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Sample records for hiv discordant unions

  1. Experience of sexual violence among women in HIV discordant unions after voluntary HIV counselling and testing

    Science.gov (United States)

    Emusu, Donath; Ivankova, Nataliya; Jolly, Pauline; Kirby, Russell; Foushee, Herman; Wabwire-Mangen, Fred; Katongole, Drake; Ehiri, John

    2009-01-01

    HIV-serodiscordant relationships are those in which one partner is infected with HIV while the other is not. We investigated experiences of sexual violence among women in HIV discordant unions attending HIV post-test club services in Uganda. A volunteer sample of 26 women from three AIDS Information Centres in Uganda who reported having experienced sexual violence in a larger epidemiological study were interviewed, using the qualitative critical incident technique. Data were analysed using TEXTPACK, a software application for computer-assisted content analysis. Incidents of sexual violence narrated by the women included use of physical force and verbal threats. Overall, four themes that characterise the women’s experience of sexual violence emerged from the analysis: knowledge of HIV test results, prevalence of sexual violence, vulnerability and proprietary views and reactions to sexual violence. Alcohol abuse by the male partners was an important factor in the experience of sexual violence among the women. Their experiences evoked different reactions and feelings, including concern over the need to have children, fear of infection, desire to separate from their spouses/partners, helplessness, anger and suicidal tendencies. HIV counselling and testing centres should be supported with the capacity to address issues related to sexual violence for couples who are HIV discordant. PMID:20024712

  2. Sexual violence and associated factors among women in HIV discordant and concordant relationships in Uganda.

    Science.gov (United States)

    Shuaib, Faisal M B; Ehiri, John E; Jolly, Pauline; Zhang, Qionghui; Emusu, Donath; Ngu, Julius; Foushee, Herman; Katongole, Drake; Kirby, Russell; Wabwire-Mangen, Fred

    2012-01-01

    HIV serodiscordance is a sexual partnership in which one partner is infected with HIV while the other is not. Managing emotional and sexual intimacy in HIV serodiscordant unions can be difficult due to concerns about HIV transmission and the challenge of initiating and maintaining safe sex. In situations where couples are jointly aware of their HIV status, women in serodiscordant unions may face increased risk of partner violence. We conducted an investigation to assess risk factors for HIV serodiscordance and determine if HIV serodiscordance is associated with incident sexual violence among a cohort of women attending HIV post-test club services at three AIDS Information Centers (AICs) in Uganda. Using a prospective study of 250 women, we elicited information about sexual violence using structured face-to-face interviews. Sexual violence and risk factors were assessed and compared among HIV positive women in HIV discordant unions, HIV negative women in discordant unions, and HIV negative women in negative concordant unions. Multivariable logistic regression was used to assess the association between participants' serostatus and sexual violence. HIV negative women in serodiscordant relationships (36.1±11.1 years, range: 19-65 years) were significantly older than either HIV positive women in serodiscordant relationships (32.2±9.0 years, range: 18-56 years), or HIV negative women in concordant relationships (32.3±11.0 years, range: 18-62), (p=0.033). Early age at sexual debut was associated with a 2.4-fold increased risk of experiencing sexual violence (OR 2.4, 95% CI 1.27-4.65). Based on unadjusted analysis, HIV positive women in discordant relationship were at highest risk for sexual violence compared to HIV negative women in discordant unions, and HIV negative women in negative concordant unions. HIV negative women in discordant relationships and those in concordant negative relationships showed no increased risk for sexual violence. However, couples' HIV

  3. Stakeholders perception of HIV sero-discordant couples in western Kenya.

    Science.gov (United States)

    Were, E; Wools-Kaloustian, K; Baliddawa, J; Ayuo, P O; Sidle, J; Fife, K

    2008-07-01

    To describe the perceptions of key stakeholders regarding the counselling needs of HIV sero-discordant couples as part of preparation for a clinical trial involving HIV sero-discordant couples. Qualitative study using key informant and couple interviews. Moi Teaching and Referral Hospital (MTRH). A purposive sample of nine key informants and 31 couple interviews totaling 71 participants. The couple interviews consisted of HIV untested, HIV concordant (positive and negative) and discordant couples. Seventy one individuals participated in nine key informant and 31 couple interviews. The responses identified the following as key issues in counselling HIV discordant couples: The need for education on the meaning of HIV sero-discordancy including potential sources of infection; assistance in disclosing HIV test results to one's partner; discussion of the stigma surrounding formula feeding. Overall, the participants supported safer sexual practices in discordant partnerships. Psychosocial support of HIV sero-discordant couples should include messages about the meaning, mechanisms and implications of sero-discordancy. Culturally appropriate HIV-disclosure and safer sex messages are also needed to support these partnerships.

  4. a reflection on the impact of HIV discordance on child HIV infection

    African Journals Online (AJOL)

    cqq1a

    2010-05-09

    May 9, 2010 ... discordant couples with an HIV positive man is almost the same as that of discordant couples with an HIV positive woman [1]. There is a need to better analyze the impact of HIV sero-discordance in the context of pregnancy and prevention of mother to child transmission (PMTCT). In general, PMTCT ...

  5. Sexually transmitted infections among HIV-1-discordant couples.

    Directory of Open Access Journals (Sweden)

    Brandon L Guthrie

    2009-12-01

    Full Text Available More new HIV-1 infections occur within stable HIV-1-discordant couples than in any other group in Africa, and sexually transmitted infections (STIs may increase transmission risk among discordant couples, accounting for a large proportion of new HIV-1 infections. Understanding correlates of STIs among discordant couples will aid in optimizing interventions to prevent HIV-1 transmission in these couples.HIV-1-discordant couples in which HIV-1-infected partners were HSV-2-seropositive were tested for syphilis, chlamydia, gonorrhea, and trichomoniasis, and HIV-1-uninfected partners were tested for HSV-2. We assessed sociodemographic, behavioral, and biological correlates of a current STI.Of 416 couples enrolled, 16% were affected by a treatable STI, and among these both partners were infected in 17% of couples. A treatable STI was found in 46 (11% females and 30 (7% males. The most prevalent infections were trichomoniasis (5.9% and syphilis (2.6%. Participants were 5.9-fold more likely to have an STI if their partner had an STI (P<0.01, and STIs were more common among those reporting any unprotected sex (OR = 2.43; P<0.01 and those with low education (OR = 3.00; P<0.01. Among HIV-1-uninfected participants with an HSV-2-seropositive partner, females were significantly more likely to be HSV-2-seropositive than males (78% versus 50%, P<0.01.Treatable STIs were common among HIV-1-discordant couples and the majority of couples affected by an STI were discordant for the STI, with relatively high HSV-2 discordance. Awareness of STI correlates and treatment of both partners may reduce HIV-1 transmission.ClinicalTrials.gov NCT00194519.

  6. HIV sero-discordance among Nigerian couples: challenges and ...

    African Journals Online (AJOL)

    History of extramarital affairs, alcoholism, viral subtype, age range and duration of marriage were seen as independent behavioral and sexual risk factors for HIV infection among spouses that were HIV-infected in sero-discordant relationship. The highest incidence of HIV sero-discordance occurred among couples < 5 years ...

  7. HIV discordant couples: What is new? | Kongnyuy | Clinics in Mother ...

    African Journals Online (AJOL)

    We reviewed the existing literature on the HIV discordant couples: determinants of seroconversion, reproductive options, ethical issues and future perspectives. About 10% to 20% of couples in Sub-Saharan Africa are HIV discordant. Factors influencing the risk of seroconversion in HIV discordant couples include the ...

  8. Determination of HIV Status in African Adults With Discordant HIV Rapid Tests.

    Science.gov (United States)

    Fogel, Jessica M; Piwowar-Manning, Estelle; Donohue, Kelsey; Cummings, Vanessa; Marzinke, Mark A; Clarke, William; Breaud, Autumn; Fiamma, Agnès; Donnell, Deborah; Kulich, Michal; Mbwambo, Jessie K K; Richter, Linda; Gray, Glenda; Sweat, Michael; Coates, Thomas J; Eshleman, Susan H

    2015-08-01

    In resource-limited settings, HIV infection is often diagnosed using 2 rapid tests. If the results are discordant, a third tie-breaker test is often used to determine HIV status. This study characterized samples with discordant rapid tests and compared different testing strategies for determining HIV status in these cases. Samples were previously collected from 173 African adults in a population-based survey who had discordant rapid test results. Samples were classified as HIV positive or HIV negative using a rigorous testing algorithm that included two fourth-generation tests, a discriminatory test, and 2 HIV RNA tests. Tie-breaker tests were evaluated, including rapid tests (1 performed in-country), a third-generation enzyme immunoassay, and two fourth-generation tests. Selected samples were further characterized using additional assays. Twenty-nine samples (16.8%) were classified as HIV positive and 24 of those samples (82.8%) had undetectable HIV RNA. Antiretroviral drugs were detected in 1 sample. Sensitivity was 8.3%-43% for the rapid tests; 24.1% for the third-generation enzyme immunoassay; 95.8% and 96.6% for the fourth-generation tests. Specificity was lower for the fourth-generation tests than the other tests. Accuracy ranged from 79.5% to 91.3%. In this population-based survey, most HIV-infected adults with discordant rapid tests were virally suppressed without antiretroviral drugs. Use of individual assays as tie-breaker tests was not a reliable method for determining HIV status in these individuals. More extensive testing algorithms that use a fourth-generation screening test with a discriminatory test and HIV RNA test are preferable for determining HIV status in these cases.

  9. Sociodemographic Correlates of HIV Discordant and Concordant ...

    African Journals Online (AJOL)

    AIDS is significant. An understanding of the characteristics of HIV- affected couples will help modify preventive strategies. The aim of this study was to compare the HIV discordant and concordant partnerships for sociodemographic ...

  10. Differences in knowledge, attitudes and behaviors of Israeli HIV-uninfected gay men in HIV-discordant vs. concordant steady relationships.

    Science.gov (United States)

    Tairy, Daniel; Levy, Itzchak; Turner, Dan; Livnat, Yuval; Mor, Zohar

    2018-06-01

    HIV-discordant gay male couples may play an important role in HIV-transmissions. This cross-sectional study compared the knowledge, attitudes and sexual behaviors of HIV-uninfected gay men, between those in HIV-discordant and those in HIV-concordant steady relationships. Anonymous questionnaires were distributed electronically in designated gay-related internet sites and in AIDS-clinics in 2015. The dependent variable was defined as a steady relationship of an HIV-uninfected man with an HIV-infected partner. Risky sexual behavior was defined as unprotected anal intercourse (UAI) with a sex partner whose HIV-status was either positive or unknown. Of 2,319 responders, 460 (20%) were HIV-uninfected gay men in steady relationships, of whom 72 were in HIV-discordant relationships and 388 were in HIV-concordant relationships. Those in HIV-discordant relationships presented better established knowledge regarding HIV-transmission, more lenient attitudes regarding UAI, and reported being involved in riskier sexual behavior, both within and outside their steady relationship compared to men in HIV-concordant relationships. UAI was performed by 48% of the HIV-discordant couples and was associated with the use of sero-positioning strategy and with achieving undetectable viral-load. These findings reflect the complexity of constant use of condoms during long-term sero-discordant relationships. Targeted interventions for HIV-prevention in HIV-discordant couples should be employed for balancing the partners' desire for intimacy and sexual pleasure in the relationship, while reducing the risk for acquiring HIV. ART: Antiretroviral therapy; PEP: Post exposure prophylaxis; PrEP: Pre exposure prophylaxis; STI: Sexually transmitted infections; UAI: Unprotected anal intercourse.

  11. HIV Status Discordance: Associated Factors Among HIV Positive ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    HIV status Discordance among Pregnant Women in Lagos. African Journal ... Social marketing aimed at reducing concurrency should focus on both male and females, if we must .... This strategy is insufficient as available evidence shows that ...

  12. Incident HSV-2 Infections Are Common Among HIV-1-discordant Couples

    Science.gov (United States)

    Muiru, Anthony N.; Guthrie, Brandon L.; Bosire, Rose; Merkel, Michele; Liu, Amy Y.; Choi, Robert Y.; Lohman-Payne, Barbara; Gatuguta, Ann; Mackelprang, Romel D.; Kiarie, James N.; Farquhar, Carey

    2013-01-01

    Background. The synergy between herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus type 1 (HIV-1) is well known, but lack of knowledge about the epidemiology of HSV-2 acquisition in HIV-1-discordant couples hampers development of HSV-2 prevention interventions that could reduce HIV-1 transmission. Methods. HIV-1-discordant couples were enrolled in Nairobi, Kenya, and followed for up to 2 years. HSV-2 status was determined using HerpeSelect HSV-2 ELISA. Correlates of prevalence and incidence were assessed. Results. Of 469 HIV-1-discordant couples, at baseline, 353 (75.3%) were affected by HSV-2, of which 189 (53.5%) were concordantly HSV-2 seropositive and 164 (46.5%) were HSV-2-discordant. Prevalence was lowest among HIV-1-uninfected men (39.9%) compared to HIV-1-infected women (64.8%), HIV-1-infected men (66.7%), and HIV-1-uninfected women (68.5%). During follow-up, HSV-2 seroincidence was 14.9 per 100 person-years. Incidence was 1.6-fold higher among females compared to males (95% confidence interval [CI], 1.00–2.48) and 2.5-fold higher in HIV-1-infected compared to uninfected women (95% CI, 1.12–5.74). At least 30% of incident HSV-2 infections originated from an outside partner. Conclusions. The high HSV-2 prevalence and incidence in HIV-1-discordant couples in sub-Saharan Africa suggest HSV-2 treatment and prevention could be an effective targeted strategy to reduce HSV-2 and HIV-1 transmission in this high-risk population. PMID:23840044

  13. "I Do Not Take My Medicine while Hiding" - A Longitudinal Qualitative Assessment of HIV Discordant Couples' Beliefs in Discordance and ART as Prevention in Uganda.

    Directory of Open Access Journals (Sweden)

    Rachel King

    Full Text Available HIV negative members of serostatus discordant couples are at high risk for HIV acquisition, but few interventions are in place to target them in sub-Saharan Africa.In this study, we interviewed 28 couples, 3 times over a period of one year to understand their perceptions and attitudes around discordance, their relationship dynamics, their HIV risk behaviour, their beliefs and attitudes about antiretroviral therapy (ART and their views of the community perceptions of discordance and treatment for HIV.Findings revealed that at baseline there were multiple complex explanations and interpretations about discordance among discordant couples and their surrounding community. Shifts in beliefs and attitudes about discordance, HIV risk reduction and ART over time were enabled through re-testing negative members of discordant couples and repeat counselling but some beliefs remain solidly embedded in cultural imperatives of the importance of childbearing as well as culturally determined and enforced gender roles.Interventions that aim to target discordant couples must embrace the complex and dynamic understandings of HIV diagnosis and treatment in context of fluid relationships, and changing beliefs about HIV risk and treatment.

  14. Risk factors for discordant immune response among HIV-infected ...

    African Journals Online (AJOL)

    Risk factors for discordant immune response among HIV-infected patients initiating antiretroviral therapy: A retrospective cohort study. ... Multivariate logistic regression models were used to estimate adjusted odds ratios (AORs) to determine associations between discordant immune response and clinical and demographic ...

  15. Risky sexual behaviours among HIV Sero-discordant individuals ...

    African Journals Online (AJOL)

    Backgound: HIV/AIDS pandemic is a great public health concern hence the need to identify interventions to prevent new infections among risk groups. Objective: To determine risky sexual behaviours among HIV sero-discordant individuals attending Defence Forces Memorial Hospital (DFMH). Design: A descriptive ...

  16. Stakeholders perception of HIV sero-discordant couples in western ...

    African Journals Online (AJOL)

    Stakeholders perception of HIV sero-discordant couples in western Kenya. E Were, K Wools-Kaloustian, J Baliddawa, PO Ayuo, J Sidle, K Fife. Abstract. Objective: To describe the perceptions of key stakeholders regarding the counselling needs of HI V sero-discordant couples as part of preparation for a clinical trial ...

  17. Discordant CSF/plasma HIV-1 RNA in individuals on virologically suppressive antiretroviral therapy in Western India.

    Science.gov (United States)

    Dravid, Ameet N; Natrajan, Kartik; Kulkarni, Milind M; Saraf, Chinmay K; Mahajan, Uma S; Kore, Sachin D; Rathod, Niranjan M; Mahajan, Umakant S; Wadia, Rustom S

    2018-02-01

    Aim of this study was to estimate the prevalence of cerebrospinal fluid (CSF)/Plasma HIV-1 RNA discordance in virologically suppressed individuals presenting with incident neurologic symptoms.In this retrospective cohort study conducted between March 1, 2009, and March 1, 2017, HIV-1 infected adults exposed to atleast 12 months of antiretroviral therapy (ART) and having plasma viral load (VL) CSF/Plasma HIV-1 RNA discordance by measuring HIV-1 RNA in collected plasma and CSF samples. CSF/plasma HIV-1 RNA discordance was defined as either detectable CSF HIV-1 RNA (VL > 20 copies/mL) with an undetectable plasma RNA (complete viral suppression, VL ≤20 copies/mL) or CSF HIV-1 RNA ≥ 0.5 log10 higher than plasma RNA when plasma VL was between 20 and 1000 copies/mL (low-level viremia, LLV).Out of 1584 virologically suppressed patients, 71 (4.4%) presented with incident neurologic symptoms. Twenty out of 71 (28.2%) patients were diagnosed with CSF/Plasma HIV-1 discordance. Median plasma and CSF VL in patients with discordance was 120 [interquartile range (IQR): CSF HIV-1 genotypic resistance testing was done showed mutations that would compromise efficacy of prescribed ART regimen. Prevalence of CSF/plasma HIV-1 RNA discordance was higher among neurologically symptomatic patients with plasma LLV as compared with those with complete viral suppression (70% vs 11.8%, P CSF/plasma HIV-1 RNA discordance indicates replication of HIV-1 that has adapted to the CNS or has developed antiretroviral drug resistance. Larger studies should be performed to study incidence of discordance in India. This will help in managing patients presenting with neurologic symptoms on suppressive ART with appropriate neuroeffective therapy.

  18. Can the Catholic Church agree to condom use by HIV-discordant couples?

    Science.gov (United States)

    Bovens, L

    2009-12-01

    Does the position of the Roman Catholic Church on contraception also imply that the usage of condoms by HIV-discordant couples is illicit? A standard argument is to appeal to the doctrine of double effect to condone such usage, but this meets with the objection that there exists an alternative action that brings about the good effect-namely, abstinence. I argue against this objection, because an HIV-discordant couple does not bring about any bad outcome through condom usage-there is no disrespect displayed for the generative function of sex. One might retort that the badness of condom usage consists in thwarting the unitive function of sex. I argue that also this objection cannot be upheld. In conclusion, if there are no in-principle objections against condom usage for HIV-discordant couples, then policies that deny access to condoms to such couples are indefensible. HIV-discordant couples have a right to continue consummating their marriage in a manner that is minimally risky and this right cannot be trumped by utilitarian concerns that the distribution of condoms might increase promiscuity and along with it the HIV infection rate.

  19. Antiretroviral Therapy Reduces HIV Transmission in Discordant Couples in Rural Yunnan, China

    Science.gov (United States)

    He, Na; Duan, Song; Ding, Yingying; Rou, Keming; McGoogan, Jennifer M.; Jia, Manhong; Yang, Yuecheng; Wang, Jibao; Montaner, Julio S. G.; Wu, Zunyou

    2013-01-01

    Background Although HIV treatment as prevention (TasP) via early antiretroviral therapy (ART) has proven to reduce transmissions among HIV-serodiscordant couples, its full implementation in developing countries remains a challenge. In this study, we determine whether China's current HIV treatment program prevents new HIV infections among discordant couples in rural China. Methods A prospective, longitudinal cohort study was conducted from June 2009 to March 2011, in rural Yunnan. A total of 1,618 HIV-discordant couples were eligible, 1,101 were enrolled, and 813 were followed for an average of 1.4 person-years (PY). Routine ART was prescribed to HIV-positive spouses according to eligibility (CD4HIV incidence. Results A total of 17 seroconversions were documented within 1,127 PY of follow-up, for an overall incidence of 1.5 per 100 PY. Epidemiological and genetic evidence confirmed that all 17 seroconverters were infected via marital secondary sexual transmission. Having an ART-experienced HIV-positive partner was associated with a lower rate of seroconvertion compared with having an ART-naïve HIV-positive partner (0.8 per 100 PY vs. 2.4 per 100 PY, HR = 0.34, 95%CI = 0.12–0.97, p = 0.0436). While we found that ART successfully suppressed plasma viral load to HIV incidence among discordant couples in our sample, demonstrating the effectiveness of China's HIV treatment program at preventing new infections, and providing support for earlier ART initiation and TasP implementation in this region. PMID:24236010

  20. 'We keep her status to ourselves': experiences of stigma and discrimination among HIV-discordant couples in South Africa, Tanzania and Ukraine.

    Science.gov (United States)

    Rispel, Laetitia C; Cloete, Allanise; Metcalf, Carol A

    2015-01-01

    In HIV-discordant relationships, the HIV-negative partner also carries the burden of a stigmatised disease. For this reason, couples often hide their HIV-discordant status from family, friends and community members. This perpetuates the silence around HIV-discordant relationships and impacts on targeted HIV prevention, treatment and counselling efforts. This article reports on experiences of stigma and discrimination among HIV-discordant couples in South Africa, Tanzania and Ukraine. During 2008, HIV-discordant couples who had been in a relationship for at least one year were recruited purposively through health-care providers and civil society organisations in the three countries. Participants completed a brief self-administered questionnaire, while semi-structured interviews were conducted with each partner separately and with both partners together. Interviews were analysed using thematic content analysis. Fifty-one couples were recruited: 26 from South Africa, 10 from Tanzania, and 15 from Ukraine. Although most participants had disclosed their HIV status to someone other than their partner, few were living openly with HIV discordance. Experiences of stigma were common and included being subjected to gossip, rumours and name-calling, and HIV-negative partners being labelled as HIV-positive. Perpetrators of discrimination included family members and health workers. Stigma and discrimination present unique and complex challenges to couples in HIV sero-discordant relationships in these three diverse countries. Addressing stigmatisation of HIV-discordant couples requires a holistic human rights approach and specific programme efforts to address discrimination in the health system.

  1. Barriers to Antiretroviral Initiation in HIV-1-Discordant Couples

    Science.gov (United States)

    Guthrie, Brandon L.; Choi, Robert Y.; Liu, Amy Y.; Mackelprang, Romel D.; Rositch, Anne F.; Bosire, Rose; Manyara, Lucy; Gatuguta, Anne; Kiarie, James N.; Farquhar, Carey

    2011-01-01

    BACKGROUND In Kenya and much of sub-Saharan Africa, nearly half of all couples affected by HIV are discordant. Antiretroviral therapy (ART) slows disease progression in HIV-1-infected individuals, and reduces transmission to uninfected partners. We examined time to ART initiation and factors associated with delayed initiation in HIV-1-discordant couples in Nairobi. METHODS HIV-1-discordant couples were enrolled and followed quarterly for up to 2 years. Clinical staff administered questionnaires and conducted viral loads and CD4 counts. Participants with a CD4 count meeting ART criteria were referred to a nearby PEPFAR-funded treatment center. Barriers to ART initiation among participants with a CD4 count eligible for ART were assessed by Cox regression. RESULTS Of 439 HIV-1-infected participants (63.6% females and 36.4% males) 146 met CD4 count criteria for ART during follow-up. Median time from meeting CD4 criteria until ART initiation was 8.9 months, with 42.0% of eligible participants on ART by 6 months and 63.4% on ART by 1 year. The CD4 count at the time of eligibility was inversely associated with time to ART initiation (HR=0.49, p< 0.001). Compared to homeowners, those paying higher rents started ART 48% more slowly (p=0.062) and those paying lower rents started 71% more slowly (p=0.002). CONCLUSIONS Despite access to regular health care, referrals to treatment centers, and free access to ART, over a third of participants with an eligible CD4 count had not started ART within 1 year. Factors of lower socioeconomic status may slow ART initiation and targeted approaches are needed to avoid delays in treatment initiation. PMID:21826010

  2. Case series of fertility treatment in HIV-discordant couples (male positive, female negative: the Ontario experience.

    Directory of Open Access Journals (Sweden)

    Trent Newmeyer

    Full Text Available The success of combination antiretroviral therapies for the treatment of human immunodeficiency virus (HIV has resulted in prolonged life expectancy (over 40 years from diagnosis and an improved quality of life for people living with HIV. The risk of vertical HIV transmission during pregnancy has been reduced to less than 1%. As a result of these breakthroughs and as many of these individuals are of reproductive age, fertility issues are becoming increasingly important for this population. One population in which conception planning and reduction of horizontal HIV transmission warrants further research is HIV-discordant couples where the male partner is HIV-positive and the female partner is HIV-negative. Sperm washing is a technique carried out in a fertility clinic that separates HIV from the seminal fluid. Although sperm washing followed by intrauterine insemination significantly reduces the risk of horizontal HIV transmission, there has been limited access to the procedure in North America. Furthermore, little is known about the conception decision-making experiences of HIV-discordant couples who might benefit from sperm washing. Chart reviews and semi-structured interviews were completed with 12 HIV-discordant couples in Ontario, Canada. Couples were recruited through HIV clinics and one fertility clinic that offered sperm washing. Participants identified a number of factors that affected their decision-making around pregnancy planning. Access to sperm washing and other fertility services was an issue (cost, travel and few clinics. Participants identified a lack of information on the procedure (availability, safety. Sources of support (social networks, healthcare providers were unevenly distributed, especially among those who did not disclose their HIV status to friends and family. Finally, the stigmatisation of HIV continues to have a negative affect on HIV-discordant couples and their intentions to conceive. Access to sperm washing and

  3. Effectiveness of semen washing to prevent HIV transmission and assist pregnancy in HIV-discordant couples: a systematic review and meta-analysis

    Science.gov (United States)

    Zafer, Maryam; Horvath, Hacsi; Mmeje, Okeoma; van der Poel, Sheryl; Semprini, Augusto; Rutherford, George; Brown, Joelle

    2015-01-01

    Objective To evaluate the effectiveness of semen washing in HIV-discordant couples in which the male partner is infected Design Systematic review and meta-analysis Setting All countries Patient(s) Forty single-arm, open label studies among HIV-discordant couples that underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI) using washed semen Intervention(s) Semen washing followed by IUI, IVF, or IVF/ICSI Main outcome measure(s) Primary outcome: HIV transmission to HIV-uninfected women; secondary outcomes: HIV transmission to newborns and proportion of couples achieving a clinical pregnancy Result(s) No HIV transmission occurred in 11,585 cycles of assisted reproduction using washed semen among 3,994 women (95% confidence interval [CI] = 0–0.0001). Among the subset of HIV-infected men without plasma viral suppression at the time of semen washing, no HIV seroconversions occurred among 1,023 women following 2,863 cycles of assisted reproduction using washed semen (95%CI= 0–0.0006). Studies that measured HIV transmission to infants reported no cases of vertical transmission (0/1,026, 95% CI= 0–0.0029). Overall, 56.3% (2,357/4,184, 95%CI=54.8%–57.8%) of couples achieved a clinical pregnancy using washed semen. Conclusion(s) Semen washing appears to significantly reduce the risk of transmission in HIV-discordant couples desiring children, regardless of viral suppression in the male partner. There are no randomized, controlled studies or studies from low-income countries, especially those with a large burden of HIV. Continued development of lower-cost semen washing and assisted reproduction technologies is needed. Integration of semen washing into HIV prevention interventions could help further reduce the spread of HIV. PMID:26688556

  4. Qualitative analysis of an educational intervention with HIV-discordant heterosexual Latino couples.

    Science.gov (United States)

    Pérez-Jiménez, David; Orengo-Aguayo, Rosaura E

    2011-12-01

    This qualitative analysis elucidates the potential elements of the intervention that may be effective in terms of a) increasing knowledge about HIV/ AIDS in the members of this population; b) increasing the use of male condoms and the practice of mutual masturbation; and c) changing opinions toward male condom use and mutual masturbation. Five heterosexual HIV-discordant couples participated in the adapted intervention, which consisted of four three-hour-long sessions. One month after the intervention, we conducted a qualitative semi-structured interview with every participant to evaluate issues related to the process and content of the activities comprising the intervention, the impact of the intervention, logistics, and recruitment and retention as well as to make a more general evaluation. The information was submitted to qualitative content analysis. After the intervention, participants reported having better attitudes regarding safer sex, particularly in terms of condom use. A reason given by the participants to feel more positive toward condom use and mutual masturbation was that these practices could prevent the infection of the HIV-negative partner. This study provides important evidence of an intervention that promises to be efficacious in preventing some high-risk sexual behaviors among Latino HIV-discordant heterosexual couples. The evidence presented seems to suggest that an intervention that includes basic relevant information about HIV/AIDS, that explains the benefits of condom use and other safer sex options, and that provides effective negotiation and communication strategies could significantly reduce HIV transmission among these couples.

  5. Effectiveness of semen washing to prevent human immunodeficiency virus (HIV) transmission and assist pregnancy in HIV-discordant couples: a systematic review and meta-analysis.

    Science.gov (United States)

    Zafer, Maryam; Horvath, Hacsi; Mmeje, Okeoma; van der Poel, Sheryl; Semprini, Augusto E; Rutherford, George; Brown, Joelle

    2016-03-01

    To evaluate the effectiveness of semen washing in human immunodeficiency virus (HIV)-discordant couples in which the male partner is infected. Systematic review and meta-analysis. Not applicable. Forty single-arm open-label studies among HIV-discordant couples that underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI) using washed semen. Semen washing followed by IUI, IVF, or IVF/ICSI. HIV transmission to HIV-uninfected women; secondary outcomes: HIV transmission to newborns and proportion of couples achieving a clinical pregnancy. No HIV transmission occurred in 11,585 cycles of assisted reproduction with the use of washed semen among 3,994 women. Among the subset of HIV-infected men without plasma viral suppression at the time of semen washing, no HIV seroconversions occurred among 1,023 women after 2,863 cycles of assisted reproduction with the use of washed semen. Studies that measured HIV transmission to infants reported no cases of vertical transmission. Overall, 56.3% of couples (2,357/4,184) achieved a clinical pregnancy with the use of washed semen. Semen washing appears to significantly reduce the risk of transmission in HIV-discordant couples desiring children, regardless of viral suppression in the male partner. There are no randomized controlled studies or studies from low-income countries, especially those with a large burden of HIV. Continued development of lower-cost semen washing and assisted reproduction technologies is needed. Integration of semen washing into HIV prevention interventions could help to further reduce the spread of HIV. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  6. An Event-Level Analysis of Condomless Anal Intercourse with a HIV-Discordant or HIV Status-Unknown Partner Among Black Men Who Have Sex with Men from a Multi-site Study.

    Science.gov (United States)

    Yang, Cui; Latkin, Carl; Tobin, Karin; Seal, David; Koblin, Beryl; Chander, Geetanjali; Siconolfi, Daniel; Flores, Stephen; Spikes, Pilgrim

    2018-05-19

    Despite the high HIV incidence and prevalence among black men who have sex with men (BMSM), little research has examined partner characteristics, partner seeking venue, sexual position, substance use, and sexual risk behavior at the sex event-level among BMSM. Using the baseline data from a multi-site study of 807 BMSM stratified by their HIV status, the goal of this study was to conduct a detailed event-level analysis of 1577 male anal sex events to assess the factors associated with condomless anal intercourse (CLAI) with a HIV-discordant or HIV status-unknown partner. We found CLAI with an HIV-discordant or unknown HIV status partner among HIV-negative BMSM was negatively associated with having sex with a main partner, and was positively associated with taking both receptive and insertive sexual positions during sex. As compared to a sex partner met at bar, night club or dance club, HIV-positive BMSM were less likely to engage in CLAI with HIV-discordant and unknown HIV status partner met at party or friend's house or at community organizations. HIV-positive BMSM had lower odds of engaging in CLAI with HIV-discordant and unknown HIV status partner if they had insertive sexual position or both receptive and insertive sexual positions. These results underscore the importance of delineating unique sex event-level factors associated with sexual risk behavior depending on individuals' HIV status. Our findings suggest event-level partner characteristics, sexual position, and partner seeking venues may contribute to disparities in HIV incidence.

  7. Gender Differences in Depressive Symptoms Among HIV-Positive Concordant and Discordant Heterosexual Couples in China

    OpenAIRE

    Li, Li; Liang, Li-Jung; Lin, Chunqing; Ji, Guoping; Xiao, Yongkang

    2016-01-01

    HIV seropositive individuals and their heterosexual partners/spouses, either seropositive or seronegative, are facing several mental health challenges. The objective of this study was to examine gender differences in depressive symptoms among HIV-positive concordant and HIV-discordant couples. We identified heterosexual couples from participants of a randomized controlled trial conducted in Anhui province, China. A total of 265 couples, comprising 129 HIV+ male/HIV− female couples, 98 HIV− ma...

  8. Qualitative Analysis of an Educational Intervention with HIV-Discordant Heterosexual Latino Couples

    Science.gov (United States)

    Pérez-Jiménez, David; Orengo-Aguayo, Rosaura E.

    2012-01-01

    Objective This qualitative analysis elucidates the potential elements of the intervention that may be effective in terms of a) increasing knowledge about HIV/AIDS in the members of this population; b) increasing the use of male condoms and the practice of mutual masturbation; and c) changing opinions toward male condom use and mutual masturbation. Methods Five heterosexual HIV-discordant couples participated in the adapted intervention, which consisted of four three-hour-long sessions. One month after the intervention, we conducted a qualitative semi-structured interview with every participant to evaluate issues related to the process and content of the activities comprising the intervention, the impact of the intervention, logistics, and recruitment and retention as well as to make a more general evaluation. The information was submitted to qualitative content analysis. Results After the intervention, participants reported having better attitudes regarding safer sex, particularly in terms of condom use. A reason given by the participants to feel more positive toward condom use and mutual masturbation was that these practices could prevent the infection of the HIV-negative partner. Conclusion This study provides important evidence of an intervention that promises to be efficacious in preventing some high-risk sexual behaviors among Latino HIV-discordant heterosexual couples. The evidence presented seems to suggest that an intervention that includes basic relevant information about HIV/AIDS, that explains the benefits of condom use and other safer sex options, and that provides effective negotiation and communication strategies could significantly reduce HIV transmission among these couples. PMID:22263299

  9. Repeat confirmatory testing for persons with discordant whole blood and oral fluid rapid HIV test results: findings from post marketing surveillance.

    Science.gov (United States)

    Wesolowski, Laura G; Mackellar, Duncan A; Ethridge, Steven F; Zhu, Julia H; Owen, S Michele; Sullivan, Patrick S

    2008-02-06

    Reactive oral fluid and whole blood rapid HIV tests must be followed with a confirmatory test (Western blot (WB), immunofluorescent assay (IFA) or approved nucleic acid amplification test (NAAT)). When the confirmatory result is negative or indeterminate (i.e. discordant with rapid result), repeat confirmatory testing should be conducted using a follow-up specimen. Previous reports have not described whether repeat testing adequately resolves the HIV-infection status of persons with discordant results. Post-marketing surveillance was conducted in 368 testing sites affiliated with 14 state and 2 city health departments from August 11, 2004 to June 30, 2005 and one health department through December 31, 2005. For persons with discordant results, data were collected on demographics, risk behaviors, HIV test results and specimen types. Persons with repeat confirmatory results were classified as HIV-infected or uninfected. Regression models were created to assess risk factors for not having repeat testing. Of 167,371 rapid tests conducted, 2589 (1.6%) were reactive: of these, 2417 (93%) had positive WB/IFA, 172 (7%) had negative or indeterminate WB/IFA. Of 89/172 (52%) persons with a repeat confirmatory test: 17 (19%) were HIV-infected, including 3 with indeterminate WB and positive NAAT; 72 (81%) were uninfected, including 12 with repeat indeterminate WB. Factors associated with HIV-infection included having an initial indeterminate WB/IFA (vs. negative) (ptest [adjusted OR 2.6, 95% CI (1.3, 4.9)]. Though only half of persons with discordant results had repeat confirmatory testing, of those who did, nearly one in five were HIV-infected. These findings underscore the need for rapid HIV testing programs to increase repeat confirmatory testing for persons with discordant results. Because of the lower sensitivity of oral fluid WBs, confirmatory testing following a reactive rapid test should be conducted using serum or plasma, when possible.

  10. Estimating the annual risk of HIV transmission within HIV sero-discordant couples in sub-Saharan Africa.

    Science.gov (United States)

    Awad, Susanne F; Chemaitelly, Hiam; Abu-Raddad, Laith J

    2018-01-01

    To estimate the annual risk of HIV transmission (ϕ) within HIV sero-discordant couples in 23 countries in sub-Saharan Africa (SSA), by utilizing newly available national population-based data and accounting for factors known to potentially affect this estimation. We used a recently developed pair-based mathematical model that accommodates for HIV-dynamics temporal variation, sexual risk-behavior heterogeneity, and antiretroviral therapy (ART) scale-up. Estimated country-specific ϕ (in absence of ART) ranged between 4.2% (95% uncertainty interval (UI): 1.9%-6.3%) and 47.4% (95% UI: 37.2%-69.0%) per person-year (ppy), with a median of 12.4%. ϕ was strongly associated with HIV prevalence, with a Pearson correlation coefficient of 0.92, and was larger in high- versus low-HIV-prevalence countries. ϕ increased by 1.31% (95% confidence interval: 1.00%-1.55%) ppy for every 1% increase in HIV prevalence. ϕ estimates were similar to earlier estimates, and suggested considerable heterogeneity in HIV infectiousness across SSA. This heterogeneity may explain, partly, the differences in epidemic scales. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  11. Repeat confirmatory testing for persons with discordant whole blood and oral fluid rapid HIV test results: findings from post marketing surveillance.

    Directory of Open Access Journals (Sweden)

    Laura G Wesolowski

    Full Text Available BACKGROUND: Reactive oral fluid and whole blood rapid HIV tests must be followed with a confirmatory test (Western blot (WB, immunofluorescent assay (IFA or approved nucleic acid amplification test (NAAT. When the confirmatory result is negative or indeterminate (i.e. discordant with rapid result, repeat confirmatory testing should be conducted using a follow-up specimen. Previous reports have not described whether repeat testing adequately resolves the HIV-infection status of persons with discordant results. METHODOLOGY: Post-marketing surveillance was conducted in 368 testing sites affiliated with 14 state and 2 city health departments from August 11, 2004 to June 30, 2005 and one health department through December 31, 2005. For persons with discordant results, data were collected on demographics, risk behaviors, HIV test results and specimen types. Persons with repeat confirmatory results were classified as HIV-infected or uninfected. Regression models were created to assess risk factors for not having repeat testing. PRINCIPAL FINDINGS: Of 167,371 rapid tests conducted, 2589 (1.6% were reactive: of these, 2417 (93% had positive WB/IFA, 172 (7% had negative or indeterminate WB/IFA. Of 89/172 (52% persons with a repeat confirmatory test: 17 (19% were HIV-infected, including 3 with indeterminate WB and positive NAAT; 72 (81% were uninfected, including 12 with repeat indeterminate WB. Factors associated with HIV-infection included having an initial indeterminate WB/IFA (vs. negative (p<0.001 and having an initial oral fluid WB (vs. serum (p<0.001. Persons who had male-female sex (vs. male-male sex were at increased risk for not having a repeat test [adjusted OR 2.6, 95% CI (1.3, 4.9]. CONCLUSIONS: Though only half of persons with discordant results had repeat confirmatory testing, of those who did, nearly one in five were HIV-infected. These findings underscore the need for rapid HIV testing programs to increase repeat confirmatory testing for

  12. Hormonal contraception does not increase women's HIV acquisition risk in Zambian discordant couples, 1994-2012.

    Science.gov (United States)

    Wall, Kristin M; Kilembe, William; Vwalika, Bellington; Htee Khu, Naw; Brill, Ilene; Chomba, Elwyn; Johnson, Brent A; Haddad, Lisa; Tichacek, Amanda; Allen, Susan

    2015-06-01

    To determine the impact of hormonal contraceptive methods on risk of HIV acquisition among HIV-negative women cohabiting with HIV-positive male partners. From 1994-2012, HIV discordant couples recruited from a couples' voluntary HIV counseling and testing center in Lusaka, Zambia were followed longitudinally. HIV-negative partners were tested quarterly. This analysis is restricted to couples in which the man was HIV-positive and the woman was HIV-negative at enrollment and the man was not on antiretroviral treatment. Multivariate Cox models evaluated associations between time-varying contraceptive methods and HIV acquisition among women. Sensitivity analyses explored exposure misclassification and time-varying confounder mediation. Among 1393 couples, 252 incident infections occurred in women over 2842 couple-years (8.9 infections per 100 couple-years; 95% CI, 7.8-10.0). Multivariate Cox models indicated that neither injectable [adjusted hazard ratio (aHR)=1.2; 95% CI, 0.8-1.7], oral contraceptive pill (OCP, aHR=1.3; 95% CI, 0.9-1.8), or implant (aHR=1.1; 95% CI, 0.5-2.2) use was significantly associated with HIV acquisition relative to non-hormonal contraception controlling for woman's age, literacy and time-varying measures of genital ulceration/inflammation. This remained true when only looking at the subset of infections acquired from the spouse (82% of infections) and additionally controlling for baseline HIV viral load of the male partner, pregnancy status, and time-varying measures of sperm on a vaginal swab wet prep and self-reported unprotected sex. OCP and injectable users reported more unprotected sex (pcontraception and HIV acquisition risk in women. Condom use and reinforced condom counseling should always be recommended for HIV discordant couples. HIV testing of sex partners together is critical to establish HIV risk, ascertain couple fertility intentions and counsel appropriately. These findings add to a controversial literature and uniquely address

  13. Optimizing Prevention of HIV and Unplanned Pregnancy in Discordant African Couples.

    Science.gov (United States)

    Wall, Kristin M; Kilembe, William; Vwalika, Bellington; Haddad, Lisa B; Khu, Naw Htee; Brill, Ilene; Onwubiko, Udodirim; Chomba, Elwyn; Tichacek, Amanda; Allen, Susan

    2017-08-01

    Dual method use, which combines condoms with a more effective modern contraceptive to optimize prevention of HIV and unplanned pregnancy, is underutilized in high-risk heterosexual couples. Heterosexual HIV-discordant Zambian couples were enrolled from couples' voluntary HIV counseling and testing services into an open cohort with 3-monthly follow-up (1994-2012). Relative to dual method use, defined as consistent condom use plus modern contraception, we examine predictors of (1) condom-only use (suboptimal pregnancy prevention) or (2) modern contraceptive use with inconsistent condom use (effective pregnancy prevention and suboptimal HIV prevention). Among 3,049 couples, dual method use occurred in 28% of intervals in M+F- and 23% in M-F+, p HIV+ (adjusted hazard ratio, aHR = 1.15); baseline oral contraceptive pill (aHR = 0.76), injectable (aHR = 0.48), or implant (aHR = 0.60) use; woman's age (aHR = 1.04 per 5 years) and lifetime number of sex partners (aHR = 1.01); postpartum periods (aHR = 1.25); and HIV stage of the index partner III/IV versus I (aHR = 1.10). Predictors (p HIV+ male circumcision (aHR = 1.51), while time-varying implant use was associated with more consistent condom use (aHR = 0.80). Three-quarters of follow-up intervals did not include dual method use. This highlights the need for counseling to reduce unintended pregnancy and HIV transmission and enable safer conception.

  14. Hormonal contraception does not increase women's HIV acquisition risk in Zambian discordant couples, 1994–2012

    Science.gov (United States)

    Wall, Kristin M.; Kilembe, William; Vwalika, Bellington; Khu, Naw Htee; Brill, Ilene; Chomba, Elwyn; Johnson, Brent A.; Haddad, Lisa; Tichacek, Amanda; Allen, Susan

    2015-01-01

    Objective To determine the impact of hormonal contraceptive methods on risk of HIV acquisition among HIV-negative women cohabiting with HIV-positive male partners. Study design From 1994–2012, HIV discordant couples recruited from a couples’ voluntary HIV counseling and testing center in Lusaka, Zambia were followed longitudinally. HIV-negative partners were tested quarterly. This analysis is restricted to couples in which the man was HIV-positive and the woman was HIV-negative at enrollment and the man was not on antiretroviral treatment. Multivariate Cox models evaluated associations between time-varying contraceptive methods and HIV acquisition among women. Sensitivity analyses explored exposure misclassification and time-varying confounder mediation. Results Among 1393 couples, 252 incident infections occurred in women over 2842 couple-years (8.9 infections per 100 couple-years; 95% CI, 7.8–10.0). Multivariate Cox models indicated that neither injectable [adjusted hazard ratio (aHR)=1.2; 95% CI, 0.8–1.7], oral contraceptive pill (OCP, aHR=1.3; 95% CI, 0.9–1.8), or implant (aHR=1.1; 95% CI, 0.5–2.2) use was significantly associated with HIV acquisition relative to non-hormonal contraception controlling for woman's age, literacy and time-varying measures of genital ulceration/inflammation. This remained true when only looking at the subset of infections acquired from the spouse (82% of infections) and additionally controlling for baseline HIV viral load of the male partner, pregnancy status, and time-varying measures of sperm on a vaginal swab wet prep and self-reported unprotected sex. OCP and injectable users reported more unprotected sex (pcontraception and HIV acquisition risk in women. Condom use and reinforced condom counseling should always be recommended for HIV discordant couples. HIV testing of sex partners together is critical to establish HIV risk, ascertain couple fertility intentions and counsel appropriately. Implications These findings

  15. Gender Differences in Depressive Symptoms Among HIV-Positive Concordant and Discordant Heterosexual Couples in China.

    Science.gov (United States)

    Li, Li; Liang, Li-Jung; Lin, Chunqing; Ji, Guoping; Xiao, Yongkang

    2017-03-01

    HIV seropositive individuals and their heterosexual partners/spouses, either seropositive or seronegative, are facing several mental health challenges. The objective of this study was to examine gender differences in depressive symptoms among HIV-positive concordant and HIV-discordant couples. We identified heterosexual couples from participants of a randomized controlled trial conducted in Anhui province, China. A total of 265 couples, comprising 129 HIV+ male/HIV- female couples, 98 HIV- male/HIV+ female couples, and 38 HIV-positive concordant couples, were included in the analyses. We collected data using the computer-assisted personal interview method. We used a linear mixed-effects regression model to assess whether gender differences in depressive symptoms varied across couple types. HIV-positive women reported a significantly higher level of depressive symptoms than their partners/spouses. HIV-positive women with HIV-positive partners had higher depressive symptoms than those with HIV-negative partners, whereas HIV-positive men reported similar levels of depressive symptoms regardless of their partners' serostatus. Among the concordant couples, those with the highest annual family income showed the greatest gender differences in depressive symptoms. We suggest that family interventions should be gender- and couple-type specific and that mental health counseling is warranted not only for HIV-positive women but also for HIV-negative women in an HIV-affected relationship.

  16. High discordance in blood and genital tract HIV-1 drug resistance in Indian women failing first-line therapy.

    Science.gov (United States)

    Saravanan, Shanmugam; Gomathi, Selvamurthi; Delong, Allison; Kausalya, Bagavathi; Sivamalar, Sathasivam; Poongulali, Selvamuthu; Brooks, Katherine; Kumarasamy, Nagalingeswaran; Balakrishnan, Pachamuthu; Solomon, Sunil S; Cu-Uvin, Susan; Kantor, Rami

    2018-05-24

    Examine HIV-1 plasma viral load (PVL) and genital tract (GT) viral load (GVL) and drug resistance in India. At the YRG Centre for AIDS Research and Education, Chennai, we tested: PVL in women on first-line ART for ≥6 months; GVL when PVL >2000 copies/mL; and plasma, genital and proviral reverse transcriptase drug resistance when GVL >2000 copies/mL. Wilcoxon rank-sum and Fisher's exact tests were used to identify failure and resistance associations. Pearson correlations were calculated to evaluate PVL-GVL associations. Inter-compartmental resistance discordance was evaluated using generalized estimating equations. Of 200 women, 37% had detectable (>400 copies/mL) PVL and 31% had PVL >1000 copies/mL. Of women with detectable PVL, 74% had PVL >2000 copies/mL, of which 74% had detectable GVL. Higher PVL was associated with higher GVL. Paired plasma and genital sequences were available for 21 women; mean age of 34 years, median ART duration of 33 months, median CD4 count of 217 cells/mm3, median PVL of 5.4 log10 copies/mL and median GVL of 4.6 log10 copies/mL. Drug resistance was detected in 81%-91% of samples and 67%-76% of samples had dual-class resistance. Complete three-compartment concordance was seen in only 10% of women. GT-proviral discordance was significantly larger than plasma-proviral discordance. GT or proviral mutations discordant from plasma led to clinically relevant resistance in 24% and 30%, respectively. We identified high resistance and high inter-compartmental resistance discordance in Indian women, which might lead to unrecognized resistance transmission and re-emergence compromising treatment outcomes, particularly relevant to countries like India, where sexual HIV transmission is predominant.

  17. Risk factors for discordant immune response among HIV-infected patients initiating antiretroviral therapy: A retrospective cohort study

    Directory of Open Access Journals (Sweden)

    B P Muzah

    2012-10-01

    Full Text Available Background. The therapeutic goal of antiretroviral therapy (ART is sustained immune recovery and viral suppression. However, some patients experience poor CD4 cell count responses despite achieving viral suppression. Such discordant immune responses have been associated with poor clinical outcomes. Objective. We aimed to determine the prevalence of discordant immune response and explore associated factors in a retrospective cohort of patients attending 2 large public sector clinics, during the 6 months following ART initiation. Methods. Data were analysed from 810 HIV-infected adults initiated on first-line ART at 2 clinics in Johannesburg, between 1 November 2008 and 31 December 2009. Multivariate logistic regression models were used to estimate adjusted odds ratios (AORs to determine associations between discordant immune response and clinical and demographic factors. Results. At ART initiation, 65% (n=592 of participants were female, with a mean age of 38.5 years. Median baseline CD4 cell count was 155 cells/mm3, 70% (n=645 of patients had a haemoglobin level >11 g/dl and 88% (n=803 were initiated on stavudine-lamivudine-efavirenz/nevirapine (D4T-3TC-EFV/NVP. Six months after ART initiation, 24% (n=220 of patients had a discordant immune response and 7% (n=67 a discordant virological response. On multivariate analysis, baseline CD cell count ≥200 cells/mm3 (AOR 3.02; 95% confidence interval (CI 2.08 - 4.38; p

  18. Outcomes of Assisted Reproductive Techniques for HIV-1-discordant Couples Using Thawed Washed Sperm in Taiwan: Comparison With Control and Testicular Sperm Extraction/Microscopic Epididymal Sperm Aspiration Groups

    Directory of Open Access Journals (Sweden)

    Ming-Yih Wu

    2011-08-01

    Conclusion: The preliminary data showed good ART results in HIV-1-discordant couples. Fertility services should not be withheld from individuals with HIV-1, although larger series are needed to reach conclusions about safety.

  19. Discordance of HIV and HSV-2 biomarkers and self-reported sexual behaviour among orphan adolescents in Western Kenya.

    Science.gov (United States)

    Cho, Hyunsan; Luseno, Winnie; Halpern, Carolyn; Zhang, Lei; Mbai, Isabella; Milimo, Benson; Hallfors, Denise Dion

    2015-06-01

    This paper examines the discordance between biological data of HIV and herpes simplex virus type 2 (HSV-2) infections and self-reported questionnaire responses among orphan adolescents in Western Kenya. In 2011, 837 orphan adolescents from 26 primary schools were enrolled in an HIV prevention trial. At baseline, blood samples were drawn for HIV and HSV-2 infection biomarker testing, and participants completed an audio computer-assisted self-interviewing survey. Comparing biological data with self-reported responses indicated that 70% of HIV-positive (7 out of 10) and 64% of HSV-2-positive (18 out of 28 positive) participants reported never having had sex. Among ever-married adolescents, 65% (57 out of 88) reported never having had sex. Overall, 10% of study participants appeared to have inconsistently reported their sexual behaviour. Logistic regression analyses indicated that lower educational level and exam scores were significant predictors of inconsistent reporting. Our study demonstrates the discordance between infections measured by biomarkers and self-reports of having had sex among orphan adolescents in Kenya. In order to detect programme effects accurately in prevention research, it is necessary to collect both baseline and endline biological data. Furthermore, it is recommended to triangulate multiple data sources about adolescent participants' self-reported information about marriage and pregnancies from school records and parent/guardians to verify the information. Researchers should recognise potential threats to validity in data and design surveys to consider cognitive factors and/or cultural context to obtain more accurate and reliable information from adolescents regarding HIV/sexually transmitted infection risk behaviours. NCT01501864. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. HIV Status Discordance: Associated Factors Among HIV Positive ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    infection for a partner of a person with HIV is about 10%, with higher annual transmission rates ... We recommend the tracking of both men and women as index cases in other to reduce HIV .... HIV status was accepted as known only if backed.

  1. Impact of relationship dynamics and gender roles in the protection of HIV discordant heterosexual couples: an exploratory study in the Puerto Rican context.

    Science.gov (United States)

    Orengo-Aguayo, Rosaura; Pérez-Jiménez, David

    2009-03-01

    Most of the HIV/AIDS prevention efforts have not taken into consideration the context of the relationship and the gender constructs that influence relationship dynamics. These efforts have failed to view HIV prevention as a collaborative process between partners. Therefore, it is important to explore how relationship dynamics and gender constructs influence how men and women involved in an HIV discordant heterosexual relationship, visualize their role in the protection of their partners in order to design more effective prevention interventions. Five Puerto Rican HIV discordant heterosexual couples were interviewed via a qualitative semi-structured interview. The taped interviews were transcribed and analyzed using content analysis according to a set of defined categories. Women visualized their role as one of convincing their partners to use protection as well as being strong and firm in the demand of its use. Men viewed their role as one of being more supportive and willing to use protection, but recognized their resistance towards the use of condoms. Relationship dynamics such as communication and support promoted protection. Traditional and non-traditional gender roles were assumed by both men and women. Traditional gender roles inhibited protection but were also used in positive ways to promote it. Men showed a greater initiative to break with traditional gender norms. A positive relationship, marked by communication and support could serve as a facilitator in the protection and in the transformation of traditional gender norms. This points out to the need of viewing HIV/AIDS prevention as a collaborative rather than individualistic process.

  2. Assessment of HIV molecular surveillance capacity in the European Union, 2016.

    Science.gov (United States)

    Keating, Patrick; Pharris, Anastasia; Leitmeyer, Katrin; De Angelis, Stefania; Wensing, Annemarie; Amato-Gauci, Andrew J; Broberg, Eeva

    2017-12-01

    IntroductionExpanding access to HIV antiretroviral treatment is expected to decrease HIV incidence and acquired immunodeficiency syndrome (AIDS) mortality. However, this may also result in increased HIV drug resistance (DR). Better monitoring and surveillance of HIV DR is required to inform treatment regimens and maintain the long term effectiveness of antiretroviral drugs. As there is currently no formal European Union (EU)-wide collection of HIV DR data, this study aimed to assess the current HIV molecular surveillance capacity in EU/European Economic Area (EEA) countries in order to inform the planning of HIV DR monitoring at EU level. Methods: Thirty EU/EEA countries were invited to participate in a survey on HIV molecular surveillance capacity, which also included laboratory aspects. Results: Among 21 responding countries, 13 reported using HIV sequence data (subtype and/or DR) for surveillance purposes at national level. Of those, nine stated that clinical, epidemiological and sequence data were routinely linked for analysis. Discussion/conclusion : We identified similarities between existing HIV molecular surveillance systems, but also found important challenges including human resources, data ownership and legal issues that would need to be addressed.Information on capacities should allow better planning of the phased introduction of HIV DR surveillance at EU/EEA level.

  3. Reduction in undiagnosed HIV infection in the European Union/European Economic Area, 2012 to 2016.

    Science.gov (United States)

    van Sighem, Ard; Pharris, Anastasia; Quinten, Chantal; Noori, Teymur; Amato-Gauci, Andrew J

    2017-11-01

    It is well-documented that early HIV diagnosis and linkage to care reduces morbidity and mortality as well as HIV transmission. We estimated the median time from HIV infection to diagnosis in the European Union/European Economic Area (EU/EEA) at 2.9 years in 2016, with regional variation. Despite evidence of a decline in the number of people living with undiagnosed HIV in the EU/EEA, many remain undiagnosed, including 33% with more advanced HIV infection (CD4 < 350 cells/mm3).

  4. Molecular epidemiology of HIV-1 subtype A in former Soviet Union countries.

    Science.gov (United States)

    Aibekova, Lazzat; Foley, Brian; Hortelano, Gonzalo; Raees, Muhammad; Abdraimov, Sabit; Toichuev, Rakhmanbek; Ali, Syed

    2018-01-01

    While in other parts of the world it is on decline, incidence of HIV infection continues to rise in the former Soviet Union (FSU) countries. The present study was conducted to investigate the patterns and modes of HIV transmission in FSU countries. We performed phylogenetic analysis of publicly available 2705 HIV-1 subtype A pol sequences from thirteen FSU countries: Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Russia, Ukraine and Uzbekistan. Our analysis showed that the clusters from FSU countries were intermixed, indicating a possible role of transmigration in HIV transmission. Injection drug use was found to be the most frequent mode of transmission, while the clusters from PWID and heterosexual transmission were intermixed, indicating bridging of HIV infection across populations. To control the expanding HIV epidemic in this region, harm reduction strategies should be focused on three modes of transmission, namely, cross-border migration, injection drug use and heterosexual.

  5. HIV-discordant couples

    African Journals Online (AJOL)

    Winnie

    2006-06-02

    Jun 2, 2006 ... These may broadly be divided into factors that affect the transmissibility of HIV between couples per sex act and factors influencing the number of sex acts during which exposure may occur. Examples of the former include use of condoms or other barrier methods and certain sexual behaviours, such as sex.

  6. Paediatric advance care planning survey: a cross-sectional examination of congruence and discordance between adolescents with HIV/AIDS and their families.

    Science.gov (United States)

    Lyon, Maureen E; Dallas, Ronald H; Garvie, Patricia A; Wilkins, Megan L; Garcia, Ana; Cheng, Yao Iris; Wang, Jichuan

    2017-09-21

    To identify patient-reported paediatric advance care planning (pACP) needs of adolescents living with HIV and to examine the congruence with their family's perception of their needs. A cross-sectional survey among six paediatric hospital-based outpatient HIV specialty clinics. Participants included 48 adolescent/family dyads (n=96 participants) within a larger study facilitating pACP. The main outcome measure was the Lyon Advance Care Planning Survey - Adolescent and Surrogate Versions-Revised. Adolescents' mean age was 18 years (range ≥14-congruence in pACP needs within adolescent/family dyads. There was substantial congruence in that being free from pain (PABAK=0.83), and understanding your treatment choices (PABAK=0.92) were very important or important. There was discordance about being off machines that extend life (PABAK=0.08) and when is the best time to bring up EOL decisions (PABAK=0.32). Areas of discordance were associated with life-sustaining choices and when to have the EOL conversation. Targeted, adolescent/family-centred, evidence-based pACP interventions are needed to improve family understanding of youth's EOL wishes. NCT01289444; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Couples coping with discordant HIV status.

    Science.gov (United States)

    Beckerman, Nancy L

    2002-02-01

    As we start the third decade of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic, how does HIV/AIDS affect the emotional lives of couples of mixed HIV status? This is a case report based on the findings of an exploratory research study of serodiscordant couples in the New York City area. It focuses on the issues confronting a particular couple who represent the salient issues in the lives of serodiscordant couples. This case report discusses the findings of a study that attempted to ascertain the central emotional challenges facing couples of mixed HIV status and discusses one case in particular that illustrates how these issues might commonly manifest themselves. Fear of HIV transmission, coping with uncertainty of potential illness, shifts in emotional intimacy, and dilemmas regarding how HIV has impacted reproductive alternatives were identified as the most commonly experienced emotional issues for the serodiscordant couple.

  8. HIV Risks, Testing, and Treatment in the Former Soviet Union: Challenges and Future Directions in Research and Methodology.

    Science.gov (United States)

    Saadat, Victoria M

    2015-01-01

    The dissolution of the USSR resulted in independence for constituent republics but left them battling an unstable economic environment and healthcare. Increases in injection drug use, prostitution, and migration were all widespread responses to this transition and have contributed to the emergence of an HIV epidemic in the countries of former Soviet Union. Researchers have begun to identify the risks of HIV infection as well as the barriers to HIV testing and treatment in the former Soviet Union. Significant methodological challenges have arisen and need to be addressed. The objective of this review is to determine common threads in HIV research in the former Soviet Union and provide useful recommendations for future research studies. In this systematic review of the literature, Pubmed was searched for English-language studies using the key search terms "HIV", "AIDS", "human immunodeficiency virus", "acquired immune deficiency syndrome", "Central Asia", "Kazakhstan", "Kyrgyzstan", "Uzbekistan", "Tajikistan", "Turkmenistan", "Russia", "Ukraine", "Armenia", "Azerbaijan", and "Georgia". Studies were evaluated against eligibility criteria for inclusion. Thirty-nine studies were identified across the two main topic areas of HIV risk and barriers to testing and treatment, themes subsequently referred to as "risk" and "barriers". Study design was predominantly cross-sectional. The most frequently used sampling methods were peer-to-peer and non-probabilistic sampling. The most frequently reported risks were condom misuse, risky intercourse, and unsafe practices among injection drug users. Common barriers to testing included that testing was inconvenient, and that results would not remain confidential. Frequent barriers to treatment were based on a distrust in the treatment system. The findings of this review reveal methodological limitations that span the existing studies. Small sample size, cross-sectional design, and non-probabilistic sampling methods were frequently

  9. HIV status of partners of HIV positive pregnant women in different regions of Nigeria: matters arising.

    Science.gov (United States)

    Sagay, A S; Onakewhor, J; Galadanci, H; Emuveyan, E E

    2006-12-01

    This study was conducted to determine the pattern of HIV sero-status of Partners of HIV Positive Pregnant Women in three different regions of Nigeria and to explore the implications for HIV prevention interventions. The Site Coordinators of PMTCT programs in three Nigerian cities obtained data of the HIV status of the partners of HIV positive pregnant women. The selection of Benin City, Jos and Kano was made after consideration of their ethnic, religious and cultural representation of Nigeria. Benin City represents a traditional southern Nigeria city, Kano a traditional northern city and Jos, a middle-belt, ethnically diverse cosmopolitan setting. The data were analyzed using frequencies. A total of 500 partners of HIV infected pregnant women were tested for HIV using Determine Abbott test kits. Positive results were confirmed using Western blot or a second rapid test kit. The city-by-city results showed that in Benin City (Southern Nigeria), 78.8% (104/132) of the partners were HIV negative (sero-discordant), Jos (Middle-Belt) had 48.4% (103/213) sero-discordance while Kano (Northern Nigeria) recorded a sero-discordance rate of only 7.7% (12/155). These results indicate that the dynamics of HIV transmission in marital settings in Nigeria are different in the various regions of the country. Socio-cultural and religious settings play a significant role in HIV transmission among couples. These findings should guide prevention interventions in order to achieve maximal impact.

  10. Ethical Dilemma and Management of Infertility in HIV Seropositive Discordant Couples: A Case Study in Nigeria.

    Science.gov (United States)

    Umeora, Ouj; Chukwuneke, Fn

    2013-01-01

    The traditional African society places an invaluable premium on procreation and, in some communities, a woman's place in her matrimony is only confirmed on positive reproductive outcome. Infertility is rife in Nigeria, and HIV/acquired immunodeficiency syndrome (AIDS) infection is a global pandemic, which has led to a drop in life expectancy across the world. In Nigeria, a number of cultural norms relating to gender roles and power dynamics constitute a serious barrier to issues of sexuality and infertility. Couples are concerned about their infertility diagnostic test being disclosed to each other, especially before marriage. This concern is understandable, especially in an environment that lacks the modern concepts and attitude toward sexual matters. This is complicated by the advent of HIV/AIDS infection and the societal mind-set that look at seropostive individuals as transgressors. At present, sexual and reproductive health rights are currently not in place because ethical issues are not given prominence by many physicians in Nigeria. A case of an infertile and seropostive discordant couple, which raised a lot of medical and ethical concerns, is presented here to awaken the consciousness of Nigerian physicians and stimulate discussions on the ethical matters such as this in clinical practice.

  11. HIV Risks, Testing, and Treatment in the Former Soviet Union: Challenges and Future Directions in Research and Methodology

    Directory of Open Access Journals (Sweden)

    Victoria M. Saadat

    2016-01-01

    Full Text Available Background. The dissolution of the USSR resulted in independence for constituent republics but left them battling an unstable economic environment and healthcare. Increases in injection drug use, prostitution, and migration were all widespread responses to this transition and have contributed to the emergence of an HIV epidemic in the countries of former Soviet Union. Researchers have begun to identify the risks of HIV infection as well as the barriers to HIV testing and treatment in the former Soviet Union. Significant methodological challenges have arisen and need to be addressed. The objective of this review is to determine common threads in HIV research in the former Soviet Union and provide useful recommendations for future research studies.Methods. In this systematic review of the literature, Pubmed was searched for English-language studies using the key search terms “HIV”, “AIDS”, “human immunodeficiency virus”, “acquired immune deficiency syndrome”, “Central Asia”, “Kazakhstan”, “Kyrgyzstan”, “Uzbekistan”, “Tajikistan”, “Turkmenistan”, “Russia”, “Ukraine”, “Armenia”, “Azerbaijan”, and “Georgia”. Studies were evaluated against eligibility criteria for inclusion.Results. Thirty-nine studies were identified across the two main topic areas of HIV risk and barriers to testing and treatment, themes subsequently referred to as “risk” and “barriers”. Study design was predominantly cross-sectional. The most frequently used sampling methods were peer-to-peer and non-probabilistic sampling. The most frequently reported risks were condom misuse, risky intercourse, and unsafe practices among injection drug users.  Common barriers to testing included that testing was inconvenient, and that results would not remain confidential.  Frequent barriers to treatment were based on a distrust in the treatment system. Conclusion. The findings of this review reveal methodological limitations

  12. HIV Infection in Migrant Populations in the European Union and European Economic Area in 2007-2012: An Epidemic on the Move.

    Science.gov (United States)

    Hernando, Victoria; Alvárez-del Arco, Débora; Alejos, Belén; Monge, Susana; Amato-Gauci, Andrew J; Noori, Teymur; Pharris, Anastasia; del Amo, Julia

    2015-10-01

    Migrants are considered a key group at risk for HIV infection. This study describes the epidemiology of HIV and the distribution of late HIV presentation among migrants within the European Union/European Economic Area during 2007-2012. HIV cases reported to European Surveillance System (TESSy) were analyzed. Migrants were defined as people whose geographical origin was different than the reporting country. Multiple logistic regression was used to model late HIV presentation. Overall, 156,817 HIV cases were reported, of which 60,446 (38%) were migrants. Of these, 53% were from Sub-Saharan Africa, 12% from Latin America, 9% from Western Europe, 7% from Central Europe, 5% from South and Southeast Asia, 4% from East Europe, 4% from Caribbean, and 3% from North Africa and Middle East. Male and female migrants from Sub-Saharan Africa and Latin America had higher odds of late HIV presentation than native men and women. Migrants accounted for 40% of all HIV notifications in 2007 versus 35% in 2012. HIV cases in women from Sub-Saharan Africa decreased from 3725 in 2007 to 2354 in 2012. The number of HIV cases from Latin America peaked in 2010 to decrease thereafter. HIV diagnoses in migrant men who have sex with men increased from 1927 in 2007 to 2459 in 2012. Migrants represent two-fifths of the HIV cases reported and had higher late HIV presentation. HIV epidemic in migrant populations in European Union/European Economic Area member states is changing, probably reflecting the global changes in the HIV pandemic, the impact of large-scale ART implementation, and migration fluctuations secondary to the economic crisis in Europe.

  13. 'Testing Together Challenges the Relationship': Consequences of HIV Testing as a Couple in a High HIV Prevalence Setting in Rural South Africa.

