Aim To determine the prevalence of HIV status disclosure among people living with HIV (PLHIV) in South India. Materials and Methods This descriptive cross-sectional study was done in the hospital attached to Kasturba Medical College (KMC), Mangalore, India from May–June 2013. PLHIV of age more than 18 years were included. During the study period 111 consecutive patients who consented for the study were enrolled. Statistical Analysis Data was collected using a pre-tested interviewer administered semi structured questionnaire. Data collected was analysed using SPSS Version 11.5 statistical software. Descriptive statistics were done and the results are presented as proportions and mean. Results The mean age of the study population was 44.86 ± 10.8 years. Majority of the study subjects were men 76 (68.4%). Out of 111 study subjects, 102 (91.9%) had disclosed their HIV status to at least one person while 9 (8.1%) had not disclosed their HIV status to anyone. Disclosure on doctor’s advice was the main reason for 56 (54.9%) participants to disclose their HIV status. The main reason for non-disclosure was fear of shame in family. Conclusion Disclosure rate was high in our study in the era of cART. Society must stop discriminating against PLHIV so that they can disclose their serostatus and gain access to care and treatment services without

  13. Toxic substances in the environment affecting respiratory function of people in Hawaii

    SciTech Connect

    Hallenborg, C.P.; Marsh, N.; Moser, S.

    1991-03-01

    In this trilogy the authors have collected data from authors who are concerned with patients with respiratory complaints. Surprisingly there are unique problems in the residents of our State. The full impact of problems known to cause respiratory illnesses, such as asbestosis, will not be known for years to come. Other problems such as the effect of sugarcane burning are just now being identified and may show a parallel to the inhalation of asbestos dust. VOG may be simply an irritant or it may explain in part the high incidence of asthma in our State. Clearly more work needs to be done to explain the pathophysiology, the risk and possible treatment for the consequences on people of these putative toxic substances.

  14. Improving mental health among people living with HIV: a review of intervention trials in low- and middle-income countries

    PubMed Central

    Sikkema, Kathleen J.; Dennis, Alexis C.; Watt, Melissa. H.; Choi, Karmel W.; Yemeke, Tatenda T.; Joska, John A.

    2015-01-01

    People living with HIV (PLWH) experience greater psychological distress than the general population. Evidence from high-incomes countries suggests that psychological interventions for PLWH can improve mental health symptoms, quality of life, and HIV care engagement. However, little is known about the effectiveness of mental health interventions for PLWH in low and middle-income countries (LMICs), where the large majority of PLWH reside. This systematized review aims to synthesize findings from mental health intervention trials with PLWH in LMICs to inform the delivery of mental health services in these settings. A systematic search strategy was undertaken to identify peer-reviewed published papers of intervention trials addressing negative psychological states or disorders (e.g., depression, anxiety) among PLWH in LMIC settings. Search results were assessed against pre-established inclusion and exclusion criteria. Data from papers meeting criteria were extracted for synthesis. Twenty-six papers, published between 2000 and 2014, describing 22 unique interventions were identified. Trials were implemented in sub-Saharan Africa (n=13), Asia (n=7), and the Middle East (n=2), and addressed mental health using a variety of approaches, including cognitive-behavioral (n=18), family-level (n=2), and pharmacological (n=2) treatments. Four randomized controlled trials reported significant intervention effects in mental health outcomes, and eleven preliminary studies demonstrated promising findings. Among the limited mental health intervention trials with PLWH in LMICs, few demonstrated efficacy. Mental health interventions for PLWH in LMICs must be further developed and adapted for resource-limited settings to improve effectiveness. PMID:26435843

  15. Alcohol-antiretroviral therapy interactive toxicity beliefs and daily medication adherence and alcohol use among people living with HIV.

    PubMed

    Pellowski, Jennifer A; Kalichman, Seth C; Kalichman, Moira O; Cherry, Chauncey

    2016-08-01

    Alcohol-antiretroviral therapy (ART) interactive toxicity beliefs reflect perceived adverse outcomes of mixing alcohol and ART. Previous research has shown a significant relationship between alcohol-ART interactive toxicity beliefs and ART non-adherence, over and above other correlates of non-adherence such as human immunodeficiency virus (HIV)symptoms and frequency of alcohol use. Most past studies have collected data over extended periods and have not determined if alcohol use and missed medications occur at the day-level among people holding interactive toxicity beliefs. Previous daily analyses, however, have been limited by self-reported adherence and relatively short periods of observation. To address these gaps in the literature, men and women living with HIV in Atlanta, GA, were enrolled in a 45-day observational cohort study. Daily alcohol use was collected using two-way interactive text message surveys and daily adherence was collected via the Wisepill device. Fifty-seven participants completed a measure of alcohol-ART interactive toxicity beliefs and contributed 2565 days of daily data. Participants who endorsed high levels of interactive toxicity beliefs had significantly more days when they missed doses of medication. Alcohol-antiretroviral toxicity beliefs predicted missing doses of medication on days when participants were drinking and on days when they were not drinking. Multilevel multivariate regressions showed that these toxicity beliefs predicted daily missed doses of medication over and above quantity of alcohol consumed, depression and general medication concerns. This study replicates and extends previous literature and indicates the necessity of addressing alcohol-ART toxicity beliefs within adherence interventions. PMID:26964014

  16. Gender asymmetry in healthcare-facility attendance of people living with HIV/AIDS in Burkina Faso.

    PubMed

    Bila, Blandine; Egrot, Marc

    2009-09-01

    Anthropological research in Burkina Faso indicates that more HIV-positive women than HIV-positive men are attending care facilities for people living with HIV/AIDS (PLWH) and accessing antiretroviral medicine. This article, situated in the field of study of interactions between gender and AIDS, offers a description of this asymmetry and an anthropological analysis of the socio-cultural determinants, through analysis of data from ethnographic research among PLWH and health actors. Examining social representations of femininity and masculinity in Burkinabe society and the organisation of the healthcare system in connection with gender shed light on the decision-making processes of both sexes around therapeutic choices and the itinerary of care. On the one hand, the social values attached to femininity, maternity and the status of wife create conditions for women that favour their attendance at care facilities for PLWH and encourage a widespread practice where wives take the place of their husbands in healthcare queues. Moreover, health policies and the effects of women's empowerment within the healthcare system strengthen women's access to health services. On the other hand, representations of masculinity are fully implicated in the cultural construction of men's reluctance to attend care facilities for PLWH. The values associated with this masculinity cause men to run great health, economic and social risks, not only for themselves, but also for their wives and children. By better understanding the interaction between gender, the experience of HIV and the institutional organisation of healthcare, we can identify ways to reduce men's reluctance to attend care facilities for PLWH and improve both prevention and treatment-oriented programmes. PMID:19539415

  17. Pregnancy desire and dual method contraceptive use among people living with HIV attending clinical care in Kenya, Namibia and Tanzania

    PubMed Central

    Antelman, Gretchen; Medley, Amy; Mbatia, Redempta; Pals, Sherri; Arthur, Gilly; Haberlen, Sabina; Ackers, Marta; Elul, Batya; Parent, Julie; Rwebembera, Anath; Wanjiku, Lucy; Muraguri, Nicholas; Gweshe, Justice; Mudhune, Sandra; Bachanas, Pamela

    2015-01-01

    Aim To describe factors associated with pregnancy desire and dual method use among people living with HIV in clinical care in sub-Saharan Africa. Design Sexually active HIV-positive adults were enrolled in 18 HIV clinics in Kenya, Namibia and Tanzania. Demographic, clinical and reproductive health data were captured by interview and medical record abstraction. Correlates of desiring a pregnancy within the next 6 months, and dual method use [defined as consistent condom use together with a highly effective method of contraception (hormonal, intrauterine device (IUD), permanent)], among those not desiring pregnancy, were identified using logistic regression. Results Among 3375 participants (median age 37 years, 42% male, 64% on antiretroviral treatment), 565 (17%) desired a pregnancy within the next 6 months. Of those with no short-term fertility desire (n=2542), 686 (27%) reported dual method use, 250 (10%) highly effective contraceptive use only, 1332 (52%) condom use only, and 274 (11%) no protection. Respondents were more likely to desire a pregnancy if they were from Namibia and Tanzania, male, had a primary education, were married/cohabitating, and had fewer children. Factors associated with increased likelihood of dual method use included being female, being comfortable asking a partner to use a condom, and communication with a health care provider about family planning. Participants who perceived that their partner wanted a pregnancy were less likely to report dual method use. Conclusions There was low dual method use and low use of highly effective contraception. Contraceptive protection was predominantly through condom-only use. These findings demonstrate the importance of integrating reproductive health services into routine HIV care. PMID:25512359

  18. Changing access to mental health care and social support when people living with HIV/AIDS become service providers.

    PubMed

    Li, Alan Tai-Wai; Wales, Joshua; Wong, Josephine Pui-Hing; Owino, Maureen; Perreault, Yvette; Miao, Andrew; Maseko, Precious; Guiang, Charlie

    2015-01-01

    As people living with HIV/AIDS (PHAs) achieve more stable health, many have taken on active peer support and professional roles within AIDS service organizations. Although the increased engagement has been associated with many improved health outcomes, emerging program and research evidence have identified new challenges associated with such transition. This paper reports on the results of a qualitative interpretive study that explored the effect of this role transition on PHA service providers' access to mental health support and self care. A total of 27 PHA service providers of diverse ethno-racial backgrounds took part in the study. Results show that while role transition often improves access to financial and health-care benefits, it also leads to new stress from workload demands, emotional triggers from client's narratives, feeling of burnout from over-immersion in HIV at both personal and professional levels, and diminished self care. Barriers to seeking support included: concerns regarding confidentiality; self-imposed and enacted stigma associated with accessing mental health services; and boundary issues resulting from changes in relationships with peers and other service providers. Evolving support mechanisms included: new formal and informal peer support networks amongst colleagues or other PHA service providers to address both personal and professional challenges, and having access to professional support offered through the workplace. The findings suggest the need for increased organizational recognition of HIV support work as a form of emotional labor that places complex demands on PHA service providers. Increased access to employer-provided mental health services, supportive workplace policies, and adequate job-specific training will contribute to reduced work-related stress. Community level strategies that support expansion of social networks amongst PHA service providers would reduce isolation. Systemic policies to increase access to insurance

  19. Prevalence and Correlates of Smoking and Readiness to Quit Smoking in People Living with HIV in Austria and Germany

    PubMed Central

    Brath, Helmut; Grabovac, Igor; Schalk, Horst; Degen, Olaf; Dorner, Thomas E.

    2016-01-01

    We aimed to investigate the prevalence and correlates of smoking in people living with HIV (PLWHIV) in Germany and Austria and their readiness to quit. A total of 447 consecutive patients with confirmed positive HIV status who were treated in different outpatient HIV centres in Austria and Germany were included. Nicotine dependence and stages of change were assessed by standardized questionnaires, and this was confirmed by measuring exhaled carbon monoxide. Prevalence of smoking was 49.4%. According to a multivariate logistic regression analysis, higher age (for each year of life OR = 0.96; 95% CI 0.92–1.00) and tertiary education level (OR = 0.43; 95% CI 0.15–0.79) were associated with a lower chance, and occasional (OR = 3.75; 95% CI 1.74–8.07) and daily smoking of the partner (OR 8.78; 95% CI 4.49–17.17) were significantly associated with a higher chance of smoking. Moderate (OR = 3.41; 95% CI = 1.30–9.05) and higher nicotine dependency level (OR = 3.40; 95% CI 1.46–7.94), were significantly associated with higher chance, and older age (for each year of life OR = 0.95; 95% CI = 0.91–0.99), with lower chance for readiness to quit smoking. Those results may be used to address preventive measures to quit smoking aimed at PLWHIV and the importance of addressing smoking habits. PMID:26919722

  20. Combined cognitive–behavioural and mindfulness programme for people living with dystonia: a proof-of-concept study

    PubMed Central

    Sandhu, H; Bernstein, C J; Davies, G; Tang, N K Y; Belhag, M; Tingle, A; Field, M; Foss, J; Lindahl, A; Underwood, M; Ellard, D R

    2016-01-01

    Objectives To design and test the delivery of an intervention targeting the non-motor symptoms of dystonia and pilot key health and well-being questionnaires in this population. Design A proof-of-concept study to test the delivery, acceptability, relevance, structure and content for a 3-day group residential programme for the management of dystonia. Setting Participants were recruited from a single botulinum toxin clinic. The intervention was delivered in the community. Participants 14 participants consented to take part (2 withdrew prior to the starting of intervention). The average age was 60 years (range 44–77), 8 of whom were female. After drop-out, 9 participants completed the 3-day programme. Intervention A 3-day group residential programme. Primary and secondary outcome measures Process evaluation and interviews were carried out before and after the intervention to explore participant's views and expectations, as well as experiences of the intervention. Select questionnaires were completed at baseline, 1-month and 3-month follow-up. Results Although participants were not sure what to expect from the programme, they found it informative and for many this together with being in a group with other people with dystonia legitimised their condition. Mindfulness was accepted and adopted as a coping strategy. This was reflected in the 1-month follow-up. Conclusions We successfully delivered a 3-day residential programme to help those living with dystonia manage their condition. Further improvements are suggested. The quantitative outcome measures were acceptable to this group of patients with dystonia. PMID:27496234

  1. Palliative chemotherapy among people living in poverty with metastasised colon cancer: facilitation by primary care and health insurance

    PubMed Central

    Gorey, Kevin M; Bartfay, Emma; Kanjeekal, Sindu M; Wright, Frances C; Hamm, Caroline; Luginaah, Isaac N; Zou, Guangyong; Holowaty, Eric J; Richter, Nancy L; Balagurusamy, Madhan K

    2016-01-01

    Background Many Americans with metastasised colon cancer do not receive indicated palliative chemotherapy. We examined the effects of health insurance and physician supplies on such chemotherapy in California. Methods We analysed registry data for 1199 people with metastasised colon cancer diagnosed between 1996 and 2000 and followed for 1 year. We obtained data on health insurance, census tract-based socioeconomic status and county-level physician supplies. Poor neighbourhoods were oversampled and the criterion was receipt of chemotherapy. Effects were described with rate ratios (RR) and tested with logistic regression models. Results Palliative chemotherapy was received by less than half of the participants (45%). Facilitating effects of primary care (RR=1.23) and health insurance (RR=1.14) as well as an impeding effect of specialised care (RR=0.86) were observed. Primary care physician (PCP) supply took precedence. Adjusting for poverty, PCP supply was the only significant and strong predictor of chemotherapy (OR=1.62, 95% CI 1.02 to 2.56). The threshold for this primary care advantage was realised in communities with 8.5 or more PCPs per 10 000 inhabitants. Only 10% of participants lived in such well-supplied communities. Conclusions This study’s observations of facilitating effects of primary care and health insurance on palliative chemotherapy for metastasised colon cancer clearly suggested a way to maximise Affordable Care Act (ACA) protections. Strengthening America’s system of primary care will probably be the best way to ensure that the ACA’s full benefits are realised. Such would go a long way towards facilitating access to palliative care.

  2. People living with HIV /AIDS (PLWHA) and HIV/AIDS associated oral lesions; a study in Malaysia

    PubMed Central

    2012-01-01

    Background The continuous increase in number of people living with HIV/AIDS (PLWHA) represents a serious health and economic burden. HIV positive individuals with oral lesions have significantly lower oral health-related quality of life than HIV positive individuals without oral lesions. The objective of this study was to assess the knowledge, attitude and practices (KAP) within a cohort of HIV/AIDS positive patients towards HIV/AIDS associated oral lesions. Methods Two hundred seventy patients attending a national referral hospital of infectious disease in Malaysia were recruited for the study. The study involved the administration of a validated interview-based questionnaire designed to elicit knowledge, attitude and practices of these patients towards HIV associated oral lesions. The last part of the questionnaire assessed the training provided to the patients in relation to the oral lesions associated with the disease and the effectiveness of this training. Data analysis was carried out using SPSS version 18. Results Thirty seven percent of patients were reported as knowledgeable, while sixty four percent reported to have positive attitude towards the care of oral hygiene. Sixty six percent of the patients reported that they would seek professional care when experiencing oral lesion. Training was reported effective for 93% patients. Conclusions Patients were non-knowledgeable in relation to oral manifestations of the disease and one third of the participating patients showed negative attitudes towards oral health care and reported various measures to manage oral lesions rather than seeking professional care. Developing effective educational methodologies can empower patients with knowledge that may translate to positive attitudes and practices. PMID:23043358

  3. Risk analysis of leukaemia incidence among people living along the Techa River: a nested case-control study.

    PubMed

    Ostroumova, E; Gagnière, B; Laurier, D; Gudkova, N; Krestinina, L; Verger, P; Hubert, P; Bard, D; Akleyev, A; Tirmarche, M; Kossenko, M

    2006-03-01

    Large quantities of radioactive materials released over time from the Mayak nuclear weapons facility caused significant internal and external exposure for people living along the banks of the Techa River (Southern Urals, Russia). We conducted a nested case-control study in the Extended Techa River Cohort to determine whether the risk of leukaemia incidence increased with protracted exposure to ionising radiation or with other non-radiation risk factors. The study included 83 cases identified over 47 years of follow-up and 415 controls matched for sex, age at diagnosis, age (within a 5 year age group), and date of initial residence in the riverside area. External and internal doses have been calculated using the Techa River Dosimetry System 1996 (TRDS96). Conditional logistic regression was used to calculate odds ratios per Gray (OR/Gy) and 95% confidence intervals (95% CI). After excluding cases of chronic lymphoid leukaemia, the OR/Gy of total, external, and internal doses were 4.6 (95% CI: 1.7-12.3), 7.2 (95%CI: 1.7-30.0) and 5.4 (95%CI: 1.1-27.2), respectively. A history of solid tumour, either malignant or benign, before the leukaemia diagnosis was associated with a 2.5-fold increase in the leukaemia risk (95% CI: 1.1-5.9). Even though the analysis of confounders was less useful than expected because of missing data, multivariate analyses that took the exposure dose into account confirmed the association between leukaemia incidence and tumour history. PMID:16522942

  4. People living with HIV travel farther to access healthcare: a population-based geographic analysis from rural Uganda

    PubMed Central

    Akullian, Adam N; Mukose, Aggrey; Levine, Gillian A; Babigumira, Joseph B

    2016-01-01

    Introduction The availability of specialized HIV services is limited in rural areas of sub-Saharan Africa where the need is the greatest. Where HIV services are available, people living with HIV (PLHIV) must overcome large geographic, economic and social barriers to access healthcare. The objective of this study was to understand the unique barriers PLHIV face when accessing healthcare compared with those not living with HIV in a rural area of sub-Saharan Africa with limited availability of healthcare infrastructure. Methods We conducted a population-based cross-sectional study of 447 heads of household on Bugala Island, Uganda. Multiple linear regression models were used to compare travel time, cost and distance to access healthcare, and log binomial models were used to test for associations between HIV status and access to nearby health services. Results PLHIV travelled an additional 1.9 km (95% CI (0.6, 3.2 km), p=0.004) to access healthcare compared with those not living with HIV, and they were 56% less likely to access healthcare at the nearest health facility to their residence, so long as that facility lacked antiretroviral therapy (ART) services (aRR=0.44, 95% CI (0.24 to 0.83), p=0.011). We found no evidence that PLHIV travelled further for care if the nearest facility supplies ART services (aRR=0.95, 95% CI (0.86 to 1.05), p=0.328). Among those who reported uptake of care at one of two facilities on the island that provides ART (81% of PLHIV and 68% of HIV-negative individuals), PLHIV tended to seek care at a higher tiered facility that provides ART, even when this facility was not their closest facility (30% of PLHIV travelled further than the closest ART facility compared with 16% of HIV-negative individuals), and travelled an additional 2.2 km (p=0.001) to access that facility, relative to HIV-negative individuals (aRR=1.91, 95% CI (1.00 to 3.65), p=0.05). Among PLHIV, residential distance was associated with access to facilities providing ART (RR=0

  5. Microcredit for people affected by HIV and AIDS: insights from Kenya.

    PubMed

    Datta, Dipankar; Njuguna, James

    2008-07-01

    Consequences of HIV and AIDS are exponential in Kenya, touching not only the health of those infected, but also depleting socioeconomic resources of entire families. Access to financial services is one of the important ways to protect and build economic resources. Unfortunately, the norm of financial viability discourages microfinance institutions from targeting people severely impacted by HIV and AIDS. Thus, HIV and AIDS service NGOs have been increasingly getting involved in microcredit activity in recent years for economic empowerment of their clients. Despite limited human resources and funding in the area of microcredit activity, these NGOs have demonstrated that nearly 50% of their microcredit beneficiaries invested money in income-generating activities, resulting in enhancement to their livelihood security. In the short term these NGOs need to improve their current practices. However, this does not mean launching microfinance initiatives within their AIDS-focused programmes, as financial services are best provided by specialised institutions. Longer-term cooperation between microfinance institutions and other AIDS service organisations and donors is necessary to master appropriate and rapid responses in areas experiencing severe impacts of HIV and AIDS. PMID:18709212

  6. Assisted Living

    MedlinePlus

    ... but they don't need full-time nursing care. Some assisted living facilities are part of retirement ... change. Assisted living costs less than nursing home care. It is still fairly expensive. Older people or ...