    Directory of Open Access Journals (Sweden)

    Hanani Tabana

    Full Text Available We conducted qualitative individual and combined interviews with couples to explore their experiences since the time of taking an HIV test and receiving the test result together, as part of a home-based HIV counselling and testing intervention.This study was conducted in October 2011 in rural KwaZulu-Natal, South Africa, about 2 years after couples tested and received results together. Fourteen couples were purposively sampled: discordant, concordant negative and concordant positive couples.Learning about each other's status together challenged relationships of the couples in different ways depending on HIV status and gender. The mutual information confirmed suspected infidelity that had not been discussed before. Negative women in discordant partnerships remained with their positive partner due to social pressure and struggled to maintain their HIV negative status. Most of the couple relationships were characterized by silence and mistrust. Knowledge of sero-status also led to loss of sexual intimacy in some couples especially the discordant. For most men in concordant negative couples, knowledge of status was an awakening of the importance of fidelity and an opportunity for behaviour change, while for concordant positive and discordant couples, it was seen as proof of infidelity. Although positive HIV status was perceived as confirmation of infidelity, couples continued their relationship and offered some support for each other, living and managing life together. Sexual life in these couples was characterized by conflict and sometimes violence. In the concordant negative couples, trust was enhanced and behaviour change was promised.Findings suggest that testing together as couples challenged relationships in both negative and positive ways. Further, knowledge of HIV status indicated potential to influence behaviour change especially among concordant negatives. In the discordant and concordant positive couples, traditional gender roles exposed

  14. HIV-1 transmission within marriage in rural Uganda: a longitudinal study.

    Directory of Open Access Journals (Sweden)

    Samuel Biraro

    Full Text Available BACKGROUND: Early initiation of antiretroviral therapy reduces risk of transmission to the uninfected partner in HIV discordant couples, but there are relatively little observational data on HIV transmission within couples from non-trial settings. The aims of this paper are to estimate HIV incidence among HIV discordant couples using longstanding observational data from a rural Ugandan population and to identify factors associated with HIV transmission within couples, including the role of HSV-2 infection. METHODS: Using existing data collected at population-wide annual serological and behavioural surveys in a rural district in southwest Uganda between 1989 and 2007, HIV discordant partners were identified. Stored serum samples were tested for HSV-2 serostatus using the Kalon ELISA test. HIV seroconversion rates and factors association with HIV seroconversion were analysed using Poisson regression. RESULTS: HIV status of both partners was known in 2465 couples and of these 259 (10.5% were HIV serodiscordant. At enrollment, HSV-2 prevalence was 87.3% in HIV positive partners and 71.5% in HIV negative partners. Of the 259 discordant couples, 62 converted to HIV (seroconversion rate 7.11/100 PYAR, 95%CI; 5.54, 9.11 with the rate decreasing from 10.89 in 1990-1994 to 4.32 in 2005-2007. Factors independently associated with HIV seroconversion were female sex, non-Muslim religion, greater age difference (man older than woman by more than 15 years, higher viral load in the positive partner and earlier calendar period. HSV-2 was not independently associated with HIV acquisition (HR 1.62, 95%CI; 0.57, 4.55 or transmission (HR 0.61, 95%CI; 0.24, 1.57. No transmissions occurred in the 29 couples where the index partner was on ART during follow up (872 person-years on ART. DISCUSSION: HIV negative partners in serodiscordant couples have a high incidence of HIV if the index partner is not on antiretroviral therapy and should be provided with interventions

  15. Indeterminate human immunodeficiency virus western blot results in Iranian patients with discordant screening assay results

    International Nuclear Information System (INIS)

    Ravanshad, M.; Sabahi, F.; Mahboudi, F.; Sabahi, F.

    2006-01-01

    The Western blot (WB) assay is the most widely accepted confirmatory assay for the detection and confirmation of antibodies to human immunodeficiency virus type 1 (HIV-1) and 2 (HIV-2). However, indeterminate WB reactivity to HIV-1 and HIV-2 proteins may occur in individuals who do not appear to be infected with HIV. In this study, we describe the results of indeterminate WB reactivity in Iranian patients with discordant screening assays. The samples were obtained from Iranian Blood Transfusion Center, Tehran, Iran and evaluated in the Biotechnology Process Development Center, Pasteur Institute of Iran, Tehran, Iran between 2003 and 2004. A total of 4707 were tested for the presence of HIV-1 antibodies. Six hundred and four (12.8%) patients tested for HIV were positive for HIV-1 antibody. Nine (1.49%) have discordant results among screening assays and indeterminate WB results as interpreted by Centers for Disease Control and Prevention (CDC) criteria. Most (66.7%) of these indeterminate WB results were due to p24 reactivity. However, 2(22.2%) display reactivity to both gp41 and gp120 proteins [Positive by World Health Organization (WHO) criteria]. Of 9 WB assays initially indeterminate by the CDC criteria and with follow-up samples 8(88.8%) became negative when retested subsequently while one (11.1%) remained indeterminate for more than a year and were thus considered negative. In addition all the indeterminate samples were negative when assessed by polymerase chain reaction assay. In general, there were was an 88.8% concordance between the CDC and WHO criteria for an indeterminate WB result. The CDC II criteria for an indeterminate WB result. The CDC II criteria best met the specified objectives for diagnosis in our setting. (author)

  16. Experiences of stigma and discrimination among HIV-discordant

    African Journals Online (AJOL)

    Laetitia C. Rispel

    2015-03-17

    Mar 17, 2015 ... the perspective of both the HIV-positive and HIV-negative part- ners. Participants .... have a decent salary – it had the name of my employer. I received a phone call .... dynamics, economic dependence, gender inequalities and power ... Africa, Tanzania, Thailand and Zimbabwe found that blame and gossip ...

  17. Spontaneous emission and quantum discord: Comparison of Hilbert–Schmidt and trace distance discord

    Energy Technology Data Exchange (ETDEWEB)

    Jakóbczyk, Lech, E-mail: ljak@ift.uni.wroc.pl

    2014-09-12

    Hilbert–Schmidt and trace norm geometric quantum discord are compared with regard to their behavior during local time evolution. We consider the system of independent two-level atoms with time evolution given by the dissipative process of spontaneous emission. It is explicitly shown that the Hilbert–Schmidt norm discord has nonphysical properties with respect to such local evolution and cannot serve as a reasonable measure of quantum correlations and the better choice is to use trace norm discord as such a measure. - Highlights: • We compare Hilbert–Schmidt and trace norm geometric quantum discord. • We consider the system of independent two-level atoms with time evolution given by spontaneous emission. • We show explicitly that Hilbert–Schmidt norm discord has nonphysical properties.

  18. Discordant HIV Test Results: Implications on Perinatal and Haemotransfusion Screening for HIV Infection, Cape Coast, Ghana.

    Science.gov (United States)

    Tetteh, Ato Kwamena; Agyarko, Edward

    2017-01-01

    Screening results of 488 pregnant women aged 15-44 years whose blood samples had been tested on-site, using First Response® HIV 1/2, and confirmed with INNO-LIA™ HIV I/II Score were used. Of this total, 178 were reactive (HIV I, 154; HIV II, 2; and HIV I and HIV II, 22). Of the 154 HIV I-reactive samples, 104 were confirmed to be HIV I-positive and 2 were confirmed to be HIV II-positive, while 48 were confirmed to be negative [false positive rate = 17.44% (13.56-21.32)]. The two HIV II samples submitted were confirmed to be negative with the confirmatory test. For the 22 HIV I and HIV II samples, 7 were confirmed to be HIV I-positive and 1 was confirmed to be HIV I- and HIV II-positive, while 14 were confirmed to be negative. Of the 310 nonreactive samples, 6 were confirmed to be HIV I-positive and 1 was confirmed to be HIV II-positive [false negative rate = 5.79% (1.63-8.38)], while 303 were negative. False negative outcomes will remain unconfirmed, with no management options for the client. False negative rate of 5.79% requires attention, as its resultant implications on control of HIV/AIDS could be dire.

  19. Condom use among people living with HIV/AIDS attending ...

    African Journals Online (AJOL)

    repeated sexual contact among HIV-discordant couples, 98-100% of those who used latex condoms correctly and ... Quick Response Code: ... Human immunodeficiency virus (HIV) ..... en/wpraids2001.pdf [Last accessed on 2009 Apr 20]. 2.

  20. Quantum discord with weak measurements

    International Nuclear Information System (INIS)

    Singh, Uttam; Pati, Arun Kumar

    2014-01-01

    Weak measurements cause small change to quantum states, thereby opening up the possibility of new ways of manipulating and controlling quantum systems. We ask, can weak measurements reveal more quantum correlation in a composite quantum state? We prove that the weak measurement induced quantum discord, called as the “super quantum discord”, is always larger than the quantum discord captured by the strong measurement. Moreover, we prove the monotonicity of the super quantum discord as a function of the measurement strength and in the limit of strong projective measurement the super quantum discord becomes the normal quantum discord. We find that unlike the normal discord, for pure entangled states, the super quantum discord can exceed the quantum entanglement. Our results provide new insights on the nature of quantum correlation and suggest that the notion of quantum correlation is not only observer dependent but also depends on how weakly one perturbs the composite system. We illustrate the key results for pure as well as mixed entangled states. -- Highlights: •Introduced the role of weak measurements in quantifying quantum correlation. •We have introduced the notion of the super quantum discord (SQD). •For pure entangled state, we show that the SQD exceeds the entanglement entropy. •This shows that quantum correlation depends not only on observer but also on measurement strength

  1. Sexual life and fertility desire in long-term HIV serodiscordant couples in Addis Ababa, Ethiopia: a grounded theory study

    Directory of Open Access Journals (Sweden)

    Hailemariam Tewodros G

    2012-10-01

    Full Text Available Abstract Background Even though remarkable progress has been achieved, HIV/AIDS continues to be a major global health priority. HIV discordant relationship is one of the emerging issues in HIV prevention endeavour. In Ethiopia, very little is known about HIV-serodiscordant couples particularly how they manage their sexual relationship and fertility desire. Therefore, we conduct this study with the aim of exploring the experiences of HIV discordant couples about their sexual life, and fertility desire in the context of long-term relationships in Addis Ababa, Ethiopia. Methods A grounded theory approach was employed using in-depth interviews among 36 informants in ART/PMTCT centers of three public hospitals, a health center and one PLHIV association in Addis Ababa. Theoretical sampling was used to recruit 28 clients who lived in a discordant relationship and eight health care providers as key informants. Data collection and analysis were undertaken simultaneously using a constant comparison. The analysis was facilitated using OpenCode software. Results A grounded theory pertaining to sexual life and desire to have a child among HIV discordant couples emerged as “maintaining the relationship” as a core category. Couples pass through a social process of struggle to maintain their relationship. The causal conditions for couples to enter into the process of struggle to maintain their relationship were collectively categorized as “Entering in-to a transition” (knowing HIV serostatus and this includes mismatch of desire to have a child, controversy on safe sex versus desire to have a child, and undeniable change in sexual desire and practice through time were the features in entering into-transition. Then after the transition, couples engaged in certain actions/strategies that are categorized as “dealing with discordancy” such as entertaining partner’s interest by scarifying once self interest to maintain their relationship. Conclusions

  2. Discord of response

    International Nuclear Information System (INIS)

    Roga, W; Illuminati, F; Giampaolo, S M

    2014-01-01

    The presence of quantum correlations in a quantum state is related to the state's response to local unitary perturbations. Such a response is quantified by the distance between the unperturbed and perturbed states, minimized with respect to suitably identified sets of local unitary operations. In order to be a bona fide measure of quantum correlations, the distance function must be chosen among those that are contractive under completely positive and trace preserving (CPTP) maps. The most relevant instances of such physically well-behaved metrics include the trace, the Bures, and the Hellinger distance. To each of these metrics one can associate the corresponding discord of response, namely the trace, or Hellinger, or Bures minimum distance from the set of unitarily perturbed states. All these three discords of response satisfy the basic axioms for a proper measure of quantum correlations. In the present work we focus in particular on the Bures distance, which enjoys the unique property of being both Riemannian and contractive under CPTP maps, and admits important operational interpretations in terms of state distinguishability. We compute analytically the Bures discord of response for two-qubit states with maximally mixed marginals and we compare it with the corresponding Bures geometric discord, namely the geometric measure of quantum correlations defined as the Bures distance from the set of classical-quantum states. Finally, we investigate and identify the maximally quantum correlated two-qubit states according to the Bures discord of response. These states exhibit a remarkable nonlinear dependence on the global state purity. (paper)

  3. A flexible method to model HIV serodiscordance among couples in Mozambique.

    Directory of Open Access Journals (Sweden)

    Adelino J C Juga

    Full Text Available Whereas the number of people newly infected by HIV is continuing to decline globally, the epidemic continues to expand in many parts of the world. As the HIV/AIDS epidemic has matured in many countries, it is believed that the proportion of new infections occurring within couples has risen. Across countries, including Mozambique, a sizeable proportion of couples with HIV infection are discordant. A serodiscordant couple is a couple in which one partner has tested positive for HIV and the other has not. To describe the HIV serodiscordance among couples, a variety of association measures can be used. In this paper, we propose the serodiscordance measure (SDM as a new alternative measure. Focus is on the specification of flexible marginal and random effects models for multivariate correlated binary data together with a full-likelihood estimation method, to adequately and directly describe the measure of interest. Fitting joint models allows examining the effects of different risk factors and other covariates on the probability to be HIV positive for each member within a couple, and estimating common effects for both probabilities more efficiently, while accounting for the association between their infection status. Moreover, the interpretation of the proposed association parameter SDM is more direct and relevant and effects of covariates can be studied as well. Results show that the HIV prevalence for the province where a couple was located as well as the union number for the woman within a couple are factors associated with HIV serodiscordance. These findings are important for the Mozambican public health policy makers to design national prevention plans, which include policies to stimulate regular HIV testing for couples as well as adolescents and young adults, prior to getting married or living together as a couple.

  4. The Advantage of Discordance

    DEFF Research Database (Denmark)

    Dalton, Leslie W.; Gerds, Thomas A.

    2017-01-01

    Discordance among multiple assessments has been a reason to criticize a biomarker. But, if different assessments are all relevant, the meaning of discordance requires explanation. As an example, for 1085 breast cancers, a low (score 1), intermediate (score 2) or high nuclear grade (NG) (score 3) ...

  5. "Getting tested is almost like going to the Salem witch trials": discordant discourses between Western public health messages and sociocultural expectations surrounding HIV testing among East African immigrant women.

    Science.gov (United States)

    De Jesus, Maria; Carrete, Claudia; Maine, Cathleen; Nalls, Patricia

    2015-01-01

    Washington, DC, has the highest AIDS diagnosis rate in the USA, and Black women are disproportionately affected. Although HIV testing is the first entryway into vital treatment services, evidence reveals that foreign-born blacks have a lower rate of recent HIV testing than US-born blacks. To date, however, there are no studies that examine the culture-specific perceptions of HIV testing among East African immigrant women (who comprise a large share of Black Africans in DC) to better understand their potential barriers to testing. Adopting the PEN-3 cultural model as our theoretical framework, the main objective of this study was to examine East African women's HIV testing perceptions and partner communication norms. Between October 2012 and March 2013, trained interviewers conducted a total of 25 interviews with East African women in the Washington, DC, metropolitan area. For triangulation purposes, data collection consisted of both in-depth, semi-structured interviews and cognitive interviews, in which participants were administered a quantitative survey and assessed on how they interpreted items. Qualitative thematic analysis revealed a systematic pattern of discordant responses across participants. While they were aware of messages related to Western public health discourse surrounding HIV testing (e.g., Everyone should get tested for HIV; One should talk to one's spouse about HIV testing), divergent sociocultural expectations rooted in cultural and religious beliefs prevailed (e.g., Getting an HIV test brings shame to the person who got tested and to one's family; it implies one is engaging in immoral behavior; One should not talk with one's spouse about HIV testing; doing so breaks cultural norms). Implications of using a culture-centered model to examine the role of sociocultural expectations in HIV prevention research and to develop culturally responsive prevention strategies are discussed.

  6. Sociodemographic Correlates of HIV Discordant and Concordant

    African Journals Online (AJOL)

    GB

    2017-07-01

    Jul 1, 2017 ... July 2017. DOI: http://dx.doi.org/10.4314/ejhs.v27i4.7. 364. INTRODUCTION. Couples are said to be human immunodeficiency virus (HIV)-affected when ..... 18. Araoye MO. Research methodology with statistics for health and social sciences. Nathadex Publications, saw-mill, Ilorin 2nd ed.2008: p 115-22.

  7. Operational interpretations of quantum discord

    International Nuclear Information System (INIS)

    Cavalcanti, D.; Modi, K.; Aolita, L.; Boixo, S.; Piani, M.; Winter, A.

    2011-01-01

    Quantum discord quantifies nonclassical correlations beyond the standard classification of quantum states into entangled and unentangled. Although it has received considerable attention, it still lacks any precise interpretation in terms of some protocol in which quantum features are relevant. Here we give quantum discord its first information-theoretic operational meaning in terms of entanglement consumption in an extended quantum-state-merging protocol. We further relate the asymmetry of quantum discord with the performance imbalance in quantum state merging and dense coding.

  8. ‘Getting tested is almost like going to the Salem witch trials’: Discordant discourses between western public health messages and sociocultural expectations surrounding HIV testing among East African immigrant women

    Science.gov (United States)

    DE JESUS, Maria; CARRETE, Claudia; MAINE, Cathleen; NALLS, Patricia

    2015-01-01

    Washington, DC has the highest AIDS diagnosis rate in the United States and Black women are disproportionately affected. Although HIV testing is the first entryway into vital treatment services, evidence reveals that foreign-born blacks have a lower rate of recent HIV testing than U.S.-born blacks. To date, however, there are no studies that examine the culture-specific perceptions of HIV testing among East African immigrant women (who comprise a large share of Black Africans in DC) to better understand their potential barriers to testing. Adopting the PEN-3 cultural model as our theoretical framework, the main objective of this study was to examine East African women’s HIV testing perceptions and partner communication norms. Between October 2012 and March 2013, trained interviewers conducted a total of 25 interviews with East African women in the Washington DC Metropolitan area. For triangulation purposes, data collection consisted of both in-depth, semi-structured interviews and cognitive interviews, in which participants were administered a quantitative survey and assessed on how they interpreted items. Qualitative thematic analysis revealed a systematic pattern of discordant responses across participants. While they were aware of messages related to western public health discourse surrounding HIV testing (e.g., Everyone should get tested for HIV; One should talk to one’s spouse about HIV testing), divergent sociocultural expectations rooted in cultural and religious beliefs prevailed (e.g., Getting an HIV test brings shame to the person who got tested and to one’s family; it implies one is engaging in immoral behavior; One should not talk with one’s spouse about HIV testing; doing so breaks cultural norms). Implications of using a culture-centered model to examine the role of sociocultural expectations in HIV prevention research and to develop culturally responsive prevention strategies are discussed. PMID:25616443

  9. Fetoscopic laser coagulation of intertwin anastomoses reduces discordant placental autophagic activities in discordant twin growth

    Directory of Open Access Journals (Sweden)

    Yao-Lung Chang

    2015-10-01

    Conclusion: The discordance of placenta autophagic activity in the monochorionic twin with sIUGR was reduced after laser coagulation of the intertwin anastomoses, which may result from the effect of correction of the discordant intertwin placenta perfusion.

  10. Computing quantum discord is NP-complete

    International Nuclear Information System (INIS)

    Huang, Yichen

    2014-01-01

    We study the computational complexity of quantum discord (a measure of quantum correlation beyond entanglement), and prove that computing quantum discord is NP-complete. Therefore, quantum discord is computationally intractable: the running time of any algorithm for computing quantum discord is believed to grow exponentially with the dimension of the Hilbert space so that computing quantum discord in a quantum system of moderate size is not possible in practice. As by-products, some entanglement measures (namely entanglement cost, entanglement of formation, relative entropy of entanglement, squashed entanglement, classical squashed entanglement, conditional entanglement of mutual information, and broadcast regularization of mutual information) and constrained Holevo capacity are NP-hard/NP-complete to compute. These complexity-theoretic results are directly applicable in common randomness distillation, quantum state merging, entanglement distillation, superdense coding, and quantum teleportation; they may offer significant insights into quantum information processing. Moreover, we prove the NP-completeness of two typical problems: linear optimization over classical states and detecting classical states in a convex set, providing evidence that working with classical states is generically computationally intractable. (paper)

  11. Collapse–revival of quantum discord and entanglement

    International Nuclear Information System (INIS)

    Yan, Xue-Qun; Zhang, Bo-Ying

    2014-01-01

    In this paper the correlations dynamics of two atoms in the case of a micromaser-type system is investigated. Our results predict certain quasi-periodic collapse and revival phenomena for quantum discord and entanglement when the field is in Fock state and the two atoms are initially in maximally mixed state, which is a special separable state. Our calculations also show that the oscillations of the time evolution of both quantum discord and entanglement are almost in phase and they both have similar evolution behavior in some time range. The fact reveals the consistency of quantum discord and entanglement in some dynamical aspects. - Highlights: • The correlations dynamics of two atoms in the case of a micromaser-type system is investigated. • A quasi-periodic collapse and revival phenomenon for quantum discord and entanglement is reported. • A phenomenon of correlations revivals different from that of non-Markovian dynamics is revealed. • The oscillations of time evolution of both quantum discord and entanglement are almost in phase in our system. • Quantum discord and entanglement have similar evolution behavior in some time range

  12. Revealing Tripartite Quantum Discord with Tripartite Information Diagram

    Directory of Open Access Journals (Sweden)

    Wei-Ting Lee

    2017-11-01

    Full Text Available A new measure based on the tripartite information diagram is proposed for identifying quantum discord in tripartite systems. The proposed measure generalizes the mutual information underlying discord from bipartite to tripartite systems, and utilizes both one-particle and two-particle projective measurements to reveal the characteristics of the tripartite quantum discord. The feasibility of the proposed measure is demonstrated by evaluating the tripartite quantum discord for systems with states close to Greenberger–Horne–Zeilinger, W, and biseparable states. In addition, the connections between tripartite quantum discord and two other quantum correlations—namely genuine tripartite entanglement and genuine tripartite Einstein–Podolsky–Rosen steering—are briefly discussed. The present study considers the case of quantum discord in tripartite systems. However, the proposed framework can be readily extended to general N-partite systems.

  13. Creating an African HIV clinical research and prevention trials network: HIV prevalence, incidence and transmission.

    Directory of Open Access Journals (Sweden)

    Anatoli Kamali

    Full Text Available HIV epidemiology informs prevention trial design and program planning. Nine clinical research centers (CRC in sub-Saharan Africa conducted HIV observational epidemiology studies in populations at risk for HIV infection as part of an HIV prevention and vaccine trial network. Annual HIV incidence ranged from below 2% to above 10% and varied by CRC and risk group, with rates above 5% observed in Zambian men in an HIV-discordant relationship, Ugandan men from Lake Victoria fishing communities, men who have sex with men, and several cohorts of women. HIV incidence tended to fall after the first three months in the study and over calendar time. Among suspected transmission pairs, 28% of HIV infections were not from the reported partner. Volunteers with high incidence were successfully identified and enrolled into large scale cohort studies. Over a quarter of new cases in couples acquired infection from persons other than the suspected transmitting partner.

  14. Creating an African HIV Clinical Research and Prevention Trials Network: HIV Prevalence, Incidence and Transmission

    Science.gov (United States)

    Kamali, Anatoli; Price, Matt A.; Lakhi, Shabir; Karita, Etienne; Inambao, Mubiana; Sanders, Eduard J.; Anzala, Omu; Latka, Mary H.; Bekker, Linda-Gail; Kaleebu, Pontiano; Asiki, Gershim; Ssetaala, Ali; Ruzagira, Eugene; Allen, Susan; Farmer, Paul; Hunter, Eric; Mutua, Gaudensia; Makkan, Heeran; Tichacek, Amanda; Brill, Ilene K.; Fast, Pat; Stevens, Gwynn; Chetty, Paramesh; Amornkul, Pauli N.; Gilmour, Jill

    2015-01-01

    HIV epidemiology informs prevention trial design and program planning. Nine clinical research centers (CRC) in sub-Saharan Africa conducted HIV observational epidemiology studies in populations at risk for HIV infection as part of an HIV prevention and vaccine trial network. Annual HIV incidence ranged from below 2% to above 10% and varied by CRC and risk group, with rates above 5% observed in Zambian men in an HIV-discordant relationship, Ugandan men from Lake Victoria fishing communities, men who have sex with men, and several cohorts of women. HIV incidence tended to fall after the first three months in the study and over calendar time. Among suspected transmission pairs, 28% of HIV infections were not from the reported partner. Volunteers with high incidence were successfully identified and enrolled into large scale cohort studies. Over a quarter of new cases in couples acquired infection from persons other than the suspected transmitting partner. PMID:25602351

  15. Gender and HIV infection in the context of alcoholism in Kenya.

    Science.gov (United States)

    Muturi, Nancy

    2015-01-01

    Women in sub-Saharan Africa account for more than half (58%) of people living with the HIV and it is the only continent where HIV prevalence is higher for women than for men. Studies have attributed alcoholism with the high rates of HIV infection due to its impact on sexual behaviour and arousal. African countries with high rates of alcoholism also reportedly have higher rates of HIV infection. This study explores rural communities' perspectives on the risk factors for HIV infection among women who are in alcohol discordant relationships where the man drinks alcohol excessively. Data were gathered through focus group discussions in rural central Kenya where alcoholism has reached epidemic levels. Key findings indicate the perceived severity of alcoholism, the perceived impact of alcoholism on men's reproductive health and the unmet sexual and reproductive needs of women in alcohol discordant relationships. Women engage in risky sexual behaviours in an attempt to meet these needs. Such risky behaviour in addition to alcohol-related sexual violence and low response-efficacy for safer sexual practices make them vulnerable to HIV infection and enhances the spread of HIV within communities. The study concludes that in preventing HIV infection among women in alcohol communities affected by alcohol, it is important to focus on their response efficacy. Intervention programmes that focus on HIV prevention among older married women and that integrate alcohol and HIV prevention are long overdue.

  16. Diagnosing acute HIV infection: The performance of quantitative HIV-1 RNA testing (viral load) in the 2014 laboratory testing algorithm.

    Science.gov (United States)

    Wu, Hsiu; Cohen, Stephanie E; Westheimer, Emily; Gay, Cynthia L; Hall, Laura; Rose, Charles; Hightow-Weidman, Lisa B; Gose, Severin; Fu, Jie; Peters, Philip J

    2017-08-01

    New recommendations for laboratory diagnosis of HIV infection in the United States were published in 2014. The updated testing algorithm includes a qualitative HIV-1 RNA assay to resolve discordant immunoassay results and to identify acute HIV-1 infection (AHI). The qualitative HIV-1 RNA assay is not widely available; therefore, we evaluated the performance of a more widely available quantitative HIV-1 RNA assay, viral load, for diagnosing AHI. We determined that quantitative viral loads consistently distinguished AHI from a false-positive immunoassay result. Among 100 study participants with AHI and a viral load result, the estimated geometric mean viral load was 1,377,793copies/mL. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Global quantum discord and matrix product density operators

    Science.gov (United States)

    Huang, Hai-Lin; Cheng, Hong-Guang; Guo, Xiao; Zhang, Duo; Wu, Yuyin; Xu, Jian; Sun, Zhao-Yu

    2018-06-01

    In a previous study, we have proposed a procedure to study global quantum discord in 1D chains whose ground states are described by matrix product states [Z.-Y. Sun et al., Ann. Phys. 359, 115 (2015)]. In this paper, we show that with a very simple generalization, the procedure can be used to investigate quantum mixed states described by matrix product density operators, such as quantum chains at finite temperatures and 1D subchains in high-dimensional lattices. As an example, we study the global discord in the ground state of a 2D transverse-field Ising lattice, and pay our attention to the scaling behavior of global discord in 1D sub-chains of the lattice. We find that, for any strength of the magnetic field, global discord always shows a linear scaling behavior as the increase of the length of the sub-chains. In addition, global discord and the so-called "discord density" can be used to indicate the quantum phase transition in the model. Furthermore, based upon our numerical results, we make some reliable predictions about the scaling of global discord defined on the n × n sub-squares in the lattice.

  18. Results of the Abbott RealTime HIV-1 assay for specimens yielding "target not detected" results by the Cobas AmpliPrep/Cobas TaqMan HIV-1 Test.

    Science.gov (United States)

    Babady, N Esther; Germer, Jeffrey J; Yao, Joseph D C

    2010-03-01

    No significantly discordant results were observed between the Abbott RealTime HIV-1 assay and the COBAS AmpliPrep/COBAS TaqMan HIV-1 Test (CTM) among 1,190 unique clinical plasma specimens obtained from laboratories located in 40 states representing all nine U.S. geographic regions and previously yielding "target not detected" results by CTM.

  19. Global quantum discord in multipartite systems

    Energy Technology Data Exchange (ETDEWEB)

    Rulli, C. C.; Sarandy, M. S. [Instituto de Fisica, Universidade Federal Fluminense, Av. Gal. Milton Tavares de Souza s/n, Gragoata, 24210-346 Niteroi, RJ (Brazil)

    2011-10-15

    We propose a global measure for quantum correlations in multipartite systems, which is obtained by suitably recasting the quantum discord in terms of relative entropy and local von Neumann measurements. The measure is symmetric with respect to subsystem exchange and is shown to be nonnegative for an arbitrary state. As an illustration, we consider tripartite correlations in the Werner-GHZ (Greenberger-Horne-Zeilinger) state and multipartite correlations at quantum criticality. In particular, in contrast with the pairwise quantum discord, we show that the global quantum discord is able to characterize the infinite-order quantum phase transition in the Ashkin-Teller spin chain.

  20. Results of the Abbott RealTime HIV-1 Assay for Specimens Yielding “Target Not Detected” Results by the Cobas AmpliPrep/Cobas TaqMan HIV-1 Test▿

    OpenAIRE

    Babady, N. Esther; Germer, Jeffrey J.; Yao, Joseph D. C.

    2009-01-01

    No significantly discordant results were observed between the Abbott RealTime HIV-1 assay and the COBAS AmpliPrep/COBAS TaqMan HIV-1 Test (CTM) among 1,190 unique clinical plasma specimens obtained from laboratories located in 40 states representing all nine U.S. geographic regions and previously yielding “target not detected” results by CTM.

  1. Quantum discord for two-qubit X states

    International Nuclear Information System (INIS)

    Ali, Mazhar; Rau, A. R. P.; Alber, G.

    2010-01-01

    Quantum discord, a kind of quantum correlation, is defined as the difference between quantum mutual information and classical correlation in a bipartite system. In general, this correlation is different from entanglement, and quantum discord may be nonzero even for certain separable states. Even in the simple case of bipartite quantum systems, this different kind of quantum correlation has interesting and significant applications in quantum information processing. So far, quantum discord has been calculated explicitly only for a rather limited set of two-qubit quantum states and expressions for more general quantum states are not known. In this article, we derive explicit expressions for quantum discord for a larger class of two-qubit states, namely, a seven-parameter family of so called X states that have been of interest in a variety of contexts in the field. We also study the relation between quantum discord, classical correlation, and entanglement for a number of two-qubit states to demonstrate that they are independent measures of correlation with no simple relative ordering between them.

  2. Couple-level Motivations to Test for HIV for Gay Men in Relationships

    Science.gov (United States)

    Beougher, Sean C.; Bircher, Anja E.; Chakravarty, Deepalika; Darbes, Lynae A.; Gómez Mandic, Carmen; Neilands, Torsten B.; Garcia, Carla C.; Hoff, Colleen C.

    2015-01-01

    Previous studies of HIV testing among gay men describe the motivations, facilitators and barriers, behaviors, and demographic characteristics of individuals who test. What little research focuses on HIV testing among gay men in relationships shows that they do not test regularly or, in some cases, at all – their motivations to test have not been investigated. With so little data on HIV testing for this population, and the continued privileging of individually-focused approaches, gay men in relationships fall into a blind spot of research and prevention efforts. This study examined motivations to test for HIV using qualitative data from both partners in 20 gay male couples. Analysis revealed that the partners’ motivations were either event-related (e.g., participants testing the beginning of their relationship or HIV-negative participants in an HIV-discordant relationship testing after risky episode with their discordant primary partner) or partner-related (e.g., participants testing in response to a request or suggestion to test from their primary partner or participants testing out of concern for their primary partner’s health and wellbeing). These data provide insight into relationship-oriented motivations to test for HIV for gay men in relationships and, in doing so, demonstrates their commitment to their primary partner and relationship. These motivations can be leveraged to increase HIV testing among gay men in relationships, a population that tests less often than single gay men, yet, until recently, has been underserved by prevention efforts. PMID:25550145

  3. 2012 HIV Diagnostics Conference: the molecular diagnostics perspective.

    Science.gov (United States)

    Branson, Bernard M; Pandori, Mark

    2013-04-01

    2012 HIV Diagnostic Conference Atlanta, GA, USA, 12-14 December 2012. This report highlights the presentations and discussions from the 2012 National HIV Diagnostic Conference held in Atlanta (GA, USA), on 12-14 December 2012. Reflecting changes in the evolving field of HIV diagnostics, the conference provided a forum for evaluating developments in molecular diagnostics and their role in HIV diagnosis. In 2010, the HIV Diagnostics Conference concluded with the proposal of a new diagnostic algorithm which included nucleic acid testing to resolve discordant screening and supplemental antibody test results. The 2012 meeting, picking up where the 2010 meeting left off, focused on scientific presentations that assessed this new algorithm and the role played by RNA testing and new developments in molecular diagnostics, including detection of total and integrated HIV-1 DNA, detection and quantification of HIV-2 RNA, and rapid formats for detection of HIV-1 RNA.

  4. Sexual Orientation Discordance and Young Adult Mental Health.

    Science.gov (United States)

    Lourie, Michael A; Needham, Belinda L

    2017-05-01

    During the course of sexual development, many people experience dissonance between dimensions of sexual orientation, including attraction, behavior, and identity. This study assesses the relationship between sexual orientation discordance and mental health. Data were obtained from the National Longitudinal Study of Adolescent to Adult Health (n = 8,915; female = 54.62 %; non-Hispanic black = 18.83 %, Hispanic = 14.91 %, other race (non-white) = 10.79 %). Multivariable linear regression evaluated the correlation between sexual orientation discordance and perceived stress and depressive symptomatology. Models were stratified by sex and sexual identity. Among self-identified heterosexual females and mostly heterosexual males, sexual orientation discordance predicted significantly increased depressive symptomatology. No other subpopulation demonstrated a significant correlation between sexual orientation discordance and depressive symptomatology or perceived stress. The association between sexual orientation discordance and depressive symptomatology suggests a link between sexuality, self-concept, and mental health.

  5. Revival and robustness of Bures distance discord under decoherence channels

    International Nuclear Information System (INIS)

    Shi, Jia-dong; Wang, Dong; Ma, Yang-cheng; Ye, Liu

    2016-01-01

    In this paper, we demonstrate the revival and robustness of Bures distance discord in comparison with entanglement under local decoherent evolutions. The results show that in depolarizing channel Bures distance discord revives after a dark point of time, while entanglement will damp into death without revival. In addition, in hybrid channel the declining initial condition can enable Bures distance discord to decay more smoothly within a limited time, but speed up the death of entanglement. In this sense, Bures distance discord is typically more robust against decoherence than entanglement. Furthermore, we also provide a geometric interpretation concerning these phenomena. - Highlights: • Bures distance discord is more robust against decoherence than entanglement. • Bures distance discord revives after a dark point of time, while entanglement damps to death. • The initial condition enables Bures distance discord to damp smoothly, but it speeds up the death of entanglement. • A geometric interpretation concerning these phenomena has been provided.

  6. Refining discordant gene trees.

    Science.gov (United States)

    Górecki, Pawel; Eulenstein, Oliver

    2014-01-01

    Evolutionary studies are complicated by discordance between gene trees and the species tree in which they evolved. Dealing with discordant trees often relies on comparison costs between gene and species trees, including the well-established Robinson-Foulds, gene duplication, and deep coalescence costs. While these costs have provided credible results for binary rooted gene trees, corresponding cost definitions for non-binary unrooted gene trees, which are frequently occurring in practice, are challenged by biological realism. We propose a natural extension of the well-established costs for comparing unrooted and non-binary gene trees with rooted binary species trees using a binary refinement model. For the duplication cost we describe an efficient algorithm that is based on a linear time reduction and also computes an optimal rooted binary refinement of the given gene tree. Finally, we show that similar reductions lead to solutions for computing the deep coalescence and the Robinson-Foulds costs. Our binary refinement of Robinson-Foulds, gene duplication, and deep coalescence costs for unrooted and non-binary gene trees together with the linear time reductions provided here for computing these costs significantly extends the range of trees that can be incorporated into approaches dealing with discordance.

  7. Detection of verbal discordances during sleep.

    Science.gov (United States)

    Perrin, Fabien; Bastuji, Hélène; Garcia-Larrea, Luis

    2002-07-19

    We used an electrophysiological marker of linguistic discordance, the N400 wave, to investigate how linguistic and pseudo-linguistic stimuli are categorised during sleep as compared to waking. During wakefulness, signs of discordance detection were, as expected, greater for pseudo-words than for real but semantically incongruous words, relative to congruous words. In sleep stage 2 all signs of hierarchic process of discordance disappeared. A new hierarchic process reappeared in paradoxical sleep, which differed from that of waking, responses to pseudo-words being similar to those to congruous words. Linguistic absurdity appears to be accepted in a different manner during paradoxical sleep than during waking, and this might explain why absurd contents are so naturally incorporated into otherwise plausible dream stories.

  8. Contraceptive options for women living with HIV.

    Science.gov (United States)

    Phillips, Sharon; Steyn, Petrus; Temmerman, Marleen

    2014-08-01

    Women living with HIV are often of reproductive age, and many desire effective contraceptive options to delay or prevent pregnancy. We review the safety of various hormonal and non-hormonal contraceptive methods for women living with human immunodeficiency virus (HIV). Additionally, we discuss drug interactions between contraceptive methods and antiretrovirals and the safety of methods with respect to onward transmission to HIV-negative partners for women in sero-discordant partnerships. In general, most methods are safe for most women living with HIV. An understanding of the reproductive goals of each individual patient, as well as her medical condition and medication, should be taken into account when counselling women on their contraceptive options. Further research is needed to understand drug interactions between contraceptives and antiretrovirals better and how to fulfil the contraceptive needs of HIV-positive women. Copyright © 2014. Published by Elsevier Ltd.

  9. Patients with discordant responses to antiretroviral therapy have impaired killing of HIV-infected T cells.

    Directory of Open Access Journals (Sweden)

    Sekar Natesampillai

    2010-11-01

    Full Text Available In medicine, understanding the pathophysiologic basis of exceptional circumstances has led to an enhanced understanding of biology. We have studied the circumstance of HIV-infected patients in whom antiretroviral therapy results in immunologic benefit, despite virologic failure. In such patients, two protease mutations, I54V and V82A, occur more frequently. Expressing HIV protease containing these mutations resulted in less cell death, caspase activation, and nuclear fragmentation than wild type (WT HIV protease or HIV protease containing other mutations. The impaired induction of cell death was also associated with impaired cleavage of procaspase 8, a requisite event for HIV protease mediated cell death. Primary CD4 T cells expressing I54V or V82A protease underwent less cell death than with WT or other mutant proteases. Human T cells infected with HIV containing these mutations underwent less cell death and less Casp8p41 production than WT or HIV containing other protease mutations, despite similar degrees of viral replication. The reductions in cell death occurred both within infected cells, as well as in uninfected bystander cells. These data indicate that single point mutations within HIV protease which are selected in vivo can significantly impact the ability of HIV to kill CD4 T cells, while not impacting viral replication. Therefore, HIV protease regulates both HIV replication as well as HIV induced T cell depletion, the hallmark of HIV pathogenesis.

  10. "I never thought that it would happen … " Experiences of HIV seroconverters among HIV-discordant partnerships in a prospective HIV prevention study in Kenya.

    Science.gov (United States)

    Ngure, Kenneth; Vusha, Sophie; Mugo, Nelly; Emmanuel-Fabula, Mira; Ngutu, Mariah; Celum, Connie; Baeten, Jared M; Heffron, Renee

    2016-12-01

    In spite of access to behavioral and biomedical HIV prevention strategies, HIV transmission occurs. For HIV-serodiscordant couples, prevention programs can be tailored to address individual and couples' needs to preserve their relationship while minimizing HIV risk. Programs for serodiscordant couples may benefit from learning from experiences of couples who transmit HIV. We conducted 20 individual in-depth interviews with 10 initially HIV-serodiscordant couples who transmitted HIV during prospective follow-up at a peri-urban research site in Thika, Kenya. Data were analyzed inductively to identify situations that led to prevention failure and coping mechanisms. Inconsistent condom use driven by low HIV risk perception and alcohol use often preceded seroconversion while persistent blame frequently hindered couples' communication soon after seroconversion. In this emerging era of antiretroviral-based HIV prevention, couples' counseling can capitalize on opportunities to foster a supportive environment to discuss initiation and adherence to time-limited pre-exposure prophylaxis and lifelong antiretroviral therapy, in addition to strategies to reduce alcohol use, diffuse blame, and use condoms.

  11. Geometric picture of quantum discord for two-qubit quantum states

    International Nuclear Information System (INIS)

    Shi Mingjun; Jiang Fengjian; Sun Chunxiao; Du Jiangfeng

    2011-01-01

    Among various definitions of quantum correlations, quantum discord has attracted considerable attention. To find an analytical expression for quantum discord is an intractable task. Exact results are known only for very special states, namely two-qubit X-shaped states. We present in this paper a geometric viewpoint, from which two-qubit quantum discord can be described clearly. The known results on X state discord are restated in the directly perceivable geometric language. As a consequence, the dynamics of classical correlations and quantum discord for an X state in the presence of decoherence is endowed with geometric interpretation. More importantly, we extend the geometric method to the case of more general states, for which numerical as well as analytical results on quantum discord have not yet been obtained. Based on the support of numerical computations, some conjectures are proposed to help us establish the geometric picture. We find that the geometric picture for these states has an intimate relationship with that for X states. Thereby, in some cases, analytical expressions for classical correlations and quantum discord can be obtained.

  12. Assisteret reproduktion ved HIV-infektion

    DEFF Research Database (Denmark)

    Kazlauskaite, Ramune; Østergaard, Lars; Laursen, Tinne

    2009-01-01

    horizontal nor vertical infection occurred. CONCLUSION: Our study confirms that insemination is a good first-choice treatment in respect to chance of pregnancy and risk for virus transmission in HIV-seropositive couples in cases without indication for IVF. Udgivelsesdato: 2009-Apr-27......INTRODUCTION: In Denmark assisted reproductive treatment to HIV discordant couples is offered in order to minimize risk of horizontal transmission of virus. MATERIAL AND METHODS: The outcome of 24 HIV-seropositive couples referred with a wish for parenthood to Aarhus University Hospital, Skejby......, between September 1999 and December 2007 was reviewed on the basis of prospectively collected data. A total of 18 couples were offered treatment. RESULTS: In all, eight couples achieved 17 pregnancies, six by home-insemination, ten by homologous intrauterine insemination, and one spontaneously. Neither...

  13. Discordance

    Science.gov (United States)

    Villa, I. M.; Hanchar, J. M.

    2013-12-01

    Half a century ago, discordant U-Pb ages of metamorphic zircon were viewed as Pb loss by diffusion. Various diffusionist schools of thought debated vigorously whether diffusion was episodic or continuous [1], but nobody questioned the reality of diffusive Pb loss. Only imaging by cathodoluminescence (CL) [2] and back-scattered electrons (BSE) [3] brought a paradigm change in U-Pb geochronology. In situ dating shows routinely accretion of young zircon rims onto older cores that never display Pb diffusion gradients across the interface. Other minerals (monazite, xenotime, etc.) show the same pattern: irregular patches of uniform age separated by sharp age gradients coinciding with petrologic boundaries. As U-Pb discordance is caused by diachronous, heterochemical mineral generations, zircon and monazite closure temperatures, and strict diffusionism, are irrelevant [4]. Knowing what to pay attention to, analytical protocols for U-Pb dating include both of the following: (i) CL/BSE characterization of phase mixtures; (ii) mass spectrometric analysis including U/Th ratios (and ideally trace element fingerprinting on the same fraction [5]). It is clear that the petrologic context is just as essential as mass spectrometry for accurate geochronology. The K-Ar community rarely uses imaging, and the tight context between microstructures, mineral chemistry, petrology and geochronology is missed. Yet the data would be clear if one looked for it. CL and/or BSE imaging and X-ray mapping of K-feldspar and micas is finding ubiquitous evidence of discrete patches of juxtaposed mineral generations. The Ca/Cl/K ratios in 39Ar-40Ar dating fulfill the same role as U/Th ratios in U-Pb dating for fingerprinting successive heterochemical mineral generations. Any linear correlation in a common-denominator three-isotope correlation diagram is certain evidence of binary mixing between heterochemical end-members. A correlation in a Ca/K vs Ar/K diagram requires two minerals having different

  14. Quantum discord dynamics of two qubits in single-mode cavities

    International Nuclear Information System (INIS)

    Wang Chen; Chen Qing-Hu

    2013-01-01

    The dynamics of quantum discord for two identical qubits in two independent single-mode cavities and a common single-mode cavity are discussed. For the initial Bell state with correlated spins, while the entanglement sudden death can occur, the quantum discord vanishes only at discrete moments in the independent cavities and never vanishes in the common cavity. Interestingly, quantum discord and entanglement show opposite behavior in the common cavity, unlike in the independent cavities. For the initial Bell state with anti-correlated spins, quantum discord and entanglement behave in the same way for both independent cavities and a common cavity. It is found that the detunings always stabilize the quantum discord. (general)

  15. Discordant non-invasive prenatal testing (NIPT)

    DEFF Research Database (Denmark)

    Hartwig, Tanja Schlaikjaer; Ambye, Louise; Sørensen, Steen

    2017-01-01

    biological or technical explanation for the discordant result. The included cases represent only a minor part of the true number of false positive or false negative NIPT cases identified in fetal medicine clinics around the world. To ensure knowledge exchange and transparency of NIPT between laboratories, we...... suggest a systematic recording of discordant NIPT results, as well as a quality assurance by external quality control and accreditation. © 2017 John Wiley & Sons, Ltd....

  16. Steady state quantum discord for circularly accelerated atoms

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Jiawei, E-mail: hujiawei@nbu.edu.cn [Center for Nonlinear Science and Department of Physics, Ningbo University, Ningbo, Zhejiang 315211 (China); Yu, Hongwei, E-mail: hwyu@hunnu.edu.cn [Center for Nonlinear Science and Department of Physics, Ningbo University, Ningbo, Zhejiang 315211 (China); Synergetic Innovation Center for Quantum Effects and Applications, Hunan Normal University, Changsha, Hunan 410081 (China)

    2015-12-15

    We study, in the framework of open quantum systems, the dynamics of quantum entanglement and quantum discord of two mutually independent circularly accelerated two-level atoms in interaction with a bath of fluctuating massless scalar fields in the Minkowski vacuum. We assume that the two atoms rotate synchronically with their separation perpendicular to the rotating plane. The time evolution of the quantum entanglement and quantum discord of the two-atom system is investigated. For a maximally entangled initial state, the entanglement measured by concurrence diminishes to zero within a finite time, while the quantum discord can either decrease monotonically to an asymptotic value or diminish to zero at first and then followed by a revival depending on whether the initial state is antisymmetric or symmetric. When both of the two atoms are initially excited, the generation of quantum entanglement shows a delayed feature, while quantum discord is created immediately. Remarkably, the quantum discord for such a circularly accelerated two-atom system takes a nonvanishing value in the steady state, and this is distinct from what happens in both the linear acceleration case and the case of static atoms immersed in a thermal bath.

  17. Knowledge of HIV serodiscordance, transmission, and prevention among couples in Durban, South Africa.

    Directory of Open Access Journals (Sweden)

    William Kilembe

    Full Text Available Couples' voluntary HIV counseling and testing (CVCT significantly decreases HIV transmission within couples, the largest risk group in sub-Saharan Africa, but it is not currently offered in most HIV testing facilities. To roll out such an intervention, understanding locale-specific knowledge barriers is critical. In this study, we measured knowledge of HIV serodiscordance, transmission, and prevention before and after receipt of CVCT services in Durban.Pre- and post-CVCT knowledge surveys were administered to a selection of individuals seeking CVCT services.Changes in knowledge scores were assessed with McNemar Chi-square tests for balanced data and generalized estimating equation methods for unbalanced data.The survey included 317 heterosexual black couples (634 individuals who were primarily Zulu (87%, unemployed (47%, and had at least a secondary level education (78%. 28% of couples proved to be discordant. Only 30% of individuals thought serodiscordance between couples was possible pre-CVCT compared to 95% post-CVCT. One-third thought there was at least one benefit of CVCT pre-CVCT, increasing to 96% post-CVCT. Overall, there were positive changes in knowledge about HIV transmission and prevention. However, many respondents thought all HIV positive mothers give birth to babies with AIDS (64% pre-CVCT, 59% post-CVCT and that male circumcision does not protect negative men against HIV (70% pre-CVCT, 67% post-CVCT.CVCT was well received and was followed by improvements in understanding of discordance, the benefits of joint testing, and HIV transmission. Country-level health messaging would benefit from targeting gaps in knowledge about serodiscordance, vertical transmission, and male circumcision.

  18. Characteristics of HIV-1 discordant couples enrolled in a trial of HSV-2 suppression to reduce HIV-1 transmission: the partners study.

    Directory of Open Access Journals (Sweden)

    Jairam R Lingappa

    Full Text Available The Partners HSV-2/HIV-1 Transmission Study (Partners Study is a phase III, placebo-controlled trial of daily acyclovir for genital herpes (HSV-2 suppression among HIV-1/HSV-2 co-infected persons to reduce HIV-1 transmission to their HIV-1 susceptible partners, which requires recruitment of HIV-1 serodiscordant heterosexual couples. We describe the baseline characteristics of this cohort.HIV-1 serodiscordant heterosexual couples, in which the HIV-1 infected partner was HSV-2 seropositive, had a CD4 count >or=250 cells/mcL and was not on antiretroviral therapy, were enrolled at 14 sites in East and Southern Africa. Demographic, behavioral, clinical and laboratory characteristics were assessed.Of the 3408 HIV-1 serodiscordant couples enrolled, 67% of the HIV-1 infected partners were women. Couples had cohabitated for a median of 5 years (range 2-9 with 28% reporting unprotected sex in the month prior to enrollment. Among HIV-1 susceptible participants, 86% of women and 59% of men were HSV-2 seropositive. Other laboratory-diagnosed sexually transmitted infections were uncommon (500 relative to <350, respectively, p<0.001.The Partners Study successfully enrolled a cohort of 3408 heterosexual HIV-1 serodiscordant couples in Africa at high risk for HIV-1 transmission. Follow-up of this cohort will evaluate the efficacy of acyclovir for HSV-2 suppression in preventing HIV-1 transmission and provide insights into biological and behavioral factors determining heterosexual HIV-1 transmission.ClinicalTrials.gov NCT00194519.

  19. Relating quantum discord with the quantum dense coding capacity

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xin; Qiu, Liang, E-mail: lqiu@cumt.edu.cn; Li, Song; Zhang, Chi [China University of Mining and Technology, School of Sciences (China); Ye, Bin [China University of Mining and Technology, School of Information and Electrical Engineering (China)

    2015-01-15

    We establish the relations between quantum discord and the quantum dense coding capacity in (n + 1)-particle quantum states. A necessary condition for the vanishing discord monogamy score is given. We also find that the loss of quantum dense coding capacity due to decoherence is bounded below by the sum of quantum discord. When these results are restricted to three-particle quantum states, some complementarity relations are obtained.

  20. Relating quantum discord with the quantum dense coding capacity

    International Nuclear Information System (INIS)

    Wang, Xin; Qiu, Liang; Li, Song; Zhang, Chi; Ye, Bin

    2015-01-01

    We establish the relations between quantum discord and the quantum dense coding capacity in (n + 1)-particle quantum states. A necessary condition for the vanishing discord monogamy score is given. We also find that the loss of quantum dense coding capacity due to decoherence is bounded below by the sum of quantum discord. When these results are restricted to three-particle quantum states, some complementarity relations are obtained

  1. Group Sex Events and HIV/STI Risk in an Urban Network

    Science.gov (United States)

    Friedman, Samuel R.; Bolyard, Melissa; Khan, Maria; Maslow, Carey; Sandoval, Milagros; Mateu-Gelabert, Pedro; Krauss, Beatrice; Aral, Sevgi O.

    2012-01-01

    Objectives To describe: a. the prevalence and individual and network characteristics of group sex events (GSE) and GSE attendees; and b. HIV/STI discordance among respondents who said they went to a GSE together. Methods and Design In a sociometric network study of risk partners (defined as sexual partners, persons with whom respondents attended a GSE, or drug-injection partners) in Brooklyn, NY, we recruited a high-risk sample of 465 adults. Respondents reported on GSE attendance, the characteristics of GSEs, and their own and others’ behaviors at GSEs. Sera and urines were collected and STI prevalence was assayed. Results Of the 465 participants, 36% had attended a GSE in the last year, 26% had sex during the most recent of these GSEs, and 13% had unprotected sex there. Certain subgroups (hard drug users, men who have sex with men, women who have sex with women, and sex workers) were more likely to attend and more likely to engage in risk behaviors at these events. Among 90 GSE dyads in which at least one partner named the other as someone with whom they attended a GSE in the previous three months, STI/HIV discordance was common (HSV-2: 45% of dyads, HIV: 12% of dyads, Chlamydia: 21% of dyads). Many GSEs had 10 or more participants, and multiple partnerships at GSEs were common. High attendance rates at GSEs among members of large networks may increase community vulnerability to STI/HIV, particularly since network data show that almost all members of a large sociometric risk network either had sex with a GSE attendee or had sex with someone who had sex with a GSE attended. Conclusions Self-reported GSE attendance and participation was common among this high-risk sample. STI/HIV discordance among GSE attendees was high, highlighting the potential transmission risk associated with GSEs. Research on sexual behaviors should incorporate measures of GSE behaviors as standard research protocol. Interventions should be developed to reduce transmission at GSEs. PMID

  2. Epigenetic signature of birth weight discordance in adult twins

    DEFF Research Database (Denmark)

    Tan, Qihua; Nielsen, Morten Frost Munk; Heijmans, Bastiaan T

    2014-01-01

    between birth weight and adult life health while controlling for not only genetics but also postnatal rearing environment. We performed an epigenome-wide profiling on blood samples from 150 pairs of adult monozygotic twins discordant for birth weight to look for molecular evidence of epigenetic signatures...... profiling did not reveal epigenetic signatures of birth weight discordance although some sites displayed age-dependent intra-pair differential methylation in the extremely discordant twin pairs....

  3. Routine HIV Testing of Family Members of Hospitalized Patients in Nigeria

    Directory of Open Access Journals (Sweden)

    Olusegun Busari

    2012-04-01

    Full Text Available Background: HIV testing for family members of HIV-positive patients may enhance disclosure of status of spouses, encourage family social support and improve access to HIV services. Objective was to employ the approach of routine HIV testing to determine the prevalence of HIV among family members of both HIV positive and negative patients on admission in a federal HIV treatment designated hospital in Western Nigeria Methodology: This prospective study was conducted between January 2006 and June 2009. Ethical clearance was obtained from the Research and Ethics committee of the hospital prior to the study. Informed consent was obtained from each participant. HIV testing was offered to consenting family members of HIV positive and negative patients on admission. The family members included spouses, children of patients, parents of paediatric patients and other family members. Analysis was done in frequencies and percentages Results: 162 family members of 184 patients were tested. Spouses were, 81 (50.0%; fathers, 14 (8.6%; mothers, 20 (12.3%; children, 19 (11.7% and others family members, 28 (17.3%. 151 (93.2% of testers were first timers. Majority of those tested (82.1% had post-test counseling. The overall HIV prevalence was 12.3% (20/162. HIV prevalence within different family members was 14.8% (12/81, 20% (4/20, 7.1% (1/14, 10.5% (2/19 and 3.6% (1/28 for spouses, mothers, fathers, children and others respectively.In addition, the prevalence of HIV among family members of HIV positive and negative patients was 15.6% (14/90 and 8.3% (6/72 respectively. Of 12 spouses that were positive, 7 (13.5% were HIV-discordant; and in 71.4% (5/7 of discordant couples, the spouse was positive while the patient on admission was negative. Conclusion: The results indicate that routine HIV testing of family members of patients on admission is a strategy for identification of vast number of HIV infected persons. This method is not only innovative, but also a novel

  4. Operational meaning of discord in terms of teleportation fidelity

    Science.gov (United States)

    Adhikari, Satyabrata; Banerjee, Subhashish

    2012-12-01

    Quantum discord is a prominent measure of quantum correlations, playing an important role in expanding its horizon beyond entanglement. Here we provide an operational meaning of (geometric) discord, which quantifies the amount of nonclassical correlations of an arbitrary quantum system based on its minimal distance from the set of classical states, in terms of teleportation fidelity for general two-qubit and (d⊗d)-dimensional isotropic and Werner states. A critical value of the discord is found beyond which the two-qubit state must violate Bell's inequality. This is illustrated by an open-system model of a dissipative two-qubit state. For the (d⊗d)-dimensional states the lower bound of discord is shown to be obtainable from an experimentally measurable witness operator.

  5. Quantum Discord in Two-Qubit System Constructed from the Yang—Baxter Equation

    International Nuclear Information System (INIS)

    Gou Li-Dan; Wang Xiao-Qian; Sun Yuan-Yuan; Xu Yu-Mei

    2014-01-01

    Quantum correlations among parts of a composite quantum system are a fundamental resource for several applications in quantum information. In general, quantum discord can measure quantum correlations. In that way, we investigate the quantum discord of the two-qubit system constructed from the Yang—Baxter Equation. The density matrix of this system is generated through the unitary Yang—Baxter matrix R. The analytical expression and numerical result of quantum discord and geometric measure of quantum discord are obtained for the Yang—Baxter system. These results show that quantum discord and geometric measure of quantum discord are only connect with the parameter θ, which is the important spectral parameter in Yang—Baxter equation. (general)

  6. Quantum discord of Bell cat states under amplitude damping

    International Nuclear Information System (INIS)

    Daoud, M; Laamara, R Ahl

    2012-01-01

    The evolution of pairwise quantum correlations of Bell cat states under amplitude damping is examined using the concept of quantum discord which goes beyond entanglement. A closed expression of the quantum discord is explicitly derived. We used the Koashi–Winter relation, a relation which facilitates the optimization process of the conditional entropy. We also discuss the temporal evolution of bipartite quantum correlations under a dephasing channel and compare the behaviors of quantum discord and entanglement whose properties are characterized through the concurrence. (paper)

  7. Discord as a quantum resource for bi-partite communication

    International Nuclear Information System (INIS)

    Chrzanowski, Helen M.; Assad, Syed M.; Symul, Thomas; Lam, Ping Koy; Gu, Mile; Modi, Kavan; Vedral, Vlatko; Ralph, Timothy C.

    2014-01-01

    Coherent interactions that generate negligible entanglement can still exhibit unique quantum behaviour. This observation has motivated a search beyond entanglement for a complete description of all quantum correlations. Quantum discord is a promising candidate. Here, we experimentally demonstrate that under certain measurement constraints, discord between bipartite systems can be consumed to encode information that can only be accessed by coherent quantum interactions. The inability to access this information by any other means allows us to use discord to directly quantify this ‘quantum advantage’

  8. Case report: Suspected clinical-radiological discord

    Directory of Open Access Journals (Sweden)

    Martin Tombe

    2013-02-01

    Full Text Available 17-year male student presented with vague constitutional symptoms and jaundice. His clinical chest findings initially suggested a discord with radiological findings. It turned out that the patient had a rare congenital disorder in addition to a seemingly common condition that brought him to the hospital. The purpose of this case presentation is to share some challenges of a clinical-radiological discord in a teaching hospital in Zimbabwe. It shows a flow of teamwork from House Officers to the Consultants as well as radiological back up.

  9. The sudden death and sudden birth of quantum discord.

    Science.gov (United States)

    Xia, Wei; Hou, Jin-Xing; Wang, Xiao-Hui; Liu, Si-Yuan

    2018-03-28

    The interaction of quantum system and its environment brings out abundant quantum phenomenons. The sudden death of quantum resources, including entanglement, quantum discord and coherence, have been studied from the perspective of quantum breaking channels (QBC). QBC of quantum resources reveal the common features of quantum resources. The definition of QBC implies the relationship between quantum resources. However, sudden death of quantum resources can also appear under some other quantum channels. We consider the dynamics of Bell-diagonal states under a stochastic dephasing noise along the z-direction, and the sudden death and sudden birth of quantum discord are investigated. Next we explain this phenomenon from the geometric structure of quantum discord. According to the above results, the states with sudden death and sudden birth can be filtered in three-parameter space. Then we provide two necessary conditions to judge which kind of noise channels can make Bell-diagonal states sudden death and sudden birth. Moreover, the relation between quantum discord and coherence indicates that the sudden death and sudden birth of quantum discord implies the sudden death and sudden birth of coherence in an optimal basis.

  10. Longitudinal weight differences, gene expression, and blood biomarkers in BMI discordant identical twins

    Science.gov (United States)

    van Dongen, Jenny; Willemsen, Gonneke; Heijmans, Bastiaan T.; Neuteboom, Jacoline; Kluft, Cornelis; Jansen, Rick; Penninx, Brenda W.J.; Slagboom, P. Eline; de Geus, Eco J.C.; Boomsma, Dorret I.

    2015-01-01

    Background BMI discordant monozygotic (MZ) twins allows an examination of the causes and consequences of adiposity in a genetically controlled design. Few studies have examined longitudinal BMI discordance in MZ pairs. Objectives To study the development over time of BMI discordance in adolescent and adult MZ twin pairs, and to examine lifestyle, metabolic, inflammatory, and gene expression differences associated with concurrent and long-term BMI discordance in MZ pairs. Subjects/Methods BMI data from 2775 MZ twin pairs, collected in eight longitudinal surveys and a biobank project between 1991 and 2011, were analyzed to characterize longitudinal discordance. Lifestyle characteristics were compared within discordant pairs (ΔBMI ≥ 3 kg/m2) and biomarkers (lipids, glucose, insulin, CRP, fibrinogen, IL-6, TNF-α and sIL-6R and liver enzymes AST, ALT and GGT) and gene expression were compared in peripheral blood from discordant pairs who participated in the NTR biobank project. Results The prevalence of discordance ranged from 3.2% in 1991 (mean age=17, SD=2.4) to 17.4% (N=202 pairs) in 2009 (mean age=35, SD=15), and was 16.5% (N=174) among pairs participating in the biobank project (mean age=35, SD=12). Of 699 MZ with BMI data from 3-5 time points, 17 pairs (2.4%) were long-term discordant (at all available time points; mean follow-up range=6.4 years). Concurrently discordant pairs showed significant differences in self-ratings of which twin eats most (p=2.3×10−13), but not in leisure time exercise activity (p=0.28) and smoking (p>0.05). Ten out of 14 biomarkers showed significantly more unfavorable levels in the heavier of twin of the discordant pairs (p-values BMI discordance is uncommon in adolescent identical pairs but increases with higher pair-mean of BMI at older ages, although long-term BMI discordance is rare. In discordant pairs, the heavier twin had a more unfavorable blood biomarker profile than the genetically matched leaner twin, in support of

  11. Epidemiology of discordance between symptoms and signs of dry eye.

    Science.gov (United States)

    Ong, Erin S; Felix, Elizabeth R; Levitt, Roy C; Feuer, William J; Sarantopoulos, Constantine D; Galor, Anat

    2018-05-01

    The frequent lack of association between dry eye (DE) symptoms and signs leads to challenges in diagnosing and assessing the disease. Participants underwent ocular surface examinations to evaluate signs of disease and completed questionnaires to assess ocular symptoms, psychological status and medication use. To assess nociceptive system integrity, quantitative sensory testing (QST), including vibratory and thermal threshold measures and temporal summation of pain were obtained at the forearm and forehead. Correlations between DE discordance score (degree of discrepancy between symptom severity and DE signs) and patient characteristics were determined. Higher discordance scores indicated more symptoms than signs. 326 patients participated (mean age: 62 years; SD: 10 years; 92% men). Age was negatively correlated with DE discordance score (Pearson r=-0.30, p<0.0005), while mental health indices were positively correlated. Chronic pain elsewhere in the body (ie, non-ocular pain conditions) and intensity ratings of prolonged aftersensations of pain evoked by noxious hot and cold stimuli were also significantly correlated with DE discordance score. Multiple linear regression demonstrated that post-traumatic stress disorder and non-ocular pain intensity were important predictors of DE discordance score, Dry Eye Questionnaire-5 and Ocular Surface Disease Index and that DE discordance was also sensitive to QST as well. The present study provides evidence that the degree of discordance between DE symptom report and measurable signs of ocular surface disease is associated with comorbidities related to clinical pain and to hyperalgesia as demonstrated with QST. Understanding the epidemiology of DE discordance can aid in interpreting the DE exam and individualising treatment. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. The STS-constructivist reform: some discordant notes | Nworgu ...

    African Journals Online (AJOL)

    It would appear that as many more voices join in the advocacy for STS constructivist Reform in science teaching/learning, more discordant notes are emitted. The purpose of the paper therefore, was to spotlight some of these discordant notes emitted in the course of the on-going reform advocacy. Specifically, three of such ...

  13. Birth weight discordance and perinatal mortality among triplets

    Directory of Open Access Journals (Sweden)

    Egić Amira

    2005-01-01

    Full Text Available INTRODUCTION. The incidence of multiple births has increased in the last decade. Perinatal mortality in triplets is significantly greater than in twin and singleton births. OBJECTIVE. The objective of this study was to describe the extent of birth weight discordance among triplets and to identify its association with an increased risk of perinatal mortality. METHOD A retrospective analysis of triplet births, for the period 1993-2003, was conducted at the Gynaecological-Obstetric Clinic "Narodni Front" in Belgrade. Birth weight discordance was defined as the difference in birth weight between the largest and the smallest triplet's weight of more than 20%. RESULTS. The rate of triplets has increased by almost 75% between the first (7.7% and the last (29.6% 5-year period of the last decade. Triplets are becoming more common because of the frequent use of assisted reproductive technology as a treatment for infertility. In the period 1993-2003, there were a total of 40 triplet live births (24 weeks and greater with incidence of 0.06%. There was no clear association between maternal age, parity, method of conception, birth gestational age, and disorders complicating pregnancy with birth discordance more than 20%. Regarding birth weight groups, statistical significance occurred only in the <999 grams group for discordant and in the 2000-2499 grams group for concordant triplets. Overall, the perinatal mortality rate in the group was 10.8%, the foetal mortality rate was 1.7% (2/120, and the neonatal (0-28 days mortality rate was 9.1% (11/120. An odds ratio of 95% confidence interval shows 3 times greater risk for adverse perinatal outcome in the discordant group. However, the difference was not significant. CONCLUSION. Increasing birth weight discordance may increase the risk of adverse perinatal outcome. Triplet pregnancies, being high risk, require intensive antenatal care in order to prevent preterm delivery and ultrasound in order to diagnose foetal

  14. Lipid discordance and carotid plaque in obese patients in primary prevention.

    Science.gov (United States)

    Masson, Walter; Siniawski, Daniel; Lobo, Martín; Molinero, Graciela

    2018-01-01

    Obese patients with lipid discordance (non-HDL cholesterol levels 30mg/dL above the LDL-c value) may have a greater prevalence of carotid atherosclerotic plaque (CAP). Our study objectives were: 1) To assess the prevalence of lipid discordance in a primary prevention population of obese patients; 2) To investigate the association between lipid discordance and presence of CAP. Obese subjects aged >18 years (BMI ≥30kg/m 2 ) with no cardiovascular disease, diabetes, or lipid-lowering treatment from six cardiology centers were included. Lipid discordance was defined when, regardless of the LDL-c level, the non-HDL cholesterol value exceeded the LDL-c value by 30mg/dL. Presence of CAP was identified by ultrasonography. Univariate and multivariate analyses were performed to explore the association between lipid discordance and presence of CAP. The study simple consisted of 325 obese patients (57.2% men; mean age, 52.3 years). Prevalence of lipid discordance was 57.9%. CAP was found in 38.6% of patients, but the proportion was higher in subjects with lipid discordance as compared to those without this lipid pattern (44.4% vs. 30.7%, P=.01). In both the univariate (OR: 1.80; 95% CI: 1.14-2.87; P=.01) and the multivariate analysis (OR: 2.07; 95% CI: 1.22-3.54; P=.007), presence of lipid discordance was associated to an increased probability of CAP. In these obese patients, lipid discordance was associated to greater prevalence of CAP. Evaluation of obese patients with this strategy could help identify subjects with higher residual cardiovascular risk. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Definition of intertwin birth weight discordance.

    Science.gov (United States)

    Breathnach, Fionnuala M; McAuliffe, Fionnuala M; Geary, Michael; Daly, Sean; Higgins, John R; Dornan, James; Morrison, John J; Burke, Gerard; Higgins, Shane; Dicker, Patrick; Manning, Fiona; Mahony, Rhona; Malone, Fergal D

    2011-07-01

    To establish the level of birth weight discordance at which perinatal morbidity increases in monochorionic and dichorionic twin pregnancy. This prospective multicenter cohort study included 1,028 unselected twin pairs recruited over a 2-year period. Participants underwent two weekly ultrasonographic surveillance from 24 weeks of gestation with surveillance of monochorionic twins two-weekly from 16 weeks. Analysis using Cox proportional hazards compared a composite measure of perinatal morbidity (including any of the following: mortality, respiratory distress syndrome, hypoxic-ischemic encephalopathy, periventricular leukomalacia, necrotizing enterocolitis, or sepsis) at different degrees of birth weight discordance with adjustment for chorionicity, gestational age, twin-twin transfusion syndrome, birth order, gender, and growth restriction. Perinatal outcome data were recorded for 977 patients (100%) who continued the study with both fetuses alive beyond 24 weeks, including 14 cases of twin-twin transfusion syndrome. Adjusting for gestation at delivery, twin order, gender, and growth restriction, perinatal mortality, individual morbidity, and composite perinatal morbidity were all seen to increase with birth weight discordance exceeding 18% for dichorionic pairs (hazard ratio 2.2, 95% confidence interval [CI] 1.6-2.9, Pbirth weights were appropriate for gestational age. : The threshold for birth weight discordance established by this prospective study is 18% both for dichorionic twin pairs and for monochorionic twins without twin-twin transfusion syndrome. This threshold is considerably lower than that defined by many retrospective series as pathologic. We suggest that an anticipated difference of 18% in birth weight should prompt more intensive fetal monitoring.

  16. Thermal quantum discord of spins in an inhomogeneous magnetic field

    International Nuclear Information System (INIS)

    Guo Jinliang; Mi Yingjuan; Zhang Jian; Song Heshan

    2011-01-01

    In contrast with the thermal entanglement, we study the quantum discord and classical correlation in a two-qubit Heisenberg XXZ model with an inhomogeneous magnetic field. It is shown that the effects of the external magnetic fields, including the uniform and inhomogeneous magnetic fields, on the thermal entanglement, quantum discord and classical correlation behave differently in various aspects, which depend on system temperature and model type. We can tune the inhomogeneous magnetic field to enhance the entanglement or classical correlation and meanwhile decrease the quantum discord. In addition, taking into account the inhomogeneous magnetic field, the sudden change in the behaviour of quantum discord still survives, which can detect the critical points of quantum phase transitions at finite temperature, but not for a uniform magnetic field.

  17. Theorizing "Big Events" as a potential risk environment for drug use, drug-related harm and HIV epidemic outbreaks.

    Science.gov (United States)

    Friedman, Samuel R; Rossi, Diana; Braine, Naomi

    2009-05-01

    Political-economic transitions in the Soviet Union, Indonesia, and China, but not the Philippines, were followed by HIV epidemics among drug users. Wars also may sometimes increase HIV risk. Based on similarities in some of the causal pathways through which wars and transitions can affect HIV risk, we use the term "Big Events" to include both. We first critique several prior epidemiological models of Big Events as inadequately incorporating social agency and as somewhat imprecise and over-generalizing in their sociology. We then suggest a model using the following concepts: first, event-specific HIV transmission probabilities are functions of (a) the probability that partners are infection-discordant; (b) the infection-susceptibility of the uninfected partner; (c) the infectivity of the infected--as well as (d) the behaviours engaged in. These probabilities depend on the distributions of HIV and other variables in populations. Sexual or injection events incorporate risk behaviours and are embedded in sexual and injection partnership patterns and community networks, which in turn are shaped by the content of normative regulation in communities. Wars and transitions can change socio-economic variables that can sometimes precipitate increases in the numbers of people who engage in high-risk drug and sexual networks and behaviours and in the riskiness of what they do. These variables that Big Events affect may include population displacement; economic difficulties and policies; police corruption, repressiveness, and failure to preserve order; health services; migration; social movements; gender roles; and inter-communal violence--which, in turn, affect normative regulation, youth alienation, networks and behaviours. As part of these pathways, autonomous action by neighbourhood residents, teenagers, drug users and sex workers to maintain their economic welfare, health or happiness may affect many of these variables or otherwise mediate whether HIV epidemics follow

  18. Gut Microbiota Linked to Sexual Preference and HIV Infection

    Directory of Open Access Journals (Sweden)

    Marc Noguera-Julian

    2016-03-01

    Full Text Available The precise effects of HIV-1 on the gut microbiome are unclear. Initial cross-sectional studies provided contradictory associations between microbial richness and HIV serostatus and suggested shifts from Bacteroides to Prevotella predominance following HIV-1 infection, which have not been found in animal models or in studies matched for HIV-1 transmission groups. In two independent cohorts of HIV-1-infected subjects and HIV-1-negative controls in Barcelona (n = 156 and Stockholm (n = 84, men who have sex with men (MSM predominantly belonged to the Prevotella-rich enterotype whereas most non-MSM subjects were enriched in Bacteroides, independently of HIV-1 status, and with only a limited contribution of diet effects. Moreover, MSM had a significantly richer and more diverse fecal microbiota than non-MSM individuals. After stratifying for sexual orientation, there was no solid evidence of an HIV-specific dysbiosis. However, HIV-1 infection remained consistently associated with reduced bacterial richness, the lowest bacterial richness being observed in subjects with a virological-immune discordant response to antiretroviral therapy. Our findings indicate that HIV gut microbiome studies must control for HIV risk factors and suggest interventions on gut bacterial richness as possible novel avenues to improve HIV-1-associated immune dysfunction.

  19. Hospital care for persons with AIDS in the European Union

    NARCIS (Netherlands)

    Postma, Maarten; Tolley, K; Leidl, R M; Downs, A M; Beck, E J; Tramarin, A M; Flori, Y A; Santin, M; Antoñanzas, F; Kornarou, H; Paparizos, V C; Dijkgraaf, M G; Borleffs, J; Luijben, A J; Jager, J C

    This study estimates the current and future hospital resources for AIDS patients in the European Union (EU), using multinational scenario analysis (EU Concerted Action BMH1-CT-941723). In collaboration with another EU-project ('Managing the Costs of HIV Infection'), six national European studies on

  20. HIV drug resistance testing among patients failing second line antiretroviral therapy. Comparison of in-house and commercial sequencing.

    Science.gov (United States)

    Chimukangara, Benjamin; Varyani, Bhavini; Shamu, Tinei; Mutsvangwa, Junior; Manasa, Justen; White, Elizabeth; Chimbetete, Cleophas; Luethy, Ruedi; Katzenstein, David

    2017-05-01

    HIV genotyping is often unavailable in low and middle-income countries due to infrastructure requirements and cost. We compared genotype resistance testing in patients with virologic failure, by amplification of HIV pol gene, followed by "in-house" sequencing and commercial sequencing. Remnant plasma samples from adults and children failing second-line ART were amplified and sequenced using in-house and commercial di-deoxysequencing, and analyzed in Harare, Zimbabwe and at Stanford, U.S.A, respectively. HIV drug resistance mutations were determined using the Stanford HIV drug resistance database. Twenty-six of 28 samples were amplified and 25 were successfully genotyped. Comparison of average percent nucleotide and amino acid identities between 23 pairs sequenced in both laboratories were 99.51 (±0.56) and 99.11 (±0.95), respectively. All pairs clustered together in phylogenetic analysis. Sequencing analysis identified 6/23 pairs with mutation discordances resulting in differences in phenotype, but these did not impact future regimens. The results demonstrate our ability to produce good quality drug resistance data in-house. Despite discordant mutations in some sequence pairs, the phenotypic predictions were not clinically significant. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Experimental verification of quantum discord in continuous-variable states

    International Nuclear Information System (INIS)

    Hosseini, S; Haw, J Y; Assad, S M; Chrzanowski, H M; Janousek, J; Symul, T; Lam, P K; Rahimi-Keshari, S; Ralph, T C

    2014-01-01

    We introduce a simple and efficient technique to verify quantum discord in unknown Gaussian states and a certain class of non-Gaussian states. We show that any separation in the peaks of the marginal distributions of one subsystem conditioned on two different outcomes of homodyne measurements performed on the other subsystem indicates correlation between the corresponding quadratures, and hence nonzero discord. We also apply this method to non-Gaussian states that are prepared by overlapping a statistical mixture of coherent and vacuum states on a beam splitter. We experimentally demonstrate this technique by verifying nonzero quantum discord in a bipartite Gaussian and certain non-Gaussian states. (paper)

  2. Interpreting quantum discord through quantum state merging

    International Nuclear Information System (INIS)

    Madhok, Vaibhav; Datta, Animesh

    2011-01-01

    We present an operational interpretation of quantum discord based on the quantum state merging protocol. Quantum discord is the markup in the cost of quantum communication in the process of quantum state merging, if one discards relevant prior information. Our interpretation has an intuitive explanation based on the strong subadditivity of von Neumann entropy. We use our result to provide operational interpretations of other quantities like the local purity and quantum deficit. Finally, we discuss in brief some instances where our interpretation is valid in the single-copy scenario.

  3. Intrapair birthweight discordance in twins

    African Journals Online (AJOL)

    2009-10-05

    The prevalence of birthweight discordance was 28.8% when a 15% cut-off point was used but dropped to. 9.6% when a 25% cut-off point was applied. Grand multiparity was associated with a significantly increased risk.

  4. Comparison of the attempts of quantum discord and quantum entanglement to capture quantum correlations

    International Nuclear Information System (INIS)

    Qasimi, Asma Al-; James, Daniel F. V.

    2011-01-01

    Measurements of quantum systems disturb their states. To quantify this nonclassical characteristic, Zurek and Ollivier [Phys. Rev. Lett. 88, 017901 (2001)] introduced the quantum discord, a quantum correlation that can be nonzero even when entanglement in the system is zero. Discord has aroused great interest as a resource that is more robust against the effects of decoherence and offers the exponential speed-up of certain computational algorithms. Here, we study general two-level bipartite systems and give general results on the relationship between discord, entanglement, and linear entropy. We also identify the states for which discord takes a maximal value for a given entropy or entanglement, thus placing strong bounds on entanglement-discord and entropy-discord relations. We find out that although discord and entanglement are identical for pure states, they differ when generalized to mixed states as a result of the difference in the method of generalization.

  5. HIV and dyadic intervention: an interdependence and communal coping analysis.

    Directory of Open Access Journals (Sweden)

    Catherine M Montgomery

    Full Text Available The most common form of HIV transmission in sub-Saharan Africa is heterosexual sex between two partners. While most HIV prevention interventions are aimed at the individual, there is mounting evidence of the feasibility, acceptability, and efficacy of dyadic interventions. However, the mechanisms through which dyadic-level interventions achieve success remain little explored. We address this gap by using Lewis et al's interdependence model of couple communal coping and behaviour change to analyse data from partners participating in an HIV prevention trial in Uganda and Zambia.We conducted a comparative qualitative study using in-depth interviews. Thirty-three interviews were conducted in total; ten with couples and twenty-three with staff members at the two sites. The Ugandan site recruited a sero-discordant couple cohort and the Zambian site recruited women alone. Spouses' transformation of motivation is strong where couples are recruited and both partners stand to gain considerably by participating in the research; it is weaker where this is not the case. As such, coping mechanisms differ in the two sites; among sero-discordant couples in Uganda, communal coping is evidenced through joint consent to participate, regular couple counselling and workshops, sharing of HIV test results, and strong spousal support for adherence and retention. By contrast, coping at the Zambian site is predominantly left to the individual woman and occurs against a backdrop of mutual mistrust and male disenfranchisement. We discuss these findings in light of practical and ethical considerations of recruiting couples to HIV research.We argue for the need to consider the broader context within which behaviour change occurs and propose that future dyadic research be situated within the framework of the 'risk environment'.

  6. Evaluation of the HIV lay counselling and testing profession in South Africa.

    Science.gov (United States)

    Mwisongo, Aziza; Mehlomakhulu, Vuyelwa; Mohlabane, Neo; Peltzer, Karl; Mthembu, Jacque; Van Rooyen, Heidi

    2015-07-22

    With the launch of the national HIV Counselling and Testing (HCT) campaign in South Africa (SA), lay HIV counsellors, who had been trained in blood withdrawal, have taken up the role of HIV testing. This study evaluated the experiences, training, motivation, support, supervision, and workload of HIV lay counsellors and testers in South Africa. The aim was to identify gaps in their resources, training, supervision, motivation, and workload related to HCT services. In addition it explored their experiences with providing HIV testing under the task shifting context. The study was conducted in eight of South Africa's nine provinces. 32 lay counsellors were recruited from 67 HCT sites, and were interviewed using two questionnaires that included structured and semi-structured questions. One questionnaire focused on their role as HIV counsellors and the other on their role as HIV testers. Ninety-seven percent of counsellors reported that they have received training in counselling and testing. Many rated their training as more than adequate or adequate, with 15.6% rating it as not adequate. Respondents reported a lack of standardised counselling and testing training, and revealed gaps in counselling skills for specific groups such as discordant couples, homosexuals, older clients and children. They indicated health system barriers, including inadequate designated space for counselling, which compromises privacy and confidentiality. Lay counsellors carry the burden of counselling and testing nationally, and have other tasks such as administration and auxiliary duties due to staff shortages. This study demonstrates that HCT counselling and testing services in South Africa are mainly performed by lay counsellors and testers. They are challenged by inadequate work space, limited counselling skills for specific groups, a lack of standardised training policies and considerable administrative and auxiliary duties. To improve HCT services, there needs to be training needs with a

  7. Immuno-Virological Discordance and the Risk of NonAIDS and AIDS Events in a Large Observational Cohort of HIV-Patients in Europe

    DEFF Research Database (Denmark)

    Zoufaly, Alexander; Cozzi-Lepri, Alessandro; Reekie, Joanne

    2014-01-01

    The impact of immunosuppression despite virological suppression (immuno-virological discordance, ID) on the risk of developing fatal and non-fatal AIDS/non-AIDS events is unclear and remains to be elucidated....

  8. Monozygotic twins discordant for attention-deficit/hyperactivity disorder: ascertainment and clinical characteristics.

    Science.gov (United States)

    Sharp, Wendy S; Gottesman, Rebecca F; Greenstein, Deanna K; Ebens, Christen L; Rapoport, Judith L; Castellanos, F Xavier

    2003-01-01

    Nongenetic factors and phenomenology of attention-deficit/hyperactivity disorder (ADHD) were examined in monozygotic (MZ) twin pairs discordant for ADHD. Recruitment included telephone screening (n = 297 pairs), behavioral ratings obtained from parents and teachers (n = 59 pairs), and, finally, in-person assessment (n = 25 pairs; structured classroom observation, diagnostic interview, psychoeducational evaluation, birth record review, establishment of monozygosity, and anatomic brain imaging). Affected twins were further contrasted with previously studied affected singletons. Of the 25 MZ twin pairs qualifying for in-person evaluation, only 10 proved discordant for ADHD. Affected twins were mostly comparable with affected singletons on clinical measures, although fathers' self-ratings of childhood ADHD status were significantly lower in twins than in singletons. Discordance for ADHD in MZ twins appears to be ascribable to greater environmental discordance and decreased familiality. Despite these differences, affected twins were phenotypically comparable with affected singletons. Thus MZ twins discordant for ADHD, while rare, can inform research on the etiology and pathophysiology of this disorder.

  9. The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013

    DEFF Research Database (Denmark)

    Gourlay, Annabelle; Noori, Teymur; Pharris, Anastasia

    2017-01-01

    Background.: The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a "90-90-90" target to curb the human immunodeficiency virus (HIV) epidemic by 2020, but methods used to assess whether countries have reached this target are not standardized, hindering comparisons. Methods.: Through......% virally suppressed (60% of people living with HIV). Two countries achieved ≥90% for all stages, and more than half had reached ≥90% for at least 1 stage. Conclusions.: European Union countries are nearing the 90-90-90 target. Reducing the proportion undiagnosed remains the greatest barrier to achieving...... this target, suggesting that further efforts are needed to improve HIV testing rates. Standardizing methods to derive comparable continuums of care remains a challenge....

  10. Fasting plasma total ghrelin concentrations in monozygotic twins discordant for obesity.

    Science.gov (United States)

    Leskelä, Piia; Ukkola, Olavi; Vartiainen, Johanna; Rönnemaa, Tapani; Kaprio, Jaakko; Bouchard, Claude; Kesäniemi, Y Antero

    2009-02-01

    Ghrelin is a hormone that is involved in the regulation of food intake. Neuronal, endocrine, and genetic factors have been shown to regulate plasma ghrelin levels; but the determinants of fasting ghrelin concentrations are not yet fully understood. The main aim was to explore the roles of adiposity and genetic differences in determining fasting plasma total ghrelin levels. We measured total ghrelin levels in a population of 23 monozygotic twin pairs discordant for obesity. In addition, 2 variants of ghrelin gene, namely, Arg51Gln and Leu72Met, were genotyped in 3 populations of monozygotic twin pairs: 23 obesity-discordant, 43 lean-concordant, and 46 obesity-concordant twin pairs. In discordant twins, lean co-twins had higher fasting plasma total ghrelin levels (950 pg/mL, SD = 328 pg/mL) than obese twins (720 pg/mL, SD = 143 pg/mL; P = .003). Arg51Gln-polymorphism of the ghrelin gene was equally distributed between the twin groups. However, there were significant differences in genotype frequencies at the Leu72Met polymorphism between the discordant and obese-concordant groups (P = .003) and between the discordant and lean-concordant groups (P = .011), but not between the 2 concordant groups. In the discordant group, there were fewer Met carriers (4%) than among the obese (17%) or the lean-concordant groups (15%). Plasma total ghrelin levels are affected by acquired obesity independent of genetic background. The Leu72 allele is particularly common among monozygotic twins discordant for obesity, suggesting that this ghrelin allele is more permissive in the regulation of energy balance. The ghrelin gene may thus play a role in the regulation of variability of body weight, such that Leu72 allele carriers are more prone to weight variability in response to environmental factors.

  11. [Vulnerability to HIV infection in serodiscordant couples in Rio de Janeiro, Brazil].

    Science.gov (United States)

    Fernandes, Nilo Martinez; Hennington, Élida Azevedo; Bernardes, Jefferson de Souza; Grinsztejn, Beatriz G

    2017-06-01

    A new era in HIV/AIDS treatment began in 1996 with the advent of highly active antiretroviral therapy (HAART). The advent of these new medicines expanded the treatment resources and improved life expectancy and quality of life for persons living with HIV and AIDS, favoring the maintenance and initiation of relationships between partners with discordant HIV serological status. The main objective of this study with serodiscordant couples was to understand the three dimensions of vulnerability - programmatic, social, and individual - in these couples. The study, belonging to the field of social constructionism, used analysis of discursive practices and production of meanings. Forty in-depth interviews were conducted with couples followed in a clinical research institute. The main results include the lack of information on sexuality in the family and in schools, distorted knowledge on HIV prevention and transmission, inadequacies in HIV testing, and flaws in communicating test results.

  12. Subjects with Discordant Airways Obstruction: Lost between Spirometric Definitions of COPD

    Directory of Open Access Journals (Sweden)

    Bernd Lamprecht

    2011-01-01

    Full Text Available Background. Since the FEV1/FVC ratio declines with age, using the fixed ratio of 0.70 leads to overdiagnosis of COPD in older populations and underdiagnosis among young adults. Objective. To evaluate whether discordant obstructive cases (FEV1/FVC < 0.70 but ≥LLN are a healthy population or have clinical features that would place them at increased risk. Methods. We used post-bronchodilator spirometry data from the population-based Austrian Burden of Obstructive Lung Disease (BOLD study. Those with post-bronchodilator FEV1/FVC ratio discordant obstructive cases. Results. Discordant obstructive cases were more likely to be older, male and never-smokers. Additionally they had less respiratory symptoms and less severe impairment of FEV1. However, discordant obstructive cases reported significantly more often a diagnosis of heart disease than subjects with normal lung function (27.2% vs 7.3%, P=.015. Conclusion. The clinical profile of discordant obstructive cases includes potentially important comorbid disease.

  13. Do MZ twins have discordant experiences of friendship? A qualitative hypothesis-generating MZ twin differences study

    Science.gov (United States)

    Moran, Nicola; Plomin, Robert

    2017-01-01

    Using a qualitative monozygotic (MZ) twin differences design we explored whether adolescent MZ twins report discordant peer relationships and, if so, whether they perceive them as causes, consequences or correlates of discordant behaviour. We gathered free-response questionnaire data from 497 families and conducted in-depth telephone interviews with 97 of them. Within this dataset n = 112 families (23% of the sample) described discordant peer relationships. Six categories of discordance were identified (peer victimisation, peer rejection, fewer friends, different friends, different attitudes to friendship and dependence on co-twin). Participants described peer relationship discordance arising as a result of chance occurrences, enhanced vulnerability in one twin or discordant behaviour. Consequences of discordant peer relationships were seen as discordance in self-confidence, future plans, social isolation, mental health and interests. In all cases the twin with worse peer experiences was seen as having a worse outcome. Specific hypotheses are presented. PMID:28727730

  14. Quantum discord and quantum phase transition in spin chains

    OpenAIRE

    Dillenschneider, Raoul

    2008-01-01

    Quantum phase transitions of the transverse Ising and antiferromagnetic XXZ spin S=1/2 chains are studied using quantum discord. Quantum discord allows the measure of quantum correlations present in many-body quantum systems. It is shown that the amount of quantum correlations increases close to the critical points. The observations are in agreement with the information provided by the concurrence which measures the entanglement of the many-body system.

  15. Geometric measure of pairwise quantum discord for superpositions of multipartite generalized coherent states

    International Nuclear Information System (INIS)

    Daoud, M.; Ahl Laamara, R.

    2012-01-01

    We give the explicit expressions of the pairwise quantum correlations present in superpositions of multipartite coherent states. A special attention is devoted to the evaluation of the geometric quantum discord. The dynamics of quantum correlations under a dephasing channel is analyzed. A comparison of geometric measure of quantum discord with that of concurrence shows that quantum discord in multipartite coherent states is more resilient to dissipative environments than is quantum entanglement. To illustrate our results, we consider some special superpositions of Weyl–Heisenberg, SU(2) and SU(1,1) coherent states which interpolate between Werner and Greenberger–Horne–Zeilinger states. -- Highlights: ► Pairwise quantum correlations multipartite coherent states. ► Explicit expression of geometric quantum discord. ► Entanglement sudden death and quantum discord robustness. ► Generalized coherent states interpolating between Werner and Greenberger–Horne–Zeilinger states

  16. Geometric measure of pairwise quantum discord for superpositions of multipartite generalized coherent states

    Energy Technology Data Exchange (ETDEWEB)

    Daoud, M., E-mail: m_daoud@hotmail.com [Department of Physics, Faculty of Sciences, University Ibnou Zohr, Agadir (Morocco); Ahl Laamara, R., E-mail: ahllaamara@gmail.com [LPHE-Modeling and Simulation, Faculty of Sciences, University Mohammed V, Rabat (Morocco); Centre of Physics and Mathematics, CPM, CNESTEN, Rabat (Morocco)

    2012-07-16

    We give the explicit expressions of the pairwise quantum correlations present in superpositions of multipartite coherent states. A special attention is devoted to the evaluation of the geometric quantum discord. The dynamics of quantum correlations under a dephasing channel is analyzed. A comparison of geometric measure of quantum discord with that of concurrence shows that quantum discord in multipartite coherent states is more resilient to dissipative environments than is quantum entanglement. To illustrate our results, we consider some special superpositions of Weyl–Heisenberg, SU(2) and SU(1,1) coherent states which interpolate between Werner and Greenberger–Horne–Zeilinger states. -- Highlights: ► Pairwise quantum correlations multipartite coherent states. ► Explicit expression of geometric quantum discord. ► Entanglement sudden death and quantum discord robustness. ► Generalized coherent states interpolating between Werner and Greenberger–Horne–Zeilinger states.

  17. Using provider performance incentives to increase HIV testing and counseling services in Rwanda.

    Science.gov (United States)

    de Walque, Damien; Gertler, Paul J; Bautista-Arredondo, Sergio; Kwan, Ada; Vermeersch, Christel; de Dieu Bizimana, Jean; Binagwaho, Agnès; Condo, Jeanine

    2015-03-01

    Paying for performance provides financial rewards to medical care providers for improvements in performance measured by utilization and quality of care indicators. In 2006, Rwanda began a pay for performance scheme to improve health services delivery, including HIV/AIDS services. Using a prospective quasi-experimental design, this study examines the scheme's impact on individual and couples HIV testing. We find a positive impact of pay for performance on HIV testing among married individuals (10.2 percentage points increase). Paying for performance also increased testing by both partners by 14.7 percentage point among discordant couples in which only one of the partners is an AIDS patient. Copyright © 2014. Published by Elsevier B.V.

  18. Partnership duration, concurrency, and HIV in sub-Saharan Africa.

    Science.gov (United States)

    Sawers, Larry; Isaac, Alan

    2017-07-01

    A widely accepted explanation for the exceptionally high HIV prevalence in sub-Saharan Africa is the practice of long-term overlapping heterosexual partnering. This article shows that long-duration concurrent partnering can be protective against HIV transmission rather than promoting it. Monogamous partnering prevents sexual transmission to anyone outside the partnership and, in an initially concordant-seronegative partnership, prevents sexual acquisition of HIV by either partner. Those protections against transmission and acquisition last as long as the partnership persists without new outside partnerships. Correspondingly, these two protective effects characterise polygynous partnerships, whether or not the polygyny is formal or informal, until a partner initiates a new partnership. Stable and exclusive unions of any size protect against HIV transmission, and more durable unions provide a longer protective effect. Survey research provides little information on partnership duration in sub-Saharan Africa and sheds no light on the interaction of duration, concurrency, and HIV. This article shows how assumptions about partnership duration in individual-based sexual-network models affect the contours of simulated HIV epidemics. Longer mean partnership duration slows the pace at which simulated epidemics grow. With plausible assumptions about partnership duration and at levels of concurrency found in the region, simulated HIV epidemics grow slowly or not at all. Those results are consistent with the hypothesis that long-duration partnering is protective against HIV and inconsistent with the hypothesis that long-term concurrency drives the HIV epidemics in sub-Saharan Africa.

  19. Evaluation of a cost effective in-house method for HIV-1 drug resistance genotyping using plasma samples.

    Directory of Open Access Journals (Sweden)

    Devidas N Chaturbhuj

    Full Text Available OBJECTIVES: Validation of a cost effective in-house method for HIV-1 drug resistance genotyping using plasma samples. DESIGN: The validation includes the establishment of analytical performance characteristics such as accuracy, reproducibility, precision and sensitivity. METHODS: The accuracy was assessed by comparing 26 paired Virological Quality Assessment (VQA proficiency testing panel sequences generated by in-house and ViroSeq Genotyping System 2.0 (Celera Diagnostics, US as a gold standard. The reproducibility and precision were carried out on five samples with five replicates representing multiple HIV-1 subtypes (A, B, C and resistance patterns. The amplification sensitivity was evaluated on HIV-1 positive plasma samples (n = 88 with known viral loads ranges from 1000-1.8 million RNA copies/ml. RESULTS: Comparison of the nucleotide sequences generated by ViroSeq and in-house method showed 99.41±0.46 and 99.68±0.35% mean nucleotide and amino acid identity respectively. Out of 135 Stanford HIVdb listed HIV-1 drug resistance mutations, partial discordance was observed at 15 positions and complete discordance was absent. The reproducibility and precision study showed high nucleotide sequence identities i.e. 99.88±0.10 and 99.82±0.20 respectively. The in-house method showed 100% analytical sensitivity on the samples with HIV-1 viral load >1000 RNA copies/ml. The cost of running the in-house method is only 50% of that for ViroSeq method (112$ vs 300$, thus making it cost effective. CONCLUSIONS: The validated cost effective in-house method may be used to collect surveillance data on the emergence and transmission of HIV-1 drug resistance in resource limited countries. Moreover, the wide applications of a cost effective and validated in-house method for HIV-1 drug resistance testing will facilitate the decision making for the appropriate management of HIV infected patients.

  20. Union banking a step towards achieving fiscal Union in the European Union

    Directory of Open Access Journals (Sweden)

    Ionuţ Marius Croitoru

    2015-05-01

    Full Text Available Introduction: Union policy needs in addition to the official language of four major components: a monetary union, a fiscal union, a union diplomatic and military union A stage in the Union is the Union banking tax. Materials and Methods: Union Bank has three pillars: a single banking supervisor (single supervisory mechanism, the only mechanism of bank resolution and a single scheme of bank guarantees. Results and conclusions: Union Bank, strengthen supervision is an inevitable process, and Romania will have to enroll in it. Option Romania is to be part of Romania deaorece bank Union can not remain outside the structures of decision as long as banks operating in Romania are predominantly Eurozone.

  1. Identifying HIV most-at-risk groups in Malawi for targeted interventions. A classification tree model.

    Science.gov (United States)

    Emina, Jacques B O; Madise, Nyovani; Kuepie, Mathias; Zulu, Eliya M; Ye, Yazoume

    2013-05-28

    To identify HIV-socioeconomic predictors as well as the most-at-risk groups of women in Malawi. A cross-sectional survey. Malawi The study used a sample of 6395 women aged 15-49 years from the 2010 Malawi Health and Demographic Surveys. Individual HIV status: positive or not. Findings from the Pearson χ(2) and χ(2) Automatic Interaction Detector analyses revealed that marital status is the most significant predictor of HIV. Women who are no longer in union and living in the highest wealth quintiles households constitute the most-at-risk group, whereas the less-at-risk group includes young women (15-24) never married or in union and living in rural areas. In the light of these findings, this study recommends: (1) that the design and implementation of targeted interventions should consider the magnitude of HIV prevalence and demographic size of most-at-risk groups. Preventive interventions should prioritise couples and never married people aged 25-49 years and living in rural areas because this group accounts for 49% of the study population and 40% of women living with HIV in Malawi; (2) with reference to treatment and care, higher priority must be given to promoting HIV test, monitoring and evaluation of equity in access to treatment among women in union disruption and never married or women in union aged 30-49 years and living in urban areas; (3) community health workers, households-based campaign, reproductive-health services and reproductive-health courses at school could be used as canons to achieve universal prevention strategy, testing, counselling and treatment.

  2. Are partners of HIV-infected people being tested for HIV? A mixed-methods research from Gujarat, India.

    Science.gov (United States)

    Selvaraj, K; Kumar, A M V; Chawla, S; Shringarpure, K S; Thekkur, P; Palanivel, C; Verma, P B; Shah, A N; Pandya, K N; Roy, G; Singh, Z; Rewari, B B; Dongre, A R

    2017-03-21

    Setting: Four selected antiretroviral therapy (ART) centres of Gujarat State, India, which accounts for 8% of the human immunodeficiency virus (HIV) burden in India. Objectives: 1) To assess the proportion of people living with HIV (PLHIV) whose partners were not tested for HIV; 2) to assess sociodemographic and clinical characteristics of index cases associated with partner testing; and 3) to understand perceived facilitators and barriers to partner testing and make suggestions on how to improve testing from the perspective of the health-care provider. Design: A mixed-method design with a quantitative phase that involved reviewing the programme records of married PLHIV enrolled during 2011-2015, followed by a qualitative phase of key informant interviews. Results: Of 3884 married PLHIV, 1279 (33%) did not have their partners tested for HIV. Factors including index cases being male, illiterate, aged >25 years, belonging to key populations, substance use and being in advanced clinical stages were more likely to be associated with partner non-testing. Non-disclosure of HIV status (due to fear of marital discord) and lack of awareness and risk perception were the key barriers to testing. Conclusion: One third of PLHIV did not have their partners tested for HIV. Several factors were identified as being associated with the non-testing of partners, and solutions were explored that need to be implemented urgently if we are to achieve the 90-90-90 targets and end HIV.

  3. Time Series Discord Detection in Medical Data using a Parallel Relational Database

    Energy Technology Data Exchange (ETDEWEB)

    Woodbridge, Diane; Rintoul, Mark Daniel; Wilson, Andrew T.; Goldstein, Richard

    2015-10-01

    Recent advances in sensor technology have made continuous real-time health monitoring available in both hospital and non-hospital settings. Since data collected from high frequency medical sensors includes a huge amount of data, storing and processing continuous medical data is an emerging big data area. Especially detecting anomaly in real time is important for patients’ emergency detection and prevention. A time series discord indicates a subsequence that has the maximum difference to the rest of the time series subsequences, meaning that it has abnormal or unusual data trends. In this study, we implemented two versions of time series discord detection algorithms on a high performance parallel database management system (DBMS) and applied them to 240 Hz waveform data collected from 9,723 patients. The initial brute force version of the discord detection algorithm takes each possible subsequence and calculates a distance to the nearest non-self match to find the biggest discords in time series. For the heuristic version of the algorithm, a combination of an array and a trie structure was applied to order time series data for enhancing time efficiency. The study results showed efficient data loading, decoding and discord searches in a large amount of data, benefiting from the time series discord detection algorithm and the architectural characteristics of the parallel DBMS including data compression, data pipe-lining, and task scheduling.

  4. Search for Genomic Alterations in Monozygotic Twins Discordant for Cleft Lip and/or Palate

    DEFF Research Database (Denmark)

    Kimani, Jane W; Yoshiura, Koh-Ichiro; Shi, Min

    2009-01-01

    consisting of 1,536 SNPs, to scan for genomic alterations in a sample of monozygotic twin pairs with discordant cleft lip and/or palate phenotypes. Paired analysis for deletions, amplifications and loss of heterozygosity, along with sequence verification of SNPs with discordant genotype calls did not reveal...... any genomic discordance between twin pairs in lymphocyte DNA samples. Our results demonstrate that postzygotic genomic alterations are not a common cause of monozygotic twin discordance for isolated cleft lip and/or palate. However, rare or balanced genomic alterations, tissue-specific events...

  5. Enhancing Quantum Discord in Cavity QED by Applying Classical Driving Field

    International Nuclear Information System (INIS)

    Qian Yi; Xu Jing-Bo

    2012-01-01

    We investigate the quantum discord dynamics in a cavity quantum electrodynamics system, which consists of two noninteracting two-level atoms driven by independent optical fields and classical fields, and find that the quantum discord vanishes only asymptotically although entanglement disappears suddenly during the time evolution in the absence of classical fields. It is shown that the amount of quantum discord can be increased by adjusting the classical driving fields because the increasing degree of the amount of quantum mutual information is greater than classical correlation by applying the classical driving fields. Finally, the influence of the classical driving field on the fidelity of the system is also examined. (general)

  6. Entanglement and discord of the superposition of Greenberger-Horne-Zeilinger states

    International Nuclear Information System (INIS)

    Parashar, Preeti; Rana, Swapan

    2011-01-01

    We calculate the analytic expression for geometric measure of entanglement for arbitrary superposition of two N-qubit canonical orthonormal Greenberger-Horne-Zeilinger (GHZ) states and the same for two W states. In the course of characterizing all kinds of nonclassical correlations, an explicit formula for quantum discord (via relative entropy) for the former class of states has been presented. Contrary to the GHZ state, the closest separable state to the W state is not classical. Therefore, in this case, the discord is different from the relative entropy of entanglement. We conjecture that the discord for the N-qubit W state is log 2 N.

  7. Individual- and contextual-level factors associated with client-initiated HIV testing

    Directory of Open Access Journals (Sweden)

    Claudia Renata dos Santos Barros

    Full Text Available ABSTRACT: Background: Knowing the reasons for seeking HIV testing is central for HIV prevention. Despite the availability of free HIV counseling and testing in Brazil, coverage remains lacking. Methods: Survey of 4,760 respondents from urban areas was analyzed. Individual-level variables included sociodemographic characteristics; sexual and reproductive health; HIV/AIDS treatment knowledge and beliefs; being personally acquainted with a person with HIV/AIDS; and holding discriminatory ideas about people living with HIV. Contextual-level variables included the Human Development Index (HDI of the municipality; prevalence of HIV/AIDS; and availability of local HIV counseling and testing (CT services. The dependent variable was client-initiated testing. Multilevel Poisson regression models with random intercepts were used to assess associated factors. Results: Common individual-level variables among men and women included being personally acquainted with a person with HIV/AIDS and age; whereas discordant variables included those related to sexual and reproductive health and experiencing sexual violence. Among contextual-level factors, availability of CT services was variable associated with client-initiated testing among women only. The contextual-level variable “HDI of the municipality” was associated with client-initiated testing among women. Conclusion: Thus, marked gender differences in HIV testing were found, with a lack of HIV testing among married women and heterosexual men, groups that do not spontaneously seek testing.

  8. Non-local correlation and quantum discord in two atoms in the non-degenerate model

    International Nuclear Information System (INIS)

    Mohamed, A.-B.A.

    2012-01-01

    By using geometric quantum discord (GQD) and measurement-induced nonlocality (MIN), quantum correlation is investigated for two atoms in the non-degenerate two-photon Tavis–Cummings model. It is shown that there is no asymptotic decay for MIN while asymptotic decay exists for GQD. Quantum correlations can be strengthened by introducing the dipole–dipole interaction. The evolvement period of quantum correlation gets shorter with the increase in the dipole–dipole parameter. It is found that there exists not only quantum nonlocality without entanglement but also quantum nonlocality without quantum discord. Also, the MIN and GQD are raised rather than entanglement, and also with weak initial entanglement, there are MIN and entanglement in a interval of death quantum discord. - Highlights: ► Geometric quantum discord (GQD) and measurement induced nonlocality (MIN) are used to investigate the correlations of two two-level atoms. ► There is no asymptotic decay for MIN while asymptotic decay exists for GQD. ► Quantum correlations can be strengthened by introducing the dipole–dipole interaction. ► There exists not only quantum nonlocality without entanglement but also without discord. ► Weak initial entanglement leads to MIN and entanglement in intervals of death discord.

  9. HIV risk associated with gay bathhouses and sex clubs: findings from 2 seattle surveys of factors related to HIV and sexually transmitted infections.

    Science.gov (United States)

    Reidy, William J; Spielberg, Freya; Wood, Robert; Binson, Diane; Woods, William J; Goldbaum, Gary M

    2009-04-01

    We studied the HIV risk behaviors of patrons of the 3 commercial sex venues for men in Seattle, Washington. We conducted cross-sectional, observational surveys in 2004 and 2006 by use of time-venue cluster sampling with probability proportional to size. Surveys were anonymous and self-reported. We analyzed the 2004 data to identify patron characteristics and predictors of risk behaviors and compared the 2 survey populations. Fourteen percent of respondents reported a previous HIV-positive test, 14% reported unprotected anal intercourse, and 9% reported unprotected anal intercourse with a partner of unknown or discordant HIV status during the current commercial sex venue visit. By logistic regression, recent unprotected anal intercourse outside of a commercial sex venue was independently associated with unprotected anal intercourse. Sex venue site and patron drug use were strongly associated with unprotected anal intercourse at the crude level. The 2004 and 2006 survey populations did not differ significantly in demographics or behaviors. Patron and venue-specific characteristics factors may each influence the frequency of HIV risk behaviors in commercial sex venues. Future research should evaluate the effect of structural and individual-level interventions on HIV transmission.

  10. HIV Risk Associated With Gay Bathhouses and Sex Clubs: Findings From 2 Seattle Surveys of Factors Related to HIV and Sexually Transmitted Infections

    Science.gov (United States)

    Spielberg, Freya; Wood, Robert; Binson, Diane; Woods, William J.; Goldbaum, Gary M.

    2009-01-01

    Objectives. We studied the HIV risk behaviors of patrons of the 3 commercial sex venues for men in Seattle, Washington. Methods. We conducted cross-sectional, observational surveys in 2004 and 2006 by use of time–venue cluster sampling with probability proportional to size. Surveys were anonymous and self-reported. We analyzed the 2004 data to identify patron characteristics and predictors of risk behaviors and compared the 2 survey populations. Results. Fourteen percent of respondents reported a previous HIV-positive test, 14% reported unprotected anal intercourse, and 9% reported unprotected anal intercourse with a partner of unknown or discordant HIV status during the current commercial sex venue visit. By logistic regression, recent unprotected anal intercourse outside of a commercial sex venue was independently associated with unprotected anal intercourse. Sex venue site and patron drug use were strongly associated with unprotected anal intercourse at the crude level. The 2004 and 2006 survey populations did not differ significantly in demographics or behaviors. Conclusions. Patron and venue-specific characteristics factors may each influence the frequency of HIV risk behaviors in commercial sex venues. Future research should evaluate the effect of structural and individual-level interventions on HIV transmission. PMID:19218174

  11. Geometric measure of quantum discord and total quantum correlations in an N-partite quantum state

    International Nuclear Information System (INIS)

    Hassan, Ali Saif M; Joag, Pramod S

    2012-01-01

    Quantum discord, as introduced by Ollivier and Zurek (2001 Phys. Rev. Lett. 88 017901), is a measure of the discrepancy between quantum versions of two classically equivalent expressions for mutual information and is found to be useful in quantification and application of quantum correlations in mixed states. It is viewed as a key resource present in certain quantum communication tasks and quantum computational models without containing much entanglement. An early step toward the quantification of quantum discord in a quantum state was by Dakic et al (2010 Phys. Rev. Lett. 105 190502) who introduced a geometric measure of quantum discord and derived an explicit formula for any two-qubit state. Recently, Luo and Fu (2010 Phys. Rev. A 82 034302) introduced a generic form of the geometric measure of quantum discord for a bipartite quantum state. We extend these results and find generic forms of the geometric measure of quantum discord and total quantum correlations in a general N-partite quantum state. Further, we obtain computable exact formulas for the geometric measure of quantum discord and total quantum correlations in an N-qubit quantum state. The exact formulas for the N-qubit quantum state can be used to get experimental estimates of the quantum discord and the total quantum correlation. (paper)

  12. Perspectives and expectations of union member and non- union member teachers on teacher unions

    Directory of Open Access Journals (Sweden)

    Tuncer FİDAN

    2015-12-01

    Full Text Available Unions, which can be regarded as one of the constitutive elements of democracy, are the pressure groups in political and social fields. Unions were born out of industrial confrontations and expanded into the field of public services over time, and thus teachers – who are also public employees-, also obtained the right to establish and affiliate to unions. In this research the views of union member and non-union member teachers on the most important functions and operational effectiveness of unions, teachers’ expectations from unions and teachers’ evaluation of the solidarity, competition and cooperation between unions were determined and the perspectives of teachers on unionization were revealed. qualitative research design was used. The data needed were collected through semi-structured interviews from volunteering union member and non-union member teachers who were working in the primary and secondary schools in Ankara province and who were selected through “maximum variation sampling approach”. The data were then analyzed by using the content analysis technique. In conclusion, it was found that political ideology was the most important reason for membership of teachers’ unions. Protection and development of personal rights was found to be the most important function of teacher unions and unions were thought to be insufficient in performing those functions.

  13. Analytic Expression of Geometric Discord in Arbitrary Mixture of any Two Bi-qubit Product Pure States

    International Nuclear Information System (INIS)

    Xie Chuan-Mei; Xing Hang; Zhang Zhan-Jun; Liu Yi-Min

    2015-01-01

    Quantum correlations in a family of states comprising any mixture of a pair of arbitrary bi-qubit product pure states are studied by employing geometric discord [Phys. Rev. Lett. 105 (2010) 190502] as the quantifier. First, the inherent symmetry in the family of states about local unitary transformations is revealed. Then, the analytic expression of geometric discords in the states is worked out. Some concrete discussions and analyses on the captured geometric discords are made so that their distinct features are exposed. It is found that, the more averagely the two bi-qubit product states are mixed, the bigger geometric discord the mixed state owns. Moreover, the monotonic relationships of geometric discord with different parameters are revealed. (paper)

  14. Exercise — Exploring Mutuality and Discordance(s Between Sport and Public Health

    Directory of Open Access Journals (Sweden)

    Eling D. de Bruin

    2013-01-01

    Full Text Available Sports is a peer-reviewed scientific journal that revolves around the interdisciplinary area of exercise sciences applied in sport and public health. The intention of Sports is to link several scientific disciplines in an integrated fashion in order to address critical issues related to exercise science, sports and public health. As the first Editor-in-Chief of Sports, I would like to share a few comments about this interdisciplinary field of research by discussing the mutuality and discordances between exercise as it is applied in sports and public health.

  15. prenatal ultrasound diagnosis of discordant occipital encephalocele

    African Journals Online (AJOL)

    drclement

    PRENATAL ULTRASOUND DIAGNOSIS OF DISCORDANT OCCIPITAL. ENCEPHALOCELE IN MULTIPLE PREGNANCY - A CASE REPORT. *O.U Ogbeide (MBBS, FMCR), *EJ IKUBOR (MBBS). *Department of Radiology University of Benin Teaching Hospital, Benin-City, Nigeria. Correspondence: Dr Ogbeide Osesogie ...

  16. Maternal concern about child weight in a study of weight-discordant siblings.

    Science.gov (United States)

    Kral, Tanja V E; Moore, Reneé H; Compher, Charlene W

    2015-01-01

    This study examined concern about child weight in mothers of weight-discordant siblings and determined the accuracy of maternal self-report versus measured child height, weight, and corresponding body mass index (BMI; kg/m(2) ) z-score. Discordant sibling design. Forty-seven mothers of 5- to 12-year-old, weight-discordant siblings. Mothers self-reported their concern about child weight for each child separately and for a subset of children, self-reported their heights and weights. Siblings' height, weight, waist circumference, and adiposity were measured. The majority (83%) of mothers expressed concern about their overweight/obese child's weight and 20% of mothers expressed concern about their normal-weight child's weight (p concern about child weight were positively associated with difference scores in sibling BMI z-score (r = 0.42; p = .01) and percent body fat (r = 0.56; p concern for their overweight/obese child's weight was greater for sibling pairs who were more discordant in their weight. © 2014 Wiley Periodicals, Inc.

  17. Time Series Discord Detection in Medical Data using a Parallel Relational Database [PowerPoint

    Energy Technology Data Exchange (ETDEWEB)

    Woodbridge, Diane; Wilson, Andrew T.; Rintoul, Mark Daniel; Goldstein, Richard H.

    2015-11-01

    Recent advances in sensor technology have made continuous real-time health monitoring available in both hospital and non-hospital settings. Since data collected from high frequency medical sensors includes a huge amount of data, storing and processing continuous medical data is an emerging big data area. Especially detecting anomaly in real time is important for patients’ emergency detection and prevention. A time series discord indicates a subsequence that has the maximum difference to the rest of the time series subsequences, meaning that it has abnormal or unusual data trends. In this study, we implemented two versions of time series discord detection algorithms on a high performance parallel database management system (DBMS) and applied them to 240 Hz waveform data collected from 9,723 patients. The initial brute force version of the discord detection algorithm takes each possible subsequence and calculates a distance to the nearest non-self match to find the biggest discords in time series. For the heuristic version of the algorithm, a combination of an array and a trie structure was applied to order time series data for enhancing time efficiency. The study results showed efficient data loading, decoding and discord searches in a large amount of data, benefiting from the time series discord detection algorithm and the architectural characteristics of the parallel DBMS including data compression, data pipe-lining, and task scheduling.

  18. Cough Aerosol Cultures of Mycobacterium tuberculosis: Insights on TST / IGRA Discordance and Transmission Dynamics.

    Directory of Open Access Journals (Sweden)

    Edward C Jones-López

    Full Text Available The diagnosis of latent tuberculosis (TB infection (LTBI is complicated by the absence of a gold standard. Discordance between tuberculin skin tests (TST and interferon gamma release assays (IGRA occurs in 10-20% of individuals, but the underlying mechanisms are poorly understood.We analyzed data from a prospective household contact study that included cough aerosol culture results from index cases, environmental and contact factors. We assessed contacts for LTBI using TST and IGRA at baseline and six weeks. We examined TST/IGRA discordance in qualitative and quantitative analyses, and used multivariable logistic regression analysis with generalized estimating equations to analyze predictors of discordance.We included 96 TB patients and 384 contacts. Discordance decreased from 15% at baseline to 8% by six weeks. In adjusted analyses, discordance was related to less crowding (p = 0.004, non-cavitary disease (OR 1.41, 95% CI: 1.02-1.96; p = 0.03, and marginally with BCG vaccination in contacts (OR 1.40, 95% CI: 0.99-1.98, p = 0.06.We observed significant individual variability and temporal dynamism in TST and IGRA results in household contacts of pulmonary TB cases. Discordance was associated with a less intense infectious exposure, and marginally associated with a BCG-mediated delay in IGRA conversion. Cough aerosols provide an additional dimension to the assessment of infectiousness and risk of infection in contacts.

  19. Quantum discord and classical correlation signatures of mobility edges in one-dimensional aperiodic single-electron systems

    International Nuclear Information System (INIS)

    Gong, Longyan; Zhu, Hao; Zhao, Shengmei; Cheng, Weiwen; Sheng, Yubo

    2012-01-01

    We investigate numerically the quantum discord and the classical correlation in a one-dimensional slowly varying potential model and a one-dimensional Soukoulis–Economou ones, respectively. There are well-defined mobility edges in the slowly varying potential model, while there are discrepancies on mobility edges in the Soukoulis–Economou ones. In the slowly varying potential model, we find that extended and localized states can be distinguished by both the quantum discord and the classical correlation. There are sharp transitions in the quantum discord and the classical correlation at mobility edges. Based on these, we study “mobility edges” in the Soukoulis–Economou model using the quantum discord and the classical correlation, which gives another perspectives for these “mobility edges”. All these provide us good quantities, i.e., the quantum discord and the classical correlation, to reflect mobility edges in these one-dimensional aperiodic single-electron systems. Moreover, our studies propose a consistent interpretation of the discrepancies between previous numerical results about the Soukoulis–Economou model. -- Highlights: ► Quantum discord and classical correlation can signal mobility edges in two models. ► An interpretation for mobility edges in the Soukoulis–Economou model is proposed. ► Quantum discord and classical correlation can reflect well localization properties.

  20. Short communication: identification of a novel HIV type 1 subtype H/J recombinant in Canada with discordant HIV viral load (RNA) values in three different commercial assays.

    Science.gov (United States)

    Kim, John E; Beckthold, Brenda; Chen, Zhaoxia; Mihowich, Jennifer; Malloch, Laurie; Gill, Michael John

    2007-11-01

    The presence of HIV-1 non-B subtypes is increasing worldwide. This poses challenges to commercial diagnostic and viral load (RNA) monitoring tests that are predominantly based on HIV-1 subtype B strains. Based on phylogenetic analysis of the gag, pol, and env gene regions, we describe the first HIV-1 H/J recombinant in Canada that presented divergent viral load values. DNA sequence analysis of the gag gene region further revealed that genetic diversity between this H/J recombinant and the primers and probes used in the bio-Merieux Nuclisens HIV-1 QT (Nuclisens) and Roche Amplicor Monitor HIV-1, v1.5 (Monitor) viral RNA assays can erroneously lead to undetectable viral load values. This observation appears to be more problematic in the Nuclisens assay. In light of increasing genetic diversity in HIV worldwide we recommend that DNA sequencing of HIV, especially in the gag gene region targeted by primers and probes used in molecular diagnostic and viral load tests, be incorporated into clinical monitoring practices.

  1. 'It's risky to walk in the city with syringes': understanding access to HIV/AIDS services for injecting drug users in the former Soviet Union countries of Ukraine and Kyrgyzstan

    Directory of Open Access Journals (Sweden)

    Harmer Andrew

    2011-07-01

    Full Text Available Abstract Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV/AIDS interventions. This paper explores the multiple access barriers to HIV/AIDS services experienced by a key risk group-injecting drug users (IDUs. Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84, service providers (Ukraine n = 138, Kyrgyzstan n = 58 and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86. Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV/AIDS and drug use was an important barrier to IDUs accessing HIV/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV/AIDS services in Ukraine and Kyrgyzstan, this does not equate with greater

  2. 'It's risky to walk in the city with syringes': understanding access to HIV/AIDS services for injecting drug users in the former Soviet Union countries of Ukraine and Kyrgyzstan

    LENUS (Irish Health Repository)

    Spicer, Neil

    2011-07-13

    Abstract Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV\\/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV\\/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV\\/AIDS interventions. This paper explores the multiple access barriers to HIV\\/AIDS services experienced by a key risk group-injecting drug users (IDUs). Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84), service providers (Ukraine n = 138, Kyrgyzstan n = 58) and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86). Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV\\/AIDS and drug use was an important barrier to IDUs accessing HIV\\/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV\\/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV\\/AIDS services in Ukraine and Kyrgyzstan, this does not equate with

  3. Quantum discord for a central two-qubit system coupled to an XY-spin-chain environment

    International Nuclear Information System (INIS)

    Liu Benqiong; Shao Bin; Zou Jian

    2010-01-01

    We investigate the dynamic behaviors of quantum discord for a central two-qubit system coupled to an XY-spin-chain environment. In the weak-coupling regime, we show that the quantum discord for the two central qubits can become minimized rapidly close to the critical point of a quantum phase transition. By considering the two qubits that are initially prepared in the Werner state, we study the evolution of the quantum discord and that of entanglement under the same conditions. Our results imply that entanglement can disappear completely after a finite time, while the quantum discord decreases and tends to be a stable value according to the initial-state parameter for a very-long-time interval. In this sense, the quantum discord is more robust than entanglement for the quantum system exposed to the environment. The relation between the quantum correlations and the classical correlation is also shown for two particular cases.

  4. The double switch for atrioventricular discordance.

    Science.gov (United States)

    Brawn, William J

    2005-01-01

    Conventional surgery for atrioventricular discordance usually associated with ventricular arterial discordance leaves the morphologic right ventricle in the systemic circulation. Long-term follow-up results with this approach reveal a high incidence of right ventricular failure. The double switch procedure was introduced to restore the morphologic left ventricle to the systemic circulation. This operation is performed in two main ways: the atrial-arterial switch and the atrial switch plus Rastelli procedure. This double switch approach has been successful at least in the medium term in abolishing morphologic right ventricular failure and its associated tricuspid valve regurgitation. In the atrial-arterial switch group, there is an incidence of morphologic left ventricular dysfunction, sometimes associated with neoaortic valve regurgitation, and the minority of cases need aortic valve replacement. The long-term function of the morphologic left ventricle and the aortic valve need careful surveillance in the future. The atrial-Rastelli group of patients has not in the medium term shown evidence of ventricular dysfunction but will require change on a regular basis of their ventricular to pulmonary artery valved conduits.

  5. Discordant Dry Eye Disease (An American Ophthalmological Society Thesis)

    Science.gov (United States)

    Shtein, Roni M.; Harper, Daniel E.; Pallazola, Vincent; Harte, Steven E.; Hussain, Munira; Sugar, Alan; Williams, David A.; Clauw, Daniel J.

    2016-01-01

    Purpose To improve understanding of dry eye disease and highlight a subgroup of patients who have a component of central sensitization and neuropathic pain contributing to their condition. Methods Prospective, cross-sectional, IRB-approved study comparing isolated dry eye disease (n=48) to fibromyalgia (positive control; n=23) and healthy (negative control; n=26) individuals with ocular surface examination, corneal confocal microscopy, quantitative sensory testing, and self-reported ocular symptoms and systemic associations. A subset of patients also underwent skin biopsy and/or brain neuroimaging. Dry eye patients were split into concordant (ie, those with dry eyes on examination) and discordant (ie, those with dry eye symptoms but normal examination) subgroups for further analysis. We hypothesized that on the systemic measures included, concordant patients would resemble healthy controls, whereas discordant patients would show evidence of centralized mechanisms similar to fibromyalgia. Results Schirmer test and Ocular Surface Disease Index (OSDI) scores indicated significant decreases in tear production (Schirmer: healthy, 18.5±8.2 mm; dry, 11.2±5.4 mm; fibromyalgia, 14.4±7.5; Pdry eye symptoms (OSDI: healthy, 1.9±3.0; dry, 20.3±17.7; fibromyalgia, 20.3±17.1; Pdry eye and fibromyalgia patients, compared to controls. The discordant subgroup had decreased corneal nerve density and decreased visual quality-of-life scores, similar to patients with fibromyalgia. Concordant patients were more similar to healthy controls on these measures. Conclusions Individuals with discordant dry eye may have a central pathophysiologic mechanism leading to their eye pain symptoms, which could be an important factor to consider in treatment of chronic idiopathic dry eye. PMID:28050051

  6. Discordant Dry Eye Disease (An American Ophthalmological Society Thesis).

    Science.gov (United States)

    Shtein, Roni M; Harper, Daniel E; Pallazola, Vincent; Harte, Steven E; Hussain, Munira; Sugar, Alan; Williams, David A; Clauw, Daniel J

    2016-08-01

    To improve understanding of dry eye disease and highlight a subgroup of patients who have a component of central sensitization and neuropathic pain contributing to their condition. Prospective, cross-sectional, IRB-approved study comparing isolated dry eye disease (n=48) to fibromyalgia (positive control; n=23) and healthy (negative control; n=26) individuals with ocular surface examination, corneal confocal microscopy, quantitative sensory testing, and self-reported ocular symptoms and systemic associations. A subset of patients also underwent skin biopsy and/or brain neuroimaging. Dry eye patients were split into concordant (ie, those with dry eyes on examination) and discordant (ie, those with dry eye symptoms but normal examination) subgroups for further analysis. We hypothesized that on the systemic measures included, concordant patients would resemble healthy controls, whereas discordant patients would show evidence of centralized mechanisms similar to fibromyalgia. Schirmer test and Ocular Surface Disease Index (OSDI) scores indicated significant decreases in tear production (Schirmer: healthy, 18.5±8.2 mm; dry, 11.2±5.4 mm; fibromyalgia, 14.4±7.5; P dry eye symptoms (OSDI: healthy, 1.9±3.0; dry, 20.3±17.7; fibromyalgia, 20.3±17.1; P dry eye and fibromyalgia patients, compared to controls. The discordant subgroup had decreased corneal nerve density and decreased visual quality-of-life scores, similar to patients with fibromyalgia. Concordant patients were more similar to healthy controls on these measures. Individuals with discordant dry eye may have a central pathophysiologic mechanism leading to their eye pain symptoms, which could be an important factor to consider in treatment of chronic idiopathic dry eye.

  7. Trade Union Organisers in Trade Union Organising Strategies: building workplace unionism or reinforcing bureaucracy

    OpenAIRE

    Looker, Gerard

    2015-01-01

    This thesis considers the role of union full time officers in union organising strategies. Two decades of promoting union organising influenced by models developed by the AFL-CIO, has failed to arrest the decline of UK trade unions let alone produce evidence of renewal. Focusing mainly on one region in the UKs largest public sector trade union, Unison, the research provides for a detailed account of how organising strategies affect union work, presenting thick and deep data from full time off...

  8. Quantum Discord Determines the Interferometric Power of Quantum States

    Science.gov (United States)

    Girolami, Davide; Souza, Alexandre M.; Giovannetti, Vittorio; Tufarelli, Tommaso; Filgueiras, Jefferson G.; Sarthour, Roberto S.; Soares-Pinto, Diogo O.; Oliveira, Ivan S.; Adesso, Gerardo

    2014-05-01

    Quantum metrology exploits quantum mechanical laws to improve the precision in estimating technologically relevant parameters such as phase, frequency, or magnetic fields. Probe states are usually tailored to the particular dynamics whose parameters are being estimated. Here we consider a novel framework where quantum estimation is performed in an interferometric configuration, using bipartite probe states prepared when only the spectrum of the generating Hamiltonian is known. We introduce a figure of merit for the scheme, given by the worst-case precision over all suitable Hamiltonians, and prove that it amounts exactly to a computable measure of discord-type quantum correlations for the input probe. We complement our theoretical results with a metrology experiment, realized in a highly controllable room-temperature nuclear magnetic resonance setup, which provides a proof-of-concept demonstration for the usefulness of discord in sensing applications. Discordant probes are shown to guarantee a nonzero phase sensitivity for all the chosen generating Hamiltonians, while classically correlated probes are unable to accomplish the estimation in a worst-case setting. This work establishes a rigorous and direct operational interpretation for general quantum correlations, shedding light on their potential for quantum technology.

  9. Associations between depressive syndromes and HIV risk behaviors among San Francisco men who have sex with men.

    Science.gov (United States)

    Chen, Yea-Hung; Raymond, Henry Fisher

    2017-12-01

    HIV prevention plans for men who have sex with men (MSM) are often multifaceted. They involve reduction of sexual risk behaviors, such as condomless intercourse, but also often include pharmaceutical approaches, such as early treatment of HIV-infected individuals with antiretroviral therapy (ART). Effectiveness is possibly threatened by individual-level factors, such as depression. In this study of 322 San Francisco MSM (240 HIV-uninfected individuals and 82 HIV-infected individuals, according to self-report), we examine associations between depressive syndromes and HIV risk behaviors (sexual risk behaviors and ART non-adherence). Our study failed to find evidence that depressive syndromes lead to increases in ART non-adherence (risk difference, RD: 27.9; 95% confidence interval, CI: -3.5, 59.3). However, the study does suggest an association between depressive syndromes and concurrence of non-adherence and potentially HIV-discordant condomless receptive anal intercourse (RD: 36.0; 95% CI: 5.2, 66.8). Among HIV-uninfected MSM, our study suggests negative associations between depressive syndromes and sexual risk behaviors. We recommend screening and treatment of depression among HIV-infected MSM.

  10. HIV/AIDS, health and wellbeing study among International Transport Workers' Federation (ITF) seafarer affiliates.

    Science.gov (United States)

    Altaf Chowdhury, Syed Asif; Smith, Jacqueline; Trowsdale, Steve; Leather, Susan

    2016-01-01

    Transport workers generally face a higher-than-average risk of HIV as well as other health challenges. In order to improve understanding of health issues in the maritime sector, including but not limited to HIV/AIDS, and to prepare appropriate responses the International Transport Workers' Federation (ITF) conducted a study of the views and needs of those affiliates. The ITF carried out two surveys. The first consisted of a questionnaire sent to all ITF seafarer affiliates to establish their concerns about health issues, including the impact of HIV/AIDS, and to assess the extent and nature of existing trade union programmes. The second consisted of a knowledge, attitude and behaviour survey on health, wellbeing and AIDS among a cross-section of individual members administered through anonymous and confidential questionnaires by maritime affiliates in four countries in different regions and an identical online questionnaire through Survey Monkey. For the first survey, replies were received from 35 unions in 30 countries, including major seafarer supplying countries - India, Indonesia, Myanmar, Philippines, Turkey, Ukraine - and major beneficial ownership countries such as Germany, Italy, Norway, and South Korea. Health issues of concern included HIV and other sexually transmitted infections for over three-quarters of them, and then alcohol use, weight control, and mental health. All said they would welcome ITF support in starting or strengthening a programme on general health and/or HIV. Replies were received to the second survey from 615 individual seafarers. Half to three-quarters said they worried about their weight, lack of exercise and drinking; over half felt depressed sometimes or often. There were serious knowledge gaps in a number of areas, especially HIV transmission and prevention, as well as high levels of stigma towards workmates with HIV. A number of health issues and information gaps remain unaddressed on board and pre-departure. Mental health is

  11. Knowledge, attitudes and practices on HIV/AIDS and prevalence of HIV in the general population of Sucre, Bolivia.

    Science.gov (United States)

    Terán Calderón, Carolina; Gorena Urizar, Dorian; González Blázquez, Cristina; Alejos Ferreras, Belén; Ramírez Rubio, Oriana; Bolumar Montrull, Francisco; Ortiz Rivera, Marta; del Amo Valero, Julia

    2015-01-01

    To analyse knowledge, attitudes and sexual practices on HIV/AIDS, and estimate HIV prevalence among residents of Sucre (Bolivia). Population-based survey of residents aged 15-49 randomly selected during 2008/2009. Blood samples were collected on Whatman-filter paper and tested with enzyme-linked immunosorbent assay. Knowledge on HIV/AIDS, sexual risk practices and discriminatory attitudes against people living with HIV/AIDS (PLWHA) were modelled with multiple logistic regression. Of 1499 subjects, 59% were women. All subjects were HIV-negative. Inadequate knowledge of HIV/AIDS transmission and prevention was observed in 67% and risk factors varied by gender (interaction p-value<0.05). Discriminatory attitudes were displayed by 85% subjects; associated factors were: rural residence, low educational level and low income. Unsafe sex was reported by 10%; risk factors varied by residence area (interaction p-value<0.05). In urban areas, risk factors were male sex, younger age and being in common-law union. Prevalence of HIV infection is very low and unsafe sex is relatively uncommon. Inadequate knowledge on HIV/AIDS and discriminatory attitudes towards PLWHA are extremely high and are associated to gender, ethnic and economic inequalities. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  12. Re-testing and misclassification of HIV-2 and HIV-1&2 dually reactive patients among the HIV-2 cohort of The West African Database to evaluate AIDS collaboration

    Science.gov (United States)

    Tchounga, Boris K; Inwoley, Andre; Coffie, Patrick A; Minta, Daouda; Messou, Eugene; Bado, Guillaume; Minga, Albert; Hawerlander, Denise; Kane, Coumba; Eholie, Serge P; Dabis, François; Ekouevi, Didier K

    2014-01-01

    Introduction West Africa is characterized by the circulation of HIV-1 and HIV-2. The laboratory diagnosis of these two infections as well as the choice of a first-line antiretroviral therapy (ART) is challenging, considering the limited access to second-line regimens. This study aimed at confirming the classification of HIV-2 and HIV-1&2 dually reactive patients followed up in the HIV-2 cohort of the West African Database to evaluate AIDS collaboration. Method A cross-sectional survey was conducted from March to December 2012 in Burkina Faso, Côte d’Ivoire and Mali among patients classified as HIV-2 or HIV-1&2 dually reactive according to the national HIV testing algorithms. A 5-ml blood sample was collected from each patient and tested in a single reference laboratory in Côte d’Ivoire (CeDReS, Abidjan) with two immuno-enzymatic tests: ImmunoCombII® (HIV-1&2 ImmunoComb BiSpot – Alere) and an in-house ELISA test, approved by the French National AIDS and hepatitis Research Agency (ANRS). Results A total of 547 patients were included; 57% of them were initially classified as HIV-2 and 43% as HIV-1&2 dually reactive. Half of the patients had CD4≥500 cells/mm3 and 68.6% were on ART. Of the 312 patients initially classified as HIV-2, 267 (85.7%) were confirmed as HIV-2 with ImmunoCombII® and in-house ELISA while 16 (5.1%) and 9 (2.9%) were reclassified as HIV-1 and HIV-1&2, respectively (Kappa=0.69; p<0.001). Among the 235 patients initially classified as HIV-1&2 dually reactive, only 54 (23.0%) were confirmed as dually reactive with ImmunoCombII® and in-house ELISA, while 103 (43.8%) and 33 (14.0%) were reclassified as HIV-1 and HIV-2 mono-infected, respectively (kappa= 0.70; p<0.001). Overall, 300 samples (54.8%) were concordantly classified as HIV-2, 63 (11.5%) as HIV-1&2 dually reactive and 119 (21.8%) as HIV-1 (kappa=0.79; p<0.001). The two tests gave discordant results for 65 samples (11.9%). Conclusions Patients with HIV-2 mono-infection are correctly

  13. Seroadaptive practices: association with HIV acquisition among HIV-negative men who have sex with men.

    Directory of Open Access Journals (Sweden)

    Snigdha Vallabhaneni

    Full Text Available Although efficacy is unknown, many men who have sex with men (MSM attempt to reduce HIV risk by adapting condom use, partner selection, or sexual position to the partner's HIV serostatus. We assessed the association of seroadaptive practices with HIV acquisition.We pooled data on North American MSM from four longitudinal HIV-prevention studies. Sexual behaviors reported during each six-month interval were assigned sequentially to one of six mutually exclusive risk categories: (1 no unprotected anal intercourse (UAI, (2 having a single negative partner, (3 being an exclusive top (only insertive anal sex, (4 serosorting (multiple partners, all HIV negative, (5 seropositioning (only insertive anal sex with potentially discordant partners, and (6 UAI with no seroadaptive practices. HIV antibody testing was conducted at the end of each interval. We used Cox models to evaluate the independent association of each category with HIV acquisition, controlling for number of partners, age, race, drug use, and intervention assignment. 12,277 participants contributed to 60,162 six-month intervals with 663 HIV seroconversions. No UAI was reported in 47.4% of intervals, UAI with some seroadaptive practices in 31.8%, and UAI with no seroadaptive practices in 20.4%. All seroadaptive practices were associated with a lower risk, compared to UAI with no seroadaptive practices. However, compared to no UAI, serosorting carried twice the risk (HR = 2.03, 95%CI:1.51-2.73, whereas seropositioning was similar in risk (HR = 0.85, 95%CI:0.50-1.44, and UAI with a single negative partner and as an exclusive top were both associated with a lower risk (HR = 0.56, 95%CI:0.32-0.96 and HR = 0.55, 95%CI:0.36-0.84, respectively.Seroadaptive practices appear protective when compared with UAI with no seroadaptive practices, but serosorting appears to be twice as risky as no UAI. Condom use and limiting number of partners should be advocated as first-line prevention

  14. Influence of Seasonality and Circulating Cytokines on Serial QuantiFERON Discordances

    Directory of Open Access Journals (Sweden)

    Marsha L. Griffin

    2018-01-01

    Full Text Available Objectives. An 18-month prospective study serially tested healthcare workers (HCWs for tuberculosis infection (TBI and reported discordant QuantiFERON Gold In-Tube® (QFT results in some participants. The purpose of the current study was to investigate whether the interferon-gamma (IFN-γ measured by QFT in discordant individuals could be influenced by other circulating cytokines that vary seasonally at the time of phlebotomy. Methods. The CDC funded TBESC Task Order 18 (TO18 project to assess the use of Interferon Gamma Release Assays (IGRAs, T-SPOT.TB® and QFT, compared to the tuberculin skin test (TST for the serial testing of TBI in HCW at 4 US sites. Unstimulated plasma from 9 discordant TO18 participants at 4 different time points from the Houston site was multiplexed to determine the association between circulating cytokines and antigen stimulated IFN-γ levels. Results. IL-12, IL-1β, IL-3, GCSF, and IL-7 were associated with the amount of IFN-γ measured in response to antigen stimulation. In addition to these cytokines, a significant relationship was found between a positive QFT result and the spring season. Conclusions. Allergens during the spring season can result in the upregulation of IL-1β and IL-3, and this upregulation was observed with the amount of IFN-γ measured in discordant results.