  7. Lighting to Make You Feel Better: Improving the Mood of Elderly People with Affective Ambiences.

    PubMed

    Kuijsters, Andre; Redi, Judith; de Ruyter, Boris; Heynderickx, Ingrid

    2015-01-01

    Current lighting technologies extend the options for changing the appearance of rooms and closed spaces, as such creating ambiences with an affective meaning. Using intelligence, these ambiences may instantly be adapted to the needs of the room's occupant(s), possibly improving their well-being. We hypothesized that ambiences with a clearly recognizable, positive affective meaning could be used to effectively mitigate negative mood in elderly. After inducing a sad mood with a short movie one group of elderly was immersed in a positive high arousing (i.e., activating) ambience, and another group in a neutral ambience. Similarly, after inducing anxiety with a short movie one group of elderly was immersed in a pleasant low arousing (i.e., cozy) ambience, and another group in a neutral ambience. We monitored the evolution of the mood of the four groups of elderly over a period of ten minutes after the mood induction, with both self-reported mood measurements (every 2 minutes) and constant measurements of the skin conductance response (SCR) and electrocardiography (ECG). In line with our hypothesis we found that the activating ambience was physiologically more arousing than the neutral ambience. The cozy ambience was more effective in calming anxious elderly than the neutral ambience, as reflected by both the self-reported and physiological measurements. PMID:26192281

  8. Lighting to Make You Feel Better: Improving the Mood of Elderly People with Affective Ambiences

    PubMed Central

    Kuijsters, Andre; Redi, Judith; de Ruyter, Boris; Heynderickx, Ingrid

    2015-01-01

    Current lighting technologies extend the options for changing the appearance of rooms and closed spaces, as such creating ambiences with an affective meaning. Using intelligence, these ambiences may instantly be adapted to the needs of the room’s occupant(s), possibly improving their well-being. We hypothesized that ambiences with a clearly recognizable, positive affective meaning could be used to effectively mitigate negative mood in elderly. After inducing a sad mood with a short movie one group of elderly was immersed in a positive high arousing (i.e., activating) ambience, and another group in a neutral ambience. Similarly, after inducing anxiety with a short movie one group of elderly was immersed in a pleasant low arousing (i.e., cozy) ambience, and another group in a neutral ambience. We monitored the evolution of the mood of the four groups of elderly over a period of ten minutes after the mood induction, with both self-reported mood measurements (every 2 minutes) and constant measurements of the skin conductance response (SCR) and electrocardiography (ECG). In line with our hypothesis we found that the activating ambience was physiologically more arousing than the neutral ambience. The cozy ambience was more effective in calming anxious elderly than the neutral ambience, as reflected by both the self-reported and physiological measurements. PMID:26192281

  9. Seeking information about HIV/AIDS: a qualitative study of health literacy among people living with HIV/AIDS in a low prevalence context.

    PubMed

    Zukoski, Ann P; Thorburn, Sheryl; Stroud, Josh

    2011-11-01

    People living with HIV/AIDS in rural and low HIV prevalence areas face a number of challenges including stigma, limited access to specialized medical care, lack of an HIV/AIDS specialist and fear which may interfere with their ability to find and use information to manage their health. With a large number of HIV cases located in non-metropolitan and rural areas in the US, more research is needed to better understand the health seeking behaviors of individuals living in this context. This study examined how 16 individuals living with HIV sought out information to meet their health needs. In qualitative semi-structured interviews, we explored participants' primary sources of information, types of information sought, and barriers to accessing information. The sample was comprised of people living with HIV/AIDS (PLWHA) who resided in a predominantly rural area with low HIV prevalence. The majority of participants relied on a combination of sources including their HIV/AIDS physician, the Internet, a Ryan-White caseworker and a staff member of a community-based support organization to meet their informational needs. Information sought focused primarily on drug regimens, drug side effects, or drug research. Participants shared barriers to accessing information including stigma, fear, concern about disclosure, and feelings of futility and anger. Findings point to a need to expand health literacy research and interventions to address broader social and structural barriers to health improvement for PLWHA, especially among those living in rural and low HIV prevalence areas. PMID:22022854

  10. Is the health of people living in rural areas different from those in cities? Evidence from routine data linked with the Scottish Health Survey

    PubMed Central

    2012-01-01

    Background To examine the association between rurality and health in Scotland, after adjusting for differences in individual and practice characteristics. Methods Design: Mortality and hospital record data linked to two cross sectional health surveys. Setting: Respondents in the community-based 1995 and 1998 Scottish Health Survey who consented to record-linkage follow-up. Main outcome measures: Hypertension, all-cause premature mortality, total hospital stays and admissions due to coronary heart disease (CHD). Results Older age and lower social class were strongly associated with an increased risk of each of the four health outcomes measured. After adjustment for individual and practice characteristics, no consistent pattern of better or poorer health in people living in rural areas was found, compared to primary cities. However, individuals living in remote small towns had a lower risk of a hospital admission for CHD and those in very remote rural had lower mortality, both compared with those living in primary cities. Conclusion This study has shown how linked data can be used to explore the possible influence of area of residence on health. We were unable to find a consistent pattern that people living in rural areas have materially different health to that of those living in primary cities. Instead, we found stronger relationships between compositional determinants (age, gender and socio-economic status) and health than contextual factors (including rurality). PMID:22340710

  11. Information and decision-making needs among people with affective disorders – results of an online survey

    PubMed Central

    Liebherz, Sarah; Tlach, Lisa; Härter, Martin; Dirmaier, Jörg

    2015-01-01

    Background Patient decision aids are one possibility for enabling and encouraging patients to participate in medical decisions. Objective This paper aims to describe patients’ information and decision-making needs as a prerequisite for the development of high-quality, web-based patient decision aids for affective disorders. Design We conducted an online cross-sectional survey by using a self-administered questionnaire including items on Internet use, online health information needs, role in decision making, and important treatment decisions, performing descriptive and comparative statistical analyses. Participants A total of 210 people with bipolar disorder/mania as well as 112 people with unipolar depression participated in the survey. Results Both groups specified general information search as their most relevant information need and decisions on treatment setting (inpatient or outpatient) as well as decisions on pharmacological treatment as the most difficult treatment decisions. For participants with unipolar depression, decisions concerning psychotherapeutic treatment were also especially difficult. Most participants of both groups preferred shared decisions but experienced less shared decisions than desired. Discussion and conclusion Our results show the importance of information for patients with affective disorders, with a focus on pharmacological treatment and on the different treatment settings, and highlight patients’ requirements to be involved in the decision-making process. Since our sample reported a chronic course of disease, we do not know if our results are applicable for newly diagnosed patients. Further studies should consider how the reported needs could be addressed in health care practice. PMID:25999698

  12. El Portal Latino Alzheimer's Project: model program for Latino caregivers of Alzheimer's disease-affected people.

    PubMed

    Aranda, Maria P; Villa, Valentine M; Trejo, Laura; Ramírez, Rosa; Ranney, Martha

    2003-04-01

    The article describes the El Portal Latino Alzheimer's Project--a dementia-specific outreach and services program targeting Latino caregivers in the Los Angeles County area. The project is an example of an interorganizational community-based collaborative developed to provide an array of coordinated, ethnic-sensitive services to Latino dementia-affected adults and their family caregivers, using culturally specific outreach and services delivery strategies. Results of an evaluation of service utilization indicate a reduction in barriers to care and an increase in services utilization. Los Angeles County provides a natural urban laboratory to study the special needs and circumstances of older Latinos dealing with chronic and debilitating illnesses. Implications for social work practice are discussed. PMID:12718421

  13. Systematic Review of TST Responses in People Living with HIV in Under-Resourced Settings: Implications for Isoniazid Preventive Therapy

    PubMed Central

    Kerkhoff, Andrew D.; Kranzer, Katharina; Samandari, Taraz; Nakiyingi-Miiro, Jessica; Whalen, Christopher C.; Harries, Anthony D.; Lawn, Stephen D.

    2012-01-01

    Background People living with HIV (PLWH) who have positive tuberculin skin tests (TST) benefit from isoniazid preventive therapy (IPT) whereas those testing TST-negative do not. Revised World Health Organization guidelines explicitly state that assessment of TST is not a requirement for initiation of IPT. However, it is not known what proportions of patients will benefit from IPT if implemented without targeting according to TST status. We therefore determined the proportions of PLWH who test TST-positive. Methodology/Principal Findings We systematically reviewed the literature published between January 1990 and February 2012 to determine the proportions of patients without active tuberculosis attending HIV care services in low and middle-income countries who tested TST-positive (≥5 mm induration). Proportions were also determined for different CD4 count strata. Data from 19 studies with 9,478 PLWH from sub-Saharan Africa, Asia and Central and South America were summarized. The vast majority were not receiving antiretroviral therapy (ART). A sub-analysis was conducted of 5 studies (5,567 subjects) from high TB prevalence countries of PLWH with negative TB screens attending HIV care and treatment settings for whom CD4 stratified data were available. The median proportion of PLWH testing TST-positive overall was 22.8% (range, 19.5–32.6%). The median (range) proportions with CD4 cell counts of <200, 200–499 or ≥500 cells/µL who tested positive were 12.4% (8.2–15.3%), 28.4% (20.1–36.9%) and 37.4% (31.3–56.3%), respectively. Heterogeneity in the data precluded calculation of pooled summary estimates. Conclusions/Significance In most settings, if IPT is administered to PLWH pre-ART without assessment of TST status, only a minority of those treated are likely to benefit, especially among those with the lowest CD4 cell counts. This may be inefficient use of resources and cost-effectiveness analyses should take this into account. Local knowledge of TST

  14. Empirical treatment for TB in HIV: lessons from a cohort study of people living with HIV treated in Recife, Brazil

    PubMed Central

    2014-01-01

    Background Tuberculosis (TB) is the leading cause of death related to HIV worldwide. This study analyzes the survival of People Living with HIV (PLHIV) reporting cough without bacteriological confirmation of TB and identify factors associated with death. Methods Prospective cohort with a consecutive sample of PLHIV, aged ≥ 18 years. Patient inclusion criteria were complaint of current cough of any duration at the time of the first study interview or during their subsequent routine visits to health services and for whom AFB sputum smear was either negative or not performed during the whole follow-up period. Kaplan-Meier method was used to calculate the probability of survival. We estimated the Hazard Ratio (HR) in bivariate and multivariate Cox regression analyses. Results Mortality was 4.6 per 100 py; 73% were receiving HAART at recruitment. Average time from the first recorded date of cough until empirical treatment for tuberculosis was six months. Mortality was higher when the CD4 count was low (HR = 5.3; CI 95%: 3.2-9.0; p = 0.000), in those with anemia (HR = 3.0; CI 95%: 1.6-5.6; p = 0.001) and with abnormal chest X-rays (HR = 2.4; CI 95%: 1.4-4.0; p = 0.001). Mortality was higher in those receiving empirical TB treatment (HR = 2.4; CI 95%: 1.4-4.0; p = 0.002), but only in those with normal X-rays, no history of tuberculosis and no bacteriology requests. Empirical treatment for TB was more frequent in PLHIV with low CD4 counts, anemia, history of opportunistic infections, weight loss, previous tuberculosis, negative bacteriology test (as opposed to not having a test) and abnormal chest X-ray. Conclusions Higher mortality in PLHIV reporting a current cough without bacteriological confirmation of tuberculosis was identified for those with a CD4 cell count <200, abnormal chest X-ray, anemia and empirical treatment for tuberculosis. Mortality was not significantly higher in those empirically treated for TB, who had three

  15. Quality of Life of People Living with HIV/AIDS: A Cross-Sectional Study in Zhejiang Province, China

    PubMed Central

    Liping, Ma; Peng, Xu; Haijiang, Lin; Lahong, Ju; Fan, Lv

    2015-01-01

    Health-related quality of life (HRQOL) has become a concept commonly used in the related research. Using the World Health Organization Quality of Life Questionnaire for Brief Version (WHOQOL-BREF), this study evaluated the Quality of Life (QOL) of people living with HIV/AIDS (PLWHA) in Zhejiang province, China, and assessed the influences of demographic, laboratory and disease-related variables on QOL. This cross-sectional study was conducted among PLWHA aged ≥ 18 years in Taizhou municipality, Zhejiang province, China, between August 1 and October 31, 2014. A multiple linear regression model was used to analyze the influential factors. Of 403 subjects, 72.48% were male, 72.46% had received a high- school or above education, 94.79% were of Han ethnicity, and 65.51% were non farmers. The total score of QOL was 15.99±1.99. The scores of QOL in physiological, psychological, social relation, and environmental domains were 14.99 ±2.25, 14.25 ±2.12, 13.22 ±2.37, and 13.31 ±1.99 respectively. Except the total score of QOL and the score of environmental domain (p<0.05), the scores in other domains had no significant difference with the results of the national norm level. The multiple linear regression model identified the physical domain related factors to be age (β = -0.045), CD4 count (β = 0.002), and ART adherence(β = 1.231). And it also showed that psychological domain related factors included CD4 count (β = 0.002) and WHO clinical stage (β = -0.437); social domain related factors included WHO clinical stage (β = -0.704) and ART adherence (β = 1.177); while environmental domain related factors included WHO clinical stage (β = -0.538), educational status(β = 0.549) and ART adherence(β = 1.078).Those who are young, with higher level of education, higher CD4 count and good access and adherence of ART, are likely to have better QOL among PLWHA in Zhejiang province. This suggests that in addition to ART, many other factors should be taken into consideration

  16. Estimating minimum adult HIV prevalence: a cross-sectional study to assess the characteristics of people living with HIV in Italy.

    PubMed

    Camoni, Laura; Raimondo, Mariangela; Dorrucci, Maria; Regine, Vincenza; Salfa, Maria Cristina; Suligoi, Barbara

    2015-03-01

    In 2012, we conducted a retrospective cross-sectional study to assess the number of people living with HIV linked to care and, among these, the number of people on antiretroviral therapy. The health authority in each of the 20 Italian Regions provided the list of Public Infectious Diseases Clinics providing antiretroviral therapy and monitoring people with HIV infection. We asked every Public Infectious Diseases Clinic to report the number of HIV-positive people diagnosed and linked to care and the number of those on antiretroviral therapy during 2012. In 2012, 94,146 people diagnosed with HIV and linked to care were reported. The majority were males (70.1%), Italians (84.4%), and aged between 25 and 49 years (63.4%); the probable route of transmission was heterosexual contact in 37.5% of cases, injecting drug use in 28.1%, and male-to-male contact in 27.9%. Among people in care, 20.1% had less than 350 CD4 cells/μl, 87.6% received antiretroviral therapy, and among these, 62.4% had a CD4 cell count higher than 350 cells/μl. The overall estimated prevalence of individuals diagnosed and linked to care in 2012 in Italy was 0.16 per 100 residents (all ages). Adding the estimated proportion of undiagnosed people, the estimated HIV prevalence would range between 0.19 and 0.26 per 100 residents. In Italy, the majority of people diagnosed and linked to care receive antiretroviral therapy. A higher prevalence of individuals diagnosed and linked to care was observed in Northern Italy and among males. More information for developing the HIV care continuum is necessary to improve the entire engagement in care, focusing on test-and-treat strategies to substantially reduce the proportion of people still undiagnosed or with a detectable viral load. PMID:25432098

  17. Estimating Minimum Adult HIV Prevalence: A Cross-Sectional Study to Assess the Characteristics of People Living with HIV in Italy

    PubMed Central

    Raimondo, Mariangela; Dorrucci, Maria; Regine, Vincenza; Salfa, Maria Cristina; Suligoi, Barbara

    2015-01-01

    Abstract In 2012, we conducted a retrospective cross-sectional study to assess the number of people living with HIV linked to care and, among these, the number of people on antiretroviral therapy. The health authority in each of the 20 Italian Regions provided the list of Public Infectious Diseases Clinics providing antiretroviral therapy and monitoring people with HIV infection. We asked every Public Infectious Diseases Clinic to report the number of HIV-positive people diagnosed and linked to care and the number of those on antiretroviral therapy during 2012. In 2012, 94,146 people diagnosed with HIV and linked to care were reported. The majority were males (70.1%), Italians (84.4%), and aged between 25 and 49 years (63.4%); the probable route of transmission was heterosexual contact in 37.5% of cases, injecting drug use in 28.1%, and male-to-male contact in 27.9%. Among people in care, 20.1% had less than 350 CD4 cells/μl, 87.6% received antiretroviral therapy, and among these, 62.4% had a CD4 cell count higher than 350 cells/μl. The overall estimated prevalence of individuals diagnosed and linked to care in 2012 in Italy was 0.16 per 100 residents (all ages). Adding the estimated proportion of undiagnosed people, the estimated HIV prevalence would range between 0.19 and 0.26 per 100 residents. In Italy, the majority of people diagnosed and linked to care receive antiretroviral therapy. A higher prevalence of individuals diagnosed and linked to care was observed in Northern Italy and among males. More information for developing the HIV care continuum is necessary to improve the entire engagement in care, focusing on test-and-treat strategies to substantially reduce the proportion of people still undiagnosed or with a detectable viral load. PMID:25432098

  18. Does Ethnicity Affect Where People with Cancer Die? A Population-Based 10 Year Study

    PubMed Central

    Koffman, Jonathan; Ho, Yuen King; Davies, Joanna; Gao, Wei; Higginson, Irene J.

    2014-01-01

    Background Ageing is a growing issue for people from UK black, Asian and minority ethnic (BAME) groups. The health experiences of these groups are recognised as a ‘tracer’ to measure success in end of life patient-preferred outcomes that includes place of death (PoD). Aim To examine patterns in PoD among BAME groups who died of cancer. Material and Methods Mortality data for 93,375 cancer deaths of those aged ≥65 years in London from 2001–2010 were obtained from the UK Office for National Statistics (ONS). Decedent's country of birth was used as a proxy for ethnicity. Linear regression examined trends in place of death across the eight ethnic groups and Poisson regression examined the association between country of birth and place of death. Results 76% decedents were born in the UK, followed by Ireland (5.9%), Europe(5.4%) and Caribbean(4.3%). Most deaths(52.5%) occurred in hospital, followed by home(18.7%). During the study period, deaths in hospital declined with an increase in home deaths; trend for time analysis for those born in UK(0.50%/yr[0.36–0.64%]p<0.001), Europe (1.00%/yr[0.64–1.30%]p<0.001), Asia(1.09%/yr[0.94–1.20%]p<0.001) and Caribbean(1.03%/yr[0.72–1.30%]p<0.001). However, time consistent gaps across the geographical groups remained. Following adjustment hospital deaths were more likely for those born in Asia(Proportion ratio(PR)1.12[95%CI1.08–1.15]p<0.001) and Africa(PR 1.11[95%CI1.07–1.16]p<0.001). Hospice deaths were less likely for those born in Asia(PR 0.73 [0.68–0.80] p<0.001), Africa (PR 0.83[95%CI0.74–0.93]p<0.001), and ‘other’ geographical regions (PR0.90[95% 0.82–0.98]p<0.001). Home deaths were less likely for those born in the Caribbean(PR0.91[95%CI 0.85–0.98]p<0.001). Conclusions Location of death varies by country of birth. BAME groups are more likely to die in a hospital and less likely to die at home or in a hospice. Further investigation is needed to determine whether these differences result from

  19. What's School about for Kids?: Meanings and Uses of Homework in Young People's Lives. Families, Literacy, and Schooling: Final Report.

    ERIC Educational Resources Information Center

    Scharf, Amy; Stack, Carol

    An ethnographic study used a multidimensional social perspective on learning and literacy to look at the educational experiences and perspectives of urban young people through an examination of student homework. Subjects, upwards of 40 young people, were drawn from four sites: a sixth-grade classroom at Woodside Elementary School (located in a…

  20. Where Should People with Dementia Live? Using the Views of Service Users to Inform Models of Care

    ERIC Educational Resources Information Center

    Forbat, Liz; Wilkinson, Heather

    2008-01-01

    This paper reports on research that illuminates how people with a learning disability understand dementia and indicates the implications of these understandings for developing appropriate models of care. As this new policy and practice area struggles to provide appropriate and effective models of care for people with a learning disability and…

  1. Informal Social Networks of People with Profound Intellectual and Multiple Disabilities: Relationship with Age, Communicative Abilities and Current Living Arrangements

    ERIC Educational Resources Information Center

    Kamstra, A.; van der Putten, A. A. J.; Post, W. J.; Vlaskamp, C.