  15. Preventing syndemic Zika virus, HIV/STIs and unintended pregnancy: dual method use and consistent condom use among Brazilian women in marital and civil unions.

    Science.gov (United States)

    Tsuyuki, Kiyomi; Gipson, Jessica D; Barbosa, Regina Maria; Urada, Lianne A; Morisky, Donald E

    2017-12-12

    Syndemic Zika virus, HIV and unintended pregnancy call for an urgent understanding of dual method (condoms with another modern non-barrier contraceptive) and consistent condom use. Multinomial and logistic regression analysis using data from the Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS), a nationally representative household survey of reproductive-aged women in Brazil, identified the socio-demographic, fertility and relationship context correlates of exclusive non-barrier contraception, dual method use and condom use consistency. Among women in marital and civil unions, half reported dual protection (30% condoms, 20% dual methods). In adjusted models, condom use was associated with older age and living in the northern region of Brazil or in urban areas, whereas dual method use (versus condom use) was associated with younger age, living in the southern region of Brazil, living in non-urban areas and relationship age homogamy. Among condom users, consistent condom use was associated with reporting Afro-religion or other religion, not wanting (more) children and using condoms only (versus dual methods). Findings highlight that integrated STI prevention and family planning services should target young married/in union women, couples not wanting (more) children and heterogamous relationships to increase dual method use and consistent condom use.

  16. Discordant results between biochemical and molecular transthyretin

    Indian Academy of Sciences (India)

    Discordant results between biochemical and molecular transthyretin assays: lessons learned from a unique testing algorithm at the Mayo Clinic. Honey V. Reddi Brittany C. Thomas Kurt S. Willkomm Matthew J. Ferber Kandelaria M. Rumilla Kimiyo M. Raymond John F. O'Brien W. Edward Highsmith. Research Note Volume ...

  17. Trade Union Channels for Influencing European Union Policies

    Directory of Open Access Journals (Sweden)

    Bengt Larsson

    2015-10-01

    Full Text Available This paper analyzes what channels trade unions in Europe use when trying to influence European Union (EU policies. It compares and contrasts trade unions in different industrial relations regimes with regard to the degree to which they cooperate with different actors to influence EU policies, while also touching on the importance of sector differences and organizational resources. The study is based on survey data collected in 2010–2011 from unions affiliated with the European Trade Union Confederation and from below peak unions in 14 European countries. Results of the survey show that the ‘national route’ is generally the most important for trade unions in influencing EU policies in the sense that this channel is, on average, used to the highest degree. In addition, the survey delineates some important differences between trade unions in different industrial relations regimes with regard to the balance between the national route and different access points in the ‘Brussels route’.

  18. Short communication: Phenotypic protease inhibitor resistance and cross-resistance in the clinic from 2006 to 2008 and mutational prevalences in HIV from patients with discordant tipranavir and darunavir susceptibility phenotypes.

    Science.gov (United States)

    Bethell, Richard; Scherer, Joseph; Witvrouw, Myriam; Paquet, Agnes; Coakley, Eoin; Hall, David

    2012-09-01

    To test tipranavir (TPV) or darunavir (DRV) as treatment options for patients with phenotypic resistance to protease inhibitors (PIs), including lopinavir, saquinavir, atazanavir, and fosamprenavir, the PhenoSense GT database was analyzed for susceptibility to DRV or TPV among PI-resistant isolates. The Monogram Biosciences HIV database (South San Francisco, CA) containing 7775 clinical isolates (2006-2008) not susceptible to at least one first-generation PI was analyzed. Phenotypic responses [resistant (R), partially susceptible (PS), or susceptible (S)] were defined by upper and lower clinical cut-offs to each PI. Genotypes were screened for amino acid substitutions associated with TPV-R/DRV-S and TPV-S/DRV-R phenotypes. In all, 4.9% (378) of isolates were resistant to all six PIs and 31.0% (2407) were resistant to none. Among isolates resistant to all four first-generation PIs, DRV resistance increased from 21.2% to 41.9% from 2006 to 2008, respectively, and resistance to TPV remained steady (53.9 to 57.3%, respectively). Higher prevalence substitutions in DRV-S/TPV-R isolates versus DRV-R/TPV-S isolates, respectively, were 82L/T (44.4% vs. 0%) and 83D (5.8% vs. 0%). Higher prevalence substitutions in DRV-R/TPV-S virus were 50V (0.0% vs. 28.9%), 54L (1.0% vs. 36.1%), and 76V (0.4% vs. 15.5%). Mutations to help predict discordant susceptibility to DRV and TPV in isolates with reduced susceptibility to other PIs were identified. DRV resistance mutations associated with improved virologic response to TPV were more prevalent in DRV-R/TPV-S isolates. TPV resistance mutations were more prevalent in TPV-R and DRV-S isolates. These results confirm the impact of genotype on phenotype, illustrating how HIV genotype and phenotype data assist regimen optimization.

  19. Description of Discordance Between LDL Cholesterol, Non-HDL Cholesterol, and LDL Particle Number Among Patients of a Lipid Clinic

    Directory of Open Access Journals (Sweden)

    Joshua W Gaborcik

    2017-09-01

    Full Text Available Background: While LDL cholesterol measures the cholesterol content within an LDL particle (LDL-P, it may not reflect LDL-P concentrations. If discordance exists, LDL-P may better predict cardiovascular events compared to LDL-C and non-HDL cholesterol (non-HDL-C. In primary prevention patients, discordance has been associated with diabetes, ethnicity, gender, metabolic syndrome, and smoking history. Objective: To describe discordance in patients of a lipid clinic by exploring associations between patient characteristics and discordance among LDL-C, non-HDL-C, or LDL-P. Secondarily to compare proportion of patients with baseline concordance versus discordance who have ASCVD events, diagnoses of new onset diabetes or death. Methods: A retrospective, single-center cohort study at a large academic medical center was conducted. Patients establishing care from January 2009 through December 2012 with complete initial labs were included. Logistic regression models were used to explore associations between discordance and patient characteristics. Results: Of 603 patients screened, the final cohort included 166 patients with 104 (62.7% discordant. LDL-P was the most common discordant value. Discordance was associated with gender, smoking status, use of lipid lowering medications, and achieving patient specific LDL-C goals. In terms of any event observed after initial measurements, no significant differences were detected between discordant and concordant groups. Conclusion: Within a lipid clinic population, discordance was associated with male gender, smoking status, lipid-lowering therapy, and being at patient specific LDL-C goal. While associations were found in our population, clinicians should consider measuring LDL-P to fully assess presence or extent of discordance. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the

  20. Methylomic analysis of monozygotic twins discordant for autism spectrum disorder and related behavioural traits.

    Science.gov (United States)

    Wong, C C Y; Meaburn, E L; Ronald, A; Price, T S; Jeffries, A R; Schalkwyk, L C; Plomin, R; Mill, J

    2014-04-01

    Autism spectrum disorder (ASD) defines a group of common, complex neurodevelopmental disorders. Although the aetiology of ASD has a strong genetic component, there is considerable monozygotic (MZ) twin discordance indicating a role for non-genetic factors. Because MZ twins share an identical DNA sequence, disease-discordant MZ twin pairs provide an ideal model for examining the contribution of environmentally driven epigenetic factors in disease. We performed a genome-wide analysis of DNA methylation in a sample of 50 MZ twin pairs (100 individuals) sampled from a representative population cohort that included twins discordant and concordant for ASD, ASD-associated traits and no autistic phenotype. Within-twin and between-group analyses identified numerous differentially methylated regions associated with ASD. In addition, we report significant correlations between DNA methylation and quantitatively measured autistic trait scores across our sample cohort. This study represents the first systematic epigenomic analyses of MZ twins discordant for ASD and implicates a role for altered DNA methylation in autism.

  1. Molecular epidemiological analysis of paired pol/env sequences from Portuguese HIV type 1 patients.

    Science.gov (United States)

    Abecasis, Ana B; Martins, Andreia; Costa, Inês; Carvalho, Ana P; Diogo, Isabel; Gomes, Perpétua; Camacho, Ricardo J

    2011-07-01

    The advent of new therapeutic approaches targeting env and the search for efficient anti-HIV-1 vaccines make it necessary to identify the number of recombinant forms using genomic regions that were previously not frequently sequenced. In this study, we have subtyped paired pol and env sequences from HIV-1 strains infecting 152 patients being clinically followed in Portugal. The percentage of strains in which we found discordant subtypes in pol and env was 25.7%. When the subtype in pol and env was concordant (65.1%), the most prevalent subtypes were subtype B (40.8%), followed by subtype C (17.8%) and subtype G (5.3%). The most prevalent recombinant form was CRF14_BGpol/Genv (7.2%).

  2. Use of 'eradication' in HIV cure-related research: a public health debate.

    Science.gov (United States)

    Dubé, Karine; Luter, Stuart; Lesnar, Breanne; Newton, Luke; Galea, Jerome; Brown, Brandon; Gianella, Sara

    2018-02-13

    The landscape of Human Immunodeficiency Virus (HIV) research has changed drastically over the past three decades. With the remarkable success of antiretroviral treatment (ART) in decreasing AIDS-related mortality, some researchers have shifted their HIV research focus from treatment to cure research. The HIV cure research community often uses the term eradication to describe the science, and talks about eradicating the virus from the body. In public discourse, the term eradication could be conflated with disease eradication at the population level. In this paper, we call for a reframing of HIV cure research as control, as it is a more accurate descriptor and achievable goal in the foreseeable future. The properties of HIV are discordant with eradicability standards at both the individual level (as a clinical concept), and at the population level (as a public health concept). At the individual level, true eradication would necessitate absolute elimination of all latent HIV reservoirs from the body. Current HIV cure-related research strategies have proven unsuccessful at accurately quantifying, let alone eliminating these reservoirs. At the population level, eradication implies the permanent global reduction of HIV to zero new cases and to zero risk for future cases. Given the absence of an efficacious HIV vaccine and the impracticality and unethicality of eliminating animal reservoirs, global eradication of HIV is highly implausible. From a public health perspective, HIV eradication remains an elusive goal. The term 'eradication' is a misleading description of current HIV cure-related research. Instead, we call for the use of more realistic expressions such as 'sustained virologic HIV suppression (or control)' or 'management of HIV persistence' to describe HIV cure-related research. Using these terms reorients what HIV cure science can potentially achieve in the near future and avoids creating unrealistic expectations, particularly among the millions of people

  3. Cognitive function in unaffected twins discordant for affective disorder

    DEFF Research Database (Denmark)

    Christensen, Maj Vinberg; Kyvik, Kirsten Ohm; Kessing, Lars Vedel

    2006-01-01

    . Cognitive performance of 203 High-Risk and Low-Risk twins was compared. RESULTS: Healthy twins discordant for unipolar disorder showed lower performance on almost all measures of cognitive function: selective and sustained attention, executive function, language processing and working and declarative memory...... impairment found seemed to be related to genetic liability, as the MZ High-Risk twins showed significant impairment on selective and sustained attention, executive function, language processing and working and declarative memory, whereas the DZ High-Risk twins presented with significantly lower scores only......, and also after adjustment for demographic variables, subclinical symptoms and minor psychopathology. Healthy twins discordant for bipolar disorder showed lower performance on tests measuring episodic and working memory, also after adjustment for the above-mentioned covariables. The discrete cognitive...

  4. Adult glucose metabolism in extremely birthweight-discordant monozygotic twins

    DEFF Research Database (Denmark)

    Frost, M; Petersen, I; Brixen, K

    2012-01-01

    Low birthweight (BW) is associated with increased risk of type 2 diabetes. We compared glucose metabolism in adult BW-discordant monozygotic (MZ) twins, thereby controlling for genetic factors and rearing environment....

  5. Variations in KIR Genes: A Study in HIV-1 Serodiscordant Couples

    Directory of Open Access Journals (Sweden)

    Vijay R. Chavan

    2014-01-01

    Full Text Available Background. NK cells have anti-HIV activity mediated through killer cell immunoglobulin-like receptors (KIRs. The current prospective cohort study evaluated whether variation in KIR genes is associated with HIV infection in discordant couples (DCs, where one spouse remains seronegative (HSN despite repeated exposure to the HIV. Methods. KIR was genotyped using PCR SSP. Viral load and CD4 counts were estimated using commercially available reagents. Data were analyzed using SPSS software. Results. Among the 47 DCs, HSN spouses had significantly (P=0.006 higher frequencies of KIR3DS1. Regression analysis revealed significant (P=0.009 association of KIR2DS1 with low viral load. KIR2DS4 variant was associated (P=0.032 with high viral load. Three pairs of KIR genes were in strong LD in HSNs and two pairs in HSPs. There were 60 KIR genotypes, and 16 are reported the first time in the Indian population. Exclusive genotypes were present either in HSPs (N=22, 11 unique genotypes or in HSNs (n=27, 9 unique genotypes. Conclusions. This study highlights for the first time in the Indian population an association of KIR genes in HIV infection where presence of exclusive and unique genotypes indicates possible association with either HIV infection or with protection.

  6. Placental pathology, birthweight discordance, and growth restriction in twin pregnancy: results of the ESPRiT Study.

    Science.gov (United States)

    Kent, Etaoin M; Breathnach, Fionnuala M; Gillan, John E; McAuliffe, Fionnuala M; Geary, Michael P; Daly, Sean; Higgins, John R; Hunter, Alyson; Morrison, John J; Burke, Gerard; Higgins, Shane; Carroll, Stephen; Dicker, Patrick; Manning, Fiona; Tully, Elizabeth; Malone, Fergal D

    2012-09-01

    We sought to evaluate the association between placental histological abnormalities and birthweight discordance and growth restriction in twin pregnancies. We performed a multicenter, prospective study of twin pregnancies. Placentas were examined for evidence of infarction, retroplacental hemorrhage, chorangioma, subchorial fibrin, or abnormal villus maturation. Association of placental lesions with chorionicity, birthweight discordance, and growth restriction were assessed. In all, 668 twin pairs were studied, 21.1% monochorionic and 78.9% dichorionic. Histological abnormalities were more frequent in placentas of smaller twins of birthweight discordant pairs (P = .02) and in placentas of small for gestational age infants (P = .0001) when compared to controls. The association of placental abnormalities with both birthweight discordance and small for gestational age was significant for dichorionic twins (P = .01 and .0001, respectively). No such association was seen in monochorionic twins. In a large, prospective, multicenter study, we observed a strong relationship between abnormalities of placental histology and birthweight discordance and growth restriction in dichorionic, but not monochorionic, twin pregnancies. Copyright © 2012 Mosby, Inc. All rights reserved.

  7. Hybrid modelling of bed-discordant river confluences

    Science.gov (United States)

    Franca, M. J.; Guillén-Ludeña, S.; Cheng, Z.; Cardoso, A. H.; Constantinescu, G.

    2016-12-01

    In fluvial networks, tributaries are the main providers of sediment and water to the main rivers. Furthermore, confluences are environmental hotspots since they provide ecological connectivity and flow and morphology diversity. Mountain confluences, in particular, are characterized by narrow and steep tributaries that provide important sediment load to the confluence, whereas the main channel supplies the dominant flow discharge. This results in a marked bed discordance between the tributary and main channel. This discordance has been observed to be a key feature that alters the dynamics of the confluence, when compared to concordant confluences. The processes of initiation and maintenance of the morphology of confluences is still unknown, and research linking morphodynamics and hydrodynamics of river confluences is required to understand this. Here, a hybrid approach combining laboratory experiments made in a live-bed model of a river confluence, with 3D numerical simulations using advanced turbulence models is presented. We use the laboratory experiments performed by Guillén-Ludeña et al. (2016) for a 70o channel confluence, which focused on sediment transport and morphology changes rather than on the structure of the flow. Highly eddy resolving simulations were performed for two extreme bathymetric conditions, at the start of the experiment and at equilibrium scour conditions. The first allows to understand the initiation mechanisms which will condition later the equilibrium morphology. The second allows to understand the hydrodynamics actions which keep the equilibrium morphology. The patterns of the mean flow, turbulence and dynamics of the large-scale coherent structures, show how the main sediment-entrainment mechanisms evolve during the scour process. The present results contribute to a better understanding of the interaction between bed morphology and flow dynamics at discordant mountain river confluences.

  8. HIV / AIDS and the law.

    Science.gov (United States)

    1997-09-01

    Since HIV is sexually transmitted, people living with AIDS and HIV (PWA/PHA) risk being stigmatized as immoral and promiscuous and they are often discriminated against in society. To this effect, the South African AIDS Law Project and Lawyers for Human Rights have developed a comprehensive resource manual detailing human rights with a special emphasis on issues relevant to PWA/PHA. The concept of the manual aimed to look at the legal and human rights questions that have been raised by the HIV/AIDS epidemic; inform people living with HIV/AIDS about their rights and the law; provide people working in businesses, trade unions, and nongovernmental organization with information about correct and incorrect responses to HIV/AIDS; and give victims of discrimination ideas on how to fight back. This manual initially introduces basic facts about HIV and AIDS and then describes the legal system and the Bill of Rights within the new South African Constitution. The main areas of focus in the manual include: 1) patient's medical rights, 2) employment rights, 3) women's rights, 4) the rights of lesbians and gay men, 5) the rights of youth and children, 6) the rights of prisoners, 7) social support for PWA, 8) HIV/AIDS and insurance law, 9) power of attorney and making wills, 10) criminal law, and 11) legal remedies, such as using the law to protect one's rights.

  9. Is the risk of HIV acquisition increased during and immediately after pregnancy? A secondary analysis of pooled HIV community-based studies from the ALPHA network.

    Directory of Open Access Journals (Sweden)

    Milly Marston

    Full Text Available Previous studies of HIV acquisition in pregnancy have been in specific population groups, such as sero-discordant couples which have shown an increased risk of HIV acquisition during pregnancy and studies of sexually active women where the results have been ambiguous. However these studies are unable to tell us what the overall impact of pregnancy is on HIV acquisition in the general population.Data from six community-based HIV cohorts were pooled to give 2,628 sero-conversions and a total of 178,000 person years of observation. Multiple imputation was used to allow for the uncertainty of exact sero-conversion date in surveillance intervals greater than the length of a pregnancy. Results were combined using Rubin's rules to give appropriate error bounds. The analysis was stratified into two periods: pre- and post- widespread availability of prevention of mother-to-child HIV transmission services. This allows us to assess whether there is reporting bias relating to a person's knowledge of their own HIV status which would become more widespread in the latter time period.Results suggest that women while pregnant have a lower risk of acquiring HIV infection over all periods (HRR 0.79, 95%CI 0.70-0.89 than women who were not pregnant. There is no evidence for a difference in the rate of HIV acquisition between postpartum and non-pregnant women (HRR 0.92 95%CI 0.84-1.03.Although there may be immunological reasons for increased risk of HIV acquisition during pregnancy, at a population level this study indicates a lower risk of HIV acquisition for pregnant women. Pregnant women may be more likely to be concordant with their current sexual partner than non-pregnant women, i.e. either already HIV positive prior to the pregnancy or if negative at the time of becoming pregnant more likely to have a negative partner.

  10. Development of AACAP practice parameters for gender nonconformity and gender discordance in children and adolescents.

    Science.gov (United States)

    Adelson, Stewart L

    2011-10-01

    The American Academy of Child and Adolescent Psychiatry (AACAP) is preparing a publication, Practice Parameter on Gay, Lesbian or Bisexual Sexual Orientation, Gender-Nonconformity, and Gender Discordance in Children and Adolescents. This article discusses the development of the part of the parameter related to gender nonconformity and gender discordance and describes the practice parameter preparation process,rationale, key scientific evidence, and methodology. Also discussed are terminology considerations, related clinical issues and practice skills, and overall organization of information including influences on gender development, gender role behavior, gender nonconformity and gender discordance, and their relationship to the development of sexual orientation.

  11. Discordance Rate between Thyroid Fine Needle Aspiration Cytology ...

    African Journals Online (AJOL)

    Discordance Rate between Thyroid Fine Needle Aspiration Cytology and Histopathologic Diagnosis. Wondwossen Ergete, Daniel Abebe. Abstract. Fine Needle Aspiration (FNA) of the thyroid is a low cost procedure, which can give an accurate diagnosis promptly. The objective of this study was to assess the diagnostic ...

  12. DNA Methylation Changes in the IGF1R Gene in Birth Weight Discordant Adult Monozygotic Twins

    DEFF Research Database (Denmark)

    Tsai, Pei-Chien; Van Dongen, Jenny; Tan, Qihua

    2015-01-01

    persists into adulthood. To investigate this further, we performed epigenome-wide association analyses of blood DNA methylation using Infinium HumanMethylation450 BeadChip profiles in 71 adult monozygotic (MZ) twin pairs who were extremely discordant for birth weight. A signal mapping to the IGF1R gene (cg...... were not significant. However, a meta-analysis across the four independent samples, in total 216 birth-weight discordant MZ twin pairs, showed a significant positive association between birth weight and DNA methylation differences at IGF1R (random-effects meta-analysis p = .04), and the effect...... was particularly pronounced in older twins (random-effects meta-analysis p = .008, 98 older birth-weight discordant MZ twin pairs). The results suggest that severe intra-uterine growth differences (birth weight discordance >20%) are associated with methylation changes in the IGF1R gene in adulthood, independent...

  13. Focusing the HIV response through estimating the major modes of HIV transmission: a multi-country analysis

    Science.gov (United States)

    Gouws, Eleanor; Cuchi, Paloma

    2012-01-01

    Objective An increasing number of countries have been estimating the distribution of new adult HIV infections by modes of transmission (MOT) to help prioritise prevention efforts. We compare results from studies conducted between 2008 and 2012 and discuss their use for planning and responding to the HIV epidemic. Methods The UNAIDS recommended MOT model helps countries to estimate the proportion of new HIV infections that occur through key transmission modes including sex work, injecting drug use (IDU), men having sex with men (MSM), multiple sexual partnerships, stable relationships and medical interventions. The model typically forms part of a country-led process that includes a comprehensive review of epidemiological data. Recent revisions to the model are described. Results Modelling results from 25 countries show large variation between and within regions. In sub-Saharan Africa, new infections occur largely in the general heterosexual population because of multiple partnerships or in stable discordant relationships, while sex work contributes significantly to new infections in West Africa. IDU and sex work are the main contributors to new infections in the Middle East and North Africa, with MSM the main contributor in Latin America. Patterns vary substantially between countries in Eastern Europe and Asia in terms of the relative contribution of sex work, MSM, IDU and spousal transmission. Conclusions The MOT modelling results, comprehensive review and critical assessment of data in a country can contribute to a more strategically focused HIV response. To strengthen this type of research, improved epidemiological and behavioural data by risk population are needed. PMID:23172348

  14. The association between weight gain during pregnancy and intertwin delivery weight discordance using 2011-2015 birth registration data from the USA.

    Science.gov (United States)

    Xiao, Yanni; Shen, Minxue; Ma, Shujuan; Tao, Xuan; Wen, Shi Wu; Tan, Hongzhuan

    2018-06-01

    To assess the effect of weight gain during pregnancy on intertwin delivery weight discordance. In the present retrospective cohort study using twin delivery records, data were extracted from the 2011-2015 USA birth registration dataset created by the Centers for Disease Control and Prevention. The outcome variable was delivery weight discordance. The nonlinear association of weight gain during pregnancy with delivery weight discordance was examined using a generalized additive model, adjusting for potential confounders. A total of 255 627 twin pairs were included in this analysis. Weight gain during pregnancy showed an inverse, yet nonlinear, association with intertwin delivery weight discordance. Women with weight gain of approximately 25 kg exhibited the lowest level of discordance. When stratified by pre-pregnancy body mass index, the association of weight gain with discordance became insignificant among obese women. When categorizing weight gain according to recommendations from the Institute of Medicine, inadequate weight gain was associated with increased risk of discordance among women of any pre-pregnancy body mass index. Twin pregnancies with maternal weight gain of approximately 25 kg demonstrated the lowest risk of developing intertwin delivery weight discordance, while inadequate weight gain was a risk factor for delivery weight discordance in all pre-pregnancy body mass index categories. © 2018 International Federation of Gynecology and Obstetrics.

  15. European union standards for tuberculosis care.

    Science.gov (United States)

    Migliori, G B; Zellweger, J P; Abubakar, I; Ibraim, E; Caminero, J A; De Vries, G; D'Ambrosio, L; Centis, R; Sotgiu, G; Menegale, O; Kliiman, K; Aksamit, T; Cirillo, D M; Danilovits, M; Dara, M; Dheda, K; Dinh-Xuan, A T; Kluge, H; Lange, C; Leimane, V; Loddenkemper, R; Nicod, L P; Raviglione, M C; Spanevello, A; Thomsen, V Ø; Villar, M; Wanlin, M; Wedzicha, J A; Zumla, A; Blasi, F; Huitric, E; Sandgren, A; Manissero, D

    2012-04-01

    The European Centre for Disease Prevention and Control (ECDC) and the European Respiratory Society (ERS) jointly developed European Union Standards for Tuberculosis Care (ESTC) aimed at providing European Union (EU)-tailored standards for the diagnosis, treatment and prevention of tuberculosis (TB). The International Standards for TB Care (ISTC) were developed in the global context and are not always adapted to the EU setting and practices. The majority of EU countries have the resources and capacity to implement higher standards to further secure quality TB diagnosis, treatment and prevention. On this basis, the ESTC were developed as standards specifically tailored to the EU setting. A panel of 30 international experts, led by a writing group and the ERS and ECDC, identified and developed the 21 ESTC in the areas of diagnosis, treatment, HIV and comorbid conditions, and public health and prevention. The ISTCs formed the basis for the 21 standards, upon which additional EU adaptations and supplements were developed. These patient-centred standards are targeted to clinicians and public health workers, providing an easy-to-use resource, guiding through all required activities to ensure optimal diagnosis, treatment and prevention of TB. These will support EU health programmes to identify and develop optimal procedures for TB care, control and elimination.

  16. Evaluation of simple rapid HIV assays and development of national rapid HIV test algorithms in Dar es Salaam, Tanzania.

    Science.gov (United States)

    Lyamuya, Eligius F; Aboud, Said; Urassa, Willy K; Sufi, Jaffer; Mbwana, Judica; Ndugulile, Faustin; Massambu, Charles

    2009-02-18

    alternative confirmatory HIV testing strategy based on initial testing on either SD Bioline or Determine assays followed by testing of reactive samples on the Determine or SD Bioline gave 100% sensitivity (95% CI; 99.1-100) and 100% specificity (95% CI; 96-99.1) with Uni-Gold as tiebreaker for discordant results.

  17. Management of language discordance in clinical nursing practice--A critical review.

    Science.gov (United States)

    Probst, Sebastian; Imhof, Lorenz

    2016-05-01

    Language plays an essential role in the provision of nursing care, since successful communication is a vital prerequisite to being able to provide appropriate nursing care efficiently and effectively. It is not known what kinds of interventions are effective in overcoming language discordance in nursing practice. This critical review aimed to examine the interventions that are most successfully used to overcome language discordance in nursing. A critical review of the literature was performed and 24 relevant research papers were included. A search was carried out between January 2004 and September 2014 in MEDLINE, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychinfo, Germanistic online, Pragmatis and Linguistic & Language Behaviour Abstracts (LLBA). Both authors independently screened the titles (n=299), abstracts and full texts to decide which articles should be chosen. The inclusion criteria were: (1) articles examine the problem of language discordance in various health care settings and (2) articles published in English, German, French or Italian. Articles were included irrespective of their design. Data were analysed using the Critical Appraisal Skills Program Tool (CASP). In total, 24 publications met the inclusion criteria. Most of the studies (n=20) were focused on the nursing intervention of using an interpreter and three were describing the nursing assessment. The study designs of the included studies were mainly non-experimental studies, qualitative studies or reviews. The only suggested intervention described in the articles is the use of ad-hoc or professional interpreters for communicating with patients who do not speak the local language. Health care institutions should provide more strategies for clinical practice to overcome language discordance. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Examining the Relationship between Communication Patterns of Source Family and Self-Consciousness with Defensive Styles of Discordant Couples

    OpenAIRE

    Ma’asoomeh Kheirkhah; Ebrahim Namani

    2016-01-01

    Research has shown the relationship between communication patterns of source family with defensive styles of discordant couples. For this reason, the present research has examined the relationship between communication patterns of source family and self-consciousness with defensive styles of discordant couples. This study is a descriptive-correlation type. Its population consisted of all discordant couples referred to counseling centers of Mashhad in 2015. Among the referred 140 disc...

  19. Assessment of the utilization of pre-marital HIV testing services and ...

    African Journals Online (AJOL)

    Preferred Customer

    focused VCT services provides a high leverage HIV prevention intervention for African countries (2). Documentation in VCT centers in Addis Ababa has shown that both couples already in union and couples preparing to be married visit the centers ...

  20. Entanglement and discord for qubits and higher spin systems

    Indian Academy of Sciences (India)

    In this paper, after §2 that sets out definitions and notation, §3 will consider an entangled pair of ... Section 4 presents a correlation called discord between two subsystems [7] .... Its 'triplet' counterpart, with a plus sign in place of the minus,.

  1. Decoherence, discord, and the quantum master equation for cosmological perturbations

    Science.gov (United States)

    Hollowood, Timothy J.; McDonald, Jamie I.

    2017-05-01

    We examine environmental decoherence of cosmological perturbations in order to study the quantum-to-classical transition and the impact of noise on entanglement during inflation. Given an explicit interaction between the system and environment, we derive a quantum master equation for the reduced density matrix of perturbations, drawing parallels with quantum Brownian motion, where we see the emergence of fluctuation and dissipation terms. Although the master equation is not in Lindblad form, we see how typical solutions exhibit positivity on super-horizon scales, leading to a physically meaningful density matrix. This allows us to write down a Langevin equation with stochastic noise for the classical trajectories which emerge from the quantum system on super-horizon scales. In particular, we find that environmental decoherence increases in strength as modes exit the horizon, with the growth driven essentially by white noise coming from local contributions to environmental correlations. Finally, we use our master equation to quantify the strength of quantum correlations as captured by discord. We show that environmental interactions have a tendency to decrease the size of the discord and that these effects are determined by the relative strength of the expansion rate and interaction rate of the environment. We interpret this in terms of the competing effects of particle creation versus environmental fluctuations, which tend to increase and decrease the discord respectively.

  2. Patient-physician discordance in global assessment in early spondyloarthritis and its change over time: the DESIR cohort.

    Science.gov (United States)

    Desthieux, Carole; Molto, Anna; Granger, Benjamin; Saraux, Alain; Fautrel, Bruno; Gossec, Laure

    2016-09-01

    To assess patient-physician discordance in global assessment of disease activity in early axial spondyloarthritis (axSpA) over time and determinants of discordance. DESIR (Devenir des Spondyloarthropathies Indifférenciées Récentes) is a French, multicentre, longitudinal cohort of patients with early inflammatory back pain suggestive of axSpA. Patient global assessment (PGA) and physician global assessment (PhGA) were rated with a 0-10 numerical rating scale, every 6 months during 2 years then at 3 years. Discordance was defined by the absolute difference |PGA-PhGA|≥3 (range 0-10) and was analysed at each visit. Determinants of (PGA-PhGA) were assessed at the visit level by a generalised linear mixed model. A total of 702 patients were analysed at baseline (401 with complete data over 3 years): mean age 33.8±8.6 years, 379 (54.0%) female, mean symptom duration 18.1±10.5 months. Mean PGA values were always higher than mean PhGA values with a mean absolute difference of 1.8 points. At baseline, 202 (28.8%) patients had discordance mainly by PGA>PhGA; over 3 years the frequency of discordance was stable (range 25.5-28.8%). Discordance was not stable at the patient level, 118 (29.4%) patients were discordant once and 88 (22.0%) twice, and only 92 (22.9%) more than twice. Determinants of (PGA-PhGA) were spine pain (β=0.24, ppatient characteristic. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Consensual Unions in Burkina Faso: Trends and Determinants

    Directory of Open Access Journals (Sweden)

    Younoussi, Zourkaleini

    2009-01-01

    Full Text Available AbstractThis paper examines entry into consensual unions versus marriages in BurkinaFaso, a topic that has received little attention to date in sub-Saharan Africa.Changes in marriage behaviors may entail or reflect profound changes in familyorganization, gender relations and fertility and, to the extent that consensualunions are relatively transitory and lead to more sexual partners, they may beassociated with greater sexual risks including HIV. The determinants of newunions being consensual are estimated from national family-life type survey datathat provide information on the timing of different types of marriages and thestart of cohabitation. While consensual unions are not new to the country, theyappear to be changing in nature and have been growing more common overtime especially in urban areas. They are also more popular among men andwomen with greater schooling or who began cohabiting while living outside thecountry, and for women who have previously lived in union.RésuméCet article compare les entrées en unions libres avec et les mariages au BurkinaFaso, un sujet ayant reçu peu d'attention en Afrique sub-saharienne jusqu'àprésent. Les changements de comportements reliés au mariage peuventimpliquer ou refléter de profondes modifications dans l'organisation desfamilles, dans les relations entre les sexes et dans la fécondité. Si les unionslibres sont en général plus transitoires que le mariage et entraînent un plusgrand nombre de partenaires sexuels, elles peuvent être associées à une haussede pratiques sexuelles à risque pouvant mener aux infections du VIH. Lesdéterminants de type d'union (libre ou mariage ont été estimés en utilisant lesdonnées d'une enquête nationale de type biographique à l'aide d'information surla chronologie des différents types de mariage et les débuts de cohabitation.Bien que les unions libres ne soient pas un nouveau phénomène au BurkinaFaso, il semble que leur nature s'évolue sur le

  4. Placental cord insertion and birthweight discordance in twin pregnancies: results of the national prospective ESPRiT Study.

    Science.gov (United States)

    Kent, Etaoin M; Breathnach, Fionnuala M; Gillan, John E; McAuliffe, Fionnuala M; Geary, Michael P; Daly, Sean; Higgins, John R; Dornan, James; Morrison, John J; Burke, Gerard; Higgins, Shane; Carroll, Stephen; Dicker, Patrick; Manning, Fiona; Malone, Fergal D

    2011-10-01

    The purpose of this study was to evaluate the impact of noncentral placental cord insertion on birthweight discordance in twins. We performed a multicenter, prospective trial of twin pregnancies. Placental cord insertion was documented as central, marginal, or velamentous according to a defined protocol. Association of the placental cord insertion site with chorionicity, birthweight discordance, and growth restriction were assessed. Eight hundred sixteen twin pairs were evaluated; 165 pairs were monochorionic, and 651 pairs were dichorionic. Monochorionic twins had higher rates of marginal (P = .0068) and velamentous (P < .0001) placental cord insertion. Noncentral placental cord insertion was more frequent in smaller twins of discordant pairs than control pairs (29.8% vs 19.1%; P = .004). Velamentous placental cord insertion in monochorionic twins was associated significantly with birthweight discordance (odds ratio, 3.5; 95% confidence interval, 1.3-9.4) and growth restriction (odds ratio, 4; 95% confidence interval, 1.1-14.3). Noncentral placental cord insertion contributes to birthweight discordance in monochorionic twin pregnancies. Sonographic delineation of placental cord insertion may be of value in antenatal assessment of twin pregnancies. Copyright © 2011 Mosby, Inc. All rights reserved.

  5. Prevalence of discordant microscopic changes with automated CBC analysis

    Directory of Open Access Journals (Sweden)

    Fabiano de Jesus Santos

    2014-12-01

    Full Text Available Introduction:The most common cause of diagnostic error is related to errors in laboratory tests as well as errors of results interpretation. In order to reduce them, the laboratory currently has modern equipment which provides accurate and reliable results. The development of automation has revolutionized the laboratory procedures in Brazil and worldwide.Objective:To determine the prevalence of microscopic changes present in blood slides concordant and discordant with results obtained using fully automated procedures.Materials and method:From January to July 2013, 1,000 hematological parameters slides were analyzed. Automated analysis was performed on last generation equipment, which methodology is based on electrical impedance, and is able to quantify all the figurative elements of the blood in a universe of 22 parameters. The microscopy was performed by two experts in microscopy simultaneously.Results:The data showed that only 42.70% were concordant, comparing with 57.30% discordant. The main findings among discordant were: Changes in red blood cells 43.70% (n = 250, white blood cells 38.46% (n = 220, and number of platelet 17.80% (n = 102.Discussion:The data show that some results are not consistent with clinical or physiological state of an individual, and cannot be explained because they have not been investigated, which may compromise the final diagnosis.Conclusion:It was observed that it is of fundamental importance that the microscopy qualitative analysis must be performed in parallel with automated analysis in order to obtain reliable results, causing a positive impact on the prevention, diagnosis, prognosis, and therapeutic follow-up.

  6. A social work study for the effects of different factors on compatible and discordant couples

    Directory of Open Access Journals (Sweden)

    Mehdi Esalat

    2012-04-01

    Full Text Available In this paper, we perform an empirical investigation to examine the impact different factors on compatible and discordant couples. The survey is performed in one of western regions of Iran near the city of Esfahan. In our study, we choose two groups of people from the population with no family dispute and from the people who have requested divorce. They are asked to fill in a questionnaire and the results are analyzed. We used Chi-square tests to verify any meaningful difference between compatible and discordant couples on different issues. The survey concludes that compatible and discordant couples were different in their motivation, marital satisfaction, continued incentive generation, finding better position among relatives and accomplishing their religious duties to get married.

  7. Unions, Vitamins, Exercise: Unionized Graduate Students

    Science.gov (United States)

    Dewberry, David R.

    2005-01-01

    After the turbulent labor history of America in the early to mid twentieth century, there has been a general decline of unions. Nevertheless, many graduate school teaching assistants are unionizing in attempts to gain better pay and benefits and remove themselves from an "Ivory Sweatshop." This article discusses a history of unions…

  8. [Status of marriage and HIV transmission between couples in newly reported HIV cases before diagnosis was made, among men who have sex with men in China, 2014].

    Science.gov (United States)

    Li, J; Han, J; Xu, J; Tang, H L; Mao, Y R

    2017-06-10

    Objective: To analyze the status of marriage and HIV transmission between couples in newly reported HIV cases before diagnoses were made, among men who have sex with men (MSM) in China. Methods: Baseline and follow-up information related to newly reported cases in 2014 were collected from the Chinese HIV/AIDS Comprehensive Response Information Management System. Infected MSM who were older than 22 years of age were included in this study. HIV cases were divided into sero-concordant or sero-discordant group, according to the HIV status of the couple who were tested 180 days post-diagnosis. Multivariate logistic regression method was used to analyze the potential factors associated with HIV transmission between couples before diagnosis was made. Results: A total of 5 081 (22.7 % ) of the HIV infected MSM who had couples, were included in this study. A total of 3 715 cases had their couples tested 180 days after the diagnosis was made. 7.6 % (282) had positive couples. Results from the multivariate logistic regression analysis showed that factors as: older than 60 ( OR =2.64, 95 % CI : 1.50-4.65) years of age, being minorities ( OR =1.93, 95 % CI : 1.13-3.29), having CD(4)(+)T cells less than 500 cells/μl (<200: OR =2.91, 95 %CI : 1.82-4.65; 200-349: OR =1.98, 95 %CI : 1.22-3.23; 350-500: OR =1.69, 95 %CI : 1.00-2.86), with self-reported unsafe behaviors ( OR =1.92, 95 % CI : 1.44-2.58) etc. , were more likely to transmit HIV to their couples before the diagnosis was made. Conclusion: Behavior interventions and early HIV testing should be promoted, especially among those MSM who had couples, to avoid inter-spousal transmission.

  9. Factors associated with unintended pregnancy, poor birth outcomes and post-partum contraceptive use among HIV-positive female adolescents in Kenya.

    Science.gov (United States)

    Obare, Francis; van der Kwaak, Anke; Birungi, Harriet

    2012-10-06

    Although the experiences of unintended pregnancies and poor birth outcomes among adolescents aged 15-19 years in the general population are well documented, there is limited understanding of the same among those who are living with HIV. This paper examines the factors associated with experiencing unintended pregnancies, poor birth outcomes, and post-partum contraceptive use among HIV-positive female adolescents in Kenya. Data are from a cross-sectional study that captured information on pregnancy histories of HIV-positive female adolescents in four regions of Kenya: Coast, Nairobi, Nyanza and Rift Valley provinces. Study participants were identified through HIV and AIDS programs in the four regions. Out of a total of 797 female participants, 394 had ever been pregnant with 24% of them experiencing multiple pregnancies. Analysis entails the estimation of random-effects logit models. Higher order pregnancies were just as likely to be unintended as lower order ones (odds ratios [OR]: 1.2; 95% confidence interval [CI]: 0.8-2.0) while pregnancies occurring within marital unions were significantly less likely to be unintended compared to those occurring outside such unions (OR: 0.1; 95% CI: 0.1-0.2). Higher order pregnancies were significantly more likely to result in poor outcomes compared to lower order ones (OR: 2.5; 95% CI: 1.6-4.0). In addition, pregnancies occurring within marital unions were significantly less likely to result in poor outcomes compared to those occurring outside such unions (OR: 0.3; 95% CI: 0.1-0.9). However, experiencing unintended pregnancy was not significantly associated with adverse birth outcomes (OR: 1.3; 95% CI: 0.5-3.3). There was also no significant difference in the likelihood of post-partum contraceptive use by whether the pregnancy was unintended (OR: 0.9; 95% CI: 0.5-1.5). The experience of repeat unintended pregnancies among HIV-positive female adolescents in the sample is partly due to inconsistent use of contraception to prevent

  10. Proposed EU-India free trade agreement could impede manufacture of generic HIV drugs.

    Science.gov (United States)

    Chu, Sandra Ka Hon

    2011-04-01

    Medical experts are warning that an international trade agreement being brokered between the European Union (EU) and India could greatly restrict the access of people living with HIV in the developing world to life-saving antiretroviral medication.

  11. Quantum discord length is enhanced while entanglement length is not by introducing disorder in a spin chain.

    Science.gov (United States)

    Sadhukhan, Debasis; Roy, Sudipto Singha; Rakshit, Debraj; Prabhu, R; Sen De, Aditi; Sen, Ujjwal

    2016-01-01

    Classical correlation functions of ground states typically decay exponentially and polynomially, respectively, for gapped and gapless short-range quantum spin systems. In such systems, entanglement decays exponentially even at the quantum critical points. However, quantum discord, an information-theoretic quantum correlation measure, survives long lattice distances. We investigate the effects of quenched disorder on quantum correlation lengths of quenched averaged entanglement and quantum discord, in the anisotropic XY and XYZ spin glass and random field chains. We find that there is virtually neither reduction nor enhancement in entanglement length while quantum discord length increases significantly with the introduction of the quenched disorder.

  12. QUANTUM DISCORD AND QUANTUM COMPUTING - AN APPRAISAL

    OpenAIRE

    Datta, Animesh; Shaji, Anil

    2011-01-01

    We discuss models of computing that are beyond classical. The primary motivation is to unearth the cause of nonclassical advantages in computation. Completeness results from computational complexity theory lead to the identification of very disparate problems, and offer a kaleidoscopic view into the realm of quantum enhancements in computation. Emphasis is placed on the `power of one qubit' model, and the boundary between quantum and classical correlations as delineated by quantum discord. A ...

  13. Trade union revitalisation

    DEFF Research Database (Denmark)

    Ibsen, Christian Lyhne; Tapia, Maite

    2017-01-01

    In this article, we review and assess research on the role of trade unions in labour markets and society, the current decline of unions and union revitalisation. The review shows three main trends. First, trade unions are converging into similar strategies of revitalisation. The ‘organising model...... their traditional strongholds of collective bargaining and corporatist policy-making. Second, research has shown that used strategies are not a panacea for success for unions in countries that pearheaded revitalisation. This finding points to the importance of supportive institutional frameworks if unions...... in adverse institutional contexts, can be effective when they reinvent their repertoires of contention, through political action or campaigning along global value chains....

  14. Short- and long-term perinatal outcome in twin pregnancies affected by weight discordance

    DEFF Research Database (Denmark)

    Vedel, Cathrine; Oldenburg, Anna; Worda, Katharina

    2017-01-01

    INTRODUCTION: The objective was to investigate the association between chorionicity-specific intertwin birthweight discordance and adverse outcomes including long-term follow up at 6, 18, and 48-60 months after term via Ages and Stages Questionnaire. MATERIAL AND METHODS: In this secondary analysis...... outcomes. Ages and Stages Questionnair scores were compared using the method of generalized estimating equation to account for the correlation within twins. RESULTS: The 75th and 90th percentiles for birthweight discordance were 14.8 and 21.4% for monochorionic and 16.0 and 23.8% for dichorionic twins...

  15. Visual Bias Predicts Gait Adaptability in Novel Sensory Discordant Conditions

    Science.gov (United States)

    Brady, Rachel A.; Batson, Crystal D.; Peters, Brian T.; Mulavara, Ajitkumar P.; Bloomberg, Jacob J.

    2010-01-01

    We designed a gait training study that presented combinations of visual flow and support-surface manipulations to investigate the response of healthy adults to novel discordant sensorimotor conditions. We aimed to determine whether a relationship existed between subjects visual dependence and their postural stability and cognitive performance in a new discordant environment presented at the conclusion of training (Transfer Test). Our training system comprised a treadmill placed on a motion base facing a virtual visual scene that provided a variety of sensory challenges. Ten healthy adults completed 3 training sessions during which they walked on a treadmill at 1.1 m/s while receiving discordant support-surface and visual manipulations. At the first visit, in an analysis of normalized torso translation measured in a scene-movement-only condition, 3 of 10 subjects were classified as visually dependent. During the Transfer Test, all participants received a 2-minute novel exposure. In a combined measure of stride frequency and reaction time, the non-visually dependent subjects showed improved adaptation on the Transfer Test compared to their visually dependent counterparts. This finding suggests that individual differences in the ability to adapt to new sensorimotor conditions may be explained by individuals innate sensory biases. An accurate preflight assessment of crewmembers biases for visual dependence could be used to predict their propensities to adapt to novel sensory conditions. It may also facilitate the development of customized training regimens that could expedite adaptation to alternate gravitational environments.

  16. Scales of Time Where the Quantum Discord Allows an Efficient Execution of the DQC1 Algorithm

    Directory of Open Access Journals (Sweden)

    M. Ávila

    2014-01-01

    Full Text Available The power of one qubit deterministic quantum processor (DQC1 (Knill and Laflamme (1998 generates a nonclassical correlation known as quantum discord. The DQC1 algorithm executes in an efficient way with a characteristic time given by τ=Tr[Un]/2n, where Un is an n qubit unitary gate. For pure states, quantum discord means entanglement while for mixed states such a quantity is more than entanglement. Quantum discord can be thought of as the mutual information between two systems. Within the quantum discord approach the role of time in an efficient evaluation of τ is discussed. It is found that the smaller the value of t/T is, where t is the time of execution of the DQC1 algorithm and T is the scale of time where the nonclassical correlations prevail, the more efficient the calculation of τ is. A Mösbauer nucleus might be a good processor of the DQC1 algorithm while a nuclear spin chain would not be efficient for the calculation of τ.

  17. Nanogeochronology of discordant zircon measured by atom probe microscopy of Pb-enriched dislocation loops

    Science.gov (United States)

    Peterman, Emily M.; Reddy, Steven M.; Saxey, David W.; Snoeyenbos, David R.; Rickard, William D. A.; Fougerouse, Denis; Kylander-Clark, Andrew R. C.

    2016-01-01

    Isotopic discordance is a common feature in zircon that can lead to an erroneous age determination, and it is attributed to the mobilization and escape of radiogenic Pb during its post-crystallization geological evolution. The degree of isotopic discordance measured at analytical scales of ~10 μm often differs among adjacent analysis locations, indicating heterogeneous distributions of Pb at shorter length scales. We use atom probe microscopy to establish the nature of these sites and the mechanisms by which they form. We show that the nanoscale distribution of Pb in a ~2.1 billion year old discordant zircon that was metamorphosed c. 150 million years ago is defined by two distinct Pb reservoirs. Despite overall Pb loss during peak metamorphic conditions, the atom probe data indicate that a component of radiogenic Pb was trapped in 10-nm dislocation loops that formed during the annealing of radiation damage associated with the metamorphic event. A second Pb component, found outside the dislocation loops, represents homogeneous accumulation of radiogenic Pb in the zircon matrix after metamorphism. The 207Pb/206Pb ratios measured from eight dislocation loops are equivalent within uncertainty and yield an age consistent with the original crystallization age of the zircon, as determined by laser ablation spot analysis. Our results provide a specific mechanism for the trapping and retention of radiogenic Pb during metamorphism and confirm that isotopic discordance in this zircon is characterized by discrete nanoscale reservoirs of Pb that record different isotopic compositions and yield age data consistent with distinct geological events. These data may provide a framework for interpreting discordance in zircon as the heterogeneous distribution of discrete radiogenic Pb populations, each yielding geologically meaningful ages. PMID:27617295

  18. Beyond HIV-serodiscordance: Partnership communication dynamics that affect engagement in safer conception care.

    Science.gov (United States)

    Matthews, Lynn T; Burns, Bridget F; Bajunirwe, Francis; Kabakyenga, Jerome; Bwana, Mwebesa; Ng, Courtney; Kastner, Jasmine; Kembabazi, Annet; Sanyu, Naomi; Kusasira, Adrine; Haberer, Jessica E; Bangsberg, David R; Kaida, Angela

    2017-01-01

    We explored acceptability and feasibility of safer conception methods among HIV-affected couples in Uganda. We recruited HIV-positive men and women on antiretroviral therapy (ART) ('index') from the Uganda Antiretroviral Rural Treatment Outcomes cohort who reported an HIV-negative or unknown-serostatus partner ('partner'), HIV-serostatus disclosure to partner, and personal or partner desire for a child within two years. We conducted in-depth interviews with 40 individuals from 20 couples, using a narrative approach with tailored images to assess acceptability of five safer conception strategies: ART for the infected partner, pre-exposure prophylaxis (PrEP) for the uninfected partner, condomless sex timed to peak fertility, manual insemination, and male circumcision. Translated and transcribed data were analyzed using thematic analysis. 11/20 index participants were women, median age of 32.5 years, median of 2 living children, and 80% had HIV-RNA perception: Participants had disparate understandings of HIV transmission and disagreed on the acceptable level of HIV risk to meet reproductive goals. (4) Partnership commitment: Participants revealed significant discord in perceptions of partnership commitment. All four types of partnership miscommunication introduced constraints to autonomous reproductive decision-making, particularly for women. Such miscommunication was common, as only 2 of 20 partnerships in our sample were mutually-disclosed with agreement across all four communication themes. Enthusiasm for safer conception programming is growing. Our findings highlight the importance of addressing gendered partnership communication regarding HIV disclosure, reproductive goals, acceptable HIV risk, and commitment, alongside technical safer conception advice. Failing to consider partnership dynamics across these domains risks limiting reach, uptake, adherence to, and retention in safer conception programming.

  19. Sleep-EEG in dizygotic twins discordant for Williams syndrome.

    Science.gov (United States)

    Bódizs, Róbert; Gombos, Ferenc; Szocs, Katalin; Réthelyi, János M; Gerván, Patrícia; Kovács, Ilona

    2014-01-30

    Reports on twin pairs concordant and discordant for Williams syndrome were published before, but no study unravelled sleep physiology in these cases yet. We aim to fill this gap by analyzing sleep records of a twin pair discordant for Williams syndrome extending our focus on presleep wakefulness and sleep spindling. We performed multiplex ligation-dependent probe amplification of the 7q11.23 region of a 17 years old dizygotic opposite-sex twin pair discordant for Williams syndrome. Polysomnography of laboratory sleep at this age was analyzed and followed-up after 1.5 years by ambulatory polysomnography. Sleep stages scoring, EEG power spectra and sleep spindle analyses were carried out. The twin brother showed reduced levels of amplification for all of the probes in the 7q11.23 region indicating a typical deletion spanning at least 1.038 Mb between FKBP6 and CLIP2. The results of the twin sister showed normal copy numbers in the investigated region. Lower sleep times and efficiencies, as well as higher slow wave sleep percents of the twin brother were evident during both recordings. Roughly equal NREM, Stage 2 and REM sleep percents were found. EEG analyses revealed state and derivation-independent decreases in alpha power, lack of an alpha spectral peak in presleep wakefulness, as well as higher NREM sleep sigma peak frequency in the twin brother. Faster sleep spindles with lower amplitude and shorter duration characterized the records of the twin brother. Spectra show a striking reliability and correspondence between the two situations (laboratory vs. home records). Alterations in sleep and specific neural oscillations including the alpha/sigma waves are inherent aspects of Williams syndrome.

  20. Evaluation of simple rapid HIV assays and development of national rapid HIV test algorithms in Dar es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Mbwana Judica

    2009-02-01

    concordantly false positive in Uni-Gold™, Determine and SD Bioline assays. Conclusion An alternative confirmatory HIV testing strategy based on initial testing on either SD Bioline or Determine assays followed by testing of reactive samples on the Determine or SD Bioline gave 100% sensitivity (95% CI; 99.1–100 and 100% specificity (95% CI; 96–99.1 with Uni-Gold™ as tiebreaker for discordant results.

  1. Specificity of the Association between Marital Discord and Longitudinal Changes in Symptoms of Depression and Generalized Anxiety Disorder in the Irish Longitudinal Study on Ageing.

    Science.gov (United States)

    Whisman, Mark A; Robustelli, Briana L; Labrecque, Lindsay T

    2018-03-25

    This longitudinal study was conducted to evaluate actor and partner effects of marital discord on changes in symptoms of depression and generalized anxiety disorder (GAD) in a large population sample of Irish adults (N = 1,445 couples), adjusting for the potential confounds of quality of other social relationships and other psychopathology symptoms. The Actor-Partner Interdependence Model was used to examine actor and partner effects of marital discord on changes in symptoms of depression and GAD at a 2-year follow-up. Additional models examined these associations adjusting for family and friend discord and symptoms of the other type of psychopathology (depressive or GAD symptoms). Actor effects of marital discord on depressive and anxiety symptoms were greater for men than for women. There were significant, positive actor effects of marital discord on depressive symptoms for husbands and wives, which remained significant when adjusting for family and friend discord and GAD symptoms. There were significant, positive actor effects of marital discord on GAD symptoms for husbands, which remained significant when adjusting for family and friend discord and depressive symptoms. Results demonstrate that longitudinal associations between marital discord and depressive symptoms (for wives and husbands) and GAD symptoms (for husbands) are incremental to other rival explanations (family and friend discord and the other set of symptoms). Findings provide evidence for a potential causal association leading from marital discord to symptoms of depression and GAD. © 2018 Family Process Institute.

  2. DISCORDANCE BETWEEN BLUE-LIGHT AUTOFLUORESCENCE AND NEAR-INFRARED AUTOFLUORESCENCE IN AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Heiferman, Michael J; Fawzi, Amani A

    2016-12-01

    To identify the origin and significance of discordance between blue-light autofluorescence (BL-AF; 488 nm) and near-infrared autofluorescence (NI-AF; 787 nm) in patients with age-related macular degeneration (AMD). A total of 86 eyes of 59 patients with a diagnosis of AMD were included in this cross-sectional study conducted between March 9, 2015 and May 1, 2015. A masked observer examined the BL-AF, NI-AF, and spectral-domain optical coherence tomography images. Areas with discordance of autofluorescence patterns between NI-AF and BL-AF images were correlated with structural findings at the corresponding location in optical coherence tomography scans. Seventy-nine eyes had discordance between BL-AF and NI-AF. The most common optical coherence tomography finding accounting for these discrepancies was pigment migration accounting for 35 lesions in 21 eyes. The most clinically relevant finding was geographic atrophy missed on BL-AF in 7 eyes. Our findings indicate that variations in the distribution of lipofuscin, melanin and melanolipofuscin account for the majority of discordance between BL-AF and NI-AF. Given our finding of missed geographic atrophy lesions on BL-AF in 24% of eyes with geographic atrophy (7/29 eyes), clinicians should consider multimodal imaging, including NI-AF and optical coherence tomography, especially in clinical trials of geographic atrophy.

  3. Encouraging innovation: ten research priorities for achieving universal access to HIV/AIDS prevention, treatment and care in Europe by 2010

    DEFF Research Database (Denmark)

    Lazarus, Jeff; Laukamm-Josten, Ulrich; Atun, Rifat A

    2008-01-01

    When the HIV epidemic officially hit western Europe in the early 1980s, central and eastern Europe were almost completely spared due to the isolation of the Soviet Union. However, in the mid-1990s, reported new cases of HIV in eastern European countries began to increase exponentially. While ther...

  4. Equivalence of qubit-environment entanglement and discord generation via pure dephasing interactions and the resulting consequences

    Science.gov (United States)

    Roszak, Katarzyna; Cywiński, Łukasz

    2018-01-01

    We find that when a qubit initialized in a pure state experiences pure dephasing due to interaction with an environment, separable qubit-environment states generated during the evolution also have zero quantum discord with respect to the environment. What follows is that the set of separable states which can be reached during the evolution has zero volume, and hence, such effects as sudden death of qubit-environment entanglement are very unlikely. In the case of the discord with respect to the qubit, a vast majority of qubit-environment separable states is discordant, but in specific situations zero-discord states are possible. This is conceptually important since there is a connection between the discordance with respect to a given subsystem and the possibility of describing the evolution of this subsystem using completely positive maps. Finally, we use the formalism to find an exemplary evolution of an entangled state of two qubits that is completely positive, and occurs solely due to interaction of only one of the qubits with its environment (so one could guess that it corresponds to a local operation, since it is local in a physical sense), but which nevertheless causes the enhancement of entanglement between the qubits. While this simply means that the considered evolution is completely positive, but does not belong to local operations and classical communication, it shows how much caution has to be exercised when identifying evolution channels that belong to that class.

  5. Metabolome and fecal microbiota in monozygotic twin pairs discordant for weight: a Big Mac challenge

    OpenAIRE

    Bondia-Pons, Isabel; Maukonen, Johanna; Mattila, Ismo; Rissanen, Aila; Saarela, Maria; Kaprio, Jaakko; Hakkarainen, Antti; Lundbom, Jesper; Lundbom, Nina; Hy?tyl?inen, Tuulia; Pietil?inen, Kirsi H.; Ore?i?, Matej

    2014-01-01

    Postprandial responses to food are complex, involving both genetic and environmental factors. We studied postprandial responses to a Big Mac meal challenge in monozygotic co-twins highly discordant for body weight. This unique design allows assessment of the contribution of obesity, independent of genetic liability. Comprehensive metabolic profiling using 3 analytical platforms was applied to fasting and postprandial serum samples from 16 healthy monozygotic twin pairs discordant for weight (...

  6. The role of HIV/AIDS committees in effective workplace governance of HIV/AIDS in South African small and medium-sized enterprises (SMEs).

    Science.gov (United States)

    Vaas, Jocelyn R

    2008-04-01

    The primary purpose of this study was to assess the role, status and scope of workplace HIV/AIDS committees as a means of effective workplace governance of the HIV/AIDS impact, and their role in extending social protective HIV/AIDS-related rights to employees. In-depth qualitative case studies were conducted in five South African small and medium-sized enterprises (SMEs) that were actively implementing HIV/AIDS policies and programmes. Companies commonly implemented HIV/AIDS policies and programmes through a workplace committee dedicated to HIV/AIDS or a generic committee dealing with issues other than HIV/ AIDS. Management, through the human resources department and the occupational health practitioner often drove initial policy formulation, and had virtually sole control of the HIV/AIDS budget. Employee members of committees were mostly volunteers, and were often production or blue collar employees, while there was a notable lack of participation by white-collar employees, line management and trade unions. While the powers of workplace committees were largely consultative, employee committee members often managed in an indirect manner to secure and extend social protective rights on HIV/AIDS to employees, and monitor their effective implementation in practice. In the interim, workplace committees represented one of the best means to facilitate more effective workplace HIV/AIDS governance. However, the increased demands on collective bargaining as a result of an anticipated rises in AIDS-related morbidity and mortality might prove to be beyond the scope of such voluntary committees in the longer term.

  7. Epigenetic differences in monozygotic twins discordant for major depressive disorder.

    Science.gov (United States)

    Malki, K; Koritskaya, E; Harris, F; Bryson, K; Herbster, M; Tosto, M G

    2016-06-14

    Although monozygotic (MZ) twins share the majority of their genetic makeup, they can be phenotypically discordant on several traits and diseases. DNA methylation is an epigenetic mechanism that can be influenced by genetic, environmental and stochastic events and may have an important impact on individual variability. In this study we explored epigenetic differences in peripheral blood samples in three MZ twin studies on major depressive disorder (MDD). Epigenetic data for twin pairs were collected as part of a previous study using 8.1-K-CpG microarrays tagging DNA modification in white blood cells from MZ twins discordant for MDD. Data originated from three geographical regions: UK, Australia and the Netherlands. Ninety-seven MZ pairs (194 individuals) discordant for MDD were included. Different methods to address non independently-and-identically distributed (non-i.i.d.) data were evaluated. Machine-learning methods with feature selection centered on support vector machine and random forest were used to build a classifier to predict cases and controls based on epivariations. The most informative variants were mapped to genes and carried forward for network analysis. A mixture approach using principal component analysis (PCA) and Bayes methods allowed to combine the three studies and to leverage the increased predictive power provided by the larger sample. A machine-learning algorithm with feature reduction classified affected from non-affected twins above chance levels in an independent training-testing design. Network analysis revealed gene networks centered on the PPAR-γ (NR1C3) and C-MYC gene hubs interacting through the AP-1 (c-Jun) transcription factor. PPAR-γ (NR1C3) is a drug target for pioglitazone, which has been shown to reduce depression symptoms in patients with MDD. Using a data-driven approach we were able to overcome challenges of non-i.i.d. data when combining epigenetic studies from MZ twins discordant for MDD. Individually, the studies yielded

  8. Robust detection of discordant sites in regional frequency analysis

    NARCIS (Netherlands)

    Neykov, N.M.; Neytchev, P.N.; Van Gelder, P.H.A.J.M.; Todorov, V.K.

    2007-01-01

    The discordancy measure in terms of the sample L?moment ratios (L?CV, L?skewness, L?kurtosis) of the at?site data is widely recommended in the screening process of atypical sites in the regional frequency analysis (RFA). The sample mean and the covariance matrix of the L?moments ratios, on which the

  9. HIV counseling and testing in a tertiary care hospital in Ganjam district, Odisha, India.

    Science.gov (United States)

    Dash, M; Padhi, S; Sahu, S; Mohanty, I; Panda, P; Parida, B; Sahoo, M K

    2013-01-01

    Human immunodeficiency virus (HIV) counseling and testing (HCT) conducted at integrated counseling and testing centers (ICTCs) is an entry point, cost-effective intervention in preventing transmission of HIV. To study the prevalence of HIV among ICTC attendees, sociodemographic characteristics, and risk behaviors of HIV-seropositive clients. It was hospital record-based cross-sectional study of 26,518 registered ICTC clients at a tertiary care hospital in Ganjam district, Odisha, India over a 4-year period from January 2009 to September 2012. A total of 1732 (7.5%) out of 22,897 who were tested for HIV were seropositive. Among HIV-seropositives, 1138 (65.7%) were males, while 594 (34.3%) were females. Majority (88.3%) of seropositives were between the age group of 15-49 years. Client-initiated HIV testing (12.1%) was more seropositive compared to provider-initiated (2.9%). Among discordant couples, majority (95.5%) were male partner/husband positive and female partner/wife negative. Positives were more amongst married, less educated, low socioeconomic status, and outmigrants (P<0.0001). Risk factors included heterosexual promiscuous (89.3%), parent-to-child transmission 5.8%, unknown 3.1%, infected blood transfusion 0.8%, homosexual 0.5%, and infected needles (0.5%). There is need to encourage activities that promote HCT in all health facilities. This will increase the diagnosis of new HIV cases. The data generated in ICTC provide an important clue to understand the epidemiology in a particular geographic region and local planning for care and treatment of those infected with HIV and preventive strategies for those at risk especially married, young adults, and outmigrants to reduce new infections.

  10. How discordant morphological and molecular evolution among microorganisms can revise our notions of biodiversity on earth

    Science.gov (United States)

    Lahr, Daniel J. G.; Laughinghouse, H. Dail; Oliverio, Angela; Gao, Feng; Katz, Laura A.

    2014-01-01

    Microscopy has revealed a tremendous diversity of bacterial and eukaryotic forms. More recent molecular analyses show discordance in estimates of biodiversity based on morphological analyses. Moreover, phylogenetic analyses of the diversity of microbial forms have revealed evidence of convergence at scales as large as interdomain – i.e. convergent forms shared between bacteria and eukaryotes. Here, we highlight examples of such discordance, focusing on exemplary lineages such as testate amoebae, ciliates and cyanobacteria, which have long histories of morphological study. We discuss examples in two categories: 1) morphologically identical (or highly similar) individuals that are genetically distinct and 2) morphologically distinct individuals that are genetically distinct. We argue that hypotheses about discordance can be tested using the concept of neutral morphologies, or more broadly neutral phenotypes, as a null hypothesis. PMID:25156897

  11. Job satisfaction and employee’s unionization decision: the mediating effect of perceived union instrumentality

    Energy Technology Data Exchange (ETDEWEB)

    Shan, H.; Hu, E.; Zhi, L.; Zhang, L.; Zhang, M.

    2016-07-01

    Purpose: Given the current lack of literature in the background of China labor force, this study aims to investigate the relationships among job satisfaction, perceived union instrumentality, and unionization from a reference-frame-based perspective and explore the referred relationships in the context of Chinese labor market. Design/methodology/approach: The study introduces perceived union instrumentality as a mediator to the relationship between job satisfaction and unionization. The applicability of western theories was tested in the Chinese context by a questionnaire survey on 390 employees who were working in private sectors of Jiangsu Province in China. Four hypothesis were proposed and tested by data analysis to verify the model. Findings: The study found that most aspects of job satisfaction were negatively correlated with unionization and perceived union instrumentality, while perceived union instrumentality had a positive relationship with unionization. Perceived union instrumentality was also found to have a mediating effect on the relationship between job satisfaction and unionization. Originality/value: The paper adapted and tested a number of western industrial relation theories in the backdrop of China, contributing to the gap in Chinese-context research by examining the relationships between job satisfaction, unionization and union instrumentality of Chinese employees. It pays a regular contribution to labor union studies both inside and outside China. (Author)

  12. What can we learn from the dynamics of entanglement and quantum discord in the Tavis-Cummings model?

    Science.gov (United States)

    Restrepo, Juliana; Rodriguez, Boris A.

    We revisit the problem of the dynamics of quantum correlations in the exact Tavis-Cummings model. We show that many of the dynamical features of quantum discord attributed to dissipation are already present in the exact framework and are due to the well known non-linearities in the model and to the choice of initial conditions. Through a comprehensive analysis, supported by explicit analytical calculations, we find that the dynamics of entanglement and quantum discord are far from being trivial or intuitive. In this context, we find states that are indistinguishable from the point of view of entanglement and distinguishable from the point of view of quantum discord, states where the two quantifiers give opposite information and states where they give roughly the same information about correlations at a certain time. Depending on the initial conditions, this model exhibits a fascinating range of phenomena that can be used for experimental purposes such as: Robust states against change of manifold or dissipation, tunable entanglement states and states with a counterintuitive sudden birth as the number of photons increase. We furthermore propose an experiment called quantum discord gates where discord is zero or non-zero depending on the number of photons. This work was supported by the Vicerrectoria de Investigacion of the Universidad Antonio Narino, Colombia under Project Number 20141031 and by the Departamento Administrativo de Ciencia, Tecnologia e Innovacion (COLCIENCIAS) of Colombia under Grant Number.