    2015-01-01

    Background: People with profound intellectual and multiple disabilities (PIMD) have limited informal social contacts. Research to determine the factors which can positively influence establishing sound informal social contacts is required. Materials and Methods: Regression analysis for 200 people with PIMD was used to analyse how age,…

  2. Specific Hopanoid Classes Differentially Affect Free-Living and Symbiotic States of Bradyrhizobium diazoefficiens

    PubMed Central

    Kulkarni, Gargi; Busset, Nicolas; Molinaro, Antonio; Gargani, Daniel; Chaintreuil, Clemence; Silipo, Alba

    2015-01-01

    ABSTRACT A better understanding of how bacteria resist stresses encountered during the progression of plant-microbe symbioses will advance our ability to stimulate plant growth. Here, we show that the symbiotic system comprising the nitrogen-fixing bacterium Bradyrhizobium diazoefficiens and the legume Aeschynomene afraspera requires hopanoid production for optimal fitness. While methylated (2Me) hopanoids contribute to growth under plant-cell-like microaerobic and acidic conditions in the free-living state, they are dispensable during symbiosis. In contrast, synthesis of extended (C35) hopanoids is required for growth microaerobically and under various stress conditions (high temperature, low pH, high osmolarity, bile salts, oxidative stress, and antimicrobial peptides) in the free-living state and also during symbiosis. These defects might be due to a less rigid membrane resulting from the absence of free or lipidA-bound C35 hopanoids or the accumulation of the C30 hopanoid diploptene. Our results also show that C35 hopanoids are necessary for symbiosis only with the host Aeschynomene afraspera but not with soybean. This difference is likely related to the presence of cysteine-rich antimicrobial peptides in Aeschynomene nodules that induce drastic modification in bacterial morphology and physiology. The study of hopanoid mutants in plant symbionts thus provides an opportunity to gain insight into host-microbe interactions during later stages of symbiotic progression, as well as the microenvironmental conditions for which hopanoids provide a fitness advantage. PMID:26489859

  3. Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: a series of meta-analyses

    PubMed Central

    Mitra, Sanjana; Chen, Shiyi; Gogolishvili, David; Globerman, Jason; Chambers, Lori; Wilson, Mike; Logie, Carmen H; Shi, Qiyun; Morassaei, Sara; Rourke, Sean B

    2016-01-01

    Objective To conduct a systematic review and series of meta-analyses on the association between HIV-related stigma and health among people living with HIV. Data sources A structured search was conducted on 6 electronic databases for journal articles reporting associations between HIV-related stigma and health-related outcomes published between 1996 and 2013. Study eligibility criteria Controlled studies, cohort studies, case-control studies and cross-sectional studies in people living with HIV were considered for inclusion. Outcome measures Mental health (depressive symptoms, emotional and mental distress, anxiety), quality of life, physical health, social support, adherence to antiretroviral therapy, access to and usage of health/social services and risk behaviours. Results 64 studies were included in our meta-analyses. We found significant associations between HIV-related stigma and higher rates of depression, lower social support and lower levels of adherence to antiretroviral medications and access to and usage of health and social services. Weaker relationships were observed between HIV-related stigma and anxiety, quality of life, physical health, emotional and mental distress and sexual risk practices. While risk of bias assessments revealed overall good quality related to how HIV stigma and health outcomes were measured on the included studies, high risk of bias among individual studies was observed in terms of appropriate control for potential confounders. Additional research should focus on elucidating the mechanisms behind the negative relationship between stigma and health to better inform interventions to reduce the impact of stigma on the health and well-being of people with HIV. Conclusions This systematic review and series of meta-analyses support the notion that HIV-related stigma has a detrimental impact on a variety of health-related outcomes in people with HIV. This review can inform the development of multifaceted, intersectoral interventions to

  4. Comparing the Metal Concentration in the Hair of Cancer Patients and Healthy People Living in the Malwa Region of Punjab, India

    PubMed Central

    Blaurock-Busch, Eleonore; Busch, Yvette M.; Friedle, Albrecht; Buerner, Holger; Parkash, Chander; Kaur, Anudeep

    2014-01-01

    The cancer prevalence in the Malwa region of Punjab (1089/million/year) is much higher than the national average cancer prevalence in India (800/million/year). The participants in the present study were 50 healthy individuals and 49 cancer patients all living in the Malwa region of Punjab, with the healthy people being selected from the same household as the cancer patients. High concentrations of several potentially toxic elements were found in hair samples from people living in Punjab. Compared to standard reference ranges, the metals in excess in both the control and patient groups were aluminium (Al), barium (Ba), manganese (Mn), strontium (Sr) and uranium (U). The most significant findings were high lead (Pb), U and Ba concentrations. The maximum values for Ba, Mn, Pb and U were found in hair from breast cancer patients. The mean concentration of U in hair from the breast cancer patients was 0.63 μg U/g, which is more than double the value found in the control group and over six times higher than the reference range of 0.1 μg U/g. Water, soil, and phosphate fertilizers all seem to play a potential role, causing an increased metal burden in Punjabi people living in the Malwa region. The present study indicates that metals, and especially U, may be a factor in the development of breast cancer among Punjabi women. PMID:24453505

  5. Validation of Six Short and Ultra-short Screening Instruments for Depression for People Living with HIV in Ontario: Results from the Ontario HIV Treatment Network Cohort Study

    PubMed Central

    Choi, Stephanie K. Y.; Boyle, Eleanor; Burchell, Ann N.; Gardner, Sandra; Collins, Evan; Grootendorst, Paul; Rourke, Sean B.

    2015-01-01

    Objective Major depression affects up to half of people living with HIV. However, among HIV-positive patients, depression goes unrecognized 60–70% of the time in non-psychiatric settings. We sought to evaluate three screening instruments and their short forms to facilitate the recognition of current depression in HIV-positive patients attending HIV specialty care clinics in Ontario. Methods A multi-centre validation study was conducted in Ontario to examine the validity and accuracy of three instruments (the Center for Epidemiologic Depression Scale [CESD20], the Kessler Psychological Distress Scale [K10], and the Patient Health Questionnaire depression scale [PHQ9]) and their short forms (CESD10, K6, and PHQ2) in diagnosing current major depression among 190 HIV-positive patients in Ontario. Results from the three instruments and their short forms were compared to results from the gold standard measured by Mini International Neuropsychiatric Interview (the “M.I.N.I.”). Results Overall, the three instruments identified depression with excellent accuracy and validity (area under the curve [AUC]>0.9) and good reliability (Kappa statistics: 0.71–0.79; Cronbach’s alpha: 0.87–0.93). We did not find that the AUCs differed in instrument pairs (p-value>0.09), or between the instruments and their short forms (p-value>0.3). Except for the PHQ2, the instruments showed good-to-excellent sensitivity (0.86–1.0) and specificity (0.81–0.87), excellent negative predictive value (>0.90), and moderate positive predictive value (0.49–0.58) at their optimal cut-points. Conclusion Among people in HIV care in Ontario, Canada, the three instruments and their short forms performed equally well and accurately. When further in-depth assessments become available, shorter instruments might find greater clinical acceptance. This could lead to clinical benefits in fast-paced speciality HIV care settings and better management of depression in HIV-positive patients. PMID:26566285

  6. ‘Not Until I'm Absolutely Half-Dead and Have To:’ Accounting for Non-Use of Antiretroviral Therapy in Semi-Structured Interviews with People Living with HIV in Australia

    PubMed Central

    Mao, Limin; Persson, Asha; Holt, Martin; Slavin, Sean; Kidd, Michael R.; Post, Jeffrey J.; Wright, Edwina; de Wit, John

    2015-01-01

    Abstract Current debates regarding the use of antiretroviral therapy (ART) to promote both individual- and population-level health benefits underscore the importance of understanding why a subpopulation of people with diagnosed HIV and access to treatment choose not to use it. Semi-structured interviews were conducted between 2012 and 2014 with 27 people living with HIV in Australia who were not using ART at the time of interview. Analytic triangulation permitted an appreciation of not only the varied personal reasons for non-use of treatment, but also underlying views on HIV treatment, and the ideal conditions imagined necessary for treatment initiation. Policy goals to increase the number of people with HIV using ART must recognize the diverse explanations for non-use of ART, which include concerns about the various impacts of committing to lifelong pharmaceutical treatment use. Our research identified distinctive subgroups among people who are not using antiretroviral therapy, with a range of individual and social needs that may affect treatment decisions. These findings challenge assumptions about treatment non-use in resource-rich settings, revealing persistent consumer fears about the potent and unknown effects of HIV medications that deserve greater recognition in policy debate on treatment uptake. PMID:25806574

  7. Factors Associated with Self and Informant Ratings of the Quality of Life of People with Dementia Living in Care Facilities: A Cross Sectional Study

    PubMed Central

    Beer, Christopher; Flicker, Leon; Horner, Barbara; Bretland, Nick; Scherer, Samuel; Lautenschlager, Nicola T.; Schaper, Frank; Almeida, Osvaldo P.

    2010-01-01

    Background There is no consensus regarding the optimal approach to assessment of the quality of life of people with dementia. We undertook the present study to describe and determine the factors associated with ratings of the quality of life of a cohort of people with dementia living in a residential care facility. Methodology/Principal Findings 351 people with dementia living in residential care facilities, and their staff and family informants participated in this cross sectional observational study. Quality of life was measured using self (Quality of Life in Alzheimer's Disease [QoL-AD] scale), and informant (QoL-AD and Alzheimer's Disease Related QoL Scale) reports. 226 people (64%) with dementia (median MMSE 17; 12–21) were able to self rate the QoL-AD scale and these subjects' ratings were compared to ratings by staff and family. Both staff and family informant ratings of the QoL-AD underestimated self ratings (mean difference −7.8, 95% CI −8.8, −6.7 for staff rated QoL-AD; and mean difference −7.2, 95% CI −8.5, −6.0 for family rated QoL-AD). Self ratings of QoL were lower among people who were restrained, had fallen or had pain. Informant ratings of the QoL of the participants with dementia were consistently and significantly lower for people with severe cognitive impairment, who had fallen, had presence of neuropsychiatric symptoms, or where care giver distress was present. Documented restraint, reported pain and neuropsychiatric symptoms were independently associated with lower self rating of the QoL-AD in multivariate models. Cognitive impairment, case conferencing, hospitalizations and neuropsychiatric symptoms were found to be independently associated with staff rated ADRQL. Conclusions The majority of people with dementia living in residential care facilities can rate their own QoL. Informant ratings underestimate self ratings of QoL of people with dementia, and appear to be associated with factors which are not associated with self

  8. A Study on Factors That Drive Variation in the Levels of Social Capital Among People Living With HIV/AIDS in Iran

    PubMed Central

    Rimaz, Shahnaz; Nikooseresht, Zahra; Vesali, Samera; Nedjat, Saharnaz; Asadi-Lari, Mohsen

    2015-01-01

    Introduction: Social capital is increasingly used in relation to health issues, particularly in sexually transmitted diseases/infections and health behaviors. Experiences indicated that social capital can contribute in changing HIV related risk behaviors and a decline of HIV infection through social groups and networking and make more effective use of HIV/AIDS prevention, care, and treatment services. We aimed to assess social capital in these persons through a quantitative study. Method: This cross-sectional study was performed with a convenience sample of 300 people living HIV/AIDS referred to a counseling center of behavioral diseases, in Imam Khomeini Hospital, in Tehran, the capital of Iran, during September 2011 to May 2012. Data collection tools were a demographic questionnaire and World Bank Social Capital Questionnaire (SC-IQ). The analysis of data was performed by the SPSS statistic software version 18. To identify factors influencing social capital in participations, Pearson correlation coefficient, ANOVA, t-test, and a multiple regression were applied. The significant level was considered 0.05 in this study. Results: 165 (55%) were male and the rest female. The mean age of participants was 34.3±7.5. The mean score of total social capital was 2.34±0.5 in all participants. The domain of individual trust had the highest mean score (2.53±0.66). The lowest mean score was related to the domain of social trust and associative relations (2.23±0.62). Variables such as ethnicity, age, and middle economic status had a significant impact on the domain of individual trust so that the mean score of this component of social capital was lower among women (0.396) than men. Factors affecting total social capital were ethnicity and middle economic status. Conclusion: Finding emphasized on the role of economic status, ethnicity and gender in persons living with HIV/AIDS. Thus recommended that policy makers and program managers consider social groups and networks

  9. Experiences and motivations underlying wishes to die in older people who are tired of living: a research area in its infancy.

    PubMed

    van Wijngaarden, Els; Leget, Carlo; Goossensen, Anne

    2014-01-01

    The wish to die in older people who are tired of living and the possibilities to organize death are currently being discussed within the debate on self-determination and physician-assisted suicide. Until now insight into the experiences and thoughts of people who are tired of life but not suffering from a severe depression or a life-threatening disease is lacking. Studies focussing specifically on this topic are rare. This review provides an overview of this research area in its infancy. The existential impact of age-related loss experiences play an important role in developing a wish to die. Other influencing factors are: personal characteristics, biographical factors, social context, perceptions and values. Further research to experiences and motivations underlying these specific age-related wishes to die and the existential impact of the loss-experiences seems necessary to deepen the understanding of this group of older people and for the development of policy and good care. PMID:25223313

  10. Factors Which Affect Students' Attitudes towards the Use of Living Animals in Learning Biology.

    ERIC Educational Resources Information Center

    Silberstein, Moshe; Tamir, Pinchas

    1981-01-01

    Identifies factors which affect students' attitudes toward the use of animals in research and in learning biology. Responses of students (N=577) in grades 5, 7, 9, and 11 to questionnaires were analyzed by two-way analysis of variance by grade level and sex. Results and implications are discussed. (CS)

  11. Older People and HIV

    MedlinePlus

    ... Many older people believe that HIV only affects younger people Most older people get little training in ... diseases among older people, as they do for younger people. Physicians may not diagnose HIV infection in ...

  12. Using Citizen Scientists to Gather, Analyze, and Disseminate Information About Neighborhood Features That Affect Active Living.

    PubMed

    Winter, Sandra J; Goldman Rosas, Lisa; Padilla Romero, Priscilla; Sheats, Jylana L; Buman, Matthew P; Baker, Cathleen; King, Abby C

    2016-10-01

    Many Latinos are insufficiently active, partly due to neighborhoods with little environmental support for physical activity. Multi-level approaches are needed to create health-promoting neighborhoods in disadvantaged communities. Participant "citizen scientists" were adolescent (n = 10, mean age = 12.8 ± 0.6 years) and older adult (n = 10, mean age = 71.3 ± 6.5 years), low income Latinos in North Fair Oaks, California. Citizen scientists conducted environmental assessments to document perceived barriers to active living using the Stanford Healthy Neighborhood Discovery Tool, which records GPS-tracked walking routes, photographs, audio narratives, and survey responses. Using a community-engaged approach, citizen scientists subsequently attended a community meeting to engage in advocacy training, review assessment data, prioritize issues to address and brainstorm potential solutions and partners. Citizen scientists each conducted a neighborhood environmental assessment and recorded 366 photographs and audio narratives. Adolescents (n = 4), older adults (n = 7) and community members (n = 4) collectively identified reducing trash and improving personal safety and sidewalk quality as the priority issues to address. Three adolescent and four older adult citizen scientists volunteered to present study findings to key stakeholders. This study demonstrated that with minimal training, low-income, Latino adolescent and older adult citizen scientists can: (1) use innovative technology to gather information about features of their neighborhood environment that influence active living, (2) analyze their information and identify potential solutions, and (3) engage with stakeholders to advocate for the development of healthier neighborhoods. PMID:26184398

  13. An outbreak of tuberculosis affecting cattle and people on an Irish dairy farm, following the consumption of raw milk

    PubMed Central

    2009-01-01

    Bovine tuberculosis is an ongoing problem in Ireland, and herd incidence has remained at approximately 5% for some years. Spillover of infection from cattle to people remains an ever-present possibility, given the ongoing pool of infection in the Irish cattle population. This paper describes an outbreak of tuberculosis affecting cattle and people on a dairy farm in southeastern Ireland following the consumption of milk from a seven-year-old cow with tuberculous mastitis. Twenty-five of 28 calves born during autumn 2004 and spring 2005 were subsequently identified as TB reactors, and five of six family members were positive on the Mantoux test. During 2005, milk from this cow had mainly been used to feed calves, and was added only occasionally to the bulk tank. Therefore, the calves each received infected milk on an almost continuous basis between birth and weaning. The family collected milk from the bulk milk tank, and consumed it without pasteurisation. This case highlights the risks associated with the consumption of raw milk. In this family, TB has had a very significant impact on the health of two young children. These risks are well recognised, and relevant information for farmers is available. It is of concern, therefore, that raw milk consumption remains prevalent on Irish farms. New strategies are needed, in partnership with industry, to address this important issue. Keywords: bovine tuberculosis, Ireland, mastitis, milk, Mycobacterium bovis, pasteurisation, TB, zoonosis PMID:21851735

  14. Answers to Questions Commonly Asked by Families, Professionals, and Members of the Community. Information Pages for People Involved in the Lives of Individuals with Deaf-Blindness.

    ERIC Educational Resources Information Center

    Wiley, David

    This packet contains six information pages providing basic answers to questions commonly asked by people involved with individuals who are deaf blind. The first one is on understanding deaf-blindness and addresses what the condition is, its impact on the ability to receive information, how the condition affects caregiver strategies, and what it is…

  15. Discounting human lives

    SciTech Connect

    Cropper, M.L. ); Portney, P.R.

    1992-09-01

    The future costs of regulatory programs to protect human health are routinely discounted, but the lives they save in the future are not. To shed light on the public's attitude toward the discounting of human lives, researchers at Resources for the Future asked 2,600 individuals to choose between one hypothetical program that would save lives immediately and another that would save lives in 5, 10, 25, 50, or 100 years. From the responses, they inferred the number of lives that must be saved in the future to make people as content as saving one life today, compared this implicit discount rate to the respondents' discount rate for money, and identified several factors that affect discount rates for human lives.

  16. Are you ready? Exploring readiness to engage in exercise among people living with HIV and multimorbidity in Toronto, Canada: a qualitative study

    PubMed Central

    Simonik, Alya; Vader, Kyle; Ellis, Denine; Kesbian, Dirouhi; Leung, Priscilla; Jachyra, Patrick; Chan Carusone, Soo; O'Brien, Kelly K

    2016-01-01

    Objectives Our aim was to explore readiness to engage in exercise among people living with HIV and multimorbidity. Design We conducted a descriptive qualitative study using face-to-face semistructured interviews with adults living with HIV. Setting We recruited adults (18 years or older) who self-identified as living with HIV and 2 or more additional health-related conditions from a specialty hospital in Toronto, Canada. Participants 14 participants with a median age of 50 years and median number of 9 concurrent health-related conditions participated in the study. The majority of participants were men (64%) with an undetectable viral load (71%). Outcome measures We asked participants to describe their readiness to engage in exercise and explored how contextual factors influenced their readiness. We analysed interview transcripts using thematic analysis. Results We developed a framework to describe readiness to engage in exercise and the interplay of factors and their influence on readiness among adults with HIV and multimorbidity. Readiness was described as a diverse, dynamic and fluctuating spectrum ranging from not thinking about exercise to routinely engaging in daily exercise. Readiness was influenced by the complex and episodic nature of HIV and multimorbidity comprised of physical impairments, mental health challenges and uncertainty from HIV and concurrent health conditions. This key factor created a context within which 4 additional subfactors (social supports, perceptions and beliefs, past experience with exercise, and accessibility) may further hinder or facilitate an individual's position along the spectrum of readiness to exercise. Conclusions Readiness to engage in exercise among people living with HIV is a dynamic and fluctuating construct that may be influenced by the episodic nature of HIV and multimorbidity and 4 subfactors. Strategies to facilitate readiness to exercise should consider the interplay of these factors in order to enhance

  17. Safeguarding inheritance and enhancing the resilience of orphaned young people living in child- and youth-headed households in Tanzania and Uganda.