  13. Discordance between location of positive cores in biopsy and location of positive surgical margin following radical prostatectomy.

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    Kim, Ji Won; Park, Hyoung Keun; Kim, Hyeong Gon; Ham, Dong Yeub; Paick, Sung Hyun; Lho, Yong Soo; Choi, Woo Suk

    2015-10-01

    We compared location of positive cores in biopsy and location of positive surgical margin (PSM) following radical prostatectomy. This retrospective analysis included patients who were diagnosed as prostate cancer by standard 12-core transrectal ultrasonography guided prostate biopsy, and who have PSM after radical prostatectomy. After exclusion of number of biopsy cores location data, 46 patients with PSM were identified. Locations of PSM in pathologic specimen were reported as 6 difference sites (apex, base and lateral in both sides). Discordance of biopsy result and PSM was defined when no positive cores in biopsy was identified at the location of PSM. Most common location of PSM were right apex (n=21) and left apex (n=15). Multiple PSM was reported in 21 specimens (45.7%). In 32 specimens (69.6%) with PSM, one or more concordant positive biopsy cores were identified, but 14 specimens (28%) had no concordant biopsy cores at PSM location. When discordant rate was separated by locations of PSM, right apex PSM had highest rate of discordant (38%). The discordant group had significantly lower prostate volume and lower number of positive cores in biopsy than concordant group. This study showed that one fourth of PSM occurred at location where tumor was not detected at biopsy and that apex PSM had highest rate of discordant. Careful dissection to avoid PSM should be performed in every location, including where tumor was not identified in biopsy.

  14. Factors associated with unintended pregnancy, poor birth outcomes and post-partum contraceptive use among HIV-positive female adolescents in Kenya

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    Obare Francis

    2012-10-01

    Full Text Available Abstract Background Although the experiences of unintended pregnancies and poor birth outcomes among adolescents aged 15–19 years in the general population are well documented, there is limited understanding of the same among those who are living with HIV. This paper examines the factors associated with experiencing unintended pregnancies, poor birth outcomes, and post-partum contraceptive use among HIV-positive female adolescents in Kenya. Methods Data are from a cross-sectional study that captured information on pregnancy histories of HIV-positive female adolescents in four regions of Kenya: Coast, Nairobi, Nyanza and Rift Valley provinces. Study participants were identified through HIV and AIDS programs in the four regions. Out of a total of 797 female participants, 394 had ever been pregnant with 24% of them experiencing multiple pregnancies. Analysis entails the estimation of random-effects logit models. Results Higher order pregnancies were just as likely to be unintended as lower order ones (odds ratios [OR]: 1.2; 95% confidence interval [CI]: 0.8–2.0 while pregnancies occurring within marital unions were significantly less likely to be unintended compared to those occurring outside such unions (OR: 0.1; 95% CI: 0.1–0.2. Higher order pregnancies were significantly more likely to result in poor outcomes compared to lower order ones (OR: 2.5; 95% CI: 1.6–4.0. In addition, pregnancies occurring within marital unions were significantly less likely to result in poor outcomes compared to those occurring outside such unions (OR: 0.3; 95% CI: 0.1–0.9. However, experiencing unintended pregnancy was not significantly associated with adverse birth outcomes (OR: 1.3; 95% CI: 0.5–3.3. There was also no significant difference in the likelihood of post-partum contraceptive use by whether the pregnancy was unintended (OR: 0.9; 95% CI: 0.5–1.5. Conclusions The experience of repeat unintended pregnancies among HIV-positive female adolescents

  15. Increased expression and altered methylation of HERVWE1 in the human placentas of smaller fetuses from monozygotic, dichorionic, discordant twins.

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    Yu Gao

    Full Text Available BACKGROUND: The human endogenous retroviral family W, Env(C7, member 1 gene (HERVWE1 is thought to participate in trophoblast cell fusion, and its expression is diminished in the placentas of singleton intrauterine growth-retarded pregnancies. However, there is limited information about the role of HERVWE1 in discordant fetal growth in twins. This study was to compare HERVWE1 gene expression between the placentas of discordant monozygotic twins and to identify its regulation by methylation. METHODOLOGY/PRINCIPAL FINDINGS: Fetuses from twenty-one pairs of monozygotic, dichorionic, discordant twins were marked as "smaller" or "larger" according to birth weight. Placental HERVWE1 mRNA and protein expression profiles were analyzed using quantitative RT-PCR and immunohistochemistry (IHC staining. Methylation profiles of the HERVWE1 promoter region were analyzed using a pyrosequencing assay. DNA methyltransferase (DNMT transcript levels were analyzed by RT-PCR. 5-methyl cytosine (5-MC was stained using an immunohistochemical assay. There was a significant negative correlation between HERVWE1 mRNA levels and birth weight in twins (P0.05. The DNMT3b3 mRNA levels in the smaller group were significantly downregulated compared with the larger group in discordant twins(P<0.05, whereas the DNMT3b7 mRNA levels in the smaller group were significantly upregulated compared with the larger group in discordant twins(P<0.05. CONCLUSIONS/SIGNIFICANCE: In discordant, monozygotic, dichorionic twins, HERVWE1 expression was higher in smaller fetuses and lower in larger fetuses. Methylation of the HERVWE1 gene promoter region may participate in the regulation of HERVWE1 gene expression in discordant twin pregnancies.

  16. Increased Expression and Altered Methylation of HERVWE1 in the Human Placentas of Smaller Fetuses from Monozygotic, Dichorionic, Discordant Twins

    Science.gov (United States)

    Wang, Zilian; Luo, Yanmin; Sun, Hongyu; Zhou, Yi; Huang, Linhuan; Li, Manchao; Fang, Qun; Jiang, Shiwen

    2012-01-01

    Background The human endogenous retroviral family W, Env(C7), member 1 gene (HERVWE1) is thought to participate in trophoblast cell fusion, and its expression is diminished in the placentas of singleton intrauterine growth-retarded pregnancies. However, there is limited information about the role of HERVWE1 in discordant fetal growth in twins. This study was to compare HERVWE1 gene expression between the placentas of discordant monozygotic twins and to identify its regulation by methylation. Methodology/Principal Findings Fetuses from twenty-one pairs of monozygotic, dichorionic, discordant twins were marked as “smaller” or “larger” according to birth weight. Placental HERVWE1 mRNA and protein expression profiles were analyzed using quantitative RT-PCR and immunohistochemistry (IHC) staining. Methylation profiles of the HERVWE1 promoter region were analyzed using a pyrosequencing assay. DNA methyltransferase (DNMT) transcript levels were analyzed by RT-PCR. 5-methyl cytosine (5-MC) was stained using an immunohistochemical assay. There was a significant negative correlation between HERVWE1 mRNA levels and birth weight in twins (P0.05). The DNMT3b3 mRNA levels in the smaller group were significantly downregulated compared with the larger group in discordant twins(P<0.05), whereas the DNMT3b7 mRNA levels in the smaller group were significantly upregulated compared with the larger group in discordant twins(P<0.05). Conclusions/Significance In discordant, monozygotic, dichorionic twins, HERVWE1 expression was higher in smaller fetuses and lower in larger fetuses. Methylation of the HERVWE1 gene promoter region may participate in the regulation of HERVWE1 gene expression in discordant twin pregnancies. PMID:22457770

  17. Systemic administration of antiretrovirals prior to exposure prevents rectal and intravenous HIV-1 transmission in humanized BLT mice.

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    Paul W Denton

    2010-01-01

    Full Text Available Successful antiretroviral pre-exposure prophylaxis (PrEP for mucosal and intravenous HIV-1 transmission could reduce new infections among targeted high-risk populations including discordant couples, injection drug users, high-risk women and men who have sex with men. Targeted antiretroviral PrEP could be particularly effective at slowing the spread of HIV-1 if a single antiretroviral combination were found to be broadly protective across multiple routes of transmission. Therefore, we designed our in vivo preclinical study to systematically investigate whether rectal and intravenous HIV-1 transmission can be blocked by antiretrovirals administered systemically prior to HIV-1 exposure. We performed these studies using a highly relevant in vivo model of mucosal HIV-1 transmission, humanized Bone marrow/Liver/Thymus mice (BLT. BLT mice are susceptible to HIV-1 infection via three major physiological routes of viral transmission: vaginal, rectal and intravenous. Our results show that BLT mice given systemic antiretroviral PrEP are efficiently protected from HIV-1 infection regardless of the route of exposure. Specifically, systemic antiretroviral PrEP with emtricitabine and tenofovir disoproxil fumarate prevented both rectal (Chi square = 8.6, df = 1, p = 0.003 and intravenous (Chi square = 13, df = 1, p = 0.0003 HIV-1 transmission. Our results indicate that antiretroviral PrEP has the potential to be broadly effective at preventing new rectal or intravenous HIV transmissions in targeted high risk individuals. These in vivo preclinical findings provide strong experimental evidence supporting the potential clinical implementation of antiretroviral based pre-exposure prophylactic measures to prevent the spread of HIV/AIDS.

  18. Monozygotic twins discordant for ROHHAD phenotype.

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    Patwari, Pallavi P; Rand, Casey M; Berry-Kravis, Elizabeth M; Ize-Ludlow, Diego; Weese-Mayer, Debra E

    2011-09-01

    Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) falls within a group of pediatric disorders with both respiratory control and autonomic nervous system dysregulation. Children with ROHHAD typically present after 1.5 years of age with rapid weight gain as the initial sign. Subsequently, they develop alveolar hypoventilation, autonomic nervous system dysregulation, and, if untreated, cardiorespiratory arrest. To our knowledge, this is the first report of discordant presentation of ROHHAD in monozygotic twins. Twin girls, born at term, had concordant growth and development until 8 years of age. From 8 to 12 years of age, the affected twin developed features characteristic of ROHHAD including obesity, alveolar hypoventilation, scoliosis, hypothalamic dysfunction (central diabetes insipidus, hypothyroidism, premature pubarche, and growth hormone deficiency), right paraspinal/thoracic ganglioneuroblastoma, seizures, and autonomic dysregulation including altered pain perception, large and sluggishly reactive pupils, hypothermia, and profound bradycardia that required a cardiac pacemaker. Results of genetic testing for PHOX2B (congenital central hypoventilation syndrome disease-defining gene) mutations were negative. With early recognition and conservative management, the affected twin had excellent neurocognitive outcome that matched that of the unaffected twin. The unaffected twin demonstrated rapid weight gain later in age but not development of signs/symptoms consistent with ROHHAD. This discordant twin pair demonstrates key features of ROHHAD including the importance of early recognition (especially hypoventilation), complexity of signs/symptoms and clinical course, and importance of initiating comprehensive, multispecialty care. These cases confound the hypothesis of a monogenic etiology for ROHHAD and indicate alternative etiologies including autoimmune or epigenetic phenomenon or a combination of genetic

  19. Turbulent flow structure at a discordant river confluence: Asymmetric jet dynamics with implications for channel morphology

    Science.gov (United States)

    Sukhodolov, Alexander N.; Krick, Julian; Sukhodolova, Tatiana A.; Cheng, Zhengyang; Rhoads, Bruce L.; Constantinescu, George S.

    2017-06-01

    Only a handful of field studies have examined turbulent flow structure at discordant confluences; the dynamics of flow at such confluences have mainly been examined in the laboratory. This paper reports results of a field-based investigation of turbulent flow structure at a discordant river confluence. These results support the hypothesis that flow at a discordant alluvial confluence with a velocity ratio greater than 2 exhibits jet-like characteristics. Scaling analysis shows that the dynamics of the jet core are quite similar to those of free jets but that the complex structure of flow at the confluence imposes strong effects that can locally suppress or enhance the spreading rate of the jet. This jet-like behavior of the flow has important implications for morphodynamic processes at these types of confluences. The highly energetic core of the jet at this discordant confluence is displaced away from the riverbed, thereby inhibiting scour; however, helical motion develops adjacent to the jet, particularly at high flows, which may promote scour. Numerical experiments demonstrate that the presence or absence of a depositional wedge at the mouth of the tributary can strongly influence detachment of the jet from the bed and the angle of the jet within the confluence.

  20. HIV risk and barriers to care for African-born immigrant women: a sociocultural outlook

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    Okoro ON

    2017-06-01

    Full Text Available Olihe N Okoro,1 Shanasha O Whitson2 1Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, University of Minnesota, Duluth, 2Community Partnership Collaborative 2.0, Minneapolis, MN, USA Background: Data from the Minnesota Department of Health (MDH HIV/AIDS Surveillance Report 2015 show that African-born (AB women continue to be disproportionately affected by HIV. In 2015, these women accounted for more than half (54% of all new cases of HIV reported among females in Minnesota and 34% of all known female cases in the state. This study was a needs assessment for HIV pre-exposure prophylaxis (PrEP in vulnerable subgroups within the AB population and adequacy of HIV care for AB persons. The primary objective of this study was to gain an insight into the strategies that will limit the spread of HIV infection and enhance HIV care among AB immigrants. Methods: Community advocates, community-based organizations (CBOs, clinicians, and other HIV-related service providers were invited to participate in a focus group, structured interview or complete an assessment tool using the same questionnaire about HIV and PrEP among AB persons. A thematic analysis was then conducted on the open-ended questions addressing perceived barriers. Results: Findings suggest the following gender-specific sociocultural factors that drive HIV transmission and constitute barriers to HIV treatment for AB women: domestic/intimate partner violence, gender-biased stigma, discriminatory cultural beliefs and normative values/expectations, unprotected sex with husbands who have sex with other men, gender discordance in health care (preference for female provider, and sexual/reproductive health illiteracy. Recommendation: Based on recommendations, a community-based sexual and reproductive health education is being initiated with a curriculum that will be 1 broad (inclusive but not limited to HIV, 2 culturally sensitive/responsive, and 3 at appropriate

  1. Discordant tasks and motor adjustments affect interactions between adaptations to altered kinematics and dynamics

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    Fritzie Arce

    2010-01-01

    Full Text Available Motor control and adaptation are multi-determinate processes with complex interactions. This is reflected for example in the ambiguous nature of interactions during sequential adaptation of reaching under kinematics and dynamics perturbations. It has been suggested that perturbations based on the same kinematic parameter interfere. Others posited that opposing motor adjustments underlie interference. Here, we examined the influence of discordances in task and in motor adjustments on sequential adaptations to visuomotor rotation and viscous force field perturbations. These two factors – perturbation direction and task discordance – have been examined separately by previous studies, thus the inherent difficulty to identify the roots of interference. Forty-eight human subjects adapted sequentially to one or two types of perturbations, of matched or conflicting directions. We found a gradient of interaction effects based on perturbation direction and task discordance. Perturbations of matched directions showed facilitation while perturbations of opposite directions, which required opposing motor adjustments, interfered with each other. Further, interaction effects increased with greater task discordance. We also found that force field and visuomotor rotation had mutual anterograde and retrograde effects. However, we found independence between anterograde and retrograde interferences between similar tasks. The results suggest that the newly acquired internal models of kinematic and dynamic perturbations are not independent but they share common neuronal resources and interact between them. Such overlap does not necessarily imply competition of resources. Rather, our results point to an additional principle of sensorimotor adaptation allowing the system to tap or harness common features across diverse sensory inputs and task contexts whenever available.

  2. HIV counseling and testing in a tertiary care hospital in Ganjam district, Odisha, India

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    M Dash

    2013-01-01

    Full Text Available Background: Human immunodeficiency virus (HIV counseling and testing (HCT conducted at integrated counseling and testing centers (ICTCs is an entry point, cost-effective intervention in preventing transmission of HIV. Objectives: To study the prevalence of HIV among ICTC attendees, sociodemographic characteristics, and risk behaviors of HIV-seropositive clients. Materials and Methods: It was hospital record-based cross-sectional study of 26,518 registered ICTC clients at a tertiary care hospital in Ganjam district, Odisha, India over a 4-year period from January 2009 to September 2012. Results: A total of 1732 (7.5% out of 22,897 who were tested for HIV were seropositive. Among HIV-seropositives, 1138 (65.7% were males, while 594 (34.3% were females. Majority (88.3% of seropositives were between the age group of 15-49 years. Client-initiated HIV testing (12.1% was more seropositive compared to provider-initiated (2.9%. Among discordant couples, majority (95.5% were male partner/husband positive and female partner/wife negative. Positives were more amongst married, less educated, low socioeconomic status, and outmigrants (P<0.0001. Risk factors included heterosexual promiscuous (89.3%, parent-to-child transmission 5.8%, unknown 3.1%, infected blood transfusion 0.8%, homosexual 0.5%, and infected needles (0.5%. Conclusions: There is need to encourage activities that promote HCT in all health facilities. This will increase the diagnosis of new HIV cases. The data generated in ICTC provide an important clue to understand the epidemiology in a particular geographic region and local planning for care and treatment of those infected with HIV and preventive strategies for those at risk especially married, young adults, and outmigrants to reduce new infections.

  3. Patterns of geographic mobility predict barriers to engagement in HIV care and antiretroviral treatment adherence.

    Science.gov (United States)

    Taylor, Barbara S; Reyes, Emily; Levine, Elizabeth A; Khan, Shah Z; Garduño, L Sergio; Donastorg, Yeycy; Hammer, Scott M; Brudney, Karen; Hirsch, Jennifer S

    2014-06-01

    Migration and geographic mobility increase risk for HIV infection and may influence engagement in HIV care and adherence to antiretroviral therapy. Our goal is to use the migration-linked communities of Santo Domingo, Dominican Republic, and New York City, New York, to determine the impact of geographic mobility on HIV care engagement and adherence to treatment. In-depth interviews were conducted with HIV+Dominicans receiving antiretroviral therapy, reporting travel or migration in the past 6 months and key informants (n=45). Mobility maps, visual representations of individual migration histories, including lifetime residence(s) and all trips over the past 2 years, were generated for all HIV+ Dominicans. Data from interviews and field observation were iteratively reviewed for themes. Mobility mapping revealed five distinct mobility patterns: travel for care, work-related travel, transnational travel (nuclear family at both sites), frequent long-stay travel, and vacation. Mobility patterns, including distance, duration, and complexity, varied by motivation for travel. There were two dominant barriers to care. First, a fear of HIV-related stigma at the destination led to delays seeking care and poor adherence. Second, longer trips led to treatment interruptions due to limited medication supply (30-day maximum dictated by programs or insurers). There was a notable discordance between what patients and providers perceived as mobility-induced barriers to care and the most common barriers found in the analysis. Interventions to improve HIV care for mobile populations should consider motivation for travel and address structural barriers to engagement in care and adherence.

  4. FDG PET and CT in locally advanced adenocarcinomas of the distal oesophagus. Clinical relevance of a discordant PET finding

    International Nuclear Information System (INIS)

    Stahl, A.; Wieder, H.; Schwaiger, M.; Weber, W.A.; Stollfuss, J.; Ott, K.; Fink, U.

    2005-01-01

    Aim: the incidence of adenocarcinomas of the distal oesophagus (ADE) has dramatically increased in Western countries. The clinical importance of a FDG PET finding discordant with CT was determined in patients with locally advanced ADE. In addition, tumour standardized uptake values (SUV) were correlated with patient survival. Patients, methods: 40 consecutive patients were analyzed retrospectively. All patients underwent an attenuation corrected FDG PET scan (neck, chest, abdomen) and contrast enhanced helical CT of the chest and abdomen. PET and CT scans were reviewed independently and concomitantly with respect to metastases in predefined lymph node sites and organs. Any discordance between PET and CT was assessed for clinical relevance. Clinical relevance was defined as a change in the overall therapeutic concept (curative vs. palliative). Follow-up imaging and histological evaluation served as the gold standard. Mean tumour SUVs were determined by 1.5 cm regions of interest placed over the tumour's maximum. Results: when read independently from the CT scan FDG PET indicated a clinically relevant change in tumour stage in 9/40 patients (23%) and a non-relevant change in 11/40 patients (28%). PET was correct in 5/9 patients (56%) with clinically relevant discordances. In 4/9 patients PET was incorrect (3 false positive due to suspicion of MI-lymph nodes or lung metastases, 1 false negative in disseminated liver metastases). With concomitant reading, PET indicated a clinically relevant change in tumour stage in 6/40 patients (15%) and a non-relevant change in 5/40 patients (13%). PET was correct in 5/6 patients (83%) with clinically relevant discordances. The patient with disseminated liver disease remained the single false negative. Overall, the benefit from PET was based on its higher diagnostic accuracy at organ sites. Tumour SUV did not correlate with patient survival. Conclusion: about half of discordances between FDG PET and CT are clinically relevant

  5. Impact of Maternal HIV Seroconversion during Pregnancy on Early Mother to Child Transmission of HIV (MTCT Measured at 4-8 Weeks Postpartum in South Africa 2011-2012: A National Population-Based Evaluation.

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    Thu-Ha Dinh

    Full Text Available Mother-to-child transmission of HIV (MTCT depends on the timing of HIV infection. We estimated HIV-seroconversion during pregnancy (HSP after having a HIV-negative result antenatally, and its contribution to early MTCT in South Africa (SA.Between August 2011 and March 2012, we recruited a nationally representative sample of mother-infant pairs with infants aged 4-to-8 weeks from 578 health facilities. Data collection included mother interviews, child health-card reviews, and infant dried-blood-spots sample (iDBS. iDBS were tested for HIV antibodies and HIV-deoxyribonucleic-acid (HIV-DNA. HSP was defined as maternal self-report of an HIV-negative test during this pregnancy, no documented use of antiretroviral drugs and a matched HIV sero-positive iDBS. We used 20 imputations from a uniform distribution for time from reported antenatal HIV-negative result to delivery to estimate time of HSP. Early MTCT was defined based on detection of HIV-DNA in iDBS. Estimates were adjusted for clustering, nonresponse, and weighted by SA's 2011 live-births.Of 9802 mother-infant pairs, 2738 iDBS were HIV sero-positive, including 212 HSP, resulting in a nationally weighted estimate of 3.3% HSP (95% Confidence Interval: 2.8%-3.8%. Median time of HIV-seroconversion was 32.8weeks gestation;28.3% (19.7%- 36.9% estimated to be >36 weeks. Early MTCT was 10.7% for HSP (6.2%-16.8% vs. 2.2% (1.7%-2.8% for mothers with known HIV-positive status. Although they represent 2.2% of all mothers and 6.7% of HIV-infected mothers, HSP accounted for 26% of early MTCT. Multivariable analysis indicated the highest risk for HSP was among women who knew the baby's father was HIV-infected (adjusted-hazard ratio (aHR 4.71; 1.49-14.99, or who had been screened for tuberculosis (aHR 1.82; 1.43-2.32.HSP risk is high and contributes significantly to early MTCT. Identification of HSP by repeat-testing at 32 weeks gestation, during labor, 6 weeks postpartum, in tuberculosis-exposed women, and in

  6. Impact of Maternal HIV Seroconversion during Pregnancy on Early Mother to Child Transmission of HIV (MTCT) Measured at 4-8 Weeks Postpartum in South Africa 2011-2012: A National Population-Based Evaluation

    Science.gov (United States)

    Dinh, Thu-Ha; Delaney, Kevin P.; Goga, Ameena; Jackson, Debra; Lombard, Carl; Woldesenbet, Selamawit; Mogashoa, Mary; Pillay, Yogan; Shaffer, Nathan

    2015-01-01

    Background Mother-to-child transmission of HIV (MTCT) depends on the timing of HIV infection. We estimated HIV-seroconversion during pregnancy (HSP) after having a HIV-negative result antenatally, and its contribution to early MTCT in South Africa (SA). Methods and Findings Between August 2011 and March 2012, we recruited a nationally representative sample of mother-infant pairs with infants aged 4-to-8 weeks from 578 health facilities. Data collection included mother interviews, child health-card reviews, and infant dried-blood-spots sample (iDBS). iDBS were tested for HIV antibodies and HIV-deoxyribonucleic-acid (HIV-DNA). HSP was defined as maternal self-report of an HIV-negative test during this pregnancy, no documented use of antiretroviral drugs and a matched HIV sero-positive iDBS. We used 20 imputations from a uniform distribution for time from reported antenatal HIV-negative result to delivery to estimate time of HSP. Early MTCT was defined based on detection of HIV-DNA in iDBS. Estimates were adjusted for clustering, nonresponse, and weighted by SA’s 2011 live-births. Results Of 9802 mother-infant pairs, 2738 iDBS were HIV sero-positive, including 212 HSP, resulting in a nationally weighted estimate of 3.3% HSP (95% Confidence Interval: 2.8%-3.8%). Median time of HIV-seroconversion was 32.8weeks gestation;28.3% (19.7%- 36.9%) estimated to be >36 weeks. Early MTCT was 10.7% for HSP (6.2%-16.8%) vs. 2.2% (1.7%-2.8%) for mothers with known HIV-positive status. Although they represent 2.2% of all mothers and 6.7% of HIV-infected mothers, HSP accounted for 26% of early MTCT. Multivariable analysis indicated the highest risk for HSP was among women who knew the baby’s father was HIV-infected (adjusted-hazard ratio (aHR) 4.71; 1.49-14.99), or who had been screened for tuberculosis (aHR 1.82; 1.43-2.32). Conclusions HSP risk is high and contributes significantly to early MTCT. Identification of HSP by repeat-testing at 32 weeks gestation, during labor, 6

  7. Relationship between Discordance in Parental Monitoring and Behavioral Problems among Chilean Adolescents

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    Han, Yoonsun; Grogan-Kaylor, Andrew; Bares, Cristina; Ma, Julie; Castillo, Marcela; Delva, Jorge

    2012-01-01

    This study investigated the role of discrepancies between parent and youth reports of perceived parental monitoring in adolescent problem behaviors with a Chilean sample (N= 850). Higher levels of discordance concerning parental monitoring predicted greater levels of maladaptive youth behaviors. A positive association between parent-youth discordance and externalizing problems indicated that large adult-youth disagreement in parental monitoring may impose a great risk, despite protective efforts of parental monitoring. Although the direct relationship between parental monitoring and youth internalizing behaviors was not significant, parent-youth incongruence in monitoring was associated with greater levels of internalizing behaviors. Therefore, differing assessments of parental behaviors, as an indicator of less optimal family functioning, may provide important information about youth maladjustment and may potentially provide a beginning point for family-focused intervention. PMID:23097593

  8. Psychiatric outcomes of bullying victimization: a study of discordant monozygotic twins.

    Science.gov (United States)

    Silberg, J L; Copeland, W; Linker, J; Moore, A A; Roberson-Nay, R; York, T P

    2016-07-01

    Bullying victimization in childhood is associated with a broad array of serious mental health disturbances, including anxiety, depression, and suicidal ideation and behavior. The key goal of this study was to evaluate whether bullying victimization is a true environmental risk factor for psychiatric disturbance using data from 145 bully-discordant monozygotic (MZ) juvenile twin pairs from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) and their follow-up into young adulthood. Since MZ twins share an identical genotype and familial environment, a higher rate of psychiatric disturbance in a bullied MZ twin compared to their non-bullied MZ co-twin would be evidence of an environmental impact of bullying victimization. Environmental correlations between being bullied and the different psychiatric traits were estimated by fitting structural equation models to the full sample of MZ and DZ twins (N = 2824). Environmental associations were further explored using the longitudinal data on the bullying-discordant MZ twins. Being bullied was associated with a wide range of psychiatric disorders in both children and young adults. The analysis of data on the MZ-discordant twins supports a genuine environmental impact of bullying victimization on childhood social anxiety [odds ratio (OR) 1.7], separation anxiety (OR 1.9), and young adult suicidal ideation (OR 1.3). There was a shared genetic influence on social anxiety and bullying victimization, consistent with social anxiety being both an antecedent and consequence of being bullied. Bullying victimization in childhood is a significant environmental trauma and should be included in any mental health assessment of children and young adults.

  9. Beyond HIV-serodiscordance: Partnership communication dynamics that affect engagement in safer conception care.

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    Lynn T Matthews

    Full Text Available We explored acceptability and feasibility of safer conception methods among HIV-affected couples in Uganda.We recruited HIV-positive men and women on antiretroviral therapy (ART ('index' from the Uganda Antiretroviral Rural Treatment Outcomes cohort who reported an HIV-negative or unknown-serostatus partner ('partner', HIV-serostatus disclosure to partner, and personal or partner desire for a child within two years. We conducted in-depth interviews with 40 individuals from 20 couples, using a narrative approach with tailored images to assess acceptability of five safer conception strategies: ART for the infected partner, pre-exposure prophylaxis (PrEP for the uninfected partner, condomless sex timed to peak fertility, manual insemination, and male circumcision. Translated and transcribed data were analyzed using thematic analysis.11/20 index participants were women, median age of 32.5 years, median of 2 living children, and 80% had HIV-RNA <400 copies/mL. Awareness of HIV prevention strategies beyond condoms and abstinence was limited and precluded opportunity to explore or validly assess acceptability or feasibility of safer conception methods. Four key partnership communication challenges emerged as primary barriers to engagement in safer conception care, including: (1 HIV-serostatus disclosure: Although disclosure was an inclusion criterion, partners commonly reported not knowing the index partner's HIV status. Similarly, the partner's HIV-serostatus, as reported by the index, was frequently inaccurate. (2 Childbearing intention: Many couples had divergent childbearing intentions and made incorrect assumptions about their partner's desires. (3 HIV risk perception: Participants had disparate understandings of HIV transmission and disagreed on the acceptable level of HIV risk to meet reproductive goals. (4 Partnership commitment: Participants revealed significant discord in perceptions of partnership commitment. All four types of partnership

  10. Knowledge, attitudes and beliefs about HIV infection and AIDS among healthy factory workers and their wives, Kinshasa, Zaire.

    Science.gov (United States)

    Irwin, K; Bertrand, J; Mibandumba, N; Mbuyi, K; Muremeri, C; Mukoka, M; Munkolenkole, K; Nzilambi, N; Bosenge, N; Ryder, R

    1991-01-01

    As a first step in designing an AIDS prevention program at a large factory in Kinshasa, Zaire, we collected information on attitudes towards human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) from factory foremen and their wives. Trained moderators conducted twelve focus group discussions (from November through December 1987) that addressed knowledge, attitudes and beliefs about HIV infection and AIDS. In general, participants were familiar with HIV infection and AIDS and considered these conditions leading health problems in Kinshasa. Although participants had a fairly accurate understanding of the causes of HIV infection, modes of transmission and preventive measures, many myths and misconceptions existed. Many participants did not believe that condom use would consistently prevent infection through sexual intercourse. Participants strongly favored the counseling of seropositive persons but showed less consensus about whether the spouse of a seropositive person should be notified of the partner's test result. Participants predicted that couples in which one member is seropositive and the other is not would experience marital discord and friction with family, neighbors and co-workers. These findings were applied to the development of a counseling and educational program for seropositive factory employees and their spouses.

  11. Discordant Impact of HLA on Viral Replicative Capacity and Disease Progression in Pediatric and Adult HIV Infection.

    Directory of Open Access Journals (Sweden)

    Emily Adland

    2015-06-01

    Full Text Available HLA class I polymorphism has a major influence on adult HIV disease progression. An important mechanism mediating this effect is the impact on viral replicative capacity (VRC of the escape mutations selected in response to HLA-restricted CD8+ T-cell responses. Factors that contribute to slow progression in pediatric HIV infection are less well understood. We here investigate the relationship between VRC and disease progression in pediatric infection, and the effect of HLA on VRC and on disease outcome in adult and pediatric infection. Studying a South African cohort of >350 ART-naïve, HIV-infected children and their mothers, we first observed that pediatric disease progression is significantly correlated with VRC. As expected, VRCs in mother-child pairs were strongly correlated (p = 0.004. The impact of the protective HLA alleles, HLA-B*57, HLA-B*58:01 and HLA-B*81:01, resulted in significantly lower VRCs in adults (p<0.0001, but not in children. Similarly, in adults, but not in children, VRCs were significantly higher in subjects expressing the disease-susceptible alleles HLA-B*18:01/45:01/58:02 (p = 0.007. Irrespective of the subject, VRCs were strongly correlated with the number of Gag CD8+ T-cell escape mutants driven by HLA-B*57/58:01/81:01 present in each virus (p = 0.0002. In contrast to the impact of VRC common to progression in adults and children, the HLA effects on disease outcome, that are substantial in adults, are small and statistically insignificant in infected children. These data further highlight the important role that VRC plays both in adult and pediatric progression, and demonstrate that HLA-independent factors, yet to be fully defined, are predominantly responsible for pediatric non-progression.

  12. Quantum discord as a resource for quantum cryptography.

    Science.gov (United States)

    Pirandola, Stefano

    2014-11-07

    Quantum discord is the minimal bipartite resource which is needed for a secure quantum key distribution, being a cryptographic primitive equivalent to non-orthogonality. Its role becomes crucial in device-dependent quantum cryptography, where the presence of preparation and detection noise (inaccessible to all parties) may be so strong to prevent the distribution and distillation of entanglement. The necessity of entanglement is re-affirmed in the stronger scenario of device-independent quantum cryptography, where all sources of noise are ascribed to the eavesdropper.

  13. Discordance between liver biopsy and Fibroscan® in assessing liver fibrosis in chronic hepatitis b: risk factors and influence of necroinflammation.

    Directory of Open Access Journals (Sweden)

    Seung Up Kim

    Full Text Available BACKGROUND: Few studies have investigated predictors of discordance between liver biopsy (LB and liver stiffness measurement (LSM using FibroScan®. We assessed predictors of discordance between LB and LSM in chronic hepatitis B (CHB and investigated the effects of necroinflammatory activity. METHODS: In total, 150 patients (107 men, 43 women were prospectively enrolled. Only LSM with ≥ 10 valid measurements was considered reliable. Liver fibrosis was evaluated using the Laennec system. LB specimens <15 mm in length were considered ineligible. Reference cutoff LSM values to determine discordance were calculated from our cohort (6.0 kPa for ≥ F2, 7.5 kPa for ≥ F3, and 9.4 kPa for F4. RESULTS: A discordance, defined as a discordance of at least two stages between LB and LSM, was identified in 21 (14.0% patients. In multivariate analyses, fibrosis stages F3-4 and F4 showed independent negative associations with discordance (P = 0.002; hazard ratio [HR], 0.073; 95% confidence interval [CI], 0.014-0.390 for F3-4 and P = 0.014; HR, 0.067; 95% CI, 0.008-0.574 for F4. LSM values were not significantly different between maximal activity grades 1-2 and 3-4 in F1 and F2 fibrosis stages, whereas LSM values were significantly higher in maximal activity grade 3-4 than 1-2 in F3 and F4 fibrosis stage (median 8.6 vs. 11.3 kPa in F3, P = 0.049; median 11.9 vs. 19.2 kPa in F4, P = 0.009. CONCLUSION: Advanced fibrosis stage (F3-4 or cirrhosis (F4 showed a negative correlation with discordance between LB and LSM in patients with CHB, and maximal activity grade 3-4 significantly influenced LSM values in F3 and F4.

  14. The diagnostic performance evaluation of the SD BIOLINE HIV/syphilis Duo rapid test in southern Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Shimelis, Techalew; Tadesse, Endale

    2015-04-23

    To determine the diagnostic performance of the SD BIOLINE HIV/syphilis Duo rapid test. A hospital-based cross-sectional study. This evaluation was conducted at one of the largest hospitals in southern Ethiopia. Serum samples obtained from clients attending the antiretroviral therapy and voluntary counselling and testing centres were used. Sera were originally collected for the purpose of investigating syphilis epidemiology. The performance of the test to detect HIV was evaluated using 400 sera (200 HIV positives and 200 HIV negatives). Also, its performance to detect syphilis was evaluated using 85 syphilis positive and 100 syphilis negative serum samples. Individuals tiebreaker to determine the result. We also used ELISA to resolve discordant HIV results. Syphilis serostatus was determined using the Treponema pallidum haemagglutination assay (TPHA). The respective sensitivity, specificity, positive predictive value and negative predictive value of the SD BIOLINE HIV/syphilis Duo test were 100, 99.5, 99.5 and 100% for HIV and 97.6, 96, 95.4 and 98% for syphilis testing, respectively. In reference to TPHA, the test kit reported 4 false positives and 2 false negative results for syphilis. The κ values were 0.99 for HIV testing and 0.94 for syphilis testing. The excellent performance of the SD BIOLINE HIV/syphilis Duo test to detect HIV as well as syphilis facilitates the integration of syphilis testing and treatment to the already established HIV prevention programme, ultimately contributing to the dual HIV and syphilis elimination goal. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Pregnancy prevention and condom use practices among HIV-infected women on antiretroviral therapy seeking family planning in Lilongwe, Malawi.

    Directory of Open Access Journals (Sweden)

    Lisa B Haddad

    Full Text Available Programs for integration of family planning into HIV care must recognize current practices and desires among clients to appropriately target and tailor interventions. We sought to evaluate fertility intentions, unintended pregnancy, contraceptive and condom use among a cohort of HIV-infected women seeking family planning services within an antiretroviral therapy (ART clinic.200 women completed an interviewer-administered questionnaire during enrollment into a prospective contraceptive study at the Lighthouse Clinic, an HIV/ART clinic in Lilongwe, Malawi, between August and December 2010.Most women (95% did not desire future pregnancy. Prior reported unintended pregnancy rates were high (69% unplanned and 61% unhappy with timing of last pregnancy. Condom use was inconsistent, even among couples with discordant HIV status, with lack of use often attributed to partner's refusal. Higher education, older age, lower parity and having an HIV negative partner were factors associated with consistent condom usage.High rates of unintended pregnancy among these women underscore the need for integ rating family planning, sexually transmitted infection (STI prevention, and HIV services. Contraceptive access and use, including condoms, must be improved with specific efforts to enlist partner support. Messages regarding the importance of condom usage in conjunction with more effective modern contraceptive methods for both infection and pregnancy prevention must continue to be reinforced over the course of ongoing ART treatment.

  16. Pregnancy prevention and condom use practices among HIV-infected women on antiretroviral therapy seeking family planning in Lilongwe, Malawi.

    Science.gov (United States)

    Haddad, Lisa B; Feldacker, Caryl; Jamieson, Denise J; Tweya, Hannock; Cwiak, Carrie; Chaweza, Thomas; Mlundira, Linly; Chiwoko, Jane; Samala, Bernadette; Kachale, Fanny; Bryant, Amy G; Hosseinipour, Mina C; Stuart, Gretchen S; Hoffman, Irving; Phiri, Sam

    2015-01-01

    Programs for integration of family planning into HIV care must recognize current practices and desires among clients to appropriately target and tailor interventions. We sought to evaluate fertility intentions, unintended pregnancy, contraceptive and condom use among a cohort of HIV-infected women seeking family planning services within an antiretroviral therapy (ART) clinic. 200 women completed an interviewer-administered questionnaire during enrollment into a prospective contraceptive study at the Lighthouse Clinic, an HIV/ART clinic in Lilongwe, Malawi, between August and December 2010. Most women (95%) did not desire future pregnancy. Prior reported unintended pregnancy rates were high (69% unplanned and 61% unhappy with timing of last pregnancy). Condom use was inconsistent, even among couples with discordant HIV status, with lack of use often attributed to partner's refusal. Higher education, older age, lower parity and having an HIV negative partner were factors associated with consistent condom usage. High rates of unintended pregnancy among these women underscore the need for integ rating family planning, sexually transmitted infection (STI) prevention, and HIV services. Contraceptive access and use, including condoms, must be improved with specific efforts to enlist partner support. Messages regarding the importance of condom usage in conjunction with more effective modern contraceptive methods for both infection and pregnancy prevention must continue to be reinforced over the course of ongoing ART treatment.

  17. Characterizing the dynamics of quantum discord under phase damping with POVM measurements

    International Nuclear Information System (INIS)

    Jiang Feng-Jian; Jian-Feng Ye; Yan Xin-Hu; Lü Hai-Jiang

    2015-01-01

    In the analysis of quantum discord, the minimization of average entropy traditionally involved over orthogonal projective measurements may be attained at more optimal decompositions by using the positive-operator-valued measure (POVM) measurements. Taking advantage of the quantum steering ellipsoid in combination with three-element POVM optimization, we show that, for a family of two-qubit X states locally interacting with Markovian non-dissipative environments, the decay rates of quantum discord show smooth dynamical evolutions without any sudden change. This is in contrast to two-element orthogonal projective measurements, in which case the sudden change of the decay rates of quantum and classical decoherences may be a common phenomenon. Notwithstanding this, we find that a subset of X states (including the Bell diagonal states) involving POVM optimization can still preserve the sudden change character as usual. (paper)

  18. HIV / AIDS, STDs and the workplace.

    Science.gov (United States)

    Jackson, H

    1995-01-01

    Even though the workplace is ideal for promoting HIV/STD (sexually transmitted disease) prevention to benefit workers and employers, many workplaces are not convinced that they should be involved in HIV/AIDS and STD education, prevention, and support. They do not realize that time and money spent on health programs save them money. Perhaps they do not feel obligated to protect the health of their employees. The AIDS epidemic adversely affects society and the economy at both the macro and micro level. AIDS tends to strike the productive age group, thereby seriously affecting the workplace. In many Sub-Saharan African countries, at least 20% of the urban workforce may be infected with HIV. Persons living with HIV include top management, skilled professionals, general hands, and farm laborers. HIV/AIDS costs for formal employment are assumed through reduced productivity; increased costs of occupational benefits and social security measures; loss of skilled labor, professionals, and managerial expertise as well as the experience among workers; increased costs of training and recruitment; and low morale from stigmatization, discrimination, and subsequent industrial relation problems. Needed are comprehensive HIV/AIDS and STD workplace programs that ensure the rights of persons with HIV and compassionate treatment of these persons. Trade union or other labor representatives, management, and appropriate government departments should work together and build on existing health legislation and policy to bring about effective negotiation and policy development concerning AIDS and employment. Training of peer educators, support services (counseling, STD referral and/or treatment), community action, management commitment, monitoring and evaluation, and supportive workplace conditions make for effective comprehensive workplace programs. Successful programs operate in fishing villages in Tanzania, tea plantations in India, the University of Papua New Guinea, and Ugandan army

  19. Credit Union Headquarters

    Data.gov (United States)

    Department of Homeland Security — The National Credit Union Administration (NCUA) is the independent federal agency that charters and supervises federal credit unions. NCUA, backed of the full faith...

  20. BANKING UNION - ROMANIAN PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Coroiu Sorina Ioana

    2015-07-01

    Full Text Available The financial crisis showed that banks were not able to face the loss, because there is no framework for a resolution, so that it intervened with money from taxpayers. So, it has been highlighted the need to update the regulations applicable to the banking sector. Creating a single supervisory mechanism in the fall of 2014 was a time reference point to achieve a banking union in Europe. Banking Union is one of the four foundations for a genuine Economic and Monetary Union. The paper’s purpose is to analyze the Banking Union structure, based on three pillars: (i The Single Supervisory Mechanism - the transfer of the main responsibility regarding banking supervision from national to European level, (ii The Single Resolution Mechanism - introduction of common provisions to ensure legal support required to manage bank failures problem, (iii The Deposit Guarantee Schemes - harmonization of deposit guarantee rules. These measures were adopted at European Union level to ensure the stability of the European banking system and to prevent future crises. Because countries that are not part of the euro area are not required to join the Banking Union, the dilemma of these countries lies in the decision to join the Banking Union quickly or to wait. It is the case of Romania, also, so, this paper analyze the opportunity of Romania's accession to the Banking Union before adopting the euro. There are analyzed the advantages and disadvantages of Romania's participation in the Banking Union, showing that, in the context of single currency introduction, Romania's participation is required. So far, there are reduced debates regarding the need, advantages and disadvantages of Romania's participation in the European Banking Union, the top representatives of the National Bank of Romania being among the few who expressed their views in public and published papers on the subject.

  1. Unions and the Sword of Justice: Unions and Pay Systems, Pay Inequality, Pay Discrimination and Low Pay

    OpenAIRE

    A Charlwood; K Hansen; David Metcalf

    2000-01-01

    Dispersion in pay is lower among union members than among non-unionists. This reflects two factors. First, union members and jobs are more homogeneous than their non-union counterparts. Second, union wage policies within and across firms lower pay dispersion. Unions'' minimum wage targets also truncate the lower tail of the union distribution. There are two major consequences of these egalitarian union wage policies. First, the return to human capital is lower in firms which recognise unions ...

  2. Discordant Immune Response with Antiretroviral Therapy in HIV-1: A Systematic Review of Clinical Outcomes

    Science.gov (United States)

    Kelly, Christine; Gaskell, Katherine M.; Richardson, Marty; Klein, Nigel; Garner, Paul; MacPherson, Peter

    2016-01-01

    Background A discordant immune response (DIR) is a failure to satisfactorily increase CD4 counts on ART despite successful virological control. Literature on the clinical effects of DIR has not been systematically evaluated. We aimed to summarise the risk of mortality, AIDS and serious non-AIDS events associated with DIR with a systematic review. Methods The protocol is registered with the Centre for Review Dissemination, University of York (registration number CRD42014010821). Included studies investigated the effect of DIR on mortality, AIDS, or serious non-AIDS events in cohort studies or cohorts contained in arms of randomised controlled trials for adults aged 16 years or older. DIR was classified as a suboptimal CD4 count (as defined by the study) despite virological suppression following at least 6 months of ART. We systematically searched PubMed, Embase, and the Cochrane Library to December 2015. Risk of bias was assessed using the Cochrane tool for assessing risk of bias in cohort studies. Two authors applied inclusion criteria and one author extracted data. Risk ratios were calculated for each clinical outcome reported. Results Of 20 studies that met the inclusion criteria, 14 different definitions of DIR were used. Risk ratios for mortality in patients with and without DIR ranged between 1.00 (95% CI 0.26 to 3.92) and 4.29 (95% CI 1.96 to 9.38) with the majority of studies reporting a 2 to 3 fold increase in risk. Conclusions DIR is associated with a marked increase in mortality in most studies but definitions vary widely. We propose a standardised definition to aid the development of management options for DIR. PMID:27284683

  3. Discordant Immune Response with Antiretroviral Therapy in HIV-1: A Systematic Review of Clinical Outcomes.

    Directory of Open Access Journals (Sweden)

    Christine Kelly

    Full Text Available A discordant immune response (DIR is a failure to satisfactorily increase CD4 counts on ART despite successful virological control. Literature on the clinical effects of DIR has not been systematically evaluated. We aimed to summarise the risk of mortality, AIDS and serious non-AIDS events associated with DIR with a systematic review.The protocol is registered with the Centre for Review Dissemination, University of York (registration number CRD42014010821. Included studies investigated the effect of DIR on mortality, AIDS, or serious non-AIDS events in cohort studies or cohorts contained in arms of randomised controlled trials for adults aged 16 years or older. DIR was classified as a suboptimal CD4 count (as defined by the study despite virological suppression following at least 6 months of ART. We systematically searched PubMed, Embase, and the Cochrane Library to December 2015. Risk of bias was assessed using the Cochrane tool for assessing risk of bias in cohort studies. Two authors applied inclusion criteria and one author extracted data. Risk ratios were calculated for each clinical outcome reported.Of 20 studies that met the inclusion criteria, 14 different definitions of DIR were used. Risk ratios for mortality in patients with and without DIR ranged between 1.00 (95% CI 0.26 to 3.92 and 4.29 (95% CI 1.96 to 9.38 with the majority of studies reporting a 2 to 3 fold increase in risk.DIR is associated with a marked increase in mortality in most studies but definitions vary widely. We propose a standardised definition to aid the development of management options for DIR.

  4. Syphilis and HIV infections among pregnant women attending antenatal clinics in Republic of Congo.

    Science.gov (United States)

    Niama, Roch Fabien; Loukabou Bongolo, Nadia Claricelle; Bayonne Kombo, Edith Sophie; Yengo, Ruth; Mayengue, Pembe Issamou; Mandingha Kosso, Etoka-Beka; Louzolo, Igor; Macosso, Lucette; Dzeret, Ghislain; Dzabatou Babeaux, Angélie Serge Patrick; Puruehnce, Marie-Francke; Parra, Henri Joseph

    2017-01-01

    HIV and syphilis during pregnancy remain a public health concern especially in developing countries. Pregnant women attending antenatal clinics sites for the first time between September and December 2011 and who accepted to participate in the study were enrolled. The objective was to estimate the syphilis and HIV infection rate in this population. A study was conducted in 44 selected ANCs from 12 departments (5 urban and 7 rural). Pregnant women who accepted to participate in the study, attending selected sentinel ANCs sites for the first time between September and December 2011 were enrolled. To detect HIV antibodies, two consecutive ELISA assays were used (Genscreen Ultra HIV Ag/Ac, (BioRad, France) and Enzygnostic Intergral II (Siemens, GMBH, Marbug-Germany). In case of discordant results, the Western blot test II, HIV1 and 2 (Bio-Rad, Marne la Coquette, France) was used as the reference method. The RPR (Bio-Scan, Karnataka, India) test was performed to detect syphilis infection. The RPR positive results were confirmed using the TPHA test (Biotech, Cambridge, UK). Data were analyzed using SPSS 17.0 software. A total of 2979 pregnant women attending ANCs were enrolled. The global HIV infection rate was estimated to be 3.6% (CI: 95%; 3.0-4.4). As expected, HIV prevalence was significantly higher in women aged above 25 years (4.4% (3.4-5.6), p = 0.026) and those attending urban ANCs (5.04%, p pregnant women (3.92%). The risk for syphilis occurrence was significantly higher among the single women compared to the married ones (4.4% VS 2.7%; p HIV and syphilis coinfection occurred in 22 cases (0.73%). The prevalence's of syphilis and HIV were relatively low. Marital status and sentinel site location were a risk factor associated with HIV and syphilis infections respectively. Therefore, substantial effort is needed to reinforce prevention strategies in this population to prevent mother-to-child and further horizontal transmissions of these infections.

  5. Ensemble Classifiers for Predicting HIV-1 Resistance from Three Rule-Based Genotypic Resistance Interpretation Systems.

    Science.gov (United States)

    Raposo, Letícia M; Nobre, Flavio F

    2017-08-30

    Resistance to antiretrovirals (ARVs) is a major problem faced by HIV-infected individuals. Different rule-based algorithms were developed to infer HIV-1 susceptibility to antiretrovirals from genotypic data. However, there is discordance between them, resulting in difficulties for clinical decisions about which treatment to use. Here, we developed ensemble classifiers integrating three interpretation algorithms: Agence Nationale de Recherche sur le SIDA (ANRS), Rega, and the genotypic resistance interpretation system from Stanford HIV Drug Resistance Database (HIVdb). Three approaches were applied to develop a classifier with a single resistance profile: stacked generalization, a simple plurality vote scheme and the selection of the interpretation system with the best performance. The strategies were compared with the Friedman's test and the performance of the classifiers was evaluated using the F-measure, sensitivity and specificity values. We found that the three strategies had similar performances for the selected antiretrovirals. For some cases, the stacking technique with naïve Bayes as the learning algorithm showed a statistically superior F-measure. This study demonstrates that ensemble classifiers can be an alternative tool for clinical decision-making since they provide a single resistance profile from the most commonly used resistance interpretation systems.

  6. A case study of discordant overlapping meta-analyses: vitamin d supplements and fracture.

    Directory of Open Access Journals (Sweden)

    Mark J Bolland

    Full Text Available BACKGROUND: Overlapping meta-analyses on the same topic are now very common, and discordant results often occur. To explore why discordant results arise, we examined a common topic for overlapping meta-analyses- vitamin D supplements and fracture. METHODS AND FINDINGS: We identified 24 meta-analyses of vitamin D (with or without calcium and fracture in a PubMed search in October 2013, and analysed a sample of 7 meta-analyses in the highest ranking general medicine journals. We used the AMSTAR tool to assess the quality of the meta-analyses, and compared their methodologies, analytic techniques and results. Applying the AMSTAR tool suggested the meta-analyses were generally of high quality. Despite this, there were important differences in trial selection, data extraction, and analytical methods that were only apparent after detailed assessment. 25 trials were included in at least one meta-analysis. Four meta-analyses included all eligible trials according to the stated inclusion and exclusion criteria, but the other 3 meta-analyses "missed" between 3 and 8 trials, and 2 meta-analyses included apparently ineligible trials. The relative risks used for individual trials differed between meta-analyses for total fracture in 10 of 15 trials, and for hip fracture in 6 of 12 trials, because of different outcome definitions and analytic approaches. The majority of differences (11/16 led to more favourable estimates of vitamin D efficacy compared to estimates derived from unadjusted intention-to-treat analyses using all randomised participants. The conclusions of the meta-analyses were discordant, ranging from strong statements that vitamin D prevents fractures to equally strong statements that vitamin D without calcium does not prevent fractures. CONCLUSIONS: Substantial differences in trial selection, outcome definition and analytic methods between overlapping meta-analyses led to discordant estimates of the efficacy of vitamin D for fracture prevention

  7. Labor unions and safety climate: perceived union safety values and retail employee safety outcomes.

    Science.gov (United States)

    Sinclair, Robert R; Martin, James E; Sears, Lindsay E

    2010-09-01

    Although trade unions have long been recognized as a critical advocate for employee safety and health, safety climate research has not paid much attention to the role unions play in workplace safety. We proposed a multiple constituency model of workplace safety which focused on three central safety stakeholders: top management, ones' immediate supervisor, and the labor union. Safety climate research focuses on management and supervisors as key stakeholders, but has not considered whether employee perceptions about the priority their union places on safety contributes contribute to safety outcomes. We addressed this gap in the literature by investigating unionized retail employee (N=535) perceptions about the extent to which their top management, immediate supervisors, and union valued safety. Confirmatory factor analyses demonstrated that perceived union safety values could be distinguished from measures of safety training, workplace hazards, top management safety values, and supervisor values. Structural equation analyses indicated that union safety values influenced safety outcomes through its association with higher safety motivation, showing a similar effect as that of supervisor safety values. These findings highlight the need for further attention to union-focused measures related to workplace safety as well as further study of retail employees in general. We discuss the practical implications of our findings and identify several directions for future safety research. 2009 Elsevier Ltd. All rights reserved.

  8. The Discordance Between HER-2/NEU Expression Assessed by Immunohistochemistry (IHC and Fluorescence in Situ Hybridization (FISH: Is It Important to Detect?

    Directory of Open Access Journals (Sweden)

    Berna Bozkurt Duman

    2014-02-01

    Conclusion: The clinical implication of this discordance rate and it\\'s affect on the choice of appropriate therapy are of critical importance. As such, it would be beneficial for each hospital to determine its own discordance rate.

  9. What predicts intention-behavior discordance? A review of the action control framework

    NARCIS (Netherlands)

    Rhodes, R.E.; de Bruijn, G.J.

    2013-01-01

    The physical activity intention-behavior gap is a focus of considerable research. The purpose of this article is to overview contemporary evidence for predictors of this intention-behavior discordance using the action control framework developed in our laboratories. We propose the hypothesis that

  10. Positivity in Marriage: The Role of Discord and Physical Aggression against Wives.

    Science.gov (United States)

    Langhinrichsen-Rohling, Jennifer; And Others

    1994-01-01

    Considered perceptions of relationship quality (positive communication, caring gestures, recollections of happiest times) in 81 discordant clinic and 51 nondiscordant community couples. Spouses in nondistressed community marriages reported more frequent and higher quality positive communication and longer lasting and more recent happiest memories…

  11. Mito-nuclear discord in six congeneric lineages of Holarctic ducks (genus Anas).

    Science.gov (United States)

    Peters, Jeffrey L; Winker, Kevin; Millam, Kendra C; Lavretsky, Philip; Kulikova, Irina; Wilson, Robert E; Zhuravlev, Yuri N; McCracken, Kevin G

    2014-06-01

    Many species have Holarctic distributions that extend across Europe, Asia and North America. Most genetics research on these species has examined only mitochondrial (mt) DNA, which has revealed wide variance in divergence between Old World (OW) and New World (NW) populations, ranging from shallow, unstructured genealogies to deeply divergent lineages. In this study, we sequenced 20 nuclear introns to test for concordant patterns of OW-NW differentiation between mtDNA and nuclear (nu) DNA for six lineages of Holarctic ducks (genus Anas). Genetic differentiation for both marker types varied widely among these lineages (idiosyncratic population histories), but mtDNA and nuDNA divergence within lineages was not significantly correlated. Moreover, compared with the association between mtDNA and nuDNA divergence observed among different species, OW-NW nuDNA differentiation was generally lower than mtDNA divergence, at least for lineages with deeply divergent mtDNA. Furthermore, coalescent estimates indicated significantly higher rates of gene flow for nuDNA than mtDNA for four of the six lineages. Thus, Holarctic ducks show prominent mito-nuclear discord between OW and NW populations, and we reject differences in sorting rates as the sole cause of the within-species discord. Male-mediated intercontinental gene flow is likely a leading contributor to this discord, although selection could also cause increased mtDNA divergence relative to weak nuDNA differentiation. The population genetics of these ducks contribute to growing evidence that mtDNA can be an unreliable indicator of stage of speciation and that more holistic approaches are needed for species delimitation. © 2014 John Wiley & Sons Ltd.

  12. Cardio-Metabolic Features of Type 2 Diabetes Subjects Discordant in the Diagnosis of Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Sa Rah Lee

    2012-10-01

    Full Text Available BackgroundThe aim of this study is to investigate the cardio-metabolic parameters and surrogate markers of insulin resistance in a discordant group of type 2 diabetes (T2DM subjects who satisfy the Adults Treatment Panel (ATP III criteria, but not the International Diabetes Federation (IDF criteria, for metabolic syndrome (MetS.MethodsWe assessed the prevalence of MetS in T2DM subjects (n=167 who were selected from subjects registered at the diabetes center of Dong-A University Medical Center. We used the ATP III criteria and the IDF criteria for the diagnosis of MetS and sorted the subjects into 2 MetS groups: one group diagnosed per ATP III criteria (MetSa and one diagnosed per IDF criteria (MetSi. We then compared the clinical characteristics, metabolic parameters (homeostasis model assessment of insulin resistance, aspartate aminotransferase, alanine aminotransferase, and uric acid values and co-morbidities (prevalence of microalbuminuria, fatty liver, and cardiovascular disease between the MetSa, MetSi, and discordant MetS groups.ResultsThe prevalence of MetS in the MetSa group (73.6% was higher than in the MetSi group (62.2%. The MetS prevalence in the discordant group was 11.4%. The discordant group showed no significant differences in clinical characteristics (except waist circumference and body mass index, metabolic parameters, or prevalence of co-morbidities, as compared with subjects with MetS by both criteria.ConclusionIn this study, cardio-metabolic features of the subjects diagnosed with MetS using ATP III criteria, but not IDF criteria, are not significantly different from those of subjects diagnosed with MetS using both criteria.

  13. Users and Union Catalogues

    Science.gov (United States)

    Hartley, R. J.; Booth, Helen

    2006-01-01

    Union catalogues have had an important place in libraries for many years. Their use has been little investigated. Recent interest in the relative merits of physical and virtual union catalogues and a recent collaborative project between a physical and several virtual union catalogues in the United Kingdom led to the opportunity to study how users…

  14. Atazanavir intracellular concentrations remain stable during pregnancy in HIV-infected patients.

    Science.gov (United States)

    Focà, Emanuele; Calcagno, Andrea; Bonito, Andrea; Simiele, Marco; Domenighini, Elisabetta; D'Avolio, Antonio; Quiros Roldan, Eugenia; Trentini, Laura; Casari, Salvatore; Di Perri, Giovanni; Castelli, Francesco; Bonora, Stefano

    2017-11-01

    Atazanavir (300 mg) boosted by ritonavir (100 mg) is the preferred third drug in pregnancy. However, there is still discordance on atazanavir dose increase during the third trimester. To evaluate plasma and intracellular atazanavir and ritonavir concentrations in HIV-infected women during pregnancy and after delivery. This was an observational study. HIV-infected pregnant patients treated with atazanavir/ritonavir plus either tenofovir/emtricitabine or abacavir/lamivudine had been prospectively enrolled after having signed a written informed consent form. Plasma and intracellular atazanavir and ritonavir Ctrough (24 ± 3 h after drug intake) were measured at each visit during the first, second and third trimesters and post-partum using validated HPLC-MS and HPLC-photodiode array methods (with direct evaluation of cellular volume). Data are described as median (IQR) and compared through non-parametric tests. Twenty-five patients were enrolled; at baseline, the median age was 32 years (27-35). All patients had plasma HIV RNA  0.05). This is the first demonstration that intracellular atazanavir exposure remains unchanged during pregnancy supporting the standard 300/100 mg atazanavir/ritonavir dosing throughout pregnancy. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Monozygotic twin discordant for Down syndrome: mos 47,XX,+21/46,XX and 46,XX.

    Science.gov (United States)

    Choi, Sun Ah; Ko, Jung Min; Shin, Choong Ho; Yang, Sei Won; Choi, Jin Sun; Oh, Sun Kyung

    2013-08-01

    Monozygotic twins, developed from a single zygote, are almost identical in clinical phenotype and concordant karyotypes. Monozygotic twins with discordant karyotypes are thought to be quite rare. Here, we report monochorionic-diamniotic twins discordant for Down syndrome. On findings of prenatal ultrasonography, nuchal translucency thickness was different between twins, and suggested that one of the twins was at high risk for having chromosomal abnormalities including Down syndrome. The twins were monochorionic-diamniotic; therefore, chorionic villi sampling of the common placenta was performed. The karyotype of the chorionic villi cells was 46,XX, and pregnancy was maintained. After delivery, dysmorphic clinical features suggesting Down syndrome were found in one of the twins, while the other twin showed a morphologically normal appearance. Karyotypes of peripheral blood leukocytes were repeatedly normal in the dysmorphic twin; however, the karyotype of skin fibroblasts from the dysmorphic twin indicated Down syndrome mosaicism; 47,XX,+21[99]/46,XX[2]. The karyotype of skin fibroblasts from the morphologically normal twin was 46,XX. Monozygosity of the twins was confirmed by a short tandem repeat analysis using 16 polymorphic markers. A mitotic nondisjunction followed by the twinning would explain the discordant karyotypes between monozygotic twins.

  16. Fatherhood, marriage and HIV risk among young men in rural Uganda.

    Science.gov (United States)

    Mathur, Sanyukta; Higgins, Jenny A; Thummalachetty, Nityanjali; Rasmussen, Mariko; Kelley, Laura; Nakyanjo, Neema; Nalugoda, Fred; Santelli, John S

    2016-01-01

    Compared to a large body of work on how gender may affect young women's vulnerability to HIV, we know little about how masculine ideals and practices relating to marriage and fertility desires shape young men's HIV risk. Using life-history interview data with 30 HIV-positive and HIV-negative young men aged 15-24 years, this analysis offers an in-depth perspective on young men's transition through adolescence, the desire for fatherhood and experience of sexual partnerships in rural Uganda. Young men consistently reported the desire for fatherhood as a cornerstone of masculinity and transition to adulthood. Ideally young men wanted children within socially sanctioned unions. Yet, most young men were unable to realise their marital intentions. Gendered expectations to be economic providers combined with structural constraints, such as limited access to educational and income-generating opportunities, led some young men to engage in a variety of HIV-risk behaviours. Multiple partnerships and limited condom use were at times an attempt by some young men to attain some part of their aspirations related to fatherhood and marriage. Our findings suggest that young men possess relationship and parenthood aspirations that - in an environment of economic scarcity - may influence HIV-related risk.

  17. Movement Discordance between Healthy and Non-Healthy US Adults.

    Directory of Open Access Journals (Sweden)

    Ann M Swartz

    Full Text Available Physical activity is known to significantly impact cardiometabolic health. Accelerometer data, as a measure of physical activity, can be used to objectively identify a disparity in movement (movement discordance between healthy and unhealthy adults. The purpose of this study was to examine the Movement Discordance between healthy and unhealthy adults in a large US population sample.Demographic, health and accelerometer data from the National Health and Nutrition Examination Study (NHANES 2003-2004 and 2005-2006 cohorts were used for this study. Participants were classified as either having a "normal" or "abnormal" value for each cardiometabolic health parameter examined, based on published criteria. Linear regression analyses were performed to determine significance of each abnormal health parameter (risk factor in its unique effect on the accelerometer counts, controlling for age and gender. Average accelerometer counts per minute (cpm by gender and age categories were estimated separately for the groups of normal and abnormal cardiometabolic risk.Average cpm for those with healthy levels of each individual cardiometabolic health parameter range from 296 cpm (for C reactive protein to 337 cpm (for waist circumference, while average cpm for those with abnormal levels of each individual cardiometabolic health parameter range from 216 cpm (for insulin to 291 cpm (for LDL-cholesterol. After controlling for age and gender, waist circumference, HbA1c, Insulin, Homocysteine, and HDL-Cholesterol were the cardiometabolic health parameters that showed significant, unique and independent effects on cpm. Overall, individuals who have abnormal values for all significant cardiometabolic health parameters ("unhealthy" averaged 267 cpm (SE = 15 cpm, while the healthy sample of this study averaged 428 cpm (SE = 10 cpm. The difference in cpm between the unhealthy and healthy groups is similar between males and females. Further, for both males and females, the

  18. Implementing and expanding HIV testing in immigrant populations in Europe: Comparing guideline's recommendations and expert's opinions.

    Science.gov (United States)

    Álvarez-Del Arco, Débora; Monge, Susana; Rivero-Montesdeoca, Yaiza; Burns, Fiona; Noori, Teymur; Del Amo, Julia

    2017-01-01

    Immigrant populations, especially those from endemic countries, living in the European Union (EU) suffer a disproportionate burden of HIV, delayed diagnosis and poorer access to antiretroviral treatment. While International Organisations are developing recommendations aimed at increasing the uptake of HIV testing, the feasibility and real outcomes of these measures remain unexplored. The aim of this review was, firstly to identify the recommendations of the main International Organisations (IO) on HIV testing in immigrants. Secondly, to describe the challenges for implementing and expanding HIV testing and counselling interventions targeting immigrants by interviewing key informants. The importance of HIV testing in immigrants is discussed, along with the appropriateness of universal HIV testing approaches vs most at risk targeted approaches. Also addressed is, pre- and post-HIV test counselling characteristics and community initiatives suitable to reach this population and, finally the legal issues regarding access to treatment for illegal immigrants. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  19. Longitudinal Associations among Discordant Sexual Orientation Dimensions and Hazardous Drinking in a Cohort of Sexual Minority Women

    Science.gov (United States)

    Talley, Amelia E.; Aranda, Frances; Hughes, Tonda L.; Everett, Bethany; Johnson, Timothy P.

    2015-01-01

    We examined differences between sexual minority women’s (SMW’s) sexual identity and sexual behavior or sexual attraction as potential contributors to hazardous drinking across a 10-year period. Data are from a longitudinal study examining drinking and drinking-related problems in a diverse, community-based sample of self-identified SMW (Wave 1: n = 447; Wave 2: n = 384; Wave 3: n = 354). Longitudinal cross-lagged models showed that SMW who report higher levels of identity-behavior or identity-attraction discordance may be at greater risk of concurrent and subsequent hazardous drinking. Results of multigroup models suggest that sexual orientation discordance is a more potent risk factor for risky drinking outcomes among SMW in older adulthood than in younger adulthood. Findings support that discordance between sexual orientation dimensions may contribute to hazardous drinking among SMW and provide evidence that cognitive-behavioral consistency is important for individuals expressing diverse and fluid sexual identities, attraction, and behavior. PMID:25911224

  20. Facilitators and Barriers of Antiretroviral Therapy Initiation among HIV Discordant Couples in Kenya: Qualitative Insights from a Pre-Exposure Prophylaxis Implementation Study.

    Directory of Open Access Journals (Sweden)

    Rena C Patel

    Full Text Available The World Health Organization now recommends antiretroviral therapy (ART initiation for all HIV-infected individuals regardless of CD4 cell count or disease status. Understanding the facilitators and barriers to initiation of and adherence to ART is essential to successful scale-up of "universal" ART.To investigate facilitators and barriers to ART initiation, we conducted 44 in-depth individual or couple interviews with 63 participants (33 participants with HIV and 30 without HIV already enrolled in a prospective implementation study of oral antiretroviral-based prevention in Kisumu, Kenya between August and September 2014. A semi-structured interview guided discussions on: 1 perceived advantages and disadvantages of ART; 2 reasons for accepting or declining ART initiation; and 3 influence of prevention of transmission to partner or infant influencing ART use. Transcripts from the interviews were iteratively analyzed using inductive content analysis.HIV-infected participants indicated that living a healthier life, preventing HIV transmission to others, and appearing "normal" or "healthy" again facilitated their initiation of ART. While appearing "normal" allowed these individuals to interact with their communities without stigmatization, they also perceived community opposition to their initiating ART, because appearing "normal" again prevented community members from easily identifying infected individuals in their community. Denial of diagnosis, disclosure stigma, perceived side-effects, and challenges in obtaining refills were additional barriers to ART initiation.Community perceptions play an important role in both facilitating and inhibiting ART initiation. Perceived stigma, including perceived community opposition to widespread ART use, is an important barrier to ART initiation. Addressing such barriers, while capitalizing on facilitators, to ART initiation should be central to universal ART scale-up efforts.