    PubMed

    Evans, Ruth

    2012-10-01

    This article explores the resilience of orphaned young people in safeguarding physical assets (land and property) inherited from their parents and sustaining their households without a co-resident adult relative. Drawing on the concept of resilience and the sustainable livelihoods framework, the article analyses the findings of an exploratory study conducted in 2008-2009 in Tanzania and Uganda with 15 orphaned young people heading households, 18 of their siblings, and 39 NGO workers and community members. The findings suggest that inherited land and property were key determining factors in the formation and viability of the child- and youth-headed households in both rural and urban areas. Despite experiences of stigma and marginalisation in the community, social networks were crucial in enabling the young people to protect themselves and their property, providing access to material and emotional resources, and enhancing their skills and capabilities to develop sustainable livelihoods. Support for child- and youth-headed households needs to recognise young people's agency and should adopt a holistic approach to their lives by analysing the physical assets, material resources, and human and social capital available to the household, as well as giving consideration to individual young people's wellbeing, outlook and aspirations. Alongside cash transfers and material support, youth-led collective mobilisation that is sustained over time may also help build resilience and foster supportive social environments in order to challenge property-grabbing and the stigmatisation of child- and youth-headed households. PMID:25860094

  18. Locating the Place and Meaning of Physical Activity in the Lives of Young People from Low-Income, Lone-Parent Families

    ERIC Educational Resources Information Center

    Quarmby, Thomas; Dagkas, Symeon

    2013-01-01

    Background: In the United Kingdom (UK), it is predicted that economic cuts and a subsequent increase in child poverty will affect those already on the lowest incomes and, in particular, those living in lone-parent families. As a result, the informal pedagogic encounters within the family that contribute to the development of physical…

  19. Refugee migration and risk of schizophrenia and other non-affective psychoses: cohort study of 1.3 million people in Sweden

    PubMed Central

    Dal, Henrik; Lewis, Glyn; Magnusson, Cecilia; Kirkbride, James B; Dalman, Christina

    2016-01-01

    Objective To determine whether refugees are at elevated risk of schizophrenia and other non-affective psychotic disorders, relative to non-refugee migrants from similar regions of origin and the Swedish-born population. Design Cohort study of people living in Sweden, born after 1 January 1984 and followed from their 14th birthday or arrival in Sweden, if later, until diagnosis of a non-affective psychotic disorder, emigration, death, or 31 December 2011. Setting Linked Swedish national register data. Participants 1 347 790 people, including people born in Sweden to two Swedish-born parents (1 191 004; 88.4%), refugees (24 123; 1.8%), and non-refugee migrants (132 663; 9.8%) from four major refugee generating regions: the Middle East and north Africa, sub-Saharan Africa, Asia, and Eastern Europe and Russia. Main outcome measures Cox regression analysis was used to estimate adjusted hazard ratios for non-affective psychotic disorders by refugee status and region of origin, controlling for age at risk, sex, disposable income, and population density. Results 3704 cases of non-affective psychotic disorder were identified during 8.9 million person years of follow-up. The crude incidence rate was 38.5 (95% confidence interval 37.2 to 39.9) per 100 000 person years in the Swedish-born population, 80.4 (72.7 to 88.9) per 100 000 person years in non-refugee migrants, and 126.4 (103.1 to 154.8) per 100 000 person years in refugees. Refugees were at increased risk of psychosis compared with both the Swedish-born population (adjusted hazard ratio 2.9, 95% confidence interval 2.3 to 3.6) and non-refugee migrants (1.7, 1.3 to 2.1) after adjustment for confounders. The increased rate in refugees compared with non-refugee migrants was more pronounced in men (likelihood ratio test for interaction χ2 (df=2) z=13.5; P=0.001) and was present for refugees from all regions except sub-Saharan Africa. Both refugees and non-refugee migrants from sub-Saharan Africa had similarly high

  20. Early associations with food in anorexia nervosa patients and obese people assessed in the affective priming paradigm.

    PubMed

    Roefs, A; Stapert, D; Isabella, L A S; Wolters, G; Wojciechowski, F; Jansen, A

    2005-02-01

    Two experiments are reported that used the affective priming paradigm (Fazio, R. H., Sanbonmatsu, D. M., Powell, M. C., & Kardess, F. R. (1986). On the automatic activation of attitudes. Journal of Personality and Social Psychology, 50, 229-238) to uncover associations with food at a relatively automatic level. Experiment 1 tested the hypothesis that anorexia nervosa (AN; n=22) patients would show less sensitivity to the palatability of foods than unrestrained lean controls (n=27). Results indeed suggested that AN patients did not display a liking of palatable foods over unpalatable foods, whereas unrestrained controls did. Experiment 2 tested the hypothesis that obese people (n=27) would show more sensitivity to the palatability of (high-fat) palatable foods than unrestrained lean controls (n=27) would. However, results suggested that the priming effect was based on health concerns, in that participants showed a preference for low-fat palatable foods over high-fat palatable foods. Average speed of responding and context are discussed as variables influencing the affective priming effect. Taken together, results suggest that food evaluations at a relatively automatic level are controlled by an interaction between participant characteristics, stimuli characteristics, and the specific context. PMID:15598602

  1. Resilience in young people living with violence and self-harm: evidence from a Norwegian national youth survey

    PubMed Central

    Huang, Lihong; Mossige, Svein

    2015-01-01

    The aim of this article is to explore the relationship between resilience and the psychological problems of young people who reported being victims of violence and who engaged in self-harm. We used data from a national survey conducted in 2007 asking young people in Norway (N=6,034; ages 18–19 years) about their experiences with violence during their childhood and during the past 12 months, and also about their mental health and experiences of self-harm. Our analyses revealed that resilience, as measured by the Resilience Scale for Adolescents, correlates significantly and negatively with psychological problems among all young people, and that this correlation is substantially stronger for those youths who reported violent experiences and those who engaged in self-harm. PMID:26316830

  2. Mental health problems in people living with HIV: changes in the last two decades: the London experience 1990-2014.

    PubMed

    Adams, Catherine; Zacharia, Shilpa; Masters, Lisa; Coffey, Caroline; Catalan, Pepe

    2016-01-01

    Mental health problems continue to be a significant comorbidity for people with HIV infection, even in the era of effective antiretroviral therapy. Here, we report on the changes in the mental health diagnoses based on clinical case reports amongst people with HIV referred to a specialist psychological medicine department over a 24-year period, which include the relative increase in depressive and anxiety disorders, often of a chronic nature, together with a decline in acute mental health syndromes, mania, and organic brain disorders. In addition, new challenges, like the presence of HIV and Hepatitis C co-infection, and the new problems created by recreational drugs, confirm the need for mental health services to be closely involved with the general medical services. A substantial proportion of people with HIV referred to specialist services suffer complex difficulties, which often require the collaboration of both psychiatrists and psychologists to deal effectively with their difficulties. PMID:26888472

  3. Our lives were healthier before: focus groups with African American, American Indian, Hispanic/Latino, and Hmong people with diabetes.

    PubMed

    Devlin, Heather; Roberts, Martha; Okaya, Amy; Xiong, Yer Moua

    2006-01-01

    Focus groups were conducted to explore health-related beliefs and experiences of African American, Hispanic/Latino, American Indian, and Hmong people with diabetes and engage community members in improving diabetes care and education for these populations. Eighty participants attended 12 focus groups, 3 per population. Major themes were loss of health attributed to modern American lifestyles, lack of confidence in the medical system, and the importance of spirituality. Participants recommended improvements in the areas of health care, diabetes education, social support, and community action. Their recommendations emphasize the importance of respectful, knowledgeable health care providers; culturally responsive diabetes education for people with diabetes and their families; and broad-based community action. These recommendations align with current public health priorities and medical knowledge. It is proposed that healthy traditions from diverse populations can be leveraged to improve the health of all people with diabetes. PMID:16410420

  4. Mental health problems in people living with HIV: changes in the last two decades: the London experience 1990–2014

    PubMed Central

    Adams, Catherine; Zacharia, Shilpa; Masters, Lisa; Coffey, Caroline; Catalan, Pepe

    2016-01-01

    ABSTRACT Mental health problems continue to be a significant comorbidity for people with HIV infection, even in the era of effective antiretroviral therapy. Here, we report on the changes in the mental health diagnoses based on clinical case reports amongst people with HIV referred to a specialist psychological medicine department over a 24-year period, which include the relative increase in depressive and anxiety disorders, often of a chronic nature, together with a decline in acute mental health syndromes, mania, and organic brain disorders. In addition, new challenges, like the presence of HIV and Hepatitis C co-infection, and the new problems created by recreational drugs, confirm the need for mental health services to be closely involved with the general medical services. A substantial proportion of people with HIV referred to specialist services suffer complex difficulties, which often require the collaboration of both psychiatrists and psychologists to deal effectively with their difficulties. PMID:26888472

  5. Health behaviour change of people living with HIV after a comprehensive community-based HIV stigma reduction intervention in North-West Province in South Africa

    PubMed Central

    Chidrawi, H. Christa; Greeff, Minrie; Temane, Q. Michael

    2014-01-01

    Abstract All over the world, health behaviour is considered a complex, far reaching and powerful phenomenon. People's lives are influenced by their own or others' health behaviour on a daily basis. Whether it has to do with smoking, drinking, pollution, global warming or HIV management, it touches lives and it challenges personal and community responses. Health behaviour, and health behaviour change, probably holds the key to many a person's immediate or prolonged life or death outcomes. The same can be said about communities, culture groups and nations. This SANPAD-funded study focused on research questions relating to health behaviour change for people living with HIV (PLWH) in the North-West Province in South Africa. It investigated whether a comprehensive community-based HIV stigma reduction intervention caused health behaviour change in PLWH. An quantitative single system research design with one pre- and four repetitive post-tests utilizing purposive sampling was used to test change-over-time in the health behaviour of 18 PLWH. The results of the study indicated statistical and/or practical significant change-over-time. The intervention not only addressed the health behaviour of PLWH, but also their HIV stigma experiences, HIV signs and symptoms and their quality of life in the context of being HIV positive. The recommendations include popularization of the comprehensive community-based HIV stigma reduction intervention and extending it to include a second intervention to strengthen health behaviour and quality of life for PLWH in the community at large. PMID:25495580

  6. Predictors of unsafe sexual behavior among people living with human immunodeficiency virus/AIDS attending antiretroviral therapy center in Western India