  1. a decade of african union and european union trans-regional

    African Journals Online (AJOL)

    Abel

    designed to link the African Union and the European Union in a process of trans- ... terrorism, drug and human trafficking and migration.5 The common value ..... have involved policing, rule of law, border assistance and monitoring and security .... Europe as exemplified by Russia and Ukraine (who provided helicopters and ...

  2. The molecular epidemiology of HIV in Asia.

    Science.gov (United States)

    Weniger, B G; Takebe, Y; Ou, C Y; Yamazaki, S

    1994-01-01

    The human immunodeficiency virus (HIV) was introduced readily into Asia and has quickly spread between Asian states through both parenteral and sexual modes of transmission. Only 1 year after Thailand's epidemic wave among intravenous drug users (IDUs) in 1988, the virus spread to the adjacent Myanmar and Malaysia, and another year later IDUs were infected in parts of India and China bordering Myanmar. Several methods can be used to quantify the genetic diversity, divergence, or variation within or between subtypes, genotypes, or isolates. Consensus sequences, representing the most common nucleotide in the genome, are often generated for comparison. 8 subtypes A through F, H, and O have been described for HIV-1 based on the genetic similarities and differences in the env gene or viral envelope. Subtype A and D have been found primarily in central and western Africa. Subtype B is predominant in Europe, the Western hemisphere, Japan, and Australia. Subtype C has been found mostly in southern Africa, the Central African Republic, and India. Subtype E was first identified in Thailand and recently in the Central African Republic. Subtype F has been found in Romania and is a rare variant in Brazil. Isolates from Gabon and the Russian Federation were designated subtype H. An "outlier" subtype O containing 2 human and 2 chimpanzee isolates has been identified in Cameroon and Gabon. Sequencing of the relatively conserved gag gene of geographically diverse HIV-1 isolates yielded a classification with 7 subtypes A-D and F-H. Other topics discussed include genome characterization, comparison with foreign isolates, segregation by mode of transmission, and biologic properties of HIV-1 variants in Thailand; regional diversity of HIV-1 subtypes and substantial spread of HIV-2 in India; as well as HIV transmission and infections in Japan, Australia, Cambodia, China, Taiwan, Philippines, Malaysia, Myanmar, and in states created out of the former Soviet Union.

  3. Trade Union Cooperation in the EU: Views Among Swedish Trade Unions and Their Members

    Directory of Open Access Journals (Sweden)

    Bengt Furåker

    2013-09-01

    Full Text Available This article compares views among Swedish trade unions with those of their members regarding cross-national union cooperation in Europe or the EU. Data are derived from two different surveys, one among trade unions in 2010–2011 and the other among employees in 2006. It turns out that trade unions are generally more affirmative than their members to transnational union cooperation. In the employee survey, differences appear between members of the three peak-level organizations—the LO (manual workers, the TCO (white-collar workers, and Saco (professionals. However, controlling for education, these differences cannot be verified statistically. Higher education—which above all Saco members have—is linked to more positive attitudes toward transnational union cooperation. The gap between the organizations and their affiliates concerning engagement in European issues appears to be larger in the LO than in Saco, with the TCO somewhere in the middle.

  4. Assessing business responses to HIV / AIDS in Kenya.

    Science.gov (United States)

    Roberts, M; Wangombe, J

    1995-01-01

    A consulting firm conducted interviews with managers of 16 businesses in 3 Kenyan cities, representatives of 2 trade unions, focus groups with workers at 13 companies, and an analysis of financial/labor data from 4 companies. It then did a needs assessment. The business types were light industry, manufacturing companies, tourism organizations, transport firms, agro-industrial and plantation businesses, and the service industry. Only one company followed all the workplace policy principles recommended by the World Health Organization and the International Labor Organization. Six businesses required all applicants and/or employees to undergo HIV testing. All their managers claimed that they would not discriminate against HIV-infected workers. Many workers thought that they would be fired if they were--or were suspected to be--HIV positive. Lack of a non-discrimination policy brings about worker mistrust of management. 11 companies had some type of HIV/AIDS education program. All the programs generated positive feedback. The main reasons for not providing HIV/AIDS education for the remaining 5 companies were: no employee requests, fears that it would be taboo, and assumptions that workers could receive adequate information elsewhere. More than 90% of all companies distributed condoms. 60% offered sexually transmitted disease diagnosis and treatment. About 33% offered counseling. Four companies provided volunteer HIV testing. Almost 50% of companies received financial or other external support for their programs. Most managers thought AIDS to be a problem mainly with manual staff and not with professional staff. Almost all businesses offered some medical benefits. The future impact of HIV/AIDS would be $90/employee/year (by 2005, $260) due to health care costs, absenteeism, retraining, and burial benefits. The annual costs of a comprehensive workplace HIV/AIDS prevention program varied from $18 to $54/worker at one company.

  5. Asymmetry and discordance for congenital anomalies in conjoined twins: a report of six cases.

    Science.gov (United States)

    Ornoy, A; Navot, D; Menashi, M; Laufer, N; Chemke, J

    1980-10-01

    Six pairs of conjoined twins have been studied. The first case was a pair of 13-week-old omphalopagus fetuses. One was a holoacradius amorphus and the other had rachischisis and anencephaly. The second case was a pair of omphalopagus twins. One of the twins was macerated and corresponded to a developmental age of 13-14 weeks, while the other was developed to 28-30 weeks of gestation and exhibited urogenital and gastrointestinal defects not found in the smaller twin. In the third case, that of a thoracoomphalopagus, one had cleft lip and palate, pulmonic stenosis, and atresia of the ileocecal valve, while the other did not show these anomalies. In the fourth cae, also omphalopagus twins, one had a lumbosacral meningomyelocele and severe gastrointestinal and urogenital anomalies not found in the second twin. The fifth case was a pair of thoracoomphalopagus twins, sharing a common heart with asymmetrical anomalies. The sixth case was a diprosopus anencephalic conjoined twin. The first pairs of conjoined twins were discordant for several abnormalities in nonshared organs, in addition to having abnormalities of the conjoined organs. It seems that discordance in conjoined twins is not a rare finding. The factors that play a role in discordance of anomalies in conjoined twins are probably similar to the factors in monozygotic twins--i.e., environmental, genetic, and abnormal placental and/or fetal circulation.

  6. Recall of intestinal helminthiasis by HIV-infected South Africans and avoidance of possible misinterpretation of egg excretion in worm/HIV co-infection analyses

    Directory of Open Access Journals (Sweden)

    van der Merwe Lize

    2006-05-01

    Full Text Available Abstract Background Ascariasis and HIV/AIDS are often co-endemic under conditions of poverty in South Africa; and discordant immune responses to the respective infections could theoretically be affecting the epidemic of HIV/AIDS in various ways. It is well-known that sensitisation to helminthic antigens can aggravate or ameliorate several non-helminthic diseases and impair immunisation against cholera, tetanus and tuberculosis. The human genotype can influence immune responses to Ascaris strongly. With these factors in mind, we have started to document the extent of long-term exposure to Ascaris and other helminths in a community where HIV/AIDS is highly prevalent. In more advanced studies, objectives are to analyse relevant immunological variables (e.g. cytokine activity and immunoglobulin levels. We postulate that when Ascaris is hyperendemic, analysis of possible consequences of co-infection by HIV cannot be based primarily on excretion vs non-excretion of eggs. Methods Recall of worms seen in faeces was documented in relation to the age of adult volunteers who were either seropositive (n = 170 or seronegative (n = 65 for HIV. Reasons for HIV testing, deworming treatments used or not used, date and place of birth, and duration of residence in Cape Town, were recorded. Confidence intervals were calculated both for group percentages and the inter-group differences, and were used to make statistical comparisons. Results In both groups, more than 70% of participants were aware of having passed worms, often both when a child and as an adult. Most of the descriptions fitted Ascaris. Evidence for significantly prolonged exposure to helminthic infection in HIV-positives was supported by more recall of deworming treatment in this group (p Conclusion There was a long-term history of ascariasis (and probably other helminthic infections in both of the groups that were studied. In women in the same community, and in children living where housing and

  7. EAMJ Know your Epidemic Mar 10.indd

    African Journals Online (AJOL)

    2010-03-03

    Mar 3, 2010 ... testing: 89% of adults and 58% of children consented to HIV testing. The prevalence of ... the likelihood that HIV-positive patients receive antiretroviral treatment ... of discordant couples, reduction of stigma as more people are tested ..... HIV prevention messages, and referrals for HIV care and treatment.

  8. Genetic determinants of LDL, lipoprotein(a), triglyceride-rich lipoproteins and HDL: concordance and discordance with cardiovascular disease risk

    DEFF Research Database (Denmark)

    Nordestgaard, Børge G; Tybjærg-Hansen, Anne

    2011-01-01

    To evaluate whether new and known genetic determinants of plasma levels of LDL cholesterol, lipoprotein(a), triglyceride-rich lipoproteins, and HDL cholesterol associate with the risk of cardiovascular disease expected from the effect on lipoprotein levels. Concordance or discordance of such gene......To evaluate whether new and known genetic determinants of plasma levels of LDL cholesterol, lipoprotein(a), triglyceride-rich lipoproteins, and HDL cholesterol associate with the risk of cardiovascular disease expected from the effect on lipoprotein levels. Concordance or discordance...

  9. Metabolome and fecal microbiota in monozygotic twin pairs discordant for weight: a Big Mac challenge.

    Science.gov (United States)

    Bondia-Pons, Isabel; Maukonen, Johanna; Mattila, Ismo; Rissanen, Aila; Saarela, Maria; Kaprio, Jaakko; Hakkarainen, Antti; Lundbom, Jesper; Lundbom, Nina; Hyötyläinen, Tuulia; Pietiläinen, Kirsi H; Orešič, Matej

    2014-09-01

    Postprandial responses to food are complex, involving both genetic and environmental factors. We studied postprandial responses to a Big Mac meal challenge in monozygotic co-twins highly discordant for body weight. This unique design allows assessment of the contribution of obesity, independent of genetic liability. Comprehensive metabolic profiling using 3 analytical platforms was applied to fasting and postprandial serum samples from 16 healthy monozygotic twin pairs discordant for weight (body mass index difference >3 kg/m(2)). Nine concordant monozygotic pairs were examined as control pairs. Fecal samples were analyzed to assess diversity of the major bacterial groups by using 5 different validated bacterial group specific denaturing gradient gel electrophoresis methods. No differences in fecal bacterial diversity were detected when comparing co-twins discordant for weight (ANOVA, P<0.05). We found that within-pair similarity is a dominant factor in the metabolic postprandial response, independent of acquired obesity. Branched chain amino acids were increased in heavier as compared with leaner co-twins in the fasting state, but their levels converged postprandially (paired t tests, FDR q<0.05). We also found that specific bacterial groups were associated with postprandial changes of specific metabolites. Our findings underline important roles of genetic and early life factors in the regulation of postprandial metabolite levels. © FASEB.

  10. Association between HIV/AIDS and multi-drug resistance tuberculosis: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Yonatan Moges Mesfin

    Full Text Available BACKGROUND: Human immunodeficiency virus (HIV, multi-drug resistant tuberculosis (MDR is emerging as major challenge facing tuberculosis control programs worldwide particularly in Asia and Africa. Findings from different studies on associations of HIV co-infection and drug resistance among patients with TB have been contradictory (discordant. Some institution based studies found strongly increased risks for multi-drug resistant TB (MDR TB among patients co-infected with TB and HIV, whereas other studies found no increased risk (it remains less clear in community based studies. The aim was to conduct a systematic review and meta-analysis of the association between multi-drug resistant tuberculosis and HIV infection. METHODS AND FINDINGS: Systematic review of the published literature of observational studies was conducted. Original studies were identified using databases of Medline/Pubmed, Google Scholar and HINARI. The descriptions of original studies were made using frequency and forest plot. Publication bias was assessed using Funnel plot graphically and Egger weighted and Begg rank regression tests statistically. Heterogeneity across studies was checked using Cochrane Q test statistic and I(2. Pool risk estimates of MDR-TB and sub-grouping analysis were computed to analyze associations with HIV. Random effects of the meta-analysis of all 24 observational studies showed that HIV is associated with a marginal increased risk of multi-drug resistant tuberculosis (estimated Pooled OR 1.24; 95%, 1.04-1.43. Subgroup analyses showed that effect estimates were higher (Pooled OR 2.28; 95%, 1.52-3.04 for primary multi-drug resistance tuberculosis and moderate association between HIV/AIDS and MDR-TB among population based studies and no significant association in institution settings. CONCLUSIONS: This study demonstrated that there is association between MDR-TB and HIV. Capacity for diagnosis of MDR-TB and initiating and scale up of antiretroviral

  11. Personal, family and social functioning among older couples concordant and discordant for high-risk alcohol consumption.

    Science.gov (United States)

    Moos, Rudolf H; Schutte, Kathleen K; Brennan, Penny L; Moos, Bernice S

    2011-02-01

    This study compares the personal, family and social functioning of older husbands and wives concordant or discordant for high-risk alcohol consumption and identifies predictors of changes in concordance and high-risk consumption. Three groups of couples were identified at baseline and followed 10 years later: (i) concordant couples in which husbands and wives engaged in low-risk alcohol consumption (n = 54); (ii) concordant couples in which husbands and wives engaged in high-risk alcohol consumption (n = 38); and (iii) discordant couples in which one partner engaged in high-risk alcohol consumption and the other partner did not (n = 75). At each follow-up, husbands and wives completed an inventory that assessed their personal, family and social functioning. Compared to the low-risk concordant group, husbands and wives in the high-risk concordant group were more likely to rely on tension-reduction coping, reported more friend approval of drinking, and were less involved in religious activities; however, they did not differ in the quality of the spousal relationship. The frequency of alcohol consumption declined among husbands in discordant couples, but not among husbands in concordant couples. Predictors of high-risk drinking included tension-reduction coping, friend approval of drinking and, for husbands, their wives' level of drinking. High-risk and discordant alcohol consumption do not seem to be linked to decrements in family functioning among older couples in long-term stable marriages. The predictors of heavy alcohol consumption among older husbands and wives identify points of intervention that may help to reduce their high-risk drinking. © 2010 Society for the Study of Addiction. No claim to US government works.

  12. Why do people join trade unions?

    DEFF Research Database (Denmark)

    Toubøl, Jonas; Jensen, Carsten Strøby

    level on union recruitment, which is not done before. Workplace union density is taken to measure the strength of the workplace’s custom of being union member creating an instrumental incentive to join the union. Self-placement on a political left-right scale measures political attitude taken...

  13. Heritability of cortical thickness changes over time in twin pairs discordant for schizophrenia.

    Science.gov (United States)

    Hedman, Anna M; van Haren, Neeltje E M; van Baal, G Caroline M; Brouwer, Rachel M; Brans, Rachel G H; Schnack, Hugo G; Kahn, René S; Hulshoff Pol, Hilleke E

    2016-06-01

    Cortical thickness and surface area changes have repeatedly been found in schizophrenia. Whether progressive loss in cortical thickness and surface area are mediated by genetic or disease related factors is unknown. Here we investigate to what extent genetic and/or environmental factors contribute to the association between change in cortical thickness and surface area and liability to develop schizophrenia. Longitudinal magnetic resonance imaging study over a 5-year interval. Monozygotic (MZ) and dizygotic (DZ) twin pairs discordant for schizophrenia were compared with healthy control twin pairs using repeated measures analysis of variance (RM-ANOVA) and structural equation modeling (SEM). Twins discordant for schizophrenia and healthy control twins were recruited from the twin cohort at the University Medical Centre Utrecht, The Netherlands. A total of 90 individuals from 46 same sex twin pairs were included: 9 MZ and 10 DZ discordant for schizophrenia and 14 MZ and 13 (11 complete and 2 incomplete) DZ healthy twin-pairs. Age varied between 19 and 57years. Higher genetic liability for schizophrenia was associated with progressive global thinning of the cortex, particularly of the left superior temporal cortex. Higher environmental liability for schizophrenia was associated with global attenuated thinning of the cortex, and including of the left superior temporal cortex. Cortical surface area change was heritable, but not significantly associated with higher genetic or environmental liability for schizophrenia. Excessive cortical thinning, particularly of the left superior temporal cortex, may represent a genetic risk marker for schizophrenia. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Revitalizing the Malaysian Trade Union Movement

    DEFF Research Database (Denmark)

    Wad, Peter

    2012-01-01

    The article takes an historic perspective on contemporary issues of trade union revival in Malaysia, focusing on the challenge of raising union density and analysing the process of organizing employees in the strategically important electronics industry. It concludes that the political support...... for transnational corporations in the electronics industry is declining. This strategic shift enables union activists to bypass enterprise and state-based unions and to establish larger, regionally based unions. However, newly organized unions have not yet overcome resistance from global corporations, nor have...... organizations prefer non-partisan engagement. In order to revitalize themselves, the unions must demonstrate to the Malaysian public that they are both relevant and important for increased productivity and that they can play a significant role in enabling Malaysia to move beyond the middle-income ‘trap’ towards...

  15. Virtual OPACs versus Union Database: Two Models of Union Catalogue Provision.

    Science.gov (United States)

    Cousins, Shirley

    1999-01-01

    Considers some of the major technical and organizational issues involved in virtual-catalog production, contrasting them with the traditional union catalog approach exemplified by COPAC, an online public-access catalog composed of academic libraries in the United Kingdom. Suggest a method of integrating these two models of the union catalog.…

  16. Imaging-histologic discordance at sonographically guided percutaneous biopsy of breast lesions

    International Nuclear Information System (INIS)

    Kim, Min Jung; Kim, Eun-Kyung; Park, Sun Young; Jung, Hae Kyoung; Park, Byeong-Woo; Kim, Haeryung; Oh, Ki Keun

    2008-01-01

    Objective: To determine the frequency of imaging-histologic discordance at percutaneous breast biopsy and to evaluate differences in clinical and radiologic findings between pathologically upgraded lesions and non-upgraded lesions. Materials and methods: From February 2000 to June 2005, we reviewed 386 cases that had suspicious imaging findings but yielded benign histology at US-core needle biopsy and that underwent subsequent excisional biopsy. In 74 of 386 cases, the benign histology at core needle biopsy could not provide a satisfactory explanation for the radiologically suspicious lesions. The clinical, radiologic and histologic findings were reviewed for those 74 cases that were classified as the upgrade group and the non-upgrade group after excisional biopsy. Results: The upgrade rate was 17.6% (95% confidence interval, 10.6-27.8%, 13 of 74 cases) revealed upgraded pathology at the subsequent excisional biopsy. Besides the size of masses, there were no statistically significant differences in imaging findings between the upgrade and non-upgrade groups at excisional biopsy. Conclusion: This upgrade rate of 17.6% suggests that excisional biopsy or re-biopsy is warranted in those cases presenting imaging-histologic discordance at US-guided core biopsy

  17. Differences in Gay Male Couples' Use of Drugs and Alcohol With Sex by Relationship HIV Status.

    Science.gov (United States)

    Mitchell, Jason W

    2016-07-01

    Prior studies with men who have sex with men have documented a strong association between substance use with sex and risk for acquisition of HIV. However, few studies have been conducted about gay male couples' use of substances with sex, despite the fact that between one third and two thirds of men who have sex with men acquire HIV from their relationship partners. The present study sought to (1) describe whether one or both partners in the male couple uses substances with sex-by substance type-within and/or outside of their relationship, and (2) assess whether differences exist in those who use substances with sex within and outside the relationship by the couples' HIV status. Dyadic data for this analysis were collected in the United States from a nation-wide cross-sectional Internet study about male couples' relationships and behaviors. Couple-level descriptive and comparative analyses were employed with 361 male couples. Except for alcohol, most couples did not use substances with sex. Of those who did, rates of who used it with sex and substance type within the relationship varied; most couples only had one partner who used substances with sex outside the relationship. Significantly higher proportions of concordantly HIV-negative and HIV-positive couples had both partners who used substances (all types) with sex within their relationship over discordant couples. Most couples had one partner who used outside the relationship; only marijuana and erectile dysfunction medication use with sex significantly differed by couples' HIV status. Findings indicate the need to conduct additional research for prevention development. © The Author(s) 2014.

  18. Genome-wide analysis of DNA methylation differences in muscle and fat from monozygotic twins discordant for type 2 diabetes

    DEFF Research Database (Denmark)

    Ribel-Madsen, Rasmus; Fraga, Mario F; Jacobsen, Stine

    2012-01-01

    Monozygotic twins discordant for type 2 diabetes constitute an ideal model to study environmental contributions to type 2 diabetic traits. We aimed to examine whether global DNA methylation differences exist in major glucose metabolic tissues from these twins.......Monozygotic twins discordant for type 2 diabetes constitute an ideal model to study environmental contributions to type 2 diabetic traits. We aimed to examine whether global DNA methylation differences exist in major glucose metabolic tissues from these twins....

  19. HIV diversity and drug resistance from plasma and non-plasma analytes in a large treatment programme in western Kenya.

    Science.gov (United States)

    Kantor, Rami; DeLong, Allison; Balamane, Maya; Schreier, Leeann; Lloyd, Robert M; Injera, Wilfred; Kamle, Lydia; Mambo, Fidelis; Muyonga, Sarah; Katzenstein, David; Hogan, Joseph; Buziba, Nathan; Diero, Lameck

    2014-01-01

    Antiretroviral resistance leads to treatment failure and resistance transmission. Resistance data in western Kenya are limited. Collection of non-plasma analytes may provide additional resistance information. We assessed HIV diversity using the REGA tool, transmitted resistance by the WHO mutation list and acquired resistance upon first-line failure by the IAS-USA mutation list, at the Academic Model Providing Access to Healthcare (AMPATH), a major treatment programme in western Kenya. Plasma and four non-plasma analytes, dried blood-spots (DBS), dried plasma-spots (DPS), ViveST(TM)-plasma (STP) and ViveST-blood (STB), were compared to identify diversity and evaluate sequence concordance. Among 122 patients, 62 were treatment-naïve and 60 treatment-experienced; 61% were female, median age 35 years, median CD4 182 cells/µL, median viral-load 4.6 log10 copies/mL. One hundred and ninety-six sequences were available for 107/122 (88%) patients, 58/62 (94%) treatment-naïve and 49/60 (82%) treated; 100/122 (82%) plasma, 37/78 (47%) attempted DBS, 16/45 (36%) attempted DPS, 14/44 (32%) attempted STP from fresh plasma and 23/34 (68%) from frozen plasma, and 5/42 (12%) attempted STB. Plasma and DBS genotyping success increased at higher VL and shorter shipment-to-genotyping time. Main subtypes were A (62%), D (15%) and C (6%). Transmitted resistance was found in 1.8% of plasma sequences, and 7% combining analytes. Plasma resistance mutations were identified in 91% of treated patients, 76% NRTI, 91% NNRTI; 76% dual-class; 60% with intermediate-high predicted resistance to future treatment options; with novel mutation co-occurrence patterns. Nearly 88% of plasma mutations were identified in DBS, 89% in DPS and 94% in STP. Of 23 discordant mutations, 92% in plasma and 60% in non-plasma analytes were mixtures. Mean whole-sequence discordance from frozen plasma reference was 1.1% for plasma-DBS, 1.2% plasma-DPS, 2.0% plasma-STP and 2.3% plasma-STB. Of 23 plasma

  20. Social Customs and Trade Union Membership

    DEFF Research Database (Denmark)

    Ibsen, Christian Lyhne; Toubøl, Jonas; Jensen, Daniel Sparwath

    2017-01-01

    In this article, we investigate the effect of social customs on one of the most important instances of collective action, namely, workers uniting in trade unions. Although many studies have used social custom theory to explain unionization, existing studies have not adequately analysed social...... customs at the workplace. Using workplace union density as a proxy for social custom, this analysis improves existing studies in a number of ways. First, multi-level analyses of a large panel data set from Denmark reveal that there is a significant positive effect of workplace union density...... in unionization are required to create self-sustaining social customs for union membership. Thirdly, we test the acceleration using segmented regression analysis and find a significant acceleration around 45–65 per cent workplace union density. In the conclusion, we discuss the implications of our study...

  1. Data-protection standards and confidentiality of HIV/AIDS status in the workplace - a South African case study.

    Science.gov (United States)

    Muskat-Gorska, Zuzanna

    2008-11-01

    The article contextualises an emerging new regime for information privacy in South Africa (i.e. the draft Protection of Personal Information Bill). Subsequently, it discusses the possibility of successful implementation of international data-protection standards in an environment where there is an urgent need to balance HIV/AIDS confidentiality rights with public health requirements. Also, the article presents a preliminary assessment of the possible impact of professionalisation (and outsourcing) of workplace HIV/AIDS management on workplace data-protection practices, and it identifies some spaces for social dialogue on HIV/AIDS-data treatment in South Africa. The study methods comprise an analysis of legal documents (concerning international data-protection standards and the development of law governing data protection and HIV/AIDS confidentiality in South Africa) and interviews conducted with workplace health managers and trade union representatives, in Johannesburg, in 2007.

  2. Quantum discord is Bohr’s notion of non-mechanical disturbance introduced to counter the Einstein–Podolsky–Rosen argument

    International Nuclear Information System (INIS)

    Wiseman, Howard M.

    2013-01-01

    By rigorously formalizing the Einstein–Podolsky–Rosen (EPR) argument, and Bohr’s reply, one can appreciate that both arguments were technically correct. Their opposed conclusions about the completeness of quantum mechanics hinged upon an explicit difference in their criteria for when a measurement on Alice’s system can be regarded as not disturbing Bob’s system. The EPR criteria allow their conclusion–incompleteness–to be reached by establishing the physical reality of just a single observable q (not of both q and its conjugate observable p), but I show that Bohr’s definition of disturbance prevents the EPR chain of reasoning from establishing even this. Moreover, I show that Bohr’s definition is intimately related to the asymmetric concept of quantum discord from quantum information theory: if and only if the joint state has no Alice-discord, she can measure any observable without disturbing (in Bohr’s sense) Bob’s system. Discord can be present even when systems are unentangled, and this has implications for our understanding of the historical development of notions of quantum nonlocality. -- Highlights: •Both the EPR argument, and Bohr’s reply, were technically correct. •Their opposed conclusions came from different criteria for disturbance. •Bohr’s criterion works against even the simplified (one-variable) EPR argument. •Bohr’s criterion for disturbance is intimately related to quantum discord. •This illuminates the historical development of notions of quantum nonlocality

  3. [Analysis for Discordance of Positive and Negative Blood Typing by Gel Card].

    Science.gov (United States)

    Li, Cui-Ying; Xu, Hong; Lei, Hui-Fen; Liu, Juan; Li, Xiao-Wei

    2017-08-01

    To explore the method of Gel card identifying ABO blood group, determine the inconsistent cause and the distribution of disease affecting factors, and put forward a method of its solutions. To collect 240 positive and negative typing-discordant blood speciments from patients examined by Gel card and send these speciments to blood type reference laboratory for examining with the classic tube method and serological test, such as salivary blood-group substance, in order to performe genotyping method when serologic test can not be determined. Among 240 positive and negative typing-discordant blood speciments from patients examined by Gel card, 107 blood speciments were positive and negative consistent examined by false agglutination test (44.58%), 133 blood specinents were discordent examined by false agglutination (55.42%), out of them, 35 cases (14.58%) with inconsistent cold agglutination test, 22 cases (9.17%) with weakened AB antigenicity, 16 cases (6.67%) with ABO subtyping, 12 cases (5.00%) with positive direct antiglobulin test, 11 cases (4.58%) with reduced or without antibodies, 11 cases (4.58%) with false aggregation caused by drugs or protein, 11 cases (4.58%) with salivary blood-type substances, 8 cases (3.33%) with non-ABO alloantibody, and 7 cases (2.92%) with allogeneic bone marrow transplantation. The distribution of disease were following: blood disease (16.83%), tumor (11.88%), and cardiopulmonary diseases (11.39%); chi-square test results indicated that the distribution significantly different. The analysis of ABO blood grouping shows a variety factors influencing positive and negative blood typing, and the Gel Card identification can produc more false positive blood types. Therefore, more attention should be paid on the high incidence diseases, such as blood disease, tumor, and cardiopulmonary disease.

  4. Antiretroviral-treated HIV-1 patients can harbour resistant viruses in CSF despite an undetectable viral load in plasma.

    Science.gov (United States)

    Soulie, Cathia; Grudé, Maxime; Descamps, Diane; Amiel, Corinne; Morand-Joubert, Laurence; Raymond, Stéphanie; Pallier, Coralie; Bellecave, Pantxika; Reigadas, Sandrine; Trabaud, Mary-Anne; Delaugerre, Constance; Montes, Brigitte; Barin, Francis; Ferré, Virginie; Jeulin, Hélène; Alloui, Chakib; Yerly, Sabine; Signori-Schmuck, Anne; Guigon, Aurélie; Fafi-Kremer, Samira; Haïm-Boukobza, Stéphanie; Mirand, Audrey; Maillard, Anne; Vallet, Sophie; Roussel, Catherine; Assoumou, Lambert; Calvez, Vincent; Flandre, Philippe; Marcelin, Anne-Geneviève

    2017-08-01

    HIV therapy reduces the CSF HIV RNA viral load (VL) and prevents disorders related to HIV encephalitis. However, these brain disorders may persist in some cases. A large population of antiretroviral-treated patients who had a VL > 1.7 log 10 copies/mL in CSF with detectable or undetectable VL in plasma associated with cognitive impairment was studied, in order to characterize discriminatory factors of these two patient populations. Blood and CSF samples were collected at the time of neurological disorders for 227 patients in 22 centres in France and 1 centre in Switzerland. Genotypic HIV resistance tests were performed on CSF. The genotypic susceptibility score was calculated according to the last Agence Nationale de Recherche sur le Sida et les hépatites virales Action Coordonnée 11 (ANRS AC11) genotype interpretation algorithm. Among the 227 studied patients with VL > 1.7 log 10 copies/mL in CSF, 195 had VL detectable in plasma [median (IQR) HIV RNA was 3.7 (2.7-4.7) log 10 copies/mL] and 32 had discordant VL in plasma (VL plasma compared with patients with plasma VL > 1.7 log 10 copies/mL. Resistance to antiretrovirals was observed in CSF for the two groups of patients. Fourteen percent of this population of patients with cognitive impairment and detectable VL in CSF had well controlled VL in plasma. Thus, it is important to explore CSF HIV (VL and genotype) even if the HIV VL is controlled in plasma because HIV resistance may be observed. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Prevalence and risk factors of previous or active Hepatitis B infection ...

    African Journals Online (AJOL)

    Background: Hepatitis B Virus (HBV) and HIV spread in the same manner, but HBV is more infectious than HIV-1. Active HBV requires modification of HIV-1 therapy and is associated with increased risk for sexual transmission of HBV. Objective: To determine the prevalence and knowledge of HBV among HIV-1 discordant ...

  6. Discordant tooth agenesis and peg-shaped in a pair of monozygotic twins: Clinical and molecular study

    Directory of Open Access Journals (Sweden)

    Lívia Azeredo Alves Antunes

    2013-01-01

    Full Text Available The present report aimed to study an uncommon case of a pair of twins that presented a discordant dental phenotype. Family investigation, clinical, radiographic examination and molecular analysis were performed in both girls. Molecular analysis confirmed the monozygosity by deoxyribonucleic acid chip technology. One twin presented tooth agenesis in left upper lateral incisor and peg-shaped on the contra lateral side while the other twin had no dental alterations. The dental casts study employed digital caliper to compare morphological dimensions and showed alteration only in peg-shaped tooth. In conclusion, this study provide support that one or more mutated gene could cause discordances in dental phenotype in these monozygotic twins.

  7. Discordance in investigator-reported and adjudicated sudden death in TIOSPIR

    Directory of Open Access Journals (Sweden)

    Robert A. Wise

    2017-03-01

    Full Text Available Accurate and consistent determination of cause of death is challenging in chronic obstructive pulmonary disease (COPD patients. TIOSPIR (N=17 135 compared the safety and efficacy of tiotropium Respimat 5/2.5 µg with HandiHaler 18 µg in COPD patients. All-cause mortality was a primary end-point. A mortality adjudication committee (MAC assessed all deaths. We aimed to investigate causes of discordance in investigator-reported and MAC-adjudicated causes of death and their impact on results, especially cardiac and sudden death. The MAC provided independent, blinded assessment of investigator-reported deaths (n=1302 and assigned underlying cause of death. Discordance between causes of death was assessed descriptively (shift tables. There was agreement between investigator-reported and MAC-adjudicated deaths in 69.4% of cases at the system organ class level. Differences were mainly observed for cardiac deaths (16.4% investigator, 5.1% MAC and deaths assigned to general disorders including sudden death (17.4% investigator, 24.6% MAC. Reasons for discrepancies included investigator attribution to the immediate (e.g. myocardial infarction (MI over the underlying cause of death (e.g. COPD and insufficient information for a definitive cause. Cause-specific mortality varies in COPD, depending on the method of assignment. Sudden death, witnessed and unwitnessed, is common in COPD and often attributed to MI without supporting evidence.

  8. The effects of union mergers and internal restructuring:

    DEFF Research Database (Denmark)

    Navrbjerg, Steen Erik; Larsen, Trine Pernille

    2016-01-01

    Trade union mergers and restructuring are often seen as strategy for union revitalisation and renewal and have been ongoing in the majority of European trade unions. This paper explores how recent union mergers and internal restructuring has affected unions service provision, union democracy...... and interest representation. This is analysed drawing on longitudinal data from two Danish shop steward surveys conducted in 1998 and 2010, comparing shop stewards in merged and non-merged unions respectively. The main results are that although it could be expected that union mergers and internal restructuring......, where union size and less so the union’s recent merger and restructuring history appears to affect shop stewards’ relations with their unions....

  9. HIV-1 transmitting couples have similar viral load set-points in Rakai, Uganda.

    Directory of Open Access Journals (Sweden)

    T Déirdre Hollingsworth

    2010-05-01

    Full Text Available It has been hypothesized that HIV-1 viral load set-point is a surrogate measure of HIV-1 viral virulence, and that it may be subject to natural selection in the human host population. A key test of this hypothesis is whether viral load set-points are correlated between transmitting individuals and those acquiring infection. We retrospectively identified 112 heterosexual HIV-discordant couples enrolled in a cohort in Rakai, Uganda, in which HIV transmission was suspected and viral load set-point was established. In addition, sequence data was available to establish transmission by genetic linkage for 57 of these couples. Sex, age, viral subtype, index partner, and self-reported genital ulcer disease status (GUD were known. Using ANOVA, we estimated the proportion of variance in viral load set-points which was explained by the similarity within couples (the 'couple effect'. Individuals with suspected intra-couple transmission (97 couples had similar viral load set-points (p = 0.054 single factor model, p = 0.0057 adjusted and the couple effect explained 16% of variance in viral loads (23% adjusted. The analysis was repeated for a subset of 29 couples with strong genetic support for transmission. The couple effect was the major determinant of viral load set-point (p = 0.067 single factor, and p = 0.036 adjusted and the size of the effect was 27% (37% adjusted. Individuals within epidemiologically linked couples with genetic support for transmission had similar viral load set-points. The most parsimonious explanation is that this is due to shared characteristics of the transmitted virus, a finding which sheds light on both the role of viral factors in HIV-1 pathogenesis and on the evolution of the virus.

  10. Pairwise correlations via quantum discord and its geometric measure in a four-qubit spin chain

    Directory of Open Access Journals (Sweden)

    Abdel-Baset A. Mohamed

    2013-04-01

    Full Text Available The dynamic of pairwise correlations, including quantum entanglement (QE and discord (QD with geometric measure of quantum discord (GMQD, are shown in the four-qubit Heisenberg XX spin chain. The results show that the effect of the entanglement degree of the initial state on the pairwise correlations is stronger for alternate qubits than it is for nearest-neighbor qubits. This parameter results in sudden death for QE, but it cannot do so for QD and GMQD. With different values for this entanglement parameter of the initial state, QD and GMQD differ and are sensitive for any change in this parameter. It is found that GMQD is more robust than both QD and QE to describe correlations with nonzero values, which offers a valuable resource for quantum computation.

  11. Assessment of a couples HIV counseling and testing program for pregnant women and their partners in antenatal care (ANC) in 7 provinces, Thailand.

    Science.gov (United States)

    Lolekha, Rangsima; Kullerk, Nareeluck; Wolfe, Mitchell I; Klumthanom, Kanyarat; Singhagowin, Thapanaporn; Pattanasin, Sarika; Sombat, Potjaman; Naiwatanakul, Thananda; Leartvanangkul, Chailai; Voramongkol, Nipunporn

    2014-12-24

    Couples HIV testing and counseling (CHTC) at antenatal care (ANC) settings allows pregnant women to learn the HIV status of themselves and their partners. Couples can make decisions together to prevent HIV transmission. In Thailand, men were tested at ANC settings only if their pregnant partners were HIV positive. A CHTC program based in ANC settings was developed and implemented at 16 pilot hospitals in 7 provinces during 2009-2010. Cross-sectional data were collected using standard data collection forms from all pregnant women and accompanying partners who presented at first ANC visit at 16 hospitals. CHTC data for women and partners were analyzed to determine service uptake and HIV test results among couples. In-depth interviews were conducted among hospital staff of participating hospitals during field supervision visits to assess feasibility and acceptability of CHTC services. During October 2009-April 2010, 4,524 women initiating ANC were enrolled. Of these, 2,435 (54%) women came for ANC alone; 2,089 (46%) came with partners. Among men presenting with partners, 2,003 (96%) received couples counseling. Of these, 1,723 (86%) men and all pregnant women accepted HIV testing. Among 1,723 couples testing for HIV, 1,604 (93%) returned for test results. Of these, 1,567 (98%) were concordant negative, 6 (0.4%) were concordant positive and 17 (1%) were HIV discordant (7 male+/female- and 10 male-/female+). Nine of ten (90%) executive hospital staff reported high acceptability of CHTC services. CHTC implemented in ANC settings helps identify more HIV-positive men whose partners were negative than previous practice, with high acceptability among hospital staff.

  12. [Heterosexual transmission of HIV infection

    Science.gov (United States)

    Coulaud, J P

    1993-02-01

    The AIDS epidemic has spread rapidly in Africa among the urban impoverished where multiple sexual partners and sexually transmitted diseases are common. Over 80% of the 9 million Africans who will develop AIDS before the year 2000 will have been contaminated sexually. Poverty, multiple sexual partners in the framework of prostitution, and drug addiction are responsible for rapid spread of HIV infection in Southeast Asia, the West India, and Brazil. Drug addiction has played a major role in diffusion of HIV into the general population of Europe and the US. Prevalence rates are much higher in sexually transmitted disease centers in France and the US than among blood donors or pregnant women. Sexually transmitted diseases and heterosexual transmission have been studied in Africas since diagnostic tests became available. Several studies, the majority conducted among prostitutes in Nairobi or Kinshasa and their clients, allow establishment of a list of sexually transmitted diseases associated with increased risk of seroconversion. Genital ulcers within the past 6 months presented a relative risk of 2-4 depending on the series. Urethral or cervical gonorrhea has a lower relative risk of 1.2 in most studies. Absence of circumcision was also a risk factor. Studies were subsequently conducted in Europe on factors favoring sexual transmission. 513 heterosexual couples together for a minimum duration of 18 months and an average of 38 months were included in the Multicenter European Study conducted in 10 centers in 9 countries. The "index" subject was male in 400 cases and female in 113. At entry into the study, 73 of 400 males (18.2%) and 10 of 113 females (8.8%) had already infected their partners. Duration of union, frequency of intercourse, mode of transmission of the index subject, and oral contraceptive use had no effect on risk of transmission. Factors increasing risk of infection included the severity of immunosuppression of the index subject, whether judged by

  13. Vocational Training in the European Union

    Directory of Open Access Journals (Sweden)

    Mehmet BALCI

    2013-01-01

    Full Text Available European Union requires some standards in all areas. Today, the importance of training qualified individuals which holds an important place in the development of countries increases and certain standards are adopted creating common European Union tools in the field of vocational and technical education. In this study, vocational education and training policies system and the standards adopted by the European Union are discussed. Furthermore, this study was accepted as a European Union project in 2010 and the results obtained from the Leonardo Da Vinci Life Learning European Union project called “Web Based Basic Vocational Training” between the years 2010-2012 were presented. Since the partners of these projects are Turkey, Spain and Germany, the structure of vocational education, institutions of public and private vocational education and the diplomas and certificates entitled after these educations are included. As Turkey is on its way to become a European Union member, a number of advices are presented for Turkey to reach its destination about vocational education standards that European Union has aimed. The purpose of the study is not only to be a guide for the young who want to get professional training in the countries that are European Union members or candidates about how and where to have education opportunities but also to give a chance for trainers and training managers, participating in vocational training, so as to glimpse different practices from different countries and compare these practices between the countries of European Union and their countries. The study is also very important as it has the opportunities for training managers to see if their countries' vocational education is close enough to vocational education in European Union.

  14. Discordance of Mutation Statuses of Epidermal Growth Factor Receptor and K-ras between Primary Adenocarcinoma of Lung and Brain Metastasis

    Directory of Open Access Journals (Sweden)

    Kun-Ming Rau

    2016-04-01

    Full Text Available Mutations on epidermal growth factor receptor (EGFR of adenocarcinomas of lung have been found to be associated with increased sensitivity to EGFR tyrosine kinase inhibitors and K-ras mutations may correlate with primary resistance. We aimed to explore the discordant mutation statuses of EGFR and K-ras between primary tumors and matched brain metastases in adenocarcinomas of lung. We used a sensitive Scorpion ARMS method to analyze EGFR mutation, and Sanger sequencing followed by allele-specific real-time polymerase chain reaction to analyze K-ras mutation. Forty-nine paired tissues with both primary adenocarcinoma of lung and matched brain metastasis were collected. Thirteen patients (26.5% were discordant for the status of EGFR between primary and metastatic sites. K-ras gene could be checked in paired specimens from 33 patients, thirteen patients (39.6% were discordant for the status of K-ras. In primary lung adenocarcinoma, there were 14 patients of mutant EGFR had mutant K-ras synchronously. This study revealed that the status of EGFR mutation in lung adenocarcinomas is relatively consistent between primary and metastatic sites compared to K-ras mutation. However, there are still a few cases of adenocarcinoma of lung showing discordance for the status of EGFR mutation. Repeated analysis of EGFR mutation is highly recommended if tissue from metastatic or recurrent site is available for the evaluation of target therapy.

  15. Unions in small and medium-sized enterprises

    DEFF Research Database (Denmark)

    Holten, Ann-Louise; Crouch, Colin

    2014-01-01

    Trade unions are commonly weak in small- and medium-sized enterprises, which constitute a majority of European firms and are often family-owned. We investigate the influence of family ownership on employee membership, perceptions and experience with unions in Danish and Italian firms in the textile...... and clothing sector. Family ownership reduces union membership; and within family firms, the number of family members employed is negatively associated with unionization rates and employee perceptions of unions....

  16. A matter of phylogenetic scale: Distinguishing incomplete lineage sorting from lateral gene transfer as the cause of gene tree discord in recent versus deep diversification histories.

    Science.gov (United States)

    Knowles, L Lacey; Huang, Huateng; Sukumaran, Jeet; Smith, Stephen A

    2018-03-01

    Discordant gene trees are commonly encountered when sequences from thousands of loci are applied to estimate phylogenetic relationships. Several processes contribute to this discord. Yet, we have no methods that jointly model different sources of conflict when estimating phylogenies. An alternative to analyzing entire genomes or all the sequenced loci is to identify a subset of loci for phylogenetic analysis. If we can identify data partitions that are most likely to reflect descent from a common ancestor (i.e., discordant loci that indeed reflect incomplete lineage sorting [ILS], as opposed to some other process, such as lateral gene transfer [LGT]), we can analyze this subset using powerful coalescent-based species-tree approaches. Test data sets were simulated where discord among loci could arise from ILS and LGT. Data sets where analyzed using the newly developed program CLASSIPHY (Huang et al., ) to assess whether our ability to distinguish the cause of discord among loci varied when ILS and LGT occurred in the recent versus deep past and whether the accuracy of these inferences were affected by the mutational process. We show that accuracy of probabilistic classification of individual loci by the cause of discord differed when ILS and LGT events occurred more recently compared with the distant past and that the signal-to-noise ratio arising from the mutational process contributes to difficulties in inferring LGT data partitions. We discuss our findings in terms of the promise and limitations of identifying subsets of loci for species-tree inference that will not violate the underlying coalescent model (i.e., data partitions in which ILS, and not LGT, contributes to discord). We also discuss the empirical implications of our work given the many recalcitrant nodes in the tree of life (e.g., origins of angiosperms, amniotes, or Neoaves), and recent arguments for concatenating loci. © 2018 Botanical Society of America.

  17. The Study of HIV and Antenatal Care Integration in Pregnancy in Kenya: Design, Methods, and Baseline Results of a Cluster-Randomized Controlled Trial

    Science.gov (United States)

    Turan, Janet M.; Steinfeld, Rachel L.; Onono, Maricianah; Bukusi, Elizabeth A.; Woods, Meghan; Shade, Starley B.; Washington, Sierra; Marima, Reson; Penner, Jeremy; Ackers, Marta L.; Mbori-Ngacha, Dorothy; Cohen, Craig R.

    2012-01-01

    Background Despite strong evidence for the effectiveness of anti-retroviral therapy for improving the health of women living with HIV and for the prevention of mother-to-child transmission (PMTCT), HIV persists as a major maternal and child health problem in sub-Saharan Africa. In most settings antenatal care (ANC) services and HIV treatment services are offered in separate clinics. Integrating these services may result in better uptake of services, reduction of the time to treatment initiation, better adherence, and reduction of stigma. Methodology/Principal Findings A prospective cluster randomized controlled trial design was used to evaluate the effects of integrating HIV treatment into ANC clinics at government health facilities in rural Kenya. Twelve facilities were randomized to provide either fully integrated services (ANC, PMTCT, and HIV treatment services all delivered in the ANC clinic) or non-integrated services (ANC clinics provided ANC and basic PMTCT services and referred clients to a separate HIV clinic for HIV treatment). During June 2009– March 2011, 1,172 HIV-positive pregnant women were enrolled in the study. The main study outcomes are rates of maternal enrollment in HIV care and treatment, infant HIV testing uptake, and HIV-free infant survival. Baseline results revealed that the intervention and control cohorts were similar with respect to socio-demographics, male partner HIV testing, sero-discordance of the couple, obstetric history, baseline CD4 count, and WHO Stage. Challenges faced while conducting this trial at low-resource rural health facilities included frequent staff turnover, stock-outs of essential supplies, transportation challenges, and changes in national guidelines. Conclusions/Significance This is the first randomized trial of ANC and HIV service integration to be conducted in rural Africa. It is expected that the study will provide critical evidence regarding the implementation and effectiveness of this service delivery

  18. The study of HIV and antenatal care integration in pregnancy in Kenya: design, methods, and baseline results of a cluster-randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Janet M Turan

    Full Text Available Despite strong evidence for the effectiveness of anti-retroviral therapy for improving the health of women living with HIV and for the prevention of mother-to-child transmission (PMTCT, HIV persists as a major maternal and child health problem in sub-Saharan Africa. In most settings antenatal care (ANC services and HIV treatment services are offered in separate clinics. Integrating these services may result in better uptake of services, reduction of the time to treatment initiation, better adherence, and reduction of stigma.A prospective cluster randomized controlled trial design was used to evaluate the effects of integrating HIV treatment into ANC clinics at government health facilities in rural Kenya. Twelve facilities were randomized to provide either fully integrated services (ANC, PMTCT, and HIV treatment services all delivered in the ANC clinic or non-integrated services (ANC clinics provided ANC and basic PMTCT services and referred clients to a separate HIV clinic for HIV treatment. During June 2009- March 2011, 1,172 HIV-positive pregnant women were enrolled in the study. The main study outcomes are rates of maternal enrollment in HIV care and treatment, infant HIV testing uptake, and HIV-free infant survival. Baseline results revealed that the intervention and control cohorts were similar with respect to socio-demographics, male partner HIV testing, sero-discordance of the couple, obstetric history, baseline CD4 count, and WHO Stage. Challenges faced while conducting this trial at low-resource rural health facilities included frequent staff turnover, stock-outs of essential supplies, transportation challenges, and changes in national guidelines.This is the first randomized trial of ANC and HIV service integration to be conducted in rural Africa. It is expected that the study will provide critical evidence regarding the implementation and effectiveness of this service delivery strategy, with important implications for programs striving

  19. CFC legislation in the European Union

    Directory of Open Access Journals (Sweden)

    Cvjetković Cvjetana M.

    2015-01-01

    Full Text Available In this paper the author considers CFC legislation in the Member States of the European Union, and points to the official attitude of the institutions of the European Union toward CFC legislation. Special attention in this paper is focused on Judgment of the Court of Justice of the European Union in the case Cadbury Schweppes. The aim of the paper is to analyze CFC legislation in the Member States in order to determine its basic characteristics, as well as to determine its compatibility with freedoms guaranteed by the primary law of the European Union, i.e. with Judgment of the Court of Justice of the European Union in the Cadbury Schweppes case.

  20. Graphic and algebraic solutions of the discordant lead-uranium age problem

    Science.gov (United States)

    Stieff, L.R.; Stern, T.W.

    1961-01-01

    Uranium-bearing minerals that give lead-uranium and lead-lead ages that are essentially in agreement, i.e. concordant, generally are considered to have had a relatively simple geologic history and to have been unaltered since their deposition. The concordant ages obtained on such materials are, therefore, assumed to approach closely the actual age of the minerals. Many uranium-bearing samples, particularly uranium ores, give the following discordant age sequences; Pb206 U238 generation of radiogenic lead. The evaluation of discordant lead isotope age data may be separated into two operations. The first operation, with which this paper is concerned, is mechanical in nature and involves the calculation of the different possible concordant ages corresponding to the various processes assumed to have produced the discordant ages. The second operation is more difficult to define and requires, in part, some personal judgement. It includes a synthesis of the possible concordant age solutions with other independent geologic and isotopic evidence. The concordant age ultimately chosen as most acceptable should be consistent not only with the known events in the geologic history of the area, the age relations of the enclosing rocks, and the mineralogic and paragenetic evidence, but also with other independent age measurements and the isotopic data obtained on the lead in related or associated non-radioactive minerals. The calculation of the possible concordant ages from discordant age data has been greatly simplified by Wetherill's graphical method of plotting the mole ratios of radiogenic Pb206 U238 ( N206 N238) vs. radiogenic Pb207 U235 ( N207 N235) after correcting for the contaminating common Pb206 and Pb207. The linear relationships noted in this graphical procedure have been extended to plots of the mole ratios of total Pb206 U238 ( tN206 N238) vs. total Pb207 U235 ( tN207 N235). This modification permits the calculation of concordant ages for unaltered samples using

  1. ETUDE - European Trade Union Distance Education.

    Science.gov (United States)

    Creanor, Linda; Walker, Steve

    2000-01-01

    Describes transnational distance learning activities among European trade union educators carried out as part of the European Trade Union Distance Education (ETUDE) project, supported by the European Commission. Highlights include the context of international trade union distance education; tutor training course; tutors' experiences; and…

  2. Adolescent Violent Victimization and Precocious Union Formation.

    Science.gov (United States)

    C Kuhl, Danielle; Warner, David F; Wilczak, Andrew

    2012-11-01

    This article bridges scholarship in criminology and family sociology by extending arguments about "precocious exits" from adolescence to consider early union formation as a salient outcome of violent victimization for youths. Research indicates that early union formation is associated with several negative outcomes; yet the absence of attention to union formation as a consequence of violent victimization is noteworthy. We address this gap by drawing on life course theory and data from the National Longitudinal Study of Adolescent Health (Add Health) to examine the effect of violent victimization ("street" violence) on the timing of first co-residential union formation-differentiating between marriage and cohabitation-in young adulthood. Estimates from Cox proportional hazard models show that adolescent victims of street violence experience higher rates of first union formation, especially marriage, early in the transition to adulthood; however, this effect declines with age, as such unions become more normative. Importantly, the effect of violent victimization on first union timing is robust to controls for nonviolent delinquency, substance abuse, and violent perpetration. We conclude by discussing directions for future research on the association between violent victimization and coresidential unions with an eye toward the implications of such early union formation for desistance.

  3. Contraception and family planning among HIV-seroconcordant and -serodiscordant couples in the US and Zambia

    Directory of Open Access Journals (Sweden)

    Deborah L Jones

    2010-05-01

    Full Text Available Deborah L Jones1, Olga Villar-Loubet1, Chipepo Kankasa2, Ndashi Chitalu2, Miriam Mumbi2, Stephen M Weiss11Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Paediatrics, University of Zambia School of Medicine, Lusaka, ZambiaAbstract: With the advent of antiretroviral therapy, remarkable progress has been made in the reduction of morbidity and mortality associated with the human immunodeficiency virus (HIV. As a result, in both the developed and developing world, reproductive decision-making and family planning has re-emerged as an important health issue among HIV-seroconcordant and -serodiscordant couples. This study sought to explore contraceptive attitudes and practices among HIV-seropositive and -serodiscordant couples in the US and Zambia and to compare contraceptive decision-making between seroconcordant and discordant couples. Study results suggest that while most participants expressed a willingness to use protection to prevent pregnancy, the majority were not using protection consistently. Similarly, among seropositive younger men in both the US and Zambia, more men expressed a desire to have children than women of either serostatus group. Study outcomes also suggest that male and female condom use to reduce HIV transmission within couples is limited. Thus, as males are largely the sexual decision makers regarding condom use, women’s attitudes or plans regarding child bearing may be eclipsed by those of their male partners, and recent reductions in provision of female condoms in the developing world may further reduce women’s options to protect themselves and prevent pregnancy. Education and counseling on vertical and horizontal transmission of HIV among both seropositive and serodiscordant couples should be an element of family planning efforts. Conversely, family planning should be a critical element of HIV counseling and testing strategies to

  4. Bipartite non-classical correlations for a lossy two connected qubit-cavity systems: trace distance discord and Bell's non-locality

    Science.gov (United States)

    Mohamed, Abdel-Baset A.

    2018-04-01

    In this paper, some non-classical correlations are investigated for bipartite partitions of two qubits trapped in two spatially separated cavities connected by an optical fiber. The results show that the trace distance discord and Bell's non-locality introduce other quantum correlations beyond the entanglement. Moreover, the correlation functions of the trace distance discord and the Bell's non-locality are very sensitive to the initial correlations, the coupling strengths, and the dissipation rates of the cavities. The fluctuations of the correlation functions between their initial values and gained (loss) values appear due to the unitary evolution of the system. These fluctuations depend on the chosen initial correlations between the two subsystems. The maximal violations of Bell's inequality occur when the logarithmic negativity and the trace distance discord reach certain values. It is shown that the robustness of the non-classical correlations, against the dissipation rates of the cavities, depends on the bipartite partitions reduced density matrices of the system, and is also greatly enhanced by choosing appropriate coupling strengths.

  5. HIV testing in Europe

    DEFF Research Database (Denmark)

    Sullivan, Ann K; Sperle, Ida; Raben, Dorthe

    2017-01-01

    BACKGROUND: An evaluation of the 2010 ECDC guidance on HIV testing, conducted in October 2015-January 2016, assessed its impact, added value, relevance and usability and the need for updated guidance. METHODS: Data sources were two surveys: one for the primary target audience (health policymakers...... and decision makers, national programme managers and ECDC official contact points in the European Union/European Economic Area (EU/EEA) countries and one for a broader target audience (clinicians, civil society organisations and international public health agencies); two moderated focus group discussions  (17...... participants each); webpage access data; a literature citation review; and an expert consultation (18 participants) to discuss the evaluation findings. RESULTS: Twenty-three of 28 primary target audience and 31 of 51 broader target audience respondents indicated the guidance was the most relevant when compared...

  6. Unionism Comes to the Public Sector

    OpenAIRE

    Richard B. Freeman

    1984-01-01

    This paper argues that public sector labor relations is best understood in a framework that focuses on unions' ability to shift demand curves rather than to raise wages, as is the case in the private sector. It reviews the public sector labor relations literature and finds that: (i) public sector unionism has flourished as a result of changes in laws; (2) the effects of public sector unions on wages are likely to have been underestimated; (3) public sector unions have a somewhat different eff...

  7. Greece and the Missing Banking Union

    DEFF Research Database (Denmark)

    N. Gordon, Jeffery; Ringe, Georg

    2015-01-01

    The Greek Crisis is a crisis rather than a problem due to the vulnerability of Greek banks. While the banks have deep problems, this column argues that these would have been mitigated if a fully operational banking union were in place. A full banking union requires joint banking supervision, join...... bank resolution, and joint deposit insurance. The EZ only has the first so far. Completing the banking union must be part of any long-term solution.......The Greek Crisis is a crisis rather than a problem due to the vulnerability of Greek banks. While the banks have deep problems, this column argues that these would have been mitigated if a fully operational banking union were in place. A full banking union requires joint banking supervision, joint...

  8. UNION-K 2.0 User's Manual

    International Nuclear Information System (INIS)

    Yoo, Jae Woon; Jang, Jin Wook; Kim, Yeong Il

    2008-12-01

    The unified Input/Output processor UNION-K(UNified Input/Output Processor for Neutronics Analysis by K-CORE) has been developed to provide the automatic input file generation and output processing for the fast reactor core analysis. UNION-K includes the material database for reactor analysis and produces the input files for effective cross section generation, core analysis, and reactivity coefficient calculations. UNION-K can execute corresponding core analysis module and edit core performance parameters from the outputs. UNION-K also provides the graphical interface to check the geometrical arrangement of core and fuel sub-assembly and produces the picture files that can be used for reporting. This report has been prepared for instruction of using UNION-K Ver. 2.0 with examples

  9. Currency union entries and trade

    OpenAIRE

    Nitsch, Volker

    2005-01-01

    Recent research suggests that adopting a common currency increases bilateral trade. In this paper, I explore experiences of currency union entry in the post-war period and find no effect on trade. Previous results derived from a large panel data set (covering more than 200 countries from 1948 through 1997) appear to depend crucially on the assumption of symmetry between currency union exits and entries: While countries leaving a currency union experience significant declines in trade, currenc...

  10. IMPORTANCE OF THE EUROPEAN BANKING UNION NEW DIRECTIVES

    OpenAIRE

    MEDAR LUCIAN-ION; Irina-Elena Chirtoc

    2014-01-01

    European Banking Union has set new rules on monetary market especially for credit institutions and for financial banking groups in general. Economic and monetary union requires accomplishment of political and monetary union and democratic control of the European institutions on a single financial market. In this respect through its management organisms, EU has designed a series of unique mechanisms of financial union and called for a fiscal union. Union of European financial marke...

  11. Adolescent Violent Victimization and Precocious Union Formation*

    Science.gov (United States)

    C. Kuhl, Danielle; Warner, David F.; Wilczak, Andrew

    2013-01-01

    This article bridges scholarship in criminology and family sociology by extending arguments about “precocious exits” from adolescence to consider early union formation as a salient outcome of violent victimization for youths. Research indicates that early union formation is associated with several negative outcomes; yet the absence of attention to union formation as a consequence of violent victimization is noteworthy. We address this gap by drawing on life course theory and data from the National Longitudinal Study of Adolescent Health (Add Health) to examine the effect of violent victimization (“street” violence) on the timing of first co-residential union formation—differentiating between marriage and cohabitation—in young adulthood. Estimates from Cox proportional hazard models show that adolescent victims of street violence experience higher rates of first union formation, especially marriage, early in the transition to adulthood; however, this effect declines with age, as such unions become more normative. Importantly, the effect of violent victimization on first union timing is robust to controls for nonviolent delinquency, substance abuse, and violent perpetration. We conclude by discussing directions for future research on the association between violent victimization and coresidential unions with an eye toward the implications of such early union formation for desistance. PMID:24431471

  12. Gray and white matter volume abnormalities in monozygotic and same-gender dizygotic twins discordant for schizophrenia

    DEFF Research Database (Denmark)

    Hilshoff, Hilleke E.; Brans, Rachel G. H.; van Haren, Neeltje E. M.

    2004-01-01

    BACKGROUND: Whole brain tissue volume decreases in schizophrenia have been related to both genetic risk factors and disease-related (possibly nongenetic) factors; however, whether genetic and environmental risk factors in the brains of patients with schizophrenia are differentially reflected...... in gray or white matter volume change is not known. METHODS: Magnetic resonance imaging (1.5 T) brain scans of 11 monozygotic and 11 same-gender dizygotic twin pairs discordant for schizophrenia were acquired and compared with 11 monozygotic and 11 same-gender dizygotic healthy control twin pairs. RESULTS......: Repeated-measures volume analysis of covariance revealed decreased whole brain volume in the patients with schizophrenia as compared with their co-twins and with healthy twin pairs. Decreased white matter volume was found in discordant twin pairs compared with healthy twin pairs, particularly...

  13. Sustained progress, but no room for complacency: Results of 2015 HIV estimations in India

    Science.gov (United States)

    Pandey, Arvind; Dhingra, Neeraj; Kumar, Pradeep; Sahu, Damodar; Reddy, D.C.S.; Narayan, Padum; Raj, Yujwal; Sangal, Bhavna; Chandra, Nalini; Nair, Saritha; Singh, Jitenkumar; Chavan, Laxmikant; Srivastava, Deepika Joshi; Jha, Ugra Mohan; Verma, Vinita; Kant, Shashi; Bhattacharya, Madhulekha; Swain, Pushpanjali; Haldar, Partha; Singh, Lucky; Bakkali, Taoufik; Stover, John; Ammassari, Savina

    2017-01-01

    Background & objectives: Evidence-based planning has been the cornerstone of India's response to HIV/AIDS. Here we describe the process, method and tools used for generating the 2015 HIV estimates and provide a summary of the main results. Methods: Spectrum software supported by the UNAIDS was used to produce HIV estimates for India as a whole and its States/Union Territories. This tool takes into consideration the size and HIV prevalence of defined population groups and programme data to estimate HIV prevalence, incidence and mortality over time as well as treatment needs. Results: India's national adult prevalence of HIV was 0.26 per cent in 2015. Of the 2.1 million people living with HIV/AIDS, the largest numbers were in Andhra Pradesh, Maharashtra and Karnataka. New HIV infections were an estimated 86,000 in 2015, reflecting a decline by around 32 per cent from 2007. The declining trend in incidence was mirrored in most States, though an increasing trend was detected in Assam, Chandigarh, Chhattisgarh, Gujarat, Sikkim, Tripura and Uttar Pradesh. AIDS-related deaths were estimated to be 67,600 in 2015, reflecting a 54 per cent decline from 2007. There were variations in the rate and trend of decline across India for this indicator also. Interpretation & conclusions: While key indicators measured through Spectrum modelling confirm success of the National AIDS Control Programme, there is no room for complacency as rising incidence trends in some geographical areas and population pockets remain the cause of concern. Progress achieved so far in responding to HIV/AIDS needs to be sustained to end the HIV epidemic. PMID:29168464

  14. High HIV Prevalence and Risk Among Male Clients of Female Sex Workers in Hanoi and Ho Chi Minh City, Vietnam.

    Science.gov (United States)

    Nadol, Patrick; Hoang, Tran Vu; Le, Linh-Vi; Nguyen, Tuan Anh; Kaldor, John; Law, Matthew

    2017-08-01

    In Vietnam's concentrated HIV epidemic, female sex workers (FSWs) are at increased risk for acquiring and transmitting HIV, largely through their male clients. A high proportion of males in Vietnam report being clients of FSWs. Studying HIV-related risk factors and prevalence among male clients is important, particularly given the potential for male clients to be a 'bridge' of HIV transmission to the more general population or to sex workers. Time-location sampling was used to identify FSW in Hanoi and Ho Chi Minh City, Vietnam's largest cities, in 2013-2014. Recruited FSWs were asked to refer one male client to the study. Demographic and risk behavior data were collected from FSWs and male clients by administered questionnaires. Biologic specimens collected from male clients were tested for HIV and opiates. Sampling weights, calculated based on the FSWs probability of being selected for enrolment, were applied to prevalence estimates for both FSWs and male clients. Logistic regression models were developed to obtain odds ratios for HIV infection among male clients. A total of 804 male clients were enrolled. Overall, HIV prevalence among male clients was 10.2%; HIV prevalence was 20.7% (95% confidence interval (CI) 15.0-27.9%) among those reporting a history of illegal drug use and 32.4% (95% CI 20.2-47.7%) among those with opioids detected in urine. HIV prevalence among male clients did not differ across 'bridging' categories defined by condom use with FSWs and regular partners over the previous 6 months. HIV among male clients was associated with a reported history of illegal drug use (OR 3.76; 95% CI 1.87-7.56), current opioid use (OR 2.55; 95% CI 1.02-6.36), and being referred by an FSW who self-reported as HIV-positive (OR 5.37; 95% CI 1.46-19.75). Self-reported HIV prevalence among enrolled FSWs was 2.8%. Based on HIV test results of male clients and self-reported status from FSWs, an estimated 12.1% of male client-FSW pairs were sero-discordant. These

  15. The two union catalogues of Myanmar

    Energy Technology Data Exchange (ETDEWEB)

    Hla, Win [Myanmar Scientific and Technological Research Dept., Yangon (Myanmar)

    1995-04-01

    The article mentions about the two union catalogues of Myanmar. The first one is the ``Consolidated Catalogue of journals and the periodicals contained in the libraries of Kasuali, Calcutta, Bombay, Madras, Coonoor, Rangoon and Shillong``. This was published by Indian Research Fund Association of Calcutta in 1933. This is the first union catalogue of medical periodicals for both Myanmar and India as well. The second one is ``the Regional Union Catalogue of Scientific Serials: Yangon``. This was published in 1977, its second printing in 1989. This union catalogue excludes medical serials. Twenty libraries took part in the compilation and publishing of the union catalogue with Technical Information Centre of Myanmar Scientific and Technological Research Department, (formerly Central Research Organization), No. 6, Kaba Aye Pagoda Road, Yankin P.O. Yangon, Myanmar, taking the leading role.

  16. The two union catalogues of Myanmar

    International Nuclear Information System (INIS)

    Hla, Win

    1995-01-01

    The article mentions about the two union catalogues of Myanmar. The first one is the ''Consolidated Catalogue of journals and the periodicals contained in the libraries of Kasuali, Calcutta, Bombay, Madras, Coonoor, Rangoon and Shillong''. This was published by Indian Research Fund Association of Calcutta in 1933. This is the first union catalogue of medical periodicals for both Myanmar and India as well. The second one is ''the Regional Union Catalogue of Scientific Serials: Yangon''. This was published in 1977, its second printing in 1989. This union catalogue excludes medical serials. Twenty libraries took part in the compilation and publishing of the union catalogue with Technical Information Centre of Myanmar Scientific and Technological Research Department, (formerly Central Research Organization), No. 6, Kaba Aye Pagoda Road, Yankin P.O. Yangon, Myanmar, taking the leading role

  17. Discordant inflammatory changes in the apophyseal and sacroiliac joints: serial observations in enthesitis-related arthritis

    Science.gov (United States)

    Amies, Thomas; Vendhan, Kanimozhi; Humphries, Paul; Sen, Debajit; Ioannou, Yiannis; Hall-Craggs, Margaret A

    2016-01-01

    Objective: To determine the extent to which inflammation of the sacroiliac joints (SIJs) and apophyseal joints (AJs) changes concordantly after treatment in enthesitis-related arthritis (ERA). Methods: A retrospective study was performed with institutional review board approval. 31 young patients with ERA who had been scanned between March 2009 and November 2014 were included. All patients had post-contrast imaging of the SIJs and lumbar spine and short tau inversion-recovery (STIR) images of the SIJs. The severity of sacroiliitis was scored using a modification of an established technique, and inflammation of the AJs was evaluated using a recently described grading system. The changes in SIJ and AJ scores after treatment were classified as either concordant or discordant, and the proportion of scan pairs in these groups was recorded. In addition, the correlation between change in SIJ STIR score (Δnfla) and change in AJ score (ΔAJ) was assessed using Spearman's correlation coefficient. Results: Of a total of 43 scan pairs, the changes in inflammation were concordant in 16 scan pairs and discordant in 27 scan pairs. There was no significant correlation between Δnfla and ΔAJ (R = 0.14, p = 0.37). Conclusion: Inflammatory changes in the SIJs and AJs are often discordant. This may be a reason why patients experience ongoing back pain despite apparent improvement in one or the other site. Advances in knowledge: Inflammation may behave differently at different anatomical sites. The SIJs and AJs should both be imaged in patients with ERA with back pain. PMID:27376529

  18. Brazilian union actions for workers' health protection

    Directory of Open Access Journals (Sweden)

    Rodolpho Repullo Junior

    Full Text Available CONTEXT: Many authors have emphasized the importance of worker strength through unionized organizations, in relation to the improvement of working procedures, and have reported on the decisiveness of labor movement actions in achieving modifications within the field of work and health. OBJECTIVE: To describe the ways in which Brazilian unions have tried to intervene in health-illness and work processes, identifying the existence of commonality in union actions in this field. TYPE OF STUDY: Qualitative study. SETTING: Postgraduate Program, Environmental Health Department, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil. METHODS: Union health advisers and directors were interviewed. Documents relating to union action towards protecting workers' health were collected and analyzed. RESULTS: Unions articulate actions regarding workers' health of a technical and political nature that involve many aspects and high complexity. These have been divided into thematic categories for better analysis. DISCUSSION: Union actions regarding workers' health in Brazil are restricted to some unions, located mainly in the southern, southeastern and northeastern regions of the country. Nonetheless, the unions undertaking such actions represent many professions of great economic and political importance. CONCLUSIONS: The recent changes in health and safety at work regulations, recognition of professional diseases, creation of workers' health services and programs within the unified health system, and operational improvements in companies' specialized safety and occupational medicine services, all basically result from union action. There is commonality of union action in this field in its seeking of technical and political strengthening for all workers and their general and local representation. This has the objective of benefiting collective bargaining between employers and workers. Inter-institutional action on behalf of workers' rights

  19. The State of the Union

    DEFF Research Database (Denmark)

    This special issue of Angles marks the three hundredth anniversary of the Union of the two kingdoms of Scotland and England. The nature and development of the relations between the constituent parts of the United Kingdom is a fascinating topic also to outside observers, and some of the contributi...... of the contributions to this volume deal with the Union in a comparative European context. Both Scottish nationalism and Scottish unionism are analysed, and Anglo-Scottish relations are looked at from historical, sociological, linguistic and literary angles...