    PubMed Central

    Mehta, Kedar G.; Baxi, Rajendra; Chavda, Parag; Patel, Sangita; Mazumdar, Vihang

    2016-01-01

    Background: As more and more people with human immunodeficiency virus (HIV) live longer and healthier lives because of antiretroviral therapy (ART), an increasing number of sexual transmissions of HIV may arise from these people living with HIV/AIDS (PLWHA). Hence, this study is conducted to assess the predictors of unsafe sexual behavior among PLWHA on ART in Western India. Materials and Methods: The current cross-sectional study was carried out among 175 PLWHAs attending ART center of a Tertiary Care Hospital in Western India. Unsafe sex was defined as inconsistent and/or incorrect condom use. A total of 39 variables from four domains viz., sociodemographic, relationship-related, medical and psycho-social factors were studied for their relationship to unsafe sexual behavior. The variables found to be significantly associated with unsafe sex practices in bivariate analysis were explored by multivariate analysis using multiple logistic regression in SPSS 17.0 version. Results: Fifty-eight percentage of PLWHAs were practicing unsafe sex. 15 out of total 39 variables showed significant association in bivariate analysis. Finally, 11 of them showed significant association in multivariate analysis. Young age group, illiteracy, lack of counseling, misbeliefs about condom use, nondisclosure to spouse and lack of partner communication were the major factors found to be independently associated with unsafe sex in multivariate analysis. Conclusion: Appropriate interventions like need-based counseling are required to address risk factors associated with unsafe sex. PMID:27190408

  7. Gender Differences in Health Related Quality of Life among People Living with HIV on Highly Active Antiretroviral Therapy in Mekelle Town, Northern Ethiopia

    PubMed Central

    Tesfay, Amanuel; Gebremariam, Abebe; Abrha, Hailay

    2015-01-01

    Background. Health related quality of life (HRQOL) is an important outcome measure for highly active antiretroviral treatment program. In Ethiopia, studies revealed that there are improved qualities of life among adults living with the viruses taking antiretroviral therapy but there is no explicit data showing gender differences in health related quality of life. Aim. To assess gender differences in HRQOL and its associated factors among people living with HIV and on highly active antiretroviral therapy in public health institutions of Mekelle town, Northern Ethiopia. Methods. A comparative cross-sectional study was conducted among 494 adult people living with HIV taking ART services. Quality of life was measured using WHOQOL-HIV BREF. Result. There was a statistically significant gender difference (P < 0.05) in HRQOL among PLHIV on HAART. Females had low score in all HRQOL domains. High perceived stigma was strongly associated with poor psychological quality of domain among both female and male groups with [AOR = 2.89(1.69,4.96)] and [AOR = 2.5(1.4,4.4)], respectively. Conclusion. There was statistically significant gender difference in all quality of life domains. Public health interventions to improve HRQOL of PLHIV should take in to account the physical, psychological, social, environmental, and spiritual health of PLHIV during treatment, care, and support. PMID:25632393

  8. Relationship between Individual Quality of Life and Family Quality of Life for People with Intellectual Disability Living in Italy

    ERIC Educational Resources Information Center

    Bertelli, M.; Bianco, A.; Rossi, M.; Scuticchio, D.; Brown, I.

    2011-01-01

    Background: There is substantial literature investigating quality of life (QoL) of individuals with intellectual disability (ID). QoL of families of people with ID is emerging as an important field of research. Despite this, there is a lack of studies regarding their relationship. Aim: The present paper aimed to study the relationship between QoL…

  9. The Enabling Role of Education in the Lives of Young People with Disabilities in India: Achieved and Desired Outcomes

    ERIC Educational Resources Information Center

    Singal, Nidhi; Jeffery, Roger; Jain, Aanchal; Sood, Neeru

    2011-01-01

    In India, the last few years have seen an increase in the school enrolment rates of children with disabilities; however, there are continuing concerns about the outcomes of these efforts, especially in terms of employment. This paper presents the findings of a qualitative enquiry into how young people (aged 15-30 years) with various impairments…

  10. The Place of Sport and Physical Activity in Young People's Lives and Its Implications for Health: Some Sociological Comments

    ERIC Educational Resources Information Center

    Smith, Andrew; Green, Ken

    2005-01-01

    This exploratory paper seeks, first, to offer some critical sociological comments on the common-sense, or rather ideological, claims surrounding two supposedly emerging "crises": namely, the alleged poor health and declining sport and physical activity participation levels of young people. In this regard, it is suggested that while young people…

  11. The Lived Experiences of Tobacco Use, Dependence, and Cessation: Insights and Perspectives of People with Mental Illness

    ERIC Educational Resources Information Center

    Solway, Erica Singer

    2011-01-01

    Even as the rate of smoking in the U.S. population overall has decreased dramatically during the last four decades, people with mental illness continue to use tobacco at alarmingly high rates. In the last two years, national initiatives have developed to address smoking within this population, yet there has not been an attempt to understand the…

  12. Living Tomorrow... An Inquiry into the Preparation of Young People for Working Life in Europe. 3rd Edition.

    ERIC Educational Resources Information Center

    Deforge, Ives

    Technological advances have created changes in working life. Automation displaces more workers than the service industry can absorb. The jobs that are left are often downgraded from the complexity they have formerly enjoyed. As society becomes more and more automated, unemployment becomes structural. How do we prepare young people for the jobs of…

  13. One Starfish at a Time: Using Fundamentals in Sociology to Rethink Impressions about People Living with HIV/AIDS

    ERIC Educational Resources Information Center

    Moremen, Robin D.

    2010-01-01

    The purpose of this article is to document how a course in the fundamentals of sociology encouraged students to rethink negative impressions about people with AIDS. Multimethod, active learning processes were utilized to introduce the sociological imagination, critical thinking, and theory and methods in sociology. The intent was to apply basic…

  14. Psychometric Evaluation of a Scale to Assess Satisfaction with Life among People with Intellectual Disabilities Living in Community Residences

    ERIC Educational Resources Information Center

    Bergstrom, H.; Hochwalder, J.; Kottorp, A.; Elinder, L. S.

    2013-01-01

    Background: In the context of a health intervention among people with intellectual disabilities (ID), there was a need to assess satisfaction with some aspects of life, in order to monitor both potential positive and negative effects of the intervention. The aim of the present study was to develop and evaluate an easily administered scale for…

  15. Building Groups and Independence: The Role of Food in the Lives of Young People in Danish Sports Centres

    ERIC Educational Resources Information Center

    Sylow, Mine; Holm, Lotte

    2009-01-01

    This article, based on an ethnographic study, examines the role of food in the social interaction of 11- to 17-year-old youths in sports centres in Denmark. The sports centres serve as a free space where young people receive no adult supervision. This is underlined by their understanding and use of food in this environment. Food serves as a medium…

  16. Gendered Family Lives through the Eyes of Young People: Diversity, Permanence and Change of Gender Representations in Portugal

    ERIC Educational Resources Information Center

    das Dores Guerreiro, Maria; Caetano, Ana; Rodrigues, Eduardo

    2014-01-01

    This article examines gender representations of family and parental roles among young people aged 11 to 14 years. It is based on the qualitative analysis of 792 essays written by Portuguese girls and boys attending compulsory education. The adolescents' texts express normative images and cultural representations about gender that are plural…

  17. Development of a Standardized Screening Rule for Tuberculosis in People Living with HIV in Resource-Constrained Settings: Individual Participant Data Meta-analysis of Observational Studies

    PubMed Central

    Getahun, Haileyesus; Kittikraisak, Wanitchaya; Heilig, Charles M.; Corbett, Elizabeth L.; Ayles, Helen; Cain, Kevin P.; Grant, Alison D.; Churchyard, Gavin J.; Kimerling, Michael; Shah, Sarita; Lawn, Stephen D.; Wood, Robin; Maartens, Gary; Granich, Reuben; Date, Anand A.; Varma, Jay K.

    2011-01-01

    Background The World Health Organization recommends the screening of all people living with HIV for tuberculosis (TB) disease, followed by TB treatment, or isoniazid preventive therapy (IPT) when TB is excluded. However, the difficulty of reliably excluding TB disease has severely limited TB screening and IPT uptake in resource-limited settings. We conducted an individual participant data meta-analysis of primary studies, aiming to identify a sensitive TB screening rule. Methods and Findings We identified 12 studies that had systematically collected sputum specimens regardless of signs or symptoms, at least one mycobacterial culture, clinical symptoms, and HIV and TB disease status. Bivariate random-effects meta-analysis and the hierarchical summary relative operating characteristic curves were used to evaluate the screening performance of all combinations of variables of interest. TB disease was diagnosed in 557 (5.8%) of 9,626 people living with HIV. The primary analysis included 8,148 people living with HIV who could be evaluated on five symptoms from nine of the 12 studies. The median age was 34 years. The best performing rule was the presence of any one of: current cough (any duration), fever, night sweats, or weight loss. The overall sensitivity of this rule was 78.9% (95% confidence interval [CI] 58.3%–90.9%) and specificity was 49.6% (95% CI 29.2%–70.1%). Its sensitivity increased to 90.1% (95% CI 76.3%–96.2%) among participants selected from clinical settings and to 88.0% (95% CI 76.1%–94.4%) among those who were not previously screened for TB. Negative predictive value was 97.7% (95% CI 97.4%–98.0%) and 90.0% (95% CI 88.6%–91.3%) at 5% and 20% prevalence of TB among people living with HIV, respectively. Abnormal chest radiographic findings increased the sensitivity of the rule by 11.7% (90.6% versus 78.9%) with a reduction of specificity by 10.7% (49.6% versus 38.9%). Conclusions Absence of all of current cough, fever, night sweats, and weight

  18. Space Unseen: A Case Study of Renovations to a Shared Living Space by Four People with Visual Impairments in Taiwan

    ERIC Educational Resources Information Center

    Shih, Chih-Ming; Huang, Kuang-Hsu

    2009-01-01

    This case study investigated a shared living space used by four participants with severe visual impairments and their four sighted children. In this case study, the authors discovered that the participants with visual impairments focused on two aspects of design features: tactile and visual. At the same time, they revealed a unique aesthetic…

  19. Living Your Own Life: A Handbook for Teenagers by Young People and Adults with Chronic Illness or Disabilities.

    ERIC Educational Resources Information Center

    Roberts, Nicole; And Others

    This book aims to provide teenagers with chronic illnesses or disabilities with useful information, moral support, and understanding as they make the transition to adulthood. It points out that although individuals with disabilities may want and need others for support, they can still live independently and make choices in all areas of their…

  20. The Sentence Completion and Three Wishes Tasks: Windows into the Inner Lives of People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Dykens, E.; Schwenk, K.; Maxwell, M.; Myatt, B.

    2007-01-01

    Background: Measuring the self-perceptions, thoughts, hopes and inner lives of persons with intellectual disabilities (ID) has long been a research challenge. Unlike objective or projective tests, semi-projective tasks may provide persons with ID with just enough structure or cues to convey their self-perceptions in a spontaneous and unbiased…