  20. Exploration of quantum phases transition in the XXZ model with Dzyaloshinskii-Moriya interaction using trance distance discord

    Science.gov (United States)

    Zhang, Ren-jie; Xu, Shuai; Shi, Jia-dong; Ma, Wen-chao; Ye, Liu

    2015-11-01

    In the paper, we researched the quantum phase transition (QPT) in the anisotropic spin XXZ model by exploiting the quantum renormalization group (QRG) method. The innovation point is that we adopt a new approach called trace distance discord to indicate the quantum correlation of the system. QPT after several iterations of renormalization in current system has been observed. Consequently, it opened the possibility of investigation of QPR in the geometric discord territory. While the anisotropy suppresses the correlation due to favoring of the alignment of spins, the DM interaction restores the spoiled correlation via creation of the quantum fluctuations. We also apply quantum renormalization group method to probe the thermodynamic limit of the model and emerging of nonanalytic behavior of the correlation.

  1. Impact of a visual aid on discordance between physicians and family members about prognosis of critically ill patients.

    Science.gov (United States)

    Burelli, Gabrielle; Berthelier, Chloé; Vanacker, Hélène; Descaillot, Léonard; Philippon-Jouve, Bénédicte; Fabre, Xavier; Kaaki, Mahmoud; Chakarian, Jean-Charles; Domine, Alexandre; Beuret, Pascal

    2018-06-01

    This study aimed to evaluate the impact of a visual aid on the discordance about prognosis between physicians and family members. The study was performed in a general intensive care department with two 6-bed units. In the unit A, family members could consult a visual aid depicting day by day the evolution of global, hemodynamic, respiratory, renal and neurological conditions of the patient on a 10-point scale. In the unit B, they only received oral medical information. On day 7 of the ICU stay, the physician and family members estimated the prognosis of the patient among four proposals (life threatened; steady state but may worsen; steady state, should heal; will heal). Then we compared the rate of discordance about prognosis between physicians and family members in the two units. Seventy-nine consecutive patients admitted in the intensive care department and still present at day 7, their family members and physicians, were enrolled. Patients in the two units were comparable in age, sex ratio, reason for admission, SAPS II at admission and SOFA score at day 7. In the unit A, physician-family members discordance about prognosis occurred for 12 out of 39 patients (31%) vs. 22 out of 40 patients (55%) in the unit B (P=0.04). In our study, adding a visual aid depicting the evolution of the condition of critically ill patients day by day to classic oral information allowed the family to have an estimate of the prognosis less discordant with the estimate of the physician. Copyright © 2018 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  2. Should trained lay providers perform HIV testing? A systematic review to inform World Health Organization guidelines.

    Science.gov (United States)

    Kennedy, C E; Yeh, P T; Johnson, C; Baggaley, R

    2017-12-01

    New strategies for HIV testing services (HTS) are needed to achieve UN 90-90-90 targets, including diagnosis of 90% of people living with HIV. Task-sharing HTS to trained lay providers may alleviate health worker shortages and better reach target groups. We conducted a systematic review of studies evaluating HTS by lay providers using rapid diagnostic tests (RDTs). Peer-reviewed articles were included if they compared HTS using RDTs performed by trained lay providers to HTS by health professionals, or to no intervention. We also reviewed data on end-users' values and preferences around lay providers preforming HTS. Searching was conducted through 10 online databases, reviewing reference lists, and contacting experts. Screening and data abstraction were conducted in duplicate using systematic methods. Of 6113 unique citations identified, 5 studies were included in the effectiveness review and 6 in the values and preferences review. One US-based randomized trial found patients' uptake of HTS doubled with lay providers (57% vs. 27%, percent difference: 30, 95% confidence interval: 27-32, p lay providers. Studies from Cambodia, Malawi, and South Africa comparing testing quality between lay providers and laboratory staff found little discordance and high sensitivity and specificity (≥98%). Values and preferences studies generally found support for lay providers conducting HTS, particularly in non-hypothetical scenarios. Based on evidence supporting using trained lay providers, a WHO expert panel recommended lay providers be allowed to conduct HTS using HIV RDTs. Uptake of this recommendation could expand HIV testing to more people globally.

  3. Trade Union Mergers: A Survey of the Literature.

    Science.gov (United States)

    Michelson, Grant

    2000-01-01

    Examines trade union mergers highlighting merger forms, merger motivation, role played by union officers, and merger waves. Discusses the consequences of mergers on members and union performance and concludes that union merger activity has had little impact. (Contains 74 references.) (JOW)

  4. Public Sector Unions and Privatization

    DEFF Research Database (Denmark)

    Foged, Søren Kjær; Aaskoven, Lasse

    2016-01-01

    Privatization varies considerably among local governments. One of the oft-listed explanations is the ability of public employees to block privatization. However, many studies on the influence of public employees on privatization do not use very precise measures of the influence of public employees...... Danish municipalities in 2012, we are able to measure the strength of the public eldercare union as well as the number of the public eldercare workers relative to the number of local voters. We find that the increased union strength measured in terms of union density at the municipal level leads...... to substantially and significantly less privatization through the voucher market. By comparison, the estimated relationship between the relative number of public workers and privatization does not reach statistical significance. Features of the voucher market and qualitative evidence suggest that the union...

  5. The African Union and Conflict Management

    Science.gov (United States)

    2006-03-02

    USAWC STRATEGY RESEARCH PROJECT THE AFRICAN UNION AND CONFLICT MANAGEMENT by Lieutenant Colonel Flemming Mathiasen Royal Danish Army Colonel Patrick...AUTHOR: Lieutenant Colonel Flemming Mathiasen TITLE: The African Union and Conflict Management FORMAT: Strategy Research Project DATE: 2 March 2006...WORD COUNT: 5850 PAGES: 28 KEY TERMS: African Union, Africa, Conflict Management , Capabilities CLASSIFICATION: Unclassified Africa is a continent with a

  6. Banking Union- Present Stage and its Perspectives

    Directory of Open Access Journals (Sweden)

    Petre Prisecaru

    2014-05-01

    Full Text Available Banking Union is very important for financial stability of EU, for preventing any future crisis, for improving corporate governance in the banking sector, for completing the single market for financial services and for the strengthening of monetary union, for opening the way to fiscal union and to political union. There is not enough theoretical research in the field of banking union, but there are many recent contributions on behalf of foreign and Romanian experts and analysts, which refer mainly to the three components/pillars of EU banking union: a Single Supervision Mechanism (SSM, a Single Resolution Mechanism (SRM and an harmonized system of deposit guarantee schemes. Some micro studies and surveys carried out by prestigious institutions, like Deutsche Bank, Brookings Institution, CEPS have been run over and analyzed together with the positions and opinions of different European officials, and also with the content of EU secondary legislation. An empirical research was made with the aim to identify all essential aspects relating to EU banking union, which may concern the academics, researchers and business community. The paper is based on a previous research study coordinated by author and contains his own conclusions focused on the main arguments in favour of banking union.

  7. The Development of Trade Unionism.

    Science.gov (United States)

    Parker, Ronald W.

    1979-01-01

    Traces the growth and evolution of the British labor union movement, troubles between the national officials and the local shop stewards, class differences and conflict between the artisans and laborers, violence between unions, and eventual transition to peaceful constitutionalism. (MF)

  8. Sexual Behavior and Vaginal Practices During Pregnancy and Postpartum: Implications for HIV Prevention Strategies.

    Science.gov (United States)

    Kinuthia, John; Richardson, Barbra A; Drake, Alison L; Matemo, Daniel; Unger, Jennifer A; McClelland, Raymond S; John-Stewart, Grace

    2017-02-01

    Understanding sexual behaviors and vaginal practices of pregnant and breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods. HIV-uninfected women presenting for antenatal care in western Kenya were enrolled and followed through 36 weeks postpartum. Sexual behavior and vaginal practices were ascertained by structured questionnaires. Logistic regression was used to assess correlates of unprotected sex, vaginal washing, and vaginal drying. Among 1252 women enrolled, 78.4% were married (of whom 15.1% were in polygamous unions), 1.4% had a known HIV-infected partner, and 33.6% had a partner of unknown HIV status. At enrollment, 58.5% reported sex in the past month (94.3% unprotected) and 4.5% reported forced sex. Odds of unprotected sex at enrollment was >11-fold higher in married than in unmarried women (P < 0.001) and lower among women who reported partners of unknown HIV status or HIV-infected compared with HIV-uninfected partners. Median time to postpartum resumption of sex was 7 weeks (interquartile range 4-12). Prevalence of unprotected sex in the past week increased from 6.6% to 60.0% between 2 and 36 weeks postpartum (P < 0.001). Vaginal washing was reported by 60.1% of women at enrollment and prevalence remained stable postpartum; vaginal drying was reported by 17.9% at enrollment and decreased to 6.1% at 36 weeks postpartum (P < 0.001). Vaginal washing and drying were associated with forced sex. High rates of unknown partner HIV status, polygamy, and less frequent condom use among pregnant/postpartum women underscore the need for female-controlled HIV prevention interventions. Vaginal washing and drying may present challenges to microbicide use.

  9. Cannabis Involvement and Nonsuicidal Self-Injury: A Discordant Twin Approach.

    Science.gov (United States)

    Few, Lauren R; Grant, Julia D; Nelson, Elliot C; Trull, Timothy J; Grucza, Richard A; Bucholz, Kathleen K; Verweij, Karin J H; Martin, Nicholas G; Statham, Dixie J; Madden, Pamela A F; Heath, Andrew C; Lynskey, Michael T; Agrawal, Arpana

    2016-11-01

    Cannabis use, particularly at an early age, has been linked to suicidal thoughts and behavior, but minimal work has examined the association between cannabis use and lifetime nonsuicidal self-injury (NSSI). The current study aims to characterize the overlap between lifetime and early cannabis use and NSSI and to examine genetic and environmental mechanisms of this association. Adult male and female twins from the Australian Twin Registry (N = 9,583) were used to examine the odds of NSSI associated with lifetime cannabis use and early cannabis use (i.e., accounting for the age at onset of cannabis use and NSSI. Lifetime cannabis use (odds ratio [OR] = 2.84, 95% CI [2.23, 3.61]) and early cannabis use were associated with increased odds of NSSI (OR = 2.15, 95% CI [1.75, 2.65]), and this association remained when accounting for covariates. The association was only significant, however, in MZ twin pairs discordant for early cannabis use (OR = 3.20, 95% CI [1.17, 8.73]). Replication analyses accounting for the temporal ordering of cannabis use and NSSI yielded similar findings of nominal significance. Results suggest that NSSI is associated with cannabis involvement via differing mechanisms. For lifetime cannabis use, the lack of association in discordant pairs suggests the role of shared genes and family environment. However, in addition to such shared familial influences, person-specific and putatively causal factors contribute to the relationship between early cannabis use and NSSI. Therefore, delaying the onset of cannabis use may reduce exposure to influences that exacerbate vulnerabilities to NSSI.

  10. Unions and the Economic Basis of Attitudes

    OpenAIRE

    White, Michael; Bryson, Alex

    2016-01-01

    Unions make differences to employee satisfaction that correspond to their effects on individual economic advantage. Panel data reveal how changes in economic circumstance and changes in job satisfaction are linked to changes in union coverage. When individuals move into a union covered job they receive a wage mark-up and express enhanced pay satisfaction. Conversely, those moving from a union covered job on average lose any mark-up and have significantly reduced satisfaction. Similar findings...

  11. Cross-sectional study on the prevalence and predictors of pregnancy among women living in HIV discordant relationships in a rural Rakai cohort, Uganda.

    Science.gov (United States)

    Nakiganda, Lydia Jacenta; Agardh, Anette; Asamoah, Benedict Oppong

    2018-04-24

    This study examines the prevalence of pregnancy in serodiscordant couples and identifies predictors associated with pregnancy in rural Rakai, Uganda. A population-based cross-sectional study that used data from the Rakai Community Cohort Study (RCCS). We used data from the RCCS survey round 17 (2015-2016), which included 488 women in serodiscordant relationships. This study was conducted in Rakai district, located in south-western Uganda. Pregnancy status. Multivariable modified Poisson regression using stepwise selection was used to determine characteristics and behaviours associated with pregnancy status. The prevalence of pregnancy was 12% in women among serodiscordant couples. HIV-negative women in serodiscordant couples had a slightly higher pregnancy prevalence rate (13.6%) compared with HIV-positive women in serodiscordant couples (11%). Factors significantly associated with higher prevalence of pregnancy were; younger age 15-24 years (prevalence risk ratio (PRR)=4.04; 95% CI 1.72 to 9.50), middle age 25-34 years (PRR=2.49; 95% CI 1.05 to 5.89), Christian religion (PRR=2.26; 95% CI 1.41 to 3.63) and inconsistent condom use in the last 12 months (PRR=4.38, 95% CI 1.09 to 17.53). Neither HIV status nor HIV status disclosure was significantly associated with risk of getting pregnant. Nearly 12% of women in serodiscordant relationships were pregnant, highlighting the need for integrated services to prevent unintended pregnancies and reduce conceptional related risks for those choosing to conceive. Association with younger age and inconsistent condom use suggests a role for early and continued couple-based conception counselling. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Trade union policy and nuclear power

    International Nuclear Information System (INIS)

    Elliot, D.

    1981-01-01

    The subject is discussed under the headings: introduction; energy policy; the beginning of doubt; SERA's role [SERA = Socialist Environment and Resources Association]; the 1980 nuclear debate [within the trade union movement]; the 1981 nuclear debate [within the trade union movement]; the issues reviewed (supply and demand; safety and employment; security); review of policy trends; conclusions. Appendix: a review of union policy statements. (U.K.)

  13. Neuroanatomic alterations and social and communication deficits in monozygotic twins discordant for autism disorder.

    Science.gov (United States)

    Mitchell, Shanti R; Reiss, Allan L; Tatusko, Danielle H; Ikuta, Ichiro; Kazmerski, Dana B; Botti, Jo-Anna C; Burnette, Courtney P; Kates, Wendy R

    2009-08-01

    Investigating neuroanatomic differences in monozygotic twins who are discordant for autism can help unravel the relative contributions of genetics and environment to this pervasive developmental disorder. The authors used magnetic resonance imaging (MRI) to investigate several brain regions of interest in monozygotic twins who varied in degree of phenotypic discordance for narrowly defined autism. The subjects were 14 pairs of monozygotic twins between the ages of 5 and 14 years old and 14 singleton age- and gender-matched typically developing comparison subjects. The monozygotic twin group was a cohort of children with narrowly defined autistic deficits and their co-twins who presented with varying levels of autistic deficits. High-resolution MRIs were acquired and volumetric/area measurements obtained for the frontal lobe, amygdala, and hippocampus and subregions of the prefrontal cortex, corpus callosum, and cerebellar vermis. No neurovolumetric/area differences were found between twin pairs. Relative to typically developing comparison subjects, dorsolateral prefrontal cortex volumes and anterior areas of the corpus callosum were significantly altered in autistic twins, and volumes of the posterior vermis were altered in both autistic twins and co-twins. Intraclass correlation analysis of brain volumes between children with autism and their co-twins indicated that the degree of within-pair neuroanatomic concordance varied with brain region. In the group of subjects with narrowly defined autism only, dorsolateral prefrontal cortex, amygdala, and posterior vermis volumes were significantly associated with the severity of autism based on scores from the Autism Diagnostic Observation Schedule-Generic. These findings support previous research demonstrating alterations in the prefrontal cortex, corpus callosum, and posterior vermis in children with autism and further suggest that alterations are associated with the severity of the autism phenotype. Continued research

  14. ERS/ECDC Statement: European Union standards for tuberculosis care, 2017 update.

    Science.gov (United States)

    Migliori, Giovanni Battista; Sotgiu, Giovanni; Rosales-Klintz, Senia; Centis, Rosella; D'Ambrosio, Lia; Abubakar, Ibrahim; Bothamley, Graham; Caminero, Jose Antonio; Cirillo, Daniela Maria; Dara, Masoud; de Vries, Gerard; Aliberti, Stefano; Dinh-Xuan, Anh Tuan; Duarte, Raquel; Midulla, Fabio; Solovic, Ivan; Subotic, Dragan R; Amicosante, Massimo; Correia, Ana Maria; Cirule, Andra; Gualano, Gina; Kunst, Heinke; Palmieri, Fabrizio; Riekstina, Vija; Tiberi, Simon; Verduin, Remi; van der Werf, Marieke J

    2018-05-01

    The International Standards for Tuberculosis Care define the essential level of care for managing patients who have or are presumed to have tuberculosis, or are at increased risk of developing the disease. The resources and capacity in the European Union (EU) and the European Economic Area permit higher standards of care to secure quality and timely TB diagnosis, prevention and treatment. On this basis, the European Union Standards for Tuberculosis Care (ESTC) were published in 2012 as standards specifically tailored to the EU setting. Since the publication of the ESTC, new scientific evidence has become available and, therefore, the standards were reviewed and updated.A panel of international experts, led by a writing group from the European Respiratory Society (ERS) and the European Centre for Disease Prevention and Control (ECDC), updated the ESTC on the basis of new published evidence. The underlying principles of these patient-centred standards remain unchanged. The second edition of the ESTC includes 21 standards in the areas of diagnosis, treatment, HIV and comorbidities, and public health and prevention.The ESTC target clinicians and public health workers, provide an easy-to-use resource and act as a guide through all the required activities to ensure optimal diagnosis, treatment and prevention of TB. The content of this work is copyright of the authors or their employers. Design and branding are copyright ©ERS 2018.

  15. European Union

    International Nuclear Information System (INIS)

    Schaller, K.

    1995-01-01

    Different instruments used by European Commission of the European Union for financial support radioactive waste management activities in the Russian Federation are outlined. Three particular programmes in the area are described

  16. Twin birth order, birthweight and birthweight discordance: any relationship

    Directory of Open Access Journals (Sweden)

    Onyiriuka A.N.

    2010-12-01

    Full Text Available Background: It is widely believed that in twin pairs, at birth, the first-born weigh more than the second-born but this concept has been challenged. Objective: To assess the truthfulness of this common concept that first-born twins are usually heavier than their second-born siblings at birth. Methods: In a series of 104 sets of live-born twins, the birth weights of first-born twins were compared with those of their second-born siblings, after controlling for gender. Their intra-pair birthweight differences were determined and twin pairs whose birthweight difference was 15% or more were designated as discordant. Results: Twin I was heavier than Twin II in 61.5% of cases while Twin II was heavier than Twin I in 28.9% of cases. Twins I and II had equal birthweights in 9.6% of cases. Comparing the mean birthweight of the first-born-male twin with that of second-born- male twin, it was 2515+427g (95% Confidence Interval, CI=2402-2628 versus 2432 +435g (95% CI=2321-2543 p>0.05. The mean birthweight of first-born-female twin was 2326+445g (95% CI=2214-2439 while that of the second-born-female twin was 2325+501g (95% CI=2197-2453 p>0.05. When the birthweight difference exceeded 750g, the probability that Twin I will be heavier than Twin II was 83.3% (5 of 6. Conclusion: Although the first-born twin was more often heavier than their second-born siblings, either could weigh more or less at birth. The larger the birthweight difference between growth-discordant twin pair, the greater the probability that the heavier twin would be delivered first

  17. One-norm geometric quantum discord and critical point estimation in the XY spin chain

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Chang-Cheng; Wang, Yao; Guo, Jin-Liang, E-mail: guojinliang80@163.com

    2016-11-15

    In contrast with entanglement and quantum discord (QD), we investigate the thermal quantum correlation in terms of Schatten one-norm geometric quantum discord (GQD) in the XY spin chain, and analyze their capabilities in detecting the critical point of quantum phase transition. We show that the one-norm GQD can reveal more properties about quantum correlation between two spins, especially for the long-range quantum correlation at finite temperature. Under the influences of site distance, anisotropy and temperature, one-norm GQD and its first derivative make it possible to detect the critical point efficiently for a general XY spin chain. - Highlights: • Comparing with entanglement and QD, one-norm GQD is more robust versus the temperature. • One-norm GQD is more efficient in characterization of long-range quantum correlation between two distant qubits. • One-norm GQD performs well in highlighting the critical point of QPT at zero or low finite temperature. • One-norm GQD has a number of advantages over QD in detecting the critical point of the spin chain.

  18. Acquired Credit Unions: Drivers of Takeover

    Directory of Open Access Journals (Sweden)

    R. Raymond Sant

    2015-08-01

    Full Text Available In this paper we study acquired credit unions and analyze their financial performance up to six years prior to merger, on a quarterly basis. The primary focus is on balance sheet (asset liability management and profitability variables (return on assets. We find that acquired credit unions during the period 2008 (third quarter to 2014 (first quarter experienced negative return on assets for several quarters prior to their takeover. This was the result of a declining loan portfolio and increasing charge offs. In spite of decreasing lending activity, such credit unions continued to increase their deposits, i.e., adding to their cost base. Due to declining loans, their net interest margin as a proportion of deposits was also in decline. We argue that this is an indicator of poor management ability. Furthermore, our analysis finds that operating expenses were increasing over time, something that has been documented in previous literature also for smaller credit unions and is attributable to lack of economies of scale. The average asset size of the acquired credit unions in our sample is about $22 million just before acquisition. We attribute our findings to poor business strategy followed by such credit unions. We also conclude that signs of trouble are evident up to two years before merger on average and regulatory policy may have to become more proactive to manage the consolidation challenge faced by the credit union industry in general.

  19. European Union and EDCTP strategy in the global context: recommendations for preventive HIV/AIDS vaccines research

    NARCIS (Netherlands)

    Lehner, Thomas; Hoelscher, Michael; Clerici, Mario; Gotch, Frances; Pedneault, Louise; Tartaglia, Jim; Gray, Clive; Mestecky, Jiri; Sattentau, Quentin; van de Wijgert, Janneke; Toure, Coumba; Osmanov, Saladin; Schmidt, Reinold E.; Debre, Patrice; Romaris, Manuel; Hoeveler, Arnd; Di Fabio, Simonetta

    2005-01-01

    The European Commission (EC) has strong commitments and recognises the need to continue to ensure that HIV/AIDS research efforts receive global attention. The EC is facing this challenge in a global context and has made substantial investments together with European Developing Countries Clinical

  20. Identification of gaps for implementation science in the HIV prevention, care and treatment cascade; a qualitative study in 19 districts in Uganda.

    Science.gov (United States)

    Bajunirwe, Francis; Tumwebaze, Flora; Abongomera, George; Akakimpa, Denis; Kityo, Cissy; Mugyenyi, Peter N

    2016-04-14

    Over the last 20 years, countries in sub Saharan Africa have made significant strides in the implementation of programs for HIV prevention, care and treatment. Despite, the significant progress made, many targets set by the United Nations have not been met. There remains a large gap between the ideal and what has been achieved. There are several operational issues that may be responsible for this gap, and these need to be addressed in order to achieve the targets. Therefore, the aim of this study was to identify gaps in the HIV prevention, care and treatment cascade, in a large district based HIV implementation program. We aimed to identify gaps that are amenable for evaluation using implementation science, in order to improve the delivery of HIV programs in rural Uganda. We conducted key informant (KI) interviews with 60 district health officers and managers of HIV/AIDS clinics and organizations and 32 focus group discussions with exit clients seeking care and treatment for HIV in the 19 districts. The data analysis process was guided using a framework approach. The recordings were transcribed verbatim. Transcripts were read back and forth and codes generated based on the framework. Nine emerging themes that comprise the gaps were identified and these were referral mechanisms indicating several loop holes, low levels of integration of HIV/TB services, low uptake of services for PMTCT services by pregnant women, low coverage of services for most at risk populations (MARPs), poor HIV coordination structures in the districts, poor continuity in the delivery of pediatric HIV/AIDS services, limited community support for orphans and vulnerable (OVC's), inadequate home based care services and HIV services and support for discordant couples. The themes indicate there are plenty of gaps that need to be covered and have been ignored by current programs. Our study has identified several gaps and suggested several interventions that should be tested before large scale

  1. Sexual practices of HIV-positive individuals attending antiretroviral treatment (ART) in Addis Ababa public hospitals: findings from in-depth interview.

    Science.gov (United States)

    Dessie, Yadeta; Deresa, Merga

    2012-01-01

    The rollout of Antiretroviral Treatment (ART) and improved health care services contributed in recuperating the quality of life and the functional status of HIV-positive people. These clinical effects of the treatment and cares are believed to bring a change on their sexual practices. The objective of this study was to explore the sexual practices of the HIV-positive people who were getting ART in selected Addis Ababa public hospitals. A qualitative in-depth interview was conducted. The interviews were made by trained nurse counselors of the same sex and were tape recorded. Verbatim transcription was made before the analysis. Thematic categorizations were made to present the findings. Most participants expressed regained sexual desires with initiation of ART while some others didn't appreciate the regains. Not using condoms or inconsistently using them was identified risky sexual practices. Sero-discordances and sero-status non-disclosure were common issues among the partners. Sero-status non-disclosure, non-use of condom and inconsistent using them were common sexual issues. These hinder the efforts that are being made to reduce new HIV infections and re-infections. Interventions against these problems can be made when clients come for their ART treatment and clinical care follow up.

  2. Probing quantum entanglement, quantum discord, classical correlation, and the quantum state without disturbing them

    International Nuclear Information System (INIS)

    Li Zhenni; Jin Jiasen; Yu Changshui

    2011-01-01

    We present schemes for a type of one-parameter bipartite quantum state to probe quantum entanglement, quantum discord, the classical correlation, and the quantum state based on cavity QED. It is shown that our detection does not influence all these measured quantities. We also discuss how the spontaneous emission introduced by our probe atom influences our detection.

  3. BUILDING A BANKING UNION IN THE EUROPEAN UNION – A SOLUTION TO THE FINANCIAL CRISIS?

    Directory of Open Access Journals (Sweden)

    Monica (ŞAGUNA FIGHIROAE

    2015-07-01

    Full Text Available The financial crisis of 2008 highlighted the need for a deeper integration of the banking system, as a warranty to support long-term financial stability. It was argued that the grounds of the crisis lie also in an uncoordinated national response to the failure of banks, in a fragmentation of the Single Market in lending and funding and, therefore, a better regulation and supervision of the financial sector can ensure financial stability and growth in the European Union. In order to restore the proper functioning of the internal market and to avoid future crisis, the European Commission launched a set of initiatives, in order to assure a safer and sounder financial sector for the single market; are included here: stronger prudential requirements for banks, improved depositor protection and rules for managing failing banks and a single rulebook for all the 28 Member States of the European Union. The single rule book is the step towards the Banking Union sits. The banking union consists of three pillars: a Single Supervisory Mechanism, a Single Resolution Mechanism and a joint deposit-insurance scheme. As on 4 November 2014 the European Central Bank assumed responsibility for euro area banking supervision, the Banking Union is still under construction. In this framework, the purpose of my paper is to analyse the process of building a Banking Union in Europe. Therefore, the objectives of my paper are to explore the steps to fulfilling a real integration of the European banking system, as a solution to the financial crisis.

  4. [The social relegation of widows living with HIV in the time of ART in Senegal].

    Science.gov (United States)

    Desclaux, A; Boye, S; Taverne, B

    2014-10-01

    While prolonged widowhood is unusual in Senegalese society, some women living with HIV receiving antiretroviral therapy for ten years remained widows. Are they maintained in this situation for refusing or being unable to remarry? To understand the conditions and the reasons for this lack of "matrimonial normalization", a qualitative interview study was conducted in Dakar with 31 widows. Their living conditions are mostly marked by economic difficulties, dependence on host families, and responsibilities visà-vis their children. They refuse to remarry, regret not being able to, or wish to without success, despite the existence locally of social forms of marital union that would respond to their situation. The refusal to disclose their HIV status combined with self-stigma prevent them from improving their condition. This form of social vulnerability that remains beyond the restoration of health is ignored by public policy and HIV/AIDS community based organizations claims. It should be acknowledged and considered for defending PLWAs' rights.

  5. Novel epigenetic changes unveiled by monozygotic twins discordant for smoking habits.

    Science.gov (United States)

    Allione, Alessandra; Marcon, Francesca; Fiorito, Giovanni; Guarrera, Simonetta; Siniscalchi, Ester; Zijno, Andrea; Crebelli, Riccardo; Matullo, Giuseppe

    2015-01-01

    Exposure to cigarette smoking affects the epigenome and could increase the risk of developing diseases such as cancer and cardiovascular disorders. Changes in DNA methylation associated with smoking may help to identify molecular pathways that contribute to disease etiology. Previous studies are not completely concordant in the identification of differentially methylated regions in the DNA of smokers. We performed an epigenome-wide DNA methylation study in a group of monozygotic (MZ) twins discordant for smoking habits to determine the effect of smoking on DNA methylation. As MZ twins are considered genetically identical, this model allowed us to identify smoking-related DNA methylation changes independent from genetic components. We investigated the whole blood genome-wide DNA methylation profiles in 20 MZ twin pairs discordant for smoking habits by using the Illumina HumanMethylation450 BeadChip. We identified 22 CpG sites that were differentially methylated between smoker and non-smoker MZ twins by intra-pair analysis. We confirmed eight loci already described by other groups, located in AHRR, F2RL3, MYOG1 genes, at 2q37.1 and 6p21.33 regions, and also identified several new loci. Moreover, pathway analysis showed an enrichment of genes involved in GTPase regulatory activity. Our study confirmed the evidence of smoking-related DNA methylation changes, emphasizing that well-designed MZ twin models can aid the discovery of novel DNA methylation signals, even in a limited sample population.

  6. Home-Based HIV Testing and Counseling for Male Couples (Project Nexus): A Protocol for a Randomized Controlled Trial.

    Science.gov (United States)

    Stephenson, Rob; Freeland, Ryan; Sullivan, Stephen P; Riley, Erin; Johnson, Brent A; Mitchell, Jason; McFarland, Deborah; Sullivan, Patrick S

    2017-05-30

    HIV prevalence remains high among men who have sex with men (MSM) in the United States, yet the majority of research has focused on MSM as individuals, not as dyads, and has discussed HIV risks primarily in the context of casual sex. Nexus is an online prevention program that combines home-based HIV testing and couples HIV testing and counseling (CHTC). It allows partners in dyadic MSM relationships to receive HIV testing and care in the comfort of their designated residence, via video-based chat. By using video-based technologies (eg, VSee video chat), male couples receive counseling and support from a remote online counselor, while testing for HIV at home. This randomized control trial (RCT) aims to examine the effects of video-based counseling combined with home-based HIV testing on couples' management of HIV risk, formation and adherence to explicit sexual agreements, and sexual risk-taking. The research implements a prospective RCT of 400 online-recruited male couples: 200 self-reported concordant-negative couples and 200 self-reported discordant couples. Couples in the control arm will receive one or two home-based HIV self-testing kits and will be asked to report their results via the study's website. Couples in the experimental arm will receive one or two home-based HIV self-testing kits and will conduct these tests together under the facilitation of a remotely located counselor during a prescheduled VSee-based video CHTC session. Study assessments are taken at baseline, as well as at 3- and 6-month follow-up sessions. Project Nexus was launched in April 2016 and is ongoing. To date, 219 eligible couples have been enrolled and randomized. Combining home-based HIV testing with video-based counseling creates an opportunity to expand CHTC to male couples who (1) live outside metro areas, (2) live in rural areas without access to testing services or LGBTQ resources, or (3) feel that current clinic-based testing is not for them (eg, due to fears of

  7. IMPORTANCE OF THE EUROPEAN BANKING UNION NEW DIRECTIVES

    Directory of Open Access Journals (Sweden)

    MEDAR LUCIAN-ION

    2014-10-01

    Full Text Available European Banking Union has set new rules on monetary market especially for credit institutions and for financial banking groups in general. Economic and monetary union requires accomplishment of political and monetary union and democratic control of the European institutions on a single financial market. In this respect through its management organisms, EU has designed a series of unique mechanisms of financial union and called for a fiscal union. Union of European financial market is possible through a new regulation of the markets. In this project, monetary union of the EU member countries is possible by implementing single mechanism of supervision (Single Supervisory Mechanism and single mechanism of resolution (Single Resolution Mechanism. European Banking Union may be made by monitoring of a single banking supervisor based on a common system for managing and resolving banking crises and a uniform system of protecting people's savings. Romania opted for these unique mechanisms of macro-prudential supervision of the financial system. And by performing the real convergence criteria of integration, Romania will have all conditions of integration in the ,,euro area,,.

  8. European [Security] Union

    DEFF Research Database (Denmark)

    Manners, Ian James

    2013-01-01

    The past 20 years, since the 1992 Treaty on European Union, have seen the gradual creation of both an “Area of Freedom, Security and Justice” and a “Common Foreign and Security Policy”. More recent is the development of a “European Neighbourhood Policy” over the past 10 years. All three...... of these policies involved the navigation and negotiation of security, borders and governance in and by the European Union (EU). This article analyses these practices of bordering and governance through a five-fold security framework. The article argues that a richer understanding of EU security discourses can...

  9. LEGAL PERSONALITY AND POWERS OF THE EUROPEAN UNION

    OpenAIRE

    Augustin FUEREA

    2010-01-01

    Based on legal personality, EU won through Treaty of Lisbon, in accordance with the system of division of competences between the Union and the Member States as provided for in the Treaty on European Union and the Treaty on the Functioning of the European Union, competences not conferred upon the Union in the Treaties remain with the Member States. When the Treaties confer on the Union a competence shared with the Member States in a specific area, the Member States shall exercise their compet...

  10. Professional Employees Turn to Unions

    Science.gov (United States)

    Chamot, Dennis

    1976-01-01

    White-collar and professional employees are increasingly turning to unions to combat their loss of independence as employees of large organizations. Managers should realize that they and professional employees have different viewpoints about job situations and that the current trend toward white-collar unionism is apt to continue. (JG)

  11. Unionization, Spill-Over Effects, and Corporate Policies

    DEFF Research Database (Denmark)

    Florysiak, David

    2017-01-01

    Labor unions influence firm decisions depending on how powerful they are. We develop a new measure of union power faced by individual firms. Our measure is based on annual 10-K filings and reflects the amount of union and labor related discourse in the narrative parts of the annual report. Thus, ...

  12. Overview of HIV molecular epidemiology among People who Inject Drugs in Europe and Asia

    Science.gov (United States)

    Nikolopoulos, Georgios K.; Kostaki, Evangelia-Georgia; Paraskevis, Dimitrios

    2016-01-01

    HIV strains continuously evolve, tend to recombine and new circulating variants are being discovered. Novel strains complicate efforts to develop a vaccine against HIV and may exhibit higher transmission efficiency and virulence, and elevated resistance to antiretroviral agents. The United Nations Joint Programme on HIV/AIDS (UNAIDS) set an ambitious goal to end HIV as a public health threat by 2030 through comprehensive strategies that include epidemiological input as the first step of the process. In this context, molecular epidemiology becomes invaluable as it captures trends in HIV evolution rates that shape epidemiological pictures across several geographical areas. This review briefly summarizes the molecular epidemiology of HIV among people who inject drugs (PWID) in Europe and Asia. Following high transmission rates of subtype G and CRF14_BG among PWID in Portugal and Spain, two European countries, Greece and Romania, experienced recent HIV outbreaks in PWID that consisted of multiple transmission clusters including subtypes B, A, F1 and recombinants CRF14_BG and CRF35_AD. The latter was first identified in Afghanistan. Russia, Ukraine and other Former Soviet Union (FSU) states are still facing the devastating effects of epidemics in PWID produced by AFSU (also known as IDU-A), BFSU (known as IDU-B), and CRF03_AB. In Asia, CRF01_AE and subtype B (Western B and Thai B) travelled from PWID in Thailand to neighboring countries. Recombination hotspots in South China, Northern Myanmar, and Malaysia have been generating several intersubtype and inter-CRF recombinants (e.g. CRF07_BC, CRF08_BC, CRF33_01B etc.) increasing the complexity of HIV molecular patterns. PMID:27287560

  13. Is Union Job Dissatisfaction Real?

    Science.gov (United States)

    Hersch, Joni; Stone, Joe A.

    1990-01-01

    A comparison of data from a Eugene, Oregon, worker survey with data from the Quality of Employment Survey found that union job dissatisfaction arises from factors independent of wages and working conditions. Union perspectives of working conditions do not accurately reflect objective measures of conditions. The dissatisfaction expressed has real…

  14. Grassmann codes and Schubert unions

    DEFF Research Database (Denmark)

    Hansen, Johan Peder; Johnsen, Trygve; Ranestad, Kristian

    2009-01-01

    We study subsets of Grassmann varieties over a field , such that these subsets are unions of Schubert cycles, with respect to a fixed flag. We study such sets in detail, and give applications to coding theory, in particular for Grassmann codes. For much is known about such Schubert unions with a ...

  15. Toward a More Perfect Union

    Science.gov (United States)

    Schachter, Ron

    2010-01-01

    This article explores school districts such as New Haven (Connecticut) Public Schools, whose local union is an American Federation of Teachers (AFT) affiliate and where a shared concern for students has trumped the often adversarial union-management relationship. The author discusses what makes the successful contract negotiations headed by David…

  16. Wage Setting in Democratic Labour Unions

    DEFF Research Database (Denmark)

    Filges, Trine

    1999-01-01

    In this paper, we analyse the wage setting of a democratic labour union. The union members differ with respect to their employment probabilities. The union wage only changes if the parameters of the median member change. An exogenous shock to revenue may increase the wage, even if labour demand...... is iso-elastic and unemployment benefits may have only a small effect on wages if the median member differs from the average. These findings are in accordance with empirical results....

  17. The European Union: Challenges and Perspectives

    Directory of Open Access Journals (Sweden)

    Botescu Ion

    2017-01-01

    If to all these we add the protectionist measures that the new president of the United States wishes to implement, as well as some deterioration in the European Union credibility generated by Brexit, the bureaucratic aspects that characterize the European institutions, etc., we can outline the context of the European Union, which requires a series of measures to ensure the progress of the European Union as a whole and, in particular, the effective integration of each Community country.

  18. The epidemiology of HIV and AIDS reports in migrants in the 27 European Union countries, Norway and Iceland: 1999-2006.

    Science.gov (United States)

    Del Amo, Julia; Likatavičius, Giedrius; Pérez-Cachafeiro, Santiago; Hernando, Victoria; González, Cristina; Jarrín, Inma; Noori, Teymur; Hamers, Françoise F; Bolúmar, Francisco

    2011-10-01

    To describe the epidemiology of HIV and AIDS by geographical origin in the EU, 1999-2006. AIDS and HIV cases from the EU 27, Norway and Iceland reported to European Centre for Epidemiological Monitoring of AIDS were analysed. Of 75,021 AIDS reports over 1999-2006, 35% were migrants. Of 2988 heterosexual AIDS reports in 2006, 50% were migrants, largely from Sub-Saharan Africa (SSA), 20% of 1404 AIDS cases in men who have sex with men (MSM) were migrants from Latin-America and Western Europe. Of 57 mother-to-child transmission (MTCT) AIDS cases, 23% were from SSA. AIDS cases decreased from 1999 to 2006 in natives (42%), Western Europeans (40%) and North Africa and Middle East (34%), but increased in people from SSA (by 89%), Eastern Europe (by 200%) and Latin-America (50%). Of 17,646 HIV infections in men and 9066 in females in 2006, 49 and 76% were migrants, largely from SSA. Of 169 MTCT infections, 41% were from SSA. Migrants, largely from SSA, represent a considerable proportion of AIDS and HIV reports in EU, especially among heterosexual and MTCT infections. Their contribution is higher among female reports. A substantial percentage of diagnoses in MSM are migrants, largely from Western Europe and Latin-America.

  19. [Female nuptiality: the importance of consensual unions].

    Science.gov (United States)

    Ojeda, N

    1988-01-01

    Mexico's National Demographic Survey of 1982 indicated that 58.4% of ever married women had been in marriages celebrated both civilly and religiously, 24.4% had been in civil marriages only, 3.0% had been in religious marriages only, and 14.2% had been in consensual unions. Transitions from 1 type of union to another by the same couple are very common, however. 53.6% of women began their conjugal lives in civil and religious marriages, 19.3% in civil marriages only, 2.3% in religious marriages only, and 24.6% in consensual unions. About 1/2 of consensual unions are eventually legalized, but the rate is lower in the less advantaged socioeconomic sectors which have a higher proportion of consensual unions. Corrected data show that only 7.5% of Mexican women remain single at the age of 45. The average age at 1st union is 21.4 years. Marriage patterns differ significantly in different social sectors. The proportion of women consensual unions varied from 16.1% for the new bourgeoisie, defined as administrators, technicians, high-level workers, and professional public officials, to over 30% for nonsalaried workers, peasants, and agricultural wage workers. Peasants, agricultural wage workers and nonagricultural nonsalaried workers had the lowest marriage ages and the highest proportion married by age 20. In the various proletarian groups, only 2.8-3.7% remained single at age 45, and 42.5%-51.3% were married or in union by age 20. Proletarian women had intermediate ages at 1st marriage. Women of the new bourgeoisie had the highest age at 1st union, 23 years, but the lowest proportion single at age 45, 1.8%. The traditional bourgeoisie and new bourgeoisie had the 2nd lowest age at 1st union, 21.9, and a proportion never married at age 45 that was similar to the national average. The proportion single at age 45 was highest among peasants and agricultural wage workers, reaching 11.3%.

  20. Mitochondrial DNA Copy Number in Sleep Duration Discordant Monozygotic Twins.

    Science.gov (United States)

    Wrede, Joanna E; Mengel-From, Jonas; Buchwald, Dedra; Vitiello, Michael V; Bamshad, Michael; Noonan, Carolyn; Christiansen, Lene; Christensen, Kaare; Watson, Nathaniel F

    2015-10-01

    Mitochondrial DNA (mtDNA) copy number is an important component of mitochondrial function and varies with age, disease, and environmental factors. We aimed to determine whether mtDNA copy number varies with habitual differences in sleep duration within pairs of monozygotic twins. Academic clinical research center. 15 sleep duration discordant monozygotic twin pairs (30 twins, 80% female; mean age 42.1 years [SD 15.0]). Sleep duration was phenotyped with wrist actigraphy. Each twin pair included a "normal" (7-9 h/24) and "short" (sleeping twin. Fasting peripheral blood leukocyte DNA was assessed for mtDNA copy number via the n-fold difference between qPCR measured mtDNA and nuclear DNA creating an mtDNA measure without absolute units. We used generalized estimating equation linear regression models accounting for the correlated data structure to assess within-pair effects of sleep duration on mtDNA copy number. Mean within-pair sleep duration difference per 24 hours was 94.3 minutes (SD 62.6 min). We found reduced sleep duration (β = 0.06; 95% CI 0.004, 0.12; P sleep efficiency (β = 0.51; 95% CI 0.06, 0.95; P sleep duration was associated with a decrease in mtDNA copy number of 0.06. Likewise, a 1% decrease in actigraphy-defined sleep efficiency was associated with a decrease in mtDNA copy number of 0.51. Reduced sleep duration and sleep efficiency were associated with reduced mitochondrial DNA copy number in sleep duration discordant monozygotic twins offering a potential mechanism whereby short sleep impairs health and longevity through mitochondrial stress. © 2015 Associated Professional Sleep Societies, LLC.

  1. DNA damage response in monozygotic twins discordant for smoking habits.

    Science.gov (United States)

    Marcon, Francesca; Carotti, Daniela; Andreoli, Cristina; Siniscalchi, Ester; Leopardi, Paola; Caiola, Stefania; Biffoni, Mauro; Zijno, Andrea; Medda, Emanuela; Nisticò, Lorenza; Rossi, Sabrina; Crebelli, Riccardo

    2013-03-01

    Previous studies in twins indicate that non-shared environment, beyond genetic factors, contributes substantially to individual variation in mutagen sensitivity; however, the role of specific causative factors (e.g. tobacco smoke, diet) was not elucidated. In this investigation, a population of 22 couples of monozygotic twins with discordant smoking habits was selected with the aim of evaluating the influence of tobacco smoke on individual response to DNA damage. The study design virtually eliminated the contribution of genetic heterogeneity to the intra-pair variation in DNA damage response, and thus any difference in the end-points investigated could directly be attributed to the non-shared environment experienced by co-twins, which included as main factor cigarette smoke exposure. Peripheral lymphocytes of study subjects were challenged ex vivo with γ-rays, and the induction, processing, fixation of DNA damage evaluated through multiple approaches. Folate status of study subjects was considered significant covariate since it is affected by smoking habits and can influence radiosensitivity. Similar responses were elicited by γ-rays in co-twins for all the end-points analysed, despite their discordant smoking habits. Folate status did not modify DNA damage response, even though a combined effect of smoking habits, low-plasma folic acid level, and ionising radiation was observed on apoptosis. A possible modulation of DNA damage response by duration and intensity of tobacco smoke exposure was suggested by Comet assay and micronucleus data, but the effect was quantitatively limited. Overall, the results obtained indicate that differences in smoking habits do not contribute to a large extent to inter-individual variability in the response to radiation-induced DNA damage observed in healthy human populations.

  2. Union Gas and Ontario gas production

    International Nuclear Information System (INIS)

    Cameron, C.

    2001-01-01

    A step-by-step review of the tie-in process of new production wells into the Union Gas System is described. Requirements of the producer and those of Union Gas are explained. Also described are the choices available to the producer to sell his gas. He can sell either to Union Gas directly at an agreed upon price, or the producer has the option to have what is called an M13 contract which allows him to sell his gas at Dawn, where it can be stored within parameters of the contract, and sold to any buyer at Dawn at a negotiated rate. This arrangement, while entailing a much greater administrative load than direct sale to Union Gas, nevertheless, allows the producer to take advantage of market fluctuations. A third option provided by Union Gas is to make available to the producer storage space greater than the provisions of the M13 contract at current market rate, thereby opening up the opportunity to the producer to capture additional value in later winter months (when gas is in greater demand)

  3. Evaluation of Performance of Two Rapid Tests for Detection of HIV-1 and -2 in High- and Low-Prevalence Populations in Nigeria.

    Science.gov (United States)

    Manak, Mark M; Njoku, Ogbonnaya S; Shutt, Ashley; Malia, Jennifer; Jagodzinski, Linda L; Milazzo, Mark; Suleiman, Aminu; Ogundeji, Amos A; Nelson, Robert; Ayemoba, Ojor R; O'Connell, Robert J; Singer, Darrell E; Michael, Nelson L; Peel, Sheila A

    2015-11-01

    The availability of reliable human immunodeficiency virus types 1 and 2 (HIV-1/2) rapid tests in resource-limited settings represents an important advancement in the accurate diagnosis of HIV infection and presents opportunities for implementation of effective prevention and treatment interventions among vulnerable populations. A study of the potential target populations for future HIV vaccine studies examined the prevalence of HIV infections at six selected sites in Nigeria and evaluated the use of two rapid diagnostic tests (RDTs) for HIV. The populations included market workers at sites adjacent to military installations and workers at highway settlements (truck stops) who may have a heightened risk of HIV exposure. Samples from 3,187 individuals who provided informed consent were tested in parallel using the Determine (DT) and Stat-Pak (SP) RDTs; discordant results were subjected to the Uni-Gold (UG) RDT as a tiebreaker. The results were compared to those of a third-generation enzyme immunoassay screen with confirmation of repeat reactive samples by HIV-1 Western blotting. One participant was HIV-2 infected, yielding positive results on both RDTs. Using the laboratory algorithm as a gold standard, we calculated sensitivities of 98.5% (confidence interval [CI], 97.1 to 99.8%) for DT and 98.1% (CI, 96.7 to 99.6%) for SP and specificities of 98.7% (CI, 98.3 -99.1%) for DT and 99.8% (CI, 99.6 to 100%) for SP. Similar results were obtained when the sites were stratified into those of higher HIV prevalence (9.4% to 22.8%) versus those of lower prevalence (3.2% to 7.3%). A parallel two-test algorithm requiring both DT and SP to be positive resulted in the highest sensitivity (98.1%; CI, 96.7 to 99.6%) and specificity (99.97%; CI, 99.9 to 100%) relative to those for the reference laboratory algorithm. Copyright © 2015, Manak et al.

  4. “One Should Have Two Homelands”: Discord and Hope in Soma Morgenstern’s Sparks in the Abyss

    Directory of Open Access Journals (Sweden)

    Kata Gellen

    2017-02-01

    Full Text Available Soma Morgenstern’s three-part novel Sparks in the Abyss, written between 1930 and 1943, exudes a spirit of serenity and optimism at the same time that its narrative is structured by repeated scenes of conflict and violence. This paper seeks to account for the place of discord in the trilogy. Morgenstern uses the interwar Galician homeland as a site to articulate the possibility of traditional Jewish life in modern Europe. By inhabiting two homes—East and West, Galicia and Vienna, secularism and piety—Jews will be able to negotiate the inevitable discord and occasional brutality that they face in the world. The lessons learned by a Western secular Jew in pluralist Galicia create hope for the negotiation of difference, if not for the complete overcoming of violence, on the eve of World War II.

  5. Non-random X chromosome inactivation in an affected twin in a monozygotic twin pair discordant for Wiedemann-Beckwith syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Oestavik, R.E.; Eiklid, K.; Oerstavik, K.H. [Ulleval Univ. Hospital, Oslo (Norway)] [and others

    1995-03-27

    Wiedemann-Beckwith syndrome (WBS) is a syndrome including exomphalos, macroglossia, and generalized overgrowth. The locus has been assigned to 11p15, and genomic imprinting may play a part in the expression of one or more genes involved. Most cases are sporadic. An excess of female monozygotic twins discordant for WBS have been reported, and it has been proposed that this excess could be related to the process of X chromosome inactivation. We have therefore studied X chromosome inactivation in 13-year-old monozygotic twin girls who were discordant for WBS. In addition, both twins had Tourette syndrome. The twins were monochorionic and therefore the result of a late twinning process. This has also been the case in previously reported discordant twin pairs with information on placentation. X chromosome inactivation was determined in DNA from peripheral blood cells by PCR analysis at the androgen receptor locus. The affected twin had a completely skewed X inactivation, where the paternal allele was on the active X chromosome in all cells. The unaffected twin had a moderately skewed X inactivation in the same direction, whereas the mother had a random pattern. Further studies are necessary to establish a possible association between the expression of WBS and X chromosome inactivation. 18 refs., 2 figs., 1 tab.

  6. Male labor migration, patriarchy, and the awareness-behavior gap: HIV risks and prevention among migrants' wives in Armenia.

    Science.gov (United States)

    Agadjanian, Victor; Markosyan, Karine

    2017-06-01

    Unlike in most of the world, HIV incidence in the former Soviet Union continues to rise. While international labor migration has been identified as a potentially important contributor to this trend, most attention has been focused on risks of male migrants themselves. This study uses recent household survey data to examine HIV-related perceptions and actions of migrants' left-behind wives in Armenia. Multivariate logistic regression analyses show that migrants' wives are significantly more likely to suspect their husbands of extramarital sex than are non-migrants' wives. The analyses detect greater worries about HIV infection and a higher likelihood of spousal communication on HIV matters among migrants' wives, compared to non-migrants' wives, but these differences are largely explained by the suspicion of husband's extramarital sex. Finally, no difference between the two categories of women in the probability of consistent condom use with husbands is found. These findings are interpreted within the context of patriarchal culture and unequal gender relations in Armenian society as they are further reinforced by male migration. Implications of these findings for policies to increase women's awareness of HIV risks associated with migration and their ability to reduce those risks are discussed.

  7. Risk Factors Associated with Discordant Ki-67 Levels between Preoperative Biopsy and Postoperative Surgical Specimens in Breast Cancers.

    Directory of Open Access Journals (Sweden)

    Hyung Sun Kim

    Full Text Available The Ki-67 labelling index is significant for the management of breast cancer. However, the concordance of Ki-67 expression between preoperative biopsy and postoperative surgical specimens has not been well evaluated. This study aimed to find the correlation in Ki-67 expression between biopsy and surgical specimens and to determine the clinicopathological risk factors associated with discordant values.Ki-67 levels were immunohistochemically measured using paired biopsy and surgical specimens in 310 breast cancer patients between 2008 and 2013. ΔKi-67 was calculated by postoperative Ki-67 minus preoperative levels. The outliers of ΔKi-67 were defined as [lower quartile of ΔKi-67-1.5 × interquartile range (IQR] or (upper quartile + 1.5 × IQR and were evaluated according to clinicopathological parameters by logistic regression analysis.The median preoperative and postoperative Ki-67 levels were 10 (IQR, 15 and 10 (IQR, 25, respectively. Correlation of Ki-67 levels between the two specimens indicated a moderately positive relationship (coefficient = 0.676. Of 310 patients, 44 (14.2% showed outliers of ΔKi-67 (range, ≤-20 or ≥28. A significant association with poor prognostic factors was found among these patients. Multivariate analysis determined that significant risk factors for outliers of ΔKi-67 were tumor size >1 cm, negative progesterone receptor (PR expression, grade III cancer, and age ≤35 years. Among 171 patients with luminal human epidermal growth factor receptor 2-negative tumors, breast cancer subtype according to preoperative or postoperative Ki-67 levels discordantly changed in 46 (26.9% patients and a significant proportion of patients with discordant cases had ≥1 risk factor.Ki-67 expression showed a substantial concordance between biopsy and surgical specimens. Extremely discordant Ki-67 levels may be associated with aggressive tumor biology. In patients with luminal subtype disease, clinical application of Ki-67

  8. Same Genes, Different Brains: Neuroanatomical Differences Between Monozygotic Twins Discordant for Musical Training.

    Science.gov (United States)

    de Manzano, Örjan; Ullén, Fredrik

    2018-01-01

    Numerous cross-sectional and observational longitudinal studies show associations between expertise and regional brain anatomy. However, since these designs confound training with genetic predisposition, the causal role of training remains unclear. Here, we use a discordant monozygotic (identical) twin design to study expertise-dependent effects on neuroanatomy using musical training as model behavior, while essentially controlling for genetic factors and shared environment of upbringing. From a larger cohort of monozygotic twins, we were able to recruit 18 individuals (9 pairs) that were highly discordant for piano practice. We used structural and diffusion magnetic resonance imaging to analyze the auditory-motor network and within-pair differences in cortical thickness, cerebellar regional volumes and white-matter microstructure/fractional anisotropy. The analyses revealed that the musically active twins had greater cortical thickness in the auditory-motor network of the left hemisphere and more developed white matter microstructure in relevant tracts in both hemispheres and the corpus callosum. Furthermore, the volume of gray matter in the left cerebellar region of interest comprising lobules I-IV + V, was greater in the playing group. These findings provide the first clear support for that a significant portion of the differences in brain anatomy between experts and nonexperts depend on causal effects of training. © The Author 2017. Published by Oxford University Press.

  9. Glycolysis-induced discordance between glucose metabolic rates measured with radiolabeled fluorodeoxyglucose and glucose

    International Nuclear Information System (INIS)

    Ackermann, R.F.; Lear, J.L.

    1989-01-01

    We have developed an autoradiographic method for estimating the oxidative and glycolytic components of local CMRglc (LCMRglc), using sequentially administered [ 18 F]fluorodeoxyglucose (FDG) and [ 14 C]-6-glucose (GLC). FDG-6-phosphate accumulation is proportional to the rate of glucose phosphorylation, which occurs before the divergence of glycolytic (GMg) and oxidative (GMo) glucose metabolism and is therefore related to total cerebral glucose metabolism GMt: GMg + GMo = GMt. With oxidative metabolism, the 14 C label of GLC is temporarily retained in Krebs cycle-related substrate pools. We hypothesize that with glycolytic metabolism, however, a significant fraction of the 14 C label is lost from the brain via lactate production and efflux from the brain. Thus, cerebral GLC metabolite concentration may be more closely related to GMo than to GMt. If true, the glycolytic metabolic rate will be related to the difference between FDG- and GLC-derived LCMRglc. Thus far, we have studied normal awake rats, rats with limbic activation induced by kainic acid (KA), and rats visually stimulated with 16-Hz flashes. In KA-treated rats, significant discordance between FDG and GLC accumulation, which we attribute to glycolysis, occurred only in activated limbic structures. In visually stimulated rats, significant discordance occurred only in the optic tectum

  10. Partnership Creates Centre for Union Studies

    Science.gov (United States)

    Smart, Carol; Roman, Stephen

    1978-01-01

    A unique cooperative venture between the city of Coventry and local trade unions is establishing a library collection of books, periodicals, historical documents, tapes, and films dealing with unions, labor studies, and industrial problems. (JAB)

  11. Attention problems and Attention-Deficit/Hyperactivity Disorder in discordant and concordant monozygotic twins: Evidence of environmental mediators.

    NARCIS (Netherlands)

    Lehn, H.; Derks, E.M.; Hudziak, J.; Heutink, P.; van Beijsterveldt, C.E.M.; Boomsma, D.I.

    2007-01-01

    OBJECTIVE: To study familial and nonfamilial environmental influences on attention problems and attention-deficit/hyperactivity disorder (ADHD) in monozygotic twins discordant and concordant-high and low for these traits. METHOD: Ninety-five twin pairs from The Netherlands Twin Register were

  12. Molecular epidemiology of HIV-1 infection in Europe: An overview.

    Science.gov (United States)

    Beloukas, Apostolos; Psarris, Alexandros; Giannelou, Polina; Kostaki, Evangelia; Hatzakis, Angelos; Paraskevis, Dimitrios

    2016-12-01

    Human Immunodeficiency Virus type 1 (HIV-1) is characterised by vast genetic diversity. Globally circulating HIV-1 viruses are classified into distinct phylogenetic strains (subtypes, sub-subtypes) and several recombinant forms. Here we describe the characteristics and evolution of European HIV-1 epidemic over time through a review of published literature and updated queries of existing HIV-1 sequence databases. HIV-1 in Western and Central Europe was introduced in the early-1980s in the form of subtype B, which is still the predominant clade. However, in Eastern Europe (Former Soviet Union (FSU) countries and Russia) the predominant strain, introduced into Ukraine in the mid-1990s, is subtype A (A FSU ) with transmission mostly occurring in People Who Inject Drugs (PWID). In recent years, the epidemic is evolving towards a complex tapestry with an increase in the prevalence of non-B subtypes and recombinants in Western and Central Europe. Non-B epidemics are mainly associated with immigrants, heterosexuals and females but more recently, non-B clades have also spread amongst groups where non-B strains were previously absent - non-immigrant European populations and amongst men having sex with men (MSM). In some countries, non-B clades have spread amongst the native population, for example subtype G in Portugal and subtype A in Greece, Albania and Cyprus. Romania provides a unique case where sub-subtype F1 has predominated throughout the epidemic. In contrast, HIV-1 epidemic in FSU countries remains more homogeneous with A FSU clade predominating in all countries. The differences between the evolution of the Western epidemic and the Eastern epidemic may be attributable to differences in transmission risk behaviours, lifestyle and the patterns of human mobility. The study of HIV-1 epidemic diversity provides a useful tool by which we can understand the history of the pandemic in addition to allowing us to monitor the spread and growth of the epidemic over time

  13. Discordance of conflict of interest self-disclosure and the Centers of Medicare and Medicaid Services.

    Science.gov (United States)

    Cherla, Deepa V; Olavarria, Oscar A; Holihan, Julie L; Viso, Cristina Perez; Hannon, Craig; Kao, Lillian S; Ko, Tien C; Liang, Mike K

    2017-10-01

    The Open Payments Database (OPD) discloses financial transactions between manufacturers and physicians. The concordance of OPD versus self-reported conflicts of interest (COI) is unknown. Our objectives were to compare (1) industry and self-disclosed COI in clinical literature, (2) payments within each disclosure level, and (3) industry- and self-disclosed COI and payments by specialty. This was an observational study. PubMed was searched for clinical studies accepted for publication from January 2014 to June 2016. Author and OPD-disclosed COIs were compared. Articles and authors were divided into full disclosure, incomplete industry disclosure, incomplete self-disclosure, and no COI. Primary outcome (differences in reported COI per article) was assessed using McNemar's test. Payment differences were compared using Kruskal-Wallis test. OPD- and self-disclosed COI differed (65.0% discordance rate by article, P disclosure category differed between specialties (P self-disclosure ($30,812). Significant discordance exists between self- and OPD-reported COI. Additional research is needed to determine reasons for these differences. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Gender Differences in Attitudes toward Unions.

    Science.gov (United States)

    Schur, Lisa A.; Kruse, Douglas L.

    1992-01-01

    A 1984 survey of 250 union members (86 women and 164 men) showed that most women, especially those in private sector white collar jobs, were interested in joining unions but face barriers such as family responsibilities. (SK)

  15. When strong unions meet precarious migrants: Building trustful relations to unionise labour migrants in a high union-density setting

    DEFF Research Database (Denmark)

    Refslund, Bjarke

    2018-01-01

    Based on case studies in a fish processing plant and a demolition company, this article shows how strong and institutionally embedded unions interact with migrant workers in a precarious labour market position in order to safeguard their working conditions and organise them. It shows how strong...... in the IR-model. The dynamic relation between migrant workers and national unions in this high-density setting is discussed emphasising the need for building a trustful relation between the migrant workers and the unions in order to empower the migrants to better navigate in the national labour market...... unions are in a good position to include migrant workers and thereby resist labour market segmentation. The strong Danish unions, faced with the serious challenges of intra-European labour migration, have increased their attention and resources devoted to organising migrant workers and including them...

  16. Irradiation defects in clayey minerals in association with discordance-type uranium deposit; Les Defauts d'Irradiation dans les Mineraux argileux associes aux gisements d'Uranium de type Discordance

    Energy Technology Data Exchange (ETDEWEB)

    Morichon, E.; Beaufort, D. [Universite de Poitiers, Laboratoire HydrASA, CNRS-FRE 3114, 86 - Poitiers (France); Morichon, E.; Allard, Th. [IMPMC, UMR 7590, 75 - Paris (France)

    2009-07-01

    Radioactivity generates defects in minerals and these defects are the witnesses of the presence of radio-elements, and therefore represent an interesting potential for uranium prospecting. Investigations made in the Athabasca basin in Canada reveal irradiation defects in very old clays (kaolinite, illite and sudoite) in the alteration halo of discordance-type uranium deposits. The authors comment the defect concentration variation among the different drillings. These differences show that hexavalent uranium circulated in the whole geological system

  17. Are unions an anachronism?

    Science.gov (United States)

    Schrank, R

    1979-01-01

    The labor movement in the United States has its roots deep in the soil of worker discontent over grueling working conditions, low pay, and indifference of bosses, who profited from others' sweaty labor. As more and more grubby jobs are replaced by technological innovations, as work becomes more abstract and everyone wears a white shirt, and as managers schooled in motivation theory and humane ideals of participation replace the owner-bosses of yesterday, what role will the unions have left to play? The author of this article, who has been in both the labor force and management, explores what the changes in the labor market will be in the future and what these changes will mean for labor-management relations. He does not conclude that there is no role for unions-only that it will be very different and that to survive unions will have to tackle new issues in the workplace. That adaptation will affect management's stance as well.

  18. union publique HR

    CERN Multimedia

    CERN. Geneva

    2010-01-01

    Chers Collègues,Je me permets de vous rappeler qu'une réunion publique organisée par le Département HR se tiendra aujourd'hui:Vendredi 30 avril 2010 à 9h30 dans l'Amphithéâtre principal (café offert dès 9h00).Durant cette réunion, des informations générales seront données sur:le CERN Admin e-guide, qui est un nouveau guide des procédures administratives du CERN ayant pour but de faciliter la recherche d'informations pratiques et d'offrir un format de lecture convivial;le régime d'Assurance Maladie de l'Organisation (présentation effectuée par Philippe Charpentier, Président du CHIS Board) et;la Caisse de Pensions (présentation effectuée par Théodore Economou, Administrateur de la Caisse de Pensions du CERN).Une transmission simultanée de cette réunion sera assur...

  19. The 1997 Protocol and the European Union (European Union and '2nd generation' responsibility conventions)

    International Nuclear Information System (INIS)

    Handrlica, Jakub; Novotna, Marianna

    2014-01-01

    The issue of accession of the Eastern European Member States to the 1997 Protocol is discussed with focus on the European Union's authority and enforcement powers. Following up the article published in the preceding issue of this journal, the present contribution analyses the relations of the '2nd generation' responsibility conventions to the law of the European Union. (orig.)

  20. Ovarian response and cumulative live birth rate of women undergoing in-vitro fertilisation who had discordant anti-Mullerian hormone and antral follicle count measurements: a retrospective study.

    Directory of Open Access Journals (Sweden)

    Hang Wun Raymond Li

    Full Text Available OBJECTIVE: To evaluate ovarian response and cumulative live birth rate of women undergoing in-vitro fertilization (IVF treatment who had discordant baseline serum anti-Mullerian hormone (AMH level and antral follicle count (AFC. METHODS: This is a retrospective cohort study on 1,046 women undergoing the first IVF cycle in Queen Mary Hospital, Hong Kong. Subjects receiving standard IVF treatment with the GnRH agonist long protocol were classified according to their quartiles of baseline AMH and AFC measurements after GnRH agonist down-regulation and before commencing ovarian stimulation. The number of retrieved oocytes, ovarian sensitivity index (OSI and cumulative live-birth rate for each classification category were compared. RESULTS: Among our studied subjects, 32.2% were discordant in their AMH and AFC quartiles. Among them, those having higher AMH within the same AFC quartile had higher number of retrieved oocytes and cumulative live-birth rate. Subjects discordant in AMH and AFC had intermediate OSI which differed significantly compared to those concordant in AMH and AFC on either end. OSI of those discordant in AMH and AFC did not differ significantly whether either AMH or AFC quartile was higher than the other. CONCLUSIONS: When AMH and AFC are discordant, the ovarian responsiveness is intermediate between that when both are concordant on either end. Women having higher AMH within the same AFC quartile had higher number of retrieved oocytes and cumulative live-birth rate.

  1. Church unions and their consequences in Poland

    Directory of Open Access Journals (Sweden)

    Antoni Mironowicz

    2014-11-01

    Full Text Available Orthodox Christians in Poland have faced numerous attempts to be forced into union with the Roman Catholic Church, ranging from the thirteenth to the twentieth century. The first attempt at a union between the Roman Catholic Church and the Orthodox Church took place as early as the mid-thirteenth century. Another attempt at forcing the Orthodox Church into union with Rome took place during the reign of Ladislaŭ II Yagiello. The problem of church union returned in the reign of Alexander the Yagiellonian. When Ivan III rejected all projects for bringing the Florence such a union into practice, discussion on church union disappeared until the end of the sixteenth century. The mission of the papal legate, Father Antonio Possevino, to Ivan IV, had been intended to draw Moscow into the union, and its failure caused the papacy to concentrate its efforts on the Orthodox Church in Poland. The Ruthenian bishops’ obedience to the Pope was officially announced on the 8 October 1596. The decisions of the Uniate-Catholic synod were met with numerous protests from the Orthodox clergy and nobility. The larger part of the clergy and the faithful, together with bishops remained in the Orthodox camp. Despite the failure of the Brest Synod in fully uniting Orthodox and Roman churches, new union projects concerning the Orthodox Church in Poland continued to arise prior to the end of 18th century. The Vatican’s interest in the Orthodox Church in Central Europe was renewed at the end of the First World War. On April 1st, 1917, the Pope created the Congregation for the Oriental Churches which was responsibile for all issues relating to the activities of all the Eastern denominations. Despite aims at unification, attempts at church union have had a negative influence on the relations between the Roman Catholic and Polish Orthodox Church in contemporary Poland. The result of centuries of attempts at unification under the Pope has been fragmentation and division.

  2. Union Free-Riding in Britain and New Zealand

    OpenAIRE

    Alex Bryson

    2006-01-01

    The percentage of workers who choose not to join the union available to them at their workplace has been rising in Britain and New Zealand. Social custom, union instrumentality, the fixed costs of joining, employee perceptions of management attitudes to unionization and employee problems at work all influence the propensity to free-ride. Ideological convictions regarding the role of unions also play some role, as do private excludable goods. There is little indication of employer-inspired pol...

  3. Postoperative Surgical Site Infections: Understanding the Discordance Between Surveillance Systems.

    Science.gov (United States)

    Ali-Mucheru, Mariam N; Seville, Maria T; Miller, Vickie; Sampathkumar, Priya; Etzioni, David A

    2018-04-18

    To characterize agreement in the ascertainment of surgical site infections (SSIs) between the National Surgical Quality Improvement Program (NSQIP), National Healthcare Safety Network (NHSN), and administrative data. The NSQIP, NHSN, and administrative data are the primary systems used to monitor and report SSIs for the purpose of quality control and benchmarking of hospitals and surgeons. These systems have different methods for identifying SSIs. We queried the NHSN, NSQIP, and administrative data systems for patients who had an operation at 1 of 4 hospitals within a single health system between January 2013 and September 2015. The detection of an SSI during a postoperative hospitalization was the outcome of analysis. Any SSI detected by one (or more) of these systems was analyzed by 2 reviewers to determine the presence of discrete elements of documentation constituting evidence of SSI. Concordance between the 3 systems (NHSN, NSQIP, and administrative data) was analyzed using Cohen's kappa. After application of appropriate exclusion criteria, a cohort of 9447 inpatient operations was analyzed. In total, 130 SSIs were detected by 1 or more of the 3 systems, with reported SSI rates of 0.5% (NHSN), 0.7% (administrative data), and 1.0% (NSQIP). Of these 130 SSIs, only 17 SSIs were reported by all 3 systems. The concordance between these 3 systems was moderate (kappa values NSQIP-NHSN = 0.50 [0.40-0.60], administrative-NHSN = 0.36 [0.24-0.47], and administrative-NSQIP = 0.47 [0.38-0.57]). Chart review found that reasons for discordance were related to issues of different criteria as well as inaccuracies. There is significant discordance in the determination of SSIs reported by the NHSN, NSQIP, and administrative data. The differences and limitations of each of these systems have to be recognized, especially when using these data for quality reports and pay for performance.

  4. 76 FR 16235 - Corporate Credit Unions, Technical Corrections

    Science.gov (United States)

    2011-03-23

    ... inadvertently included particular investments that did not--when subject to the other credit risk and asset... NATIONAL CREDIT UNION ADMINISTRATION 12 CFR Part 707 RIN 3133-AD58 Corporate Credit Unions, Technical Corrections AGENCY: National Credit Union Administration (NCUA). ACTION: Final rule. SUMMARY: In...

  5. Environment in the European Union 1995

    DEFF Research Database (Denmark)

    The update to the 1992 report on the state of the environment in the European Union requested by the European Commission......The update to the 1992 report on the state of the environment in the European Union requested by the European Commission...

  6. The last-chance Union: three questions for three observations on the union of energy

    International Nuclear Information System (INIS)

    Maisonneuve, Cecile

    2016-01-01

    As the status of the European policy on energy, and of Europe itself, and even the nature of the project of a Union of energy are either in bad shape or put into question again by numerous uncertainties, as Europe is exhausted by a financial crisis, an economic crisis, a debt crisis, the Greek crisis, the Ukrainian crisis, and the refugee crisis, the author examines whether the Union of energy raises the right questions and addresses in the right way the issue of energy, whether Europe possesses the adequate political ecosystem to succeed, whether Europe is mature enough to build up a union on energy. To shed some light on these issues, the author examine the three dimensions of the union of energy: the strategic, political and economic dimensions. She analyses evolutions introduced with respect to the previous period, and assesses the relevance, impact and feasibility of announced proposals. The strategic dimension concerns the connection of Europe to the World (how to face and cope with international energetic realities, and with the current geopolitical turmoils). The politic dimension is to be found in the way to create a common impetus again, and the economic dimension deals with giving back confidence

  7. Sex issues in HIV-1-infected persons during highly active antiretroviral therapy: a systematic review.

    Science.gov (United States)

    Nicastri, Emanuele; Leone, Sebastiano; Angeletti, Claudio; Palmisano, Lucia; Sarmati, Loredana; Chiesi, Antonio; Geraci, Andrea; Vella, Stefano; Narciso, Pasquale; Corpolongo, Angela; Andreoni, Massimo

    2007-10-01

    Since the introduction of highly active antiretroviral therapy (HAART), morbidity and mortality rates have sharply decreased among HIV-infected patients. Studies of possible differences between men and women in the course of HIV infection give conflicting results. The objective of this study was to assess sex differences during HAART. A literature search by using the MEDLINE database between March 2002 and February 2007 was performed to identify all published studies on the sex-specific differences on the impact of HAART. All articles with measures of effect (preferably adjusted odds ratio, relative risk or hazard ratio with 95% CI) of sex on viroimmunological and clinical parameters during HAART were included. Five different topics of interest in our research were selected: time of initiation of HAART, adherence, viroimmunological response, clinical response and adverse reactions during HAART. US data report an initiation of HAART at an earlier disease stage in men compared with women. After initiation of HAART, most authors do not report any viroimmunological difference, although a few clinical studies showed a significantly better virological response in women compared with men. Nevertheless, women were more likely to be less adherent to antiretrovirals and to have non-structured treatment interruptions than men. This is likely to be related to the higher number of adverse reactions they experience during HAART. Finally, discordant opinions with regard to clinical benefits during HAART exist, but recent clinical and observational trials suggest a better clinical outcome for women. We found little evidence of sex differences during antiretroviral treatment. Nevertheless, most of these studies were underpowered to detect sex differences and had limited follow-up at 6 or 12 months. Design of new gender-sensitive clinical trials with both prolonged follow-up and sample size representative of the current HIV prevalence among women are strongly needed to detect the

  8. Teacher Union Legitimacy: Shifting the Moral Center for Member Engagement

    Science.gov (United States)

    Popiel, Kara

    2013-01-01

    This mixed-method case study explored teacher union members' beliefs about the teacher union and their reasons for being active or inactive in the union. Findings suggest that teacher unions have gained pragmatic and cognitive legitimacy (Chaison and Bigelow in Unions and legitimacy. Cornell University Press, Ithaca, NY, 2002), but that…

  9. The european union as subjects of law

    Directory of Open Access Journals (Sweden)

    Fila R.

    2012-10-01

    Full Text Available At the international level it is recognized that development and progress of the new and unique international organization – European Union – is one of the appropriate form of the international organization’s integration. Although European Union was establish as international economic organization, it has gradually integrated the various “best practices” ideas from different governmental systems. Encouragement and motives for cooperation of Member states indicate that member states give more competences of government to the international organization’s institutes. Wherewith, it is observed that the economic and political internationalization has led to disappearance of integrity of territory of member states. The above mentioned opinion is not based on research of the European Union as international organization from standpoint of international law, but from standpoint of theory law – could give juridical estimate regarding executive power in European Union and who could define particular source and entity of administrative law of European Union.

  10. Rationalities in Trade Union Practices: A Discourse Analytic Perspective on The Strategies of Three Danish Trade Unions for Professionals

    Directory of Open Access Journals (Sweden)

    Anders Buch

    2015-01-01

    Full Text Available The ambition of this paper is to analyze the discursive practices of three Danish trade unions for professional and managerial staff as found in their strategy and position papers. Using discourse analytic methods, the paper analyzes, discusses, and compares the strategy papers of the three unions in order to investigate how they problematize their roles and objectives. This investigation clarifies the discursive premises of the unions and it shows how these premises restrain and afford their agendas. The overall purpose of the paper is to investigate and describe the dominant logics and rationalities that shape the documents and to point to their limits and bounds. Through an archaeological investigation, the paper critically examines the implicit and tacit naturalizations made in the documents and reveals the ideological presuppositions of the discursive practices of the authors. The paper documents how “strategic management” has become an integral part of Danish trade unions practices and the paper sets out to discuss this trend in relation to the general neo-liberal decentering of the “social” and promotion of “community” as the locus of governance. Through examples from the practices of the Danish trade unions for professionals, the paper substantiates how new technologies of governance and the subjectification of union members as “customers” tend to transform the role of the trade unions from the position of “political actors” to “service providers” in the advanced liberal societies.

  11. European Union security policy through strategic culture

    Directory of Open Access Journals (Sweden)

    Beriša Hatidža

    2014-01-01

    Full Text Available In this paper, we shall pay attention to the security policy of the European Union, through the strategic culture, starting from the existing various options for cooperation in the field of security and defense. Our goal is to look at the implementation of the Strategic Culture of the European Union (EU SK, research ways to improve the international position of the Union and its impact on policy cooperation and trust with other collectives. Analysis of flexible cooperation between the European Union, as well as access to special procedures in the field of security and defense policy, we will follow the ambition and capacity in implementing the same. Paper aims to introduce the idea of the European Union, which allows its members to rationally consider and check the box of options available to decision makers. In this regard, the EU seeks to build its own armed forces to protect the association of interests-investment terms. Reviewing and understanding the strategic culture of the EU by countries that are not its members can be seen as reasons for strengthening the capacity of the Union for the realization of the impact of the global security as well as predicting its future steps.

  12. Identifying the Intersection of Alcohol, Adherence and Sex in HIV Positive Men on ART Treatment in India Using an Adapted Timeline Followback Procedure.

    Science.gov (United States)

    Schensul, Jean J; Ha, Toan; Schensul, Stephen; Sarna, Avina; Bryant, Kendall

    2017-11-01

    People living with HIV (PLHIV) on anti-retroviral treatment (ART) who drink are less adherent and more likely to engage in unprotected sex but the connections among these events are correlational. Using an adapted Timeline Follow-Back (A-TLFB) procedure, this paper examines the day by day interface of alcohol, medication adherence and sex to provide a fine grained understanding of how multiple behavioral risks coincide in time and space, explores concordance/discordance of measures with survey data and identifies potential recall bias. Data are drawn from a survey of behavior, knowledge and attitudes, and a 30 day TLFB assessment of multiple risk behaviors adapted for the Indian PLHIV context, administered to 940 alcohol-consuming, HIV positive men on ART at the baseline evaluation stage of a multilevel, multi-centric intervention study. On days participants drank they were significantly more likely to be medication non-adherent and to have unprotected sex. In the first day after their alcohol consuming day, the pattern of nonadherence persisted. Binge and regular drinking days were associated with nonadherence but only binge drinking co-occurred with unprotected sex. Asking about specific "drinking days" improved recall for drinking days and number of drinks consumed. Recall declined for both drinking days and nonadherence from the first week to subsequent weeks but varied randomly for sex risk. There was high concordance and low discordance between A-TLFB drinking and nonadherence but these results were reversed for unprotected sex. Moving beyond simple drinking-adherence correlational analysis, the A-TLFB offers improved recall probes and provides researchers and interventionists with the opportunity to identify types of risky days and tailor behavioral modification to reduce alcohol consumption, nonadherence and risky sex on those days.

  13. Convergence: How Nursing Unions and Magnet are Advancing Nursing.

    Science.gov (United States)

    Johnson, Joyce E; Billingsley, Molley

    2014-01-01

    Historically, unions and professional associations such as the American Nurses Association have been adversaries in the fight to represent the best interests of the nursing profession. We reviewed the literature on the evolution of nursing unions, nursing's historical unease about unions, the Magnet designation in nursing, the tensions between the unions and Magnet, the core values and commonalities they share, and the obligations of nursing as a profession. Refocusing on the advancement of our profession provides a positive pathway in which the collective efforts of nursing unions and professional initiatives such as the Magnet designation converge during these turbulent times for our profession. The single, central organizing idea of nursing-where nursing unions and Magnet converge-is the pivotal role of nurses in delivering high-quality patient care. The often-maligned dialectic between unions and Magnet has advanced and not hindered the nursing profession. © 2014 Wiley Periodicals, Inc.

  14. UNION-K 2.0 User's Manual

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Jae Woon; Jang, Jin Wook; Kim, Yeong Il [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2008-12-15

    The unified Input/Output processor UNION-K(UNified Input/Output Processor for Neutronics Analysis by K-CORE) has been developed to provide the automatic input file generation and output processing for the fast reactor core analysis. UNION-K includes the material database for reactor analysis and produces the input files for effective cross section generation, core analysis, and reactivity coefficient calculations. UNION-K can execute corresponding core analysis module and edit core performance parameters from the outputs. UNION-K also provides the graphical interface to check the geometrical arrangement of core and fuel sub-assembly and produces the picture files that can be used for reporting. This report has been prepared for instruction of using UNION-K Ver. 2.0 with examples.

  15. Analysis of Abdi Kerta Rahardja Union Health Assesment

    Directory of Open Access Journals (Sweden)

    Indo Yama Nasarudin

    2016-10-01

    Full Text Available This study aims to identify and analyse the health assessment union of Abdi Kerta Raharja. Health assessment used measurement and calculation in Rule Deputy Control of Ministry of Union and SMEs of the Republic of Indonesia Number 6 Year 2016. Aspects for health assessment consists the capital aspect, productive asset quality aspects, management aspects, aspects of efficiency, liquidity aspect, the aspect of self-reliance and growth and aspects of the identity of union. Based on the results obtained value for all aspects of health assessment union of Abdi Raharja Kerta is 81.00. It can be concluded that the union of Abdi Kerta Raharja have a healthy category for health assessmentDOI: 10.15408/etk.v15i2.3865

  16. The role of union support in coping with job insecurity: A study among union members from three European countries

    OpenAIRE

    Sjoerd Goslinga; Johnny Hellgren; Antonio Chirumbolo; Hans De Witte; Katharina Näswall; Magnus Sverke

    2005-01-01

    The present study examines the potential moderating role of union support in the relationship between job insecurity and work-related attitudes and well-being of unionised employees. Survey data collected among union members from three European countries (The Netherlands, Italy and Sweden) indicate that job insecurity is associated with reduced levels of job satisfaction, well-being and organisational commitment. Contrary to expectations, union support moderated neither the effect of job inse...

  17. Free riders: the rise of alternative unionism in Denmark

    DEFF Research Database (Denmark)

    Ibsen, Flemming; Høgedahl, Laust; Scheuer, Steen

    2013-01-01

    In this article we analyse some disturbing trends in the Danish labour market: while collective bargaining coverage is still relatively high, union density has been declining and—worse than that—there has been a substantial shift away from recognised and in favour of alternative unionism....... The alternative unions are not parties to collective agreements, and they offer membership much cheaper than the recognised unions, in effect taking a free ride on the institutional supports that used to be effective only for the recognised unions. The article explains this conundrum by pointing to the political...

  18. Needle autopsy to establish the cause of death in HIV-infected hospitalized adults in Uganda: a comparison to complete autopsy.

    Science.gov (United States)

    Cox, Janneke A; Lukande, Robert L; Kalungi, Sam; Van Marck, Eric; Van de Vijver, Koen; Kambugu, Andrew; Nelson, Ann M; Manabe, Yukari C; Colebunders, Robert

    2014-10-01

    Minimal invasive but accurate methods to establish the cause of death in HIV-infected patients are needed. We studied the agreement in cause of death between blind and ultrasound-guided needle autopsy and complete autopsy in HIV-infected patients in Uganda. We subsequently performed a blind and ultrasound-guided needle autopsy followed by a complete autopsy in HIV-infected adults who died during hospitalization. Two teams of pathologists reviewed the tissue from either the needle autopsies or the complete autopsy and formulated the major diagnoses, that is, diseases directly contributing to death. The primary outcome was concordance in major diagnosis between needle and complete autopsies. We performed 96 blind needle and complete autopsies and 95 ultrasound-guided needle autopsies. Concordance in major diagnosis between blind needle and complete autopsy was 50%. For the main major diagnosis, tuberculosis (TB) concordance was higher (71%; P autopsy identified at least 1 major diagnosis in 60% of patients; and in 46%, there was complete concordance for all major diagnoses. The main reason for discordance was sampling error of the lesion. Concordance with the addition of ultrasound guidance was 52% for all major diagnoses and 79% for TB. Major diagnoses were mainly identified in tissue cores from the liver (76%) and the spleen (82%). Blind needle autopsy identified half of the major diagnosis. The addition of ultrasound guidance did not significantly improve the performance of needle autopsy. Needle autopsy is a valuable method to confirm causes of death in HIV-infected patients, especially for highly prevalent diseases like TB.

  19. Oliver Sacks: Our Correspondence About Twins/Twin Research: Vanishing Twins Syndrome; Discordant Sex in MZ Twins; Pregnancy Outcomes in IVF and ICSI Conceived Twins/Print and Media: Superfetated Twins; Twins Discordant for Smoking; Twins in Fashion; Yale University Twin Hockey Players; Conjoined Twin-Visiting Professor.

    Science.gov (United States)

    Segal, Nancy L

    2017-08-01

    The late neurologist and author, Oliver Sacks, published an insightful 1986 review of Marjorie Wallace's book, The Silent Twins, in the New York Times. Taking exception to his assertion about Sir Francis Galton, I wrote a letter to the Times' editor. The letter was unpublished, but it brought a wonderful response from Sacks himself that is reproduced and examined. Next, brief reviews of twin research concerning the vanishing twin syndrome (VTS), discordant sex in a monozygotic (MZ) twin pair, and multiple pregnancy outcomes from assisted reproductive technology (ART) are presented. This section is followed by popular coverage of superfetated twins, smoking-discordant co-twins, twins in fashion, Yale University twin hockey players, and a visiting professor who was a conjoined twin.

  20. European Union Legal Methods - Moving Away From Integration

    NARCIS (Netherlands)

    Eckes, C.; Neergaard, U.; Nielsen, R.

    2013-01-01

    Notwithstanding the permanent state of crises of the European Union (EU or Union) in the past seven years, EU law continues to govern the legal relationships of individuals and Member States in ever more areas. Union law is self-reinforcing in the sense that it is constructed to increase in scope

  1. Students Union, University Administration and Political Development ...

    African Journals Online (AJOL)

    Students Union, University Administration and Political Development of Nations. ... African Research Review ... resting on the reciprocal determinism of the social learning theory, that students union makes university administration smooth.

  2. 75 FR 81378 - Fiduciary Duties at Federal Credit Unions; Mergers and Conversions of Insured Credit Unions

    Science.gov (United States)

    2010-12-28

    ... NCUA's neutrality in the final rule and has made this change. A commenter also suggested including this..., where the net worth ratio of the merging credit union exceeds the net worth ratio of the continuing... are entitled to the net worth of a merging credit union. The NCUA Board disagrees. As discussed in the...

  3. Comparative Performance of Four Single Extreme Outlier Discordancy Tests from Monte Carlo Simulations

    Directory of Open Access Journals (Sweden)

    Surendra P. Verma

    2014-01-01

    Full Text Available Using highly precise and accurate Monte Carlo simulations of 20,000,000 replications and 102 independent simulation experiments with extremely low simulation errors and total uncertainties, we evaluated the performance of four single outlier discordancy tests (Grubbs test N2, Dixon test N8, skewness test N14, and kurtosis test N15 for normal samples of sizes 5 to 20. Statistical contaminations of a single observation resulting from parameters called δ from ±0.1 up to ±20 for modeling the slippage of central tendency or ε from ±1.1 up to ±200 for slippage of dispersion, as well as no contamination (δ=0 and ε=±1, were simulated. Because of the use of precise and accurate random and normally distributed simulated data, very large replications, and a large number of independent experiments, this paper presents a novel approach for precise and accurate estimations of power functions of four popular discordancy tests and, therefore, should not be considered as a simple simulation exercise unrelated to probability and statistics. From both criteria of the Power of Test proposed by Hayes and Kinsella and the Test Performance Criterion of Barnett and Lewis, Dixon test N8 performs less well than the other three tests. The overall performance of these four tests could be summarized as N2≅N15>N14>N8.

  4. Positioning women's and children's health in African union policy-making: a policy analysis

    Directory of Open Access Journals (Sweden)

    Toure Kadidiatou

    2012-02-01

    looking at investments and impact. AU policies related to reproductive, maternal, newborn and child health also use fewer policy frames than do AU policies related to HIV/AIDS, tuberculosis and malaria. Conclusion We suggest that more effective prioritization of women's and children's health in African Union policies would be supported by widening the range of policy frames used (notably health and economic and strengthening the evidence base of all policy frames used. In addition, we suggest it would be beneficial if the partner groups advocating for women's and children's health were multi-stakeholder, and included, for instance, health care professionals, regional institutions, parliamentarians, the media, academia, NGOs, development partners and the public and private sectors.

  5. Positioning women's and children's health in African union policy-making: a policy analysis.

    Science.gov (United States)

    Toure, Kadidiatou; Sankore, Rotimi; Kuruvilla, Shyama; Scolaro, Elisa; Bustreo, Flavia; Osotimehin, Babatunde

    2012-02-16

    to reproductive, maternal, newborn and child health also use fewer policy frames than do AU policies related to HIV/AIDS, tuberculosis and malaria. We suggest that more effective prioritization of women's and children's health in African Union policies would be supported by widening the range of policy frames used (notably health and economic) and strengthening the evidence base of all policy frames used. In addition, we suggest it would be beneficial if the partner groups advocating for women's and children's health were multi-stakeholder, and included, for instance, health care professionals, regional institutions, parliamentarians, the media, academia, NGOs, development partners and the public and private sectors.

  6. Willingness to Participate in HIV Vaccine Trials among Men Who Have Sex with Men in Chennai and Mumbai, India: A Social Ecological Approach

    Science.gov (United States)

    Chakrapani, Venkatesan; Newman, Peter A.; Singhal, Neeti; Jerajani, Jhalak; Shunmugam, Murali

    2012-01-01

    Background Recruitment of low- and middle-income country volunteers from most-at-risk populations in HIV vaccine trials is essential to vaccine development. In India, men who have sex with men (MSM) are at disproportionately high risk for HIV infection and an important population for trial recruitment. Investigations of willingness to participate (WTP) in HIV vaccine trials have focused predominantly on individual-level determinants. We explored multi-level factors associated with WTP among MSM in India. Methods We conducted 12 focus groups (n = 68) with low socioeconomic MSM in Chennai and Mumbai, and 14 key informant interviews with MSM community leaders and service providers. Focus groups/interviews were recorded, transcribed and translated into English. Two bilingual investigators conducted thematic analysis using line-by-line coding and a constant comparative method, with member-checking by community representatives. Results Factors associated with WTP were evidenced across the social ecology of MSM–social-structural: poverty, HIV-, sexual- and gender non-conformity stigma, institutionalized discrimination and government sponsorship of trials; community-level: endorsement by MSM community leaders and organizations, and fear of within-group discrimination; interpersonal: anticipated family discord, partner rejection, having financially-dependent family members and disclosure of same-sex sexuality; and individual-level: HIV vaccine trial knowledge and misconceptions, safety concerns, altruism and preventive misconception. Conclusion Pervasive familial, community and social-structural factors characteristic of the Indian sociocultural context may complicate individual-focused approaches to WTP and thereby constrain the effectiveness of interventions to support recruitment and retention in HIV vaccine trials. Interventions to reduce stigma and discrimination against MSM and people living with HIV, capacity-building of MSM community organizations and

  7. Willingness to participate in HIV vaccine trials among men who have sex with men in Chennai and Mumbai, India: a social ecological approach.

    Directory of Open Access Journals (Sweden)

    Venkatesan Chakrapani

    Full Text Available Recruitment of low- and middle-income country volunteers from most-at-risk populations in HIV vaccine trials is essential to vaccine development. In India, men who have sex with men (MSM are at disproportionately high risk for HIV infection and an important population for trial recruitment. Investigations of willingness to participate (WTP in HIV vaccine trials have focused predominantly on individual-level determinants. We explored multi-level factors associated with WTP among MSM in India.We conducted 12 focus groups (n = 68 with low socioeconomic MSM in Chennai and Mumbai, and 14 key informant interviews with MSM community leaders and service providers. Focus groups/interviews were recorded, transcribed and translated into English. Two bilingual investigators conducted thematic analysis using line-by-line coding and a constant comparative method, with member-checking by community representatives.Factors associated with WTP were evidenced across the social ecology of MSM-social-structural: poverty, HIV-, sexual- and gender non-conformity stigma, institutionalized discrimination and government sponsorship of trials; community-level: endorsement by MSM community leaders and organizations, and fear of within-group discrimination; interpersonal: anticipated family discord, partner rejection, having financially-dependent family members and disclosure of same-sex sexuality; and individual-level: HIV vaccine trial knowledge and misconceptions, safety concerns, altruism and preventive misconception.Pervasive familial, community and social-structural factors characteristic of the Indian sociocultural context may complicate individual-focused approaches to WTP and thereby constrain the effectiveness of interventions to support recruitment and retention in HIV vaccine trials. Interventions to reduce stigma and discrimination against MSM and people living with HIV, capacity-building of MSM community organizations and transparent communications tailored to

  8. Willingness to participate in HIV vaccine trials among men who have sex with men in Chennai and Mumbai, India: a social ecological approach.

    Science.gov (United States)

    Chakrapani, Venkatesan; Newman, Peter A; Singhal, Neeti; Jerajani, Jhalak; Shunmugam, Murali

    2012-01-01

    Recruitment of low- and middle-income country volunteers from most-at-risk populations in HIV vaccine trials is essential to vaccine development. In India, men who have sex with men (MSM) are at disproportionately high risk for HIV infection and an important population for trial recruitment. Investigations of willingness to participate (WTP) in HIV vaccine trials have focused predominantly on individual-level determinants. We explored multi-level factors associated with WTP among MSM in India. We conducted 12 focus groups (n = 68) with low socioeconomic MSM in Chennai and Mumbai, and 14 key informant interviews with MSM community leaders and service providers. Focus groups/interviews were recorded, transcribed and translated into English. Two bilingual investigators conducted thematic analysis using line-by-line coding and a constant comparative method, with member-checking by community representatives. Factors associated with WTP were evidenced across the social ecology of MSM-social-structural: poverty, HIV-, sexual- and gender non-conformity stigma, institutionalized discrimination and government sponsorship of trials; community-level: endorsement by MSM community leaders and organizations, and fear of within-group discrimination; interpersonal: anticipated family discord, partner rejection, having financially-dependent family members and disclosure of same-sex sexuality; and individual-level: HIV vaccine trial knowledge and misconceptions, safety concerns, altruism and preventive misconception. Pervasive familial, community and social-structural factors characteristic of the Indian sociocultural context may complicate individual-focused approaches to WTP and thereby constrain the effectiveness of interventions to support recruitment and retention in HIV vaccine trials. Interventions to reduce stigma and discrimination against MSM and people living with HIV, capacity-building of MSM community organizations and transparent communications tailored to the knowledge

  9. Skepticism, truth as coherence, and constructivist epistemology: grounds for resolving the discord between science and religion?

    Science.gov (United States)

    Staver, John R.

    2010-03-01

    Science and religion exhibit multiple relationships as ways of knowing. These connections have been characterized as cousinly, mutually respectful, non-overlapping, competitive, proximate-ultimate, dominant-subordinate, and opposing-conflicting. Some of these ties create stress, and tension between science and religion represents a significant chapter in humans' cultural heritage before and since the Enlightenment. Truth, knowledge, and their relation are central to science and religion as ways of knowing, as social institutions, and to their interaction. In religion, truth is revealed through God's word. In science, truth is sought after via empirical methods. Discord can be viewed as a competition for social legitimization between two social institutions whose goals are explaining the world and how it works. Under this view, the root of the discord is truth as correspondence. In this concept of truth, knowledge corresponds to the facts of reality, and conflict is inevitable for many because humans want to ask which one—science or religion—gets the facts correct. But, the root paradox, also known as the problem of the criterion, suggests that seeking to know nature as it is represents a fruitless endeavor. The discord can be set on new ground and resolved by taking a moderately skeptical line of thought, one which employs truth as coherence and a moderate form of constructivist epistemology. Quantum mechanics and evolution as scientific theories and scientific research on human consciousness and vision provide support for this line of argument. Within a constructivist perspective, scientists would relinquish only the pursuit of knowing reality as it is. Scientists would retain everything else. Believers who hold that religion explains reality would come to understand that God never revealed His truth of nature; rather, He revealed His truth in how we are to conduct our lives.

  10. Discordance in the diagnosis of diabetes: Comparison between HbA1c and fasting plasma glucose.

    Science.gov (United States)

    Ho-Pham, Lan T; Nguyen, Uyen D T; Tran, Truong X; Nguyen, Tuan V

    2017-01-01

    HbA1c has been introduced as a complementary diagnostic test for diabetes, but its impact on disease prevalence is unknown. This study evaluated the concordance between HbA1c and fasting plasma glucose (FPG) in the diagnosis of diabetes in the general population. The study was designed as a population based investigation, with participants being sampled from the Ho Chi Minh City, Vietnam. Blood samples were collected after overnight fasting and analyzed within 4 hours after collection. HbA1c was measured with high pressure liquid chromatography (Arkray Adams, Japan). FPG was measured by the hexokinase method (Advia Autoanalyzer; Bayer Diagnostics, Germany). Diabetes was defined as HbA1c ≥ 6.5% or FPG ≥ 7.0 mmol/L. Prediabetes was classified as HbA1c between 5.7% and 6.4%. The study included 3523 individuals (2356 women) aged 30 years and above. Based on the HbA1c test, the prevalence of diabetes and prediabetes was 9.7% (95%CI, 8.7-10.7%; n = 342) and 34.6% (33.0-36.2; n = 1219), respectively. Based on the FPG test, the prevalence of diabetes and prediabetes was 6.3% (95%CI, 5.5-7.2%; n = 223) and 12.1% (11.1-13.2; n = 427). Among the 427 individuals identified by FPG as "pre-diabetes", 28.6% were classified as diabetes by HbA1c test. The weighted kappa statistic of concordance between HbA1c and FPG was 0.55, with most of the discordance being in the prediabetes group. These data indicate that there is a significant discordance in the diagnosis of diabetes between FPG and HbA1c measurements, and the discordance could have significant impact on clinical practice. FPG appears to underestimate the burden of undiagnosed diabetes.

  11. Currency Unions, Trade Flows, and Capital Flows

    OpenAIRE

    James Yetman

    2003-01-01

    Trade within currency unions has been shown to be much larger than outside of currency unions, even after factoring in many relevant variables. The existing empirical evidence is based on reduced form models of trade, and therefore indicates that there exists a high correlation between currency union membership and trade, but does not indicate the causality, or the mechanism at work. This paper argues that the balance of evidence points to a large and statistically significant causal relation...

  12. Portfolio Optimization for Multiple Group Credit Unions

    National Research Council Canada - National Science Library

    Willis, John

    1999-01-01

    ...) to diversify, credit unions now have the opportunity to market their services to specific employee groups or industries which can reduce the overall risk to the credit unions' health or solvency...

  13. Sex Work, Heroin Injection, and HIV Risk in Tijuana: A Love Story.

    Science.gov (United States)

    Syvertsen, Jennifer L; Bazzi, Angela Robertson

    2015-01-01

    The relationships between female sex workers and their non-commercial male partners are typically viewed as sites of HIV risk rather than meaningful unions. This ethnographic case study presents a nuanced portrayal of the relationship between Cindy and Beto, a female sex worker who injects drugs and her intimate, non-commercial partner who live in Tijuana, Mexico. Based on ethnographic research in Tijuana and our long term involvement in a public health study, we suggest that emotions play a central role in sex workers' relationships and contribute in complex ways to each partner's health. We conceptualize Cindy and Beto's relationship as a "dangerous safe haven" in which HIV risk behaviors such as unprotected sex and syringe sharing convey notions of love and trust and help sustain emotional unity amidst broader uncertainties, but nevertheless carry very real health risks. Further attention to how emotions shape vulnerable couples' health remains a task for anthropology.

  14. New Roles for the Trade Unions

    DEFF Research Database (Denmark)

    Hull Kristensen, Peer; Sø Rocha, Robson

    2012-01-01

    This article builds on lessons from Denmark and the Nordic area to offer a novel and comprehensive logic of action within the emerging political economy that may be used to assess the possible new roles that unions can take on. The authors argue that unions are capable of “civilizing” globalizati...

  15. 76 FR 79531 - Corporate Credit Unions

    Science.gov (United States)

    2011-12-22

    ... exclude CLF stock subscriptions, based on the asset's negligible credit risk and to facilitate corporate... removing paragraphs (c)(3) and (f)(4) and adding paragraph (h) to read as follows: Sec. 704.6 Credit risk... NATIONAL CREDIT UNION ADMINISTRATION 12 CFR Part 704 RIN 3133-AD95 Corporate Credit Unions AGENCY...

  16. Molecular investigation of HIV-1 cross-group transmissions during an outbreak among people who inject drugs (2011-2014) in Athens, Greece.

    Science.gov (United States)

    Paraskevis, Dimitrios; Νikolopoulos, Georgios K; Sypsa, Vana; Psichogiou, Mina; Pantavou, Katerina; Kostaki, Evangelia; Karamitros, Timokratis; Paraskeva, Dimitra; Schneider, John; Malliori, Melpomeni; Friedman, Samuel R; Des Jarlais, Don C; Daikos, Georgios L; Hatzakis, Angelos

    2018-04-10

    New diagnoses of HIV-1 infection among people who inject drugs (PWID) rocketed in Athens, Greece between 2011 and 2014 (HIV-1 outbreak). Our aim was to identify, during that period, potential cross-group transmissions between the within-Greece PWID and other risk or national groups using molecular methods. Sequences from 33 PWID were outside the PWID-outbreak networks in Greece (PWID-imported transmissions). Phylogenetic analyses on 28 of these sequences (subtypes A and B) showed that 11 subtype B infections originated from Greece, whereas 8 and 7 subtype A strains were from former Soviet Union countries (A FSU ) and Greece, respectively. The putative source in half of the PWID-imported transmissions with Greek origin was an individual who acquired HIV via sexual contact. During four years of an HIV-1 outbreak among PWID in Athens, Greece, 33 individuals in this group (4.6% of all diagnoses with phylogenetic analyses) are likely to represent infections, sexually or injection-acquired, outside the within-Greece-PWID-outbreak networks. Combined molecular and traditional HIV surveillance to monitor introductions of new strains, and interventions that aim at reducing the rate of both injection and sexual risky practices are needed during drug injection-related HIV outbreaks. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Job insecurity, union support and the intention to resign membership. A psychological contract perspective tested among union members in four European countries

    NARCIS (Netherlands)

    De Witte, Hans; Sverke, Magnus; Van Ruysseveldt, Joris; Goslinga, Sjoerd; Chirumbolo, Antonio; Hellgren, Johnny; Näswall, Katharina

    2010-01-01

    This paper explores the consequences of job insecurity among union members. Starting from the dominance of the instrumental motive for union membership, and using psychological contract theory, we hypothesize that the perception of job insecurity will correlate with a lower level of perceived union

  18. The Euratom supply agency. A small ENERGY UNION?

    Energy Technology Data Exchange (ETDEWEB)

    Blohm-Hieber, Ute [European Commission, Luxembourg (Luxembourg). Unit - Nuclear Fuel Market Operations

    2015-11-15

    In the 1950s, when the European Communities were founded the ECSC (Treaty establishing the European Coal and Steel Community), concluded for 50 years and the EURATOM Treaty (Treaty establishing the European Atomic Energy Community), with unlimited validity, were signed. On the present political agenda of the European Union, energy supply security has a high priority. The Juncker Commission therefore focusses on the concept of an Energy Union. The Euratom Treaty provides one successful example of a ''small sectorial Energy Union'' and may serve as stimulation for reflections for the Energy Union in other sectors.

  19. The principle of empowerment in the European Union

    Directory of Open Access Journals (Sweden)

    Ioana Nelly MILITARU

    2011-12-01

    Full Text Available Delimitation of competences in the EU is governed by the principle of conferral. Based on the content of these provisions work in the first three parts of it, defining and classifying skills appropriate attribution Treaties underlying the European Union (Treaty on European Union and the Treaty on the Functioning of the European Union and the Court of Justice. The next three parts of the paper detailing each classification in hand, highlighting, clear delineation of the Union competences of the Member States carried out by the Lisbon Treaty and the amendments made by this treaty.

  20. Geometric quantum discord and Berry phase between two charge qubits coupled by a quantum transmission line

    International Nuclear Information System (INIS)

    Zhu Han-Jie; Zhang Guo-Feng

    2014-01-01

    Geometric quantum discord (GQD) and Berry phase between two charge qubits coupled by a quantum transmission line are investigated. We show how GQDs evolve and investigate their dependencies on the parameters of the system. We also calculate the energy and the Berry phase and compare them with GQD, finding that there are close connections between them. (general)

  1. Dynamics of quantum discord in a quantum critical environment

    International Nuclear Information System (INIS)

    Xi Zhengjun; Li Yongming; Lu Xiaoming; Sun Zhe

    2011-01-01

    We study the dynamics of quantum discord (QD) of two qubits independently coupled to an Ising spin chain in a transverse field, which exhibits a quantum phase transition. For this model, we drive the corresponding Kraus operators, obtain the analytic results of QD and compare the dynamics of QD with the dynamics of relative entropy of entanglement nearby the critical point. It is shown that the impact of the quantum criticality environment on QD can be concentrated in a very narrow region nearby the critical point, so it supplies an efficient way to detect the critical points. In the vicinity of the critical point, the evolution of QD is shown to be more complicated than that of entanglement. Furthermore, we find that separable states can also be used to reflect the quantum criticality of the environment.

  2. Ipsilateral Femoral Fracture Non-Union and Delayed Union Treated By Hybrid Plate Nail Fixation and Vascularized Fibula Bone Grafting: A Case Report

    Directory of Open Access Journals (Sweden)

    CK Chan

    2013-07-01

    Full Text Available Non-union is a well recognized complication of femoral neck fractures. The decision whether to attempt fracture fixation or to resort to hip replacement is particularly difficult in patients in the borderline age group in whom complex attempts at gaining union may fail and later present a difficult revision. On the other hand the patient may be young enough that arthroplasty best be avoided . Besides, presence of ipsilateral femoral shaft fracture with delayed union in addition to the femoral neck non-union will pose major problems at operation. We share our experience in treating a femoral neck fracture non-union with ipsilateral femoral shaft delayed union in the shaft and in the distal femur in a fifty years old patient. The fracture was treated with an angle blade plate and supracondylar nail supplemented with a free vascularised fibular bone grafting and autologous cancellous graft. There was radiological union at fourth month. At sixth months, the patient was free of pain and able to walk without support. Thus, we would like to suggest that vascularised fibula bone grafting with supracondylar nailing is a viable option for this pattern of fracture.

  3. Hormonal Contraception, Pregnancy, Breastfeeding, and Risk of HIV Disease Progression Among Zambian Women.

    Science.gov (United States)

    Wall, Kristin M; Kilembe, William; Haddad, Lisa; Vwalika, Bellington; Lakhi, Shabir; Khu, Naw Htee; Brill, Ilene; Chomba, Elwyn; Mulenga, Joseph; Tichacek, Amanda; Allen, Susan

    2016-03-01

    Some studies suggest that hormonal contraception, pregnancy, and/or breastfeeding may influence rates of HIV disease progression. From 1994 to 2012, HIV discordant couples recruited at couples' voluntary HIV counseling and testing centers in Lusaka were followed 3-monthly. Multivariate survival analyses explored associations between time-varying contraception, pregnancy, and breastfeeding and 2 outcomes among HIV-positive women: (1) time to death and (2) time to antiretroviral treatment (ART) initiation. Among 1656 female seropositive, male seronegative couples followed for 3359 person-years (PY), 224 women died [6.7/100 PY; 95% confidence interval (CI): 5.8 to 7.6]. After 2003, 290 women initiated ART (14.5/100 PY; 95% CI: 12.9 to 16.2). In a multivariate model of time to death, hormonal implant [adjusted hazard ratio (aHR) = 0.30; 95% CI: 0.10 to 0.98] and injectable (aHR = 0.59; 95% CI: 0.36 to 0.97) were significantly protective relative to nonhormonal method use, whereas oral contraceptive pill (OCP) use was not (aHR = 1.08; 95% CI: 0.74 to 1.57) controlling for baseline HIV disease stage, time-varying pregnancy, time-varying breastfeeding, and year of enrollment. In a multivariate model of time-to-ART initiation, implant was significantly protective (aHR = 0.54; 95% CI: 0.31 to 0.95), whereas OCP (aHR = 0.70; 95% CI: 0.44 to 1.10) and injectable (aHR = 0.85; 95% CI: 0.55 to 1.32) were not relative to nonhormonal method use controlling for variables above, woman's age, and literacy. Pregnancy was not significantly associated with death (aHR = 1.07; 95% CI: 0.68 to 1.66) or ART initiation (aHR = 1.24; 95% CI: 0.83 to 1.86), whereas breastfeeding was protective for death (aHR = 0.34; 95% CI: 0.19 to 0.62) and ART initiation (aHR = 0.49; 95% CI: 0.29 to 0.85). Hormonal implants and injectables significantly predicted lower mortality; implants were protective for ART initiation. OCPs and pregnancy were not associated with death or ART initiation, whereas

  4. Union Contracts and Teacher Professional Development

    Directory of Open Access Journals (Sweden)

    Paul V. Bredeson

    2001-07-01

    Full Text Available In this article, I report the results of an investigation that examined the impact of teacher union contracts on the development of professional learning communities in schools. There are three primary sources of data used in the study: 1 100 written teacher union contract documents; 2 structured interview data from 21 educators (school superintendents, principals, directors of staff development, and teacher union representatives; and 3 focus group interview data from educational leaders in schools. The analysis and discussion focus on five areas related to teacher professional development with implications for policy and practice: explicit language covering opportunities for teaching learning in their work; governance and decision making structures, that is, specific provisions covering wages, hours, and conditions of employment; the description of legitimate and sponsored activities for the professional development of teachers; and the resources supporting the on-going professional growth of teachers. The findings indicate that rethinking, restructuring, and organizational re-culturing in schools are initial expressions of a new unionism that has the potential to lead to the development of more powerful professional learning communities in schools.

  5. Health, trust, or "just understood": explicit and implicit condom decision-making processes among black, white, and interracial same-sex male couples.

    Science.gov (United States)

    Campbell, Chadwick K; Gómez, Anu Manchikanti; Dworkin, Shari; Wilson, Patrick A; Grisham, Kirk K; McReynolds, Jaih; Vielehr, Peter; Hoff, Colleen

    2014-05-01

    Among gay and bisexual men, primary partners are a leading source of HIV infection. Trust, intimacy, and advancements in HIV treatment may impact same-sex male (SSM) couples' decisions to engage in unprotected anal intercourse (UAI). This qualitative study explored how Black, White and interracial couples discussed, and made decisions regarding condoms. Qualitative interviews were conducted with 48 SSM couples in the New York and San Francisco metropolitan areas. Stratified purposive sampling was used to include Black (n = 16), White (n = 17), and interracial (Black-White) (n = 15) couples. Twenty-six couples were concordant HIV-negative and 22 were HIV-discordant. Interviews were recorded, transcribed, coded, and analyzed using a grounded theory approach. Some couples described explicit processes, which involved active discussion, while others described implicit processes, where condom-use decisions occurred without any explicit discussion. These processes also differed by race and HIV status. Black couples tended to report condom-use as "just understood." White, HIV-discordant couples decided not to use condoms, with some identifying the HIV-positive partner's suppressed viral load and high CD4 count as deciding factors. After an unplanned episode of UAI, White, HIV-negative couples tended to discontinue condom use while Black HIV-negative couples decided to revert to using condoms. HIV prevention efforts focused on same-sex, male couples must consider the explicit/implicit nature of condom decision-making processes. Understanding differences in these processes and considering relationship dynamics, across race and HIV status, can promote the development of innovative couple-level, HIV prevention interventions.

  6. Health, Trust, or “Just Understood”: Explicit and Implicit Condom Decision-Making Processes Among Black, White, and Interracial Same-Sex Male Couples

    Science.gov (United States)

    Campbell, Chadwick K.; Gómez, Anu Manchikanti; Dworkin, Shari; Wilson, Patrick A.; Grisham, Kirk; McReynolds, Jaih; Vielehr, Peter; Hoff, Colleen

    2013-01-01

    Among gay and bisexual men, primary partners are a leading source of HIV infection. Trust, intimacy, and advancements in HIV treatment may impact same-sex male couples’ decisions to engage in unprotected anal intercourse (UAI). This qualitative study explored how Black, White and interracial couples discussed, and made decisions regarding condoms. Qualitative interviews were conducted with 48 same-sex male couples in the New York and San Francisco metropolitan areas. Stratified purposive sampling was used to include Black (n = 16), White (n = 17), and interracial (Black-White) (n = 15) couples. Twenty-six couples were concordant HIV-negative and 22 were HIV-discordant. Interviews were recorded, transcribed, coded, and analyzed using a grounded theory approach. Some couples described explicit processes, which involved active discussion, while others described implicit processes, where condom-use decisions occurred without any explicit discussion. These processes also differed by race and HIV status. Black couples tended to report condom-use as “just understood.” White, HIV-discordant couples decided not to use condoms, with some identifying the HIV-positive partner’s suppressed viral load and high CD4 count as deciding factors. After an unplanned episode of UAI, White, HIV-negative couples tended to discontinue condom use while Black HIV-negative couples decided to revert to using condoms. HIV prevention efforts focused on same-sex, male couples must consider the explicit/implicit nature of condom decision-making processes. Understanding differences in these processes and considering relationship dynamics, across race and HIV status, can promote the development of innovative couple–level, HIV prevention interventions. PMID:23912774

  7. Citizenship of the European Union under the Treaty of Lisbon

    Directory of Open Access Journals (Sweden)

    Ioana Nely MILITARU

    2011-06-01

    Full Text Available The paper is structured in two parts. The first part covers history, "Union citizenship, according to previous Treaties Lisbon Treaty, and the second refers to the privileges which they have as citizens of the Union Treaty as a result of reforming the European Union, referring to documents on which this Treaty adhere it recognizes as having the same legal force, treaties, (Treaty on European Union and the Treaty on the Functioning of the European Union.

  8. Discordance of Self-report and Laboratory Measures of HIV Viral Load Among Young Men Who Have Sex with Men and Transgender Women in Chicago: Implications for Epidemiology, Care, and Prevention.

    Science.gov (United States)

    Mustanski, Brian; Ryan, Daniel T; Remble, Thomas A; D'Aquila, Richard T; Newcomb, Michael E; Morgan, Ethan

    2018-04-10

    Suppressing HIV viral load through daily antiretroviral therapy (ART) substantially reduces the risk of HIV transmission, however, the potential population impact of treatment as prevention (TasP) is mitigated due to challenges with sustained care engagement and ART adherence. For an undetectable viral load (VL) to inform decision making about transmission risk, individuals must be able to accurately classify their VL as detectable or undetectable. Participants were 205 HIV-infected young men who have sex with men (YMSM) and transgender women (TGW) from a large cohort study in the Chicago area. Analyses examined correspondence among self-reported undetectable VL, study-specific VL, and most recent medical record VL. Among HIV-positive YMSM/TGW, 54% had an undetectable VL (suppression between medical visits may represent a particular risk for the TasP strategy among YMSM/TGW. Strategies for frequent viral load monitoring, that are not burdensome to patients, may be necessary to optimize TasP.

  9. Factors predicting discordant virological and immunological responses to antiretroviral therapy in HIV-1 clade C infected Zulu/Xhosa in South Africa.

    Directory of Open Access Journals (Sweden)

    Boris Julg

    Full Text Available Factors predicting suboptimal CD4 cell recovery have been studied in HIV clade-B infected US and European populations. It is, however, uncertain to what extent these results are applicable to HIV clade-C infected African populations. Multivariate analysis using logistic regression and longitudinal analyses using mixed models were employed to assess the impact of age, gender, baseline CD4 cell count, hemoglobin, body mass index (BMI, tuberculosis and other opportunistic co-infections, and frequencies of regimen change on CD4 cell recovery at 12 and 30 months and on overtime change in CD4 cells among 442 virologically suppressed South Africans. Despite adequate virological response 37% (95% CI:32%-42% and 83% (95% CI:79%-86% of patients on antiretroviral therapy failed to restore CD4 cell counts ≥ 200 cells/mm(3 after 12 and ≥ 500 cells/mm(3 after 30 months, respectively, in this South African cohort. Critical risk factors for inadequate recovery were older age (p = 0.001 and nadir CD4 cell count at ART initiation (p<0.0001, while concurrent TB co-infection, BMI, baseline hemoglobin, gender and antiretroviral regimen were not significant risk factors. These data suggest that greater efforts are needed to identify and treat HAART-eligible patients prior to severe CD4 cell decline or achievement of advanced age.

  10. Factors predicting discordant virological and immunological responses to antiretroviral therapy in HIV-1 clade C infected Zulu/Xhosa in South Africa.

    Science.gov (United States)

    Julg, Boris; Poole, Danielle; Ghebremichael, Musie; Castilla, Carmen; Altfeld, Marcus; Sunpath, Henry; Murphy, Richard A; Walker, Bruce D

    2012-01-01

    Factors predicting suboptimal CD4 cell recovery have been studied in HIV clade-B infected US and European populations. It is, however, uncertain to what extent these results are applicable to HIV clade-C infected African populations. Multivariate analysis using logistic regression and longitudinal analyses using mixed models were employed to assess the impact of age, gender, baseline CD4 cell count, hemoglobin, body mass index (BMI), tuberculosis and other opportunistic co-infections, and frequencies of regimen change on CD4 cell recovery at 12 and 30 months and on overtime change in CD4 cells among 442 virologically suppressed South Africans. Despite adequate virological response 37% (95% CI:32%-42%) and 83% (95% CI:79%-86%) of patients on antiretroviral therapy failed to restore CD4 cell counts ≥ 200 cells/mm(3) after 12 and ≥ 500 cells/mm(3) after 30 months, respectively, in this South African cohort. Critical risk factors for inadequate recovery were older age (p = 0.001) and nadir CD4 cell count at ART initiation (p<0.0001), while concurrent TB co-infection, BMI, baseline hemoglobin, gender and antiretroviral regimen were not significant risk factors. These data suggest that greater efforts are needed to identify and treat HAART-eligible patients prior to severe CD4 cell decline or achievement of advanced age.

  11. LIMITING ORGANISATIONAL RIGHTS OF MINORITY UNIONS ...

    African Journals Online (AJOL)

    Administrator

    1996-02-19

    Feb 19, 1996 ... market in recent times can be attributed, in part, to inter-union rivalry.1 Minority unions ... March 2013 – resulting in a negative impact on South Africa's GDP and currency depreciation. In. 2013, the .... Organisational rights are regulated by Part A and B of Chapter 111 of the LRA, and the right to strike is ...

  12. Bovine cysticercosis in the European Union

    DEFF Research Database (Denmark)

    Blagojevic, Bojan; Robertson, Lucy J.; Vieira-Pinto, Madalena

    2017-01-01

    -only inspection of slaughtered cattle in order to reduce the potential for cross-contamination with bacteria that are of greatest public health risk, is expected in the European Union in the near future. With this system, the detection sensitivity for bovine cysticercosis that is already low with the current meat...... of bovine cysticercosis in the European Union....

  13. Genome-wide placental DNA methylation analysis of severely growth-discordant monochorionic twins reveals novel epigenetic targets for intrauterine growth restriction.

    Science.gov (United States)

    Roifman, Maian; Choufani, Sanaa; Turinsky, Andrei L; Drewlo, Sascha; Keating, Sarah; Brudno, Michael; Kingdom, John; Weksberg, Rosanna

    2016-01-01

    Intrauterine growth restriction (IUGR), which refers to reduced fetal growth in the context of placental insufficiency, is etiologically heterogeneous. IUGR is associated not only with perinatal morbidity and mortality but also with adult-onset disorders, such as cardiovascular disease and diabetes, posing a major health burden. Placental epigenetic dysregulation has been proposed as one mechanism that causes IUGR; however, the spectrum of epigenetic pathophysiological mechanisms leading to IUGR remains to be elucidated. Monozygotic monochorionic twins are particularly affected by IUGR, in the setting of severe discordant growth. Because monozygotic twins have the same genotype at conception and a shared maternal environment, they provide an ideal model system for studying epigenetic dysregulation of the placenta. We compared genome-wide placental DNA methylation patterns of severely growth-discordant twins to identify novel candidate genes for IUGR. Snap-frozen placental samples for eight severely growth-discordant monozygotic monochorionic twin pairs were obtained at delivery from each twin. A high-resolution DNA methylation array platform was used to identify methylation differences between IUGR and normal twins. Our analysis revealed differentially methylated regions in the promoters of eight genes: DECR1, ZNF300, DNAJA4, CCL28, LEPR, HSPA1A/L, GSTO1, and GNE. The largest methylation differences between the two groups were in the promoters of DECR1 and ZNF300. The significance of these group differences was independently validated by bisulfite pyrosequencing, implicating aberrations in fatty acid beta oxidation and transcriptional regulation, respectively. Further analysis of the array data identified methylation changes most prominently affecting the Wnt and cadherin pathways in the IUGR cohort. Our results suggest that IUGR in monozygotic twins is associated with impairments in lipid metabolism and transcriptional regulation as well as cadherin and Wnt

  14. Discordance Between Appropriate Use Criteria for Nuclear Myocardial Perfusion Imaging From Different Specialty Societies: A Potential Concern for Health Policy.

    Science.gov (United States)

    Winchester, David E; Wolinsky, David; Beyth, Rebecca J; Shaw, Leslee J

    2016-05-01

    Appropriate use criteria (AUC) assist health care professionals in making decisions about procedures and diagnostic testing. In some cases, multiple AUC exist for a single procedure or test. To date, the extent of agreement between multiple AUC has not been evaluated. To measure discordance between the American College of Cardiology Foundation (ACCF) AUC and the American College of Radiology (ACR) Appropriateness Criteria for gauging the appropriateness of nuclear myocardial perfusion imaging. Retrospective cohort study at an academically affiliated Veterans Affairs medical center. Participants were Veteran patients who underwent nuclear myocardial perfusion imaging between December 2010 and July 2011 with rating of appropriateness by the ACCF and ACR criteria. Analysis was performed in March 2015. The primary outcome was the agreement of appropriateness category as measured by κ statistic. The secondary outcome was a comparison of nuclear myocardial perfusion imaging results and frequency of ischemia across appropriateness categories for the 2 rating methods. Of 67 indications in the ACCF AUC, 35 (52.2%) could not be matched to an ACR rating, 18 (26.9%) had the same appropriateness category, and 14 (20.9%) disagreed on appropriateness. The study cohort comprised 592 individuals. Their mean (SD) age was 62.6 (9.4) years, and 570 of 592 (96.2%) were male. When applied to the patient cohort, 111 patients (18.8%) could not be matched to an ACR rating, 349 patients (59.0%) had the same appropriateness category for the ACR and ACCF methods, and 132 patients (22.3%) were discordant. Overall, the agreement of appropriateness between the 2 methods was poor (κ = 0.34, P < .001). Ischemia was rare among patients rated as "inappropriate" by the ACCF AUC (1 of 39 patients [2.6%]), while ischemia was more common among patients rated as "usually not appropriate" by the ACR Appropriateness Criteria (14 of 80 patients [17.5%]). Substantial discordance may exist between

  15. The European Union in International Financial Governance

    Directory of Open Access Journals (Sweden)

    Niamh Moloney

    2017-01-01

    Full Text Available This article considers the role of the European Union in international financial governance after the institutional reforms it undertook in connection with the global financial crisis. It suggests that the new administrative actors that support the governance of the European Union's single financial market, notably the European Supervisory Authorities, have the potential to reshape how the European Union engages with international financial governance. It finds that the European Union’s effectiveness in influencing international financial governance—and the effectiveness of international financial governance more generally—is likely to strengthen as a result.

  16. Union members at the polls in diverse trade union landscapes

    DEFF Research Database (Denmark)

    Arndt, Christoph; Rennwald, Line

    2016-01-01

    still enjoy important support from trade union members, but at the same time are under fierce competition from bourgeois and green parties among members of white-collar confederations. This reinforces the challenges for social democracy to build new voters’ coalitions in post-industrial societies....

  17. An economic evaluation of conception strategies for heterosexual serodiscordant couples where the male partner is HIV-positive.

    Science.gov (United States)

    Letchumanan, Michelle; Coyte, Peter C; Loutfy, Mona

    2015-01-01

    To conduct an economic evaluation of the three commonly used interventions that reduce sexual HIV transmission when an HIV-negative female aims to conceive with an HIV-positive male on combination antiretroviral therapy (condomless sex restricted to timed ovulation [CS], sperm washing with intrauterine insemination [SW] and condomless sex restricted to timed ovulation with pre-exposure prophylaxis [CS-PrEP]). As SW and CS-PrEP are only privately available for pregnancy planning for this population in Canada, this study was conducted to inform policy decisions concerning potential public health insurance coverage, as well as to inform fertility counselling in settings with adequate combination antiretroviral therapy access globally. We developed a cohort Markov model with a lifetime horizon and used the perspective of Ontario's Ministry of Health (MOH). Input parameters were drawn from literature, the MOH's Schedule of Benefits and a time trade-off questionnaire designed for this study. Outcome measures included quality-adjusted life-years and incremental cost-effectiveness. Costs and benefits were discounted at annual rates of 3%. Costs were reported in Canadian 2013 dollars and an exchange rate of 1 USD to 1.066 CND was applied where necessary. Sensitivity analysis assessed the uncertainty of model parameters. The base case analysis found that CS-PrEP and SW were each more costly and less effective at conception than CS. The results were robust in the sensitivity analysis and suggest that CS is the dominant conception strategy in this population. Neither CS-PrEP nor SW represent better value for money relative to CS as a conception option for HIV-discordant couples with positive male partners. Based on these findings, CS-PrEP and SW cannot be recommended for public-funding in developed countries.

  18. Breast lesions with imaging-histologic discordance during US-guided 14G automated core biopsy: can the directional vacuum-assisted removal replace the surgical excision? Initial findings

    International Nuclear Information System (INIS)

    Kim, Min Jung; Kim, Eun-Kyung; Lee, Ji Young; Youk, Ji Hyun; Oh, Ki Keun; Park, Byeong-Woo; Kim, Seung-Il; Kim, Haeryoung

    2007-01-01

    The purpose of this study was to determine the frequency of carcinoma at percutaneous directional vacuum-assisted removal (DVAR) in women with imaging-histologic discordance during ultrasound (US)-guided automated core needle biopsy, and to determine the role of DVAR in breast lesions with imaging-histologic discordance. A US-guided 14-gauge automated core needle biopsy was performed on 837 consecutive lesions. Imaging-histologic discordance was prospectively considered in 33 of 634 benign biopsies. DVAR was recommended in those lesions. Among the 33 lesions, 26 lesions that underwent subsequent DVAR or surgical excision made up our study population. Medical records, imaging studies, and histologic findings were reviewed. Among the 26 lesions, 18 lesions underwent subsequent US-guided DVAR, with 8-gauge probes for 15 of the lesions, and 11-gauge for three of the lesions. Two lesions were diagnosed as having carcinoma (2/18, 11.1% of upgrade rate; 3.1-32.8% CI). The remaining eight lesions underwent subsequent surgical excision, and carcinoma was diagnosed in one case (12.5% of upgrade rate; 2.2-47.1% CI). A US-guided DVAR of the breast mass with imaging-histologic discordance during US-guided 14-gauge automated core needle biopsy is a valuable alternative to surgery as a means of obtaining a definitive histological diagnosis. (orig.)

  19. THE INTERFERENCE OF EUROPEAN UNION LAW WITH PUBLIC INTERNATIONAL LAW

    Directory of Open Access Journals (Sweden)

    ROXANA-MARIANA POPESCU

    2011-04-01

    Full Text Available The European Union Law is an unique legal phenomenon developed in the process of European integration within the framework of the European Communities and the European Union; a result of the implementation of the supranational authority of the European institutions. The European Union law is a specific legal system having independent sources and principles that developed at the border-line of international law and domestic law of the EU’s Member States. The authonomy of the European Union law is affirmed by a case-law of the Court of Justice of the European Union.The European Union has its own legal order which is separate from international law and forms an integral part of the legal systems of the Member States. The legal order of the Union is founded on various different sources of law. The different nature of these sources has imposed a hierarchy among them. At the pinnacle of this hierarchy we find primary law, represented by the Treaties and general legal principles, followed by international treaties concluded by the Union and secondary law founded on the Treaties.

  20. Brexit and the European Union

    DEFF Research Database (Denmark)

    Jensen, Mads Dagnis; Snaith, Holly

    2018-01-01

    When on 23 June 2016 a majority voted in favour of the United Kingdom (UK) leaving the European Union (EU), it generated a host of unknowns. Prior to the referendum, scholars had already started to anticipate the implications of a potential Brexit from different perspectives, including considering...... lie and suggesting where Britain’s exit will leave the greatest strategic vacuums. The subsequent analysis centres on the actors that will likely win and lose from the UK’s exit from the Union....

  1. Coordination in the European Union

    OpenAIRE

    Martin Feldstein

    2013-01-01

    This paper examines the sources of current conflict within the EU and the EMU. The topics discussed include the recent ECB policy of bond buying (the OMT policy), the attempts to advance the "European Project" of stronger political union (the fiscal compact, the banking union, and the proposals for budget supervision). Contrary to the claims of the European leadership, the progress that has been made has been by individual countries and not by coordinated action. The special problems of Franc...

  2. The Incidence Patterns Model to Estimate the Distribution of New HIV Infections in Sub-Saharan Africa: Development and Validation of a Mathematical Model.

    Directory of Open Access Journals (Sweden)

    Annick Bórquez

    2016-09-01

    Full Text Available Programmatic planning in HIV requires estimates of the distribution of new HIV infections according to identifiable characteristics of individuals. In sub-Saharan Africa, robust routine data sources and historical epidemiological observations are available to inform and validate such estimates.We developed a predictive model, the Incidence Patterns Model (IPM, representing populations according to factors that have been demonstrated to be strongly associated with HIV acquisition risk: gender, marital/sexual activity status, geographic location, "key populations" based on risk behaviours (sex work, injecting drug use, and male-to-male sex, HIV and ART status within married or cohabiting unions, and circumcision status. The IPM estimates the distribution of new infections acquired by group based on these factors within a Bayesian framework accounting for regional prior information on demographic and epidemiological characteristics from trials or observational studies. We validated and trained the model against direct observations of HIV incidence by group in seven rounds of cohort data from four studies ("sites" conducted in Manicaland, Zimbabwe; Rakai, Uganda; Karonga, Malawi; and Kisesa, Tanzania. The IPM performed well, with the projections' credible intervals for the proportion of new infections per group overlapping the data's confidence intervals for all groups in all rounds of data. In terms of geographical distribution, the projections' credible intervals overlapped the confidence intervals for four out of seven rounds, which were used as proxies for administrative divisions in a country. We assessed model performance after internal training (within one site and external training (between sites by comparing mean posterior log-likelihoods and used the best model to estimate the distribution of HIV incidence in six countries (Gabon, Kenya, Malawi, Rwanda, Swaziland, and Zambia in the region. We subsequently inferred the potential

  3. The Incidence Patterns Model to Estimate the Distribution of New HIV Infections in Sub-Saharan Africa: Development and Validation of a Mathematical Model.

    Science.gov (United States)

    Bórquez, Annick; Cori, Anne; Pufall, Erica L; Kasule, Jingo; Slaymaker, Emma; Price, Alison; Elmes, Jocelyn; Zaba, Basia; Crampin, Amelia C; Kagaayi, Joseph; Lutalo, Tom; Urassa, Mark; Gregson, Simon; Hallett, Timothy B

    2016-09-01

    Programmatic planning in HIV requires estimates of the distribution of new HIV infections according to identifiable characteristics of individuals. In sub-Saharan Africa, robust routine data sources and historical epidemiological observations are available to inform and validate such estimates. We developed a predictive model, the Incidence Patterns Model (IPM), representing populations according to factors that have been demonstrated to be strongly associated with HIV acquisition risk: gender, marital/sexual activity status, geographic location, "key populations" based on risk behaviours (sex work, injecting drug use, and male-to-male sex), HIV and ART status within married or cohabiting unions, and circumcision status. The IPM estimates the distribution of new infections acquired by group based on these factors within a Bayesian framework accounting for regional prior information on demographic and epidemiological characteristics from trials or observational studies. We validated and trained the model against direct observations of HIV incidence by group in seven rounds of cohort data from four studies ("sites") conducted in Manicaland, Zimbabwe; Rakai, Uganda; Karonga, Malawi; and Kisesa, Tanzania. The IPM performed well, with the projections' credible intervals for the proportion of new infections per group overlapping the data's confidence intervals for all groups in all rounds of data. In terms of geographical distribution, the projections' credible intervals overlapped the confidence intervals for four out of seven rounds, which were used as proxies for administrative divisions in a country. We assessed model performance after internal training (within one site) and external training (between sites) by comparing mean posterior log-likelihoods and used the best model to estimate the distribution of HIV incidence in six countries (Gabon, Kenya, Malawi, Rwanda, Swaziland, and Zambia) in the region. We subsequently inferred the potential contribution of each

  4. Union innovation in Ontario's nuclear industry

    International Nuclear Information System (INIS)

    MacKinnon, D.

    2003-01-01

    Over the last decade the Power Worker's Union (PWU) has embarked on a number of innovative approaches that have provided significant benefit to the nuclear industry. These include advanced labour relations approaches, equity participation and groundbreaking skills training initiatives. This presentation outlines these and other initiatives in the context of the union's view of the nuclear generation industry's future. (author)

  5. Frequencies and implications of discordant findings of interictal SPECT and itcal SPECT in patients with intractable epilepsy

    International Nuclear Information System (INIS)

    Lee, D. S.; Lee, S. K.; Jeong, J. K.; Lee, M. C.; Ko, C. S.

    1997-01-01

    Interictal SPECT could be used at best as a reference image to ictal SPECT, and cause sometimes confusion if it had given unexplained discordant findings from ictal SPECT. We investigated implications of discordant findings which occurred in 26 among 268 which found their epileptogenic zones using ictal EEG and/or operative outcome. Sensitivity of interictal SPECT was only 36%. Among these 268, 69 patients had no structural lesions on MR, 14 of whom had decreased perfusion on interictal SPECT (8 trues and 6 falses (adjacent or contralateral)). Structural lesion were found in 199 on MR, 103 of whom had decreased perfusion (89 trues and 14 falses). Among 26 having discordant cases, 10 interictal SPECT were proved wrong after operation and/or invasive EEG and the other 16 were on speculation using PET and ictal EEG. Ictal hyperperfusion was observed in 14 patients in these interictal SPECT. Six ictal studies were found postictal accompanied by contralateral propagation or not. Two patients had dual pathology, and the remaining 2 unknown. Interictal SPECT was done on the 2nd day after ictal study(24), the 3rd day (18), the 4th day(16), the 5th day (23). Four among 24 interictal studies (17%) of the 2nd day and the other 4 among 57 of 3rd to 5th day revealed ictal hyperperfusion on interictal SPECT. Six interictal studies (2.7% among 221) acquired on the indifferent day showed also ictal hyperperfusion. We could suggest that the next day is not desirable for interictal SPECT after ictal study, as ictal hyperperfusion on interictal study confounded more than postictal findings of ictal SPECT in the discrete localization than reassuring ictal study

  6. Frequencies and implications of discordant findings of interictal SPECT and itcal SPECT in patients with intractable epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, D S; Lee, S K; Jeong, J K; Lee, M C; Ko, C S [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    1997-07-01

    Interictal SPECT could be used at best as a reference image to ictal SPECT, and cause sometimes confusion if it had given unexplained discordant findings from ictal SPECT. We investigated implications of discordant findings which occurred in 26 among 268 which found their epileptogenic zones using ictal EEG and/or operative outcome. Sensitivity of interictal SPECT was only 36%. Among these 268, 69 patients had no structural lesions on MR, 14 of whom had decreased perfusion on interictal SPECT (8 trues and 6 falses (adjacent or contralateral)). Structural lesion were found in 199 on MR, 103 of whom had decreased perfusion (89 trues and 14 falses). Among 26 having discordant cases, 10 interictal SPECT were proved wrong after operation and/or invasive EEG and the other 16 were on speculation using PET and ictal EEG. Ictal hyperperfusion was observed in 14 patients in these interictal SPECT. Six ictal studies were found postictal accompanied by contralateral propagation or not. Two patients had dual pathology, and the remaining 2 unknown. Interictal SPECT was done on the 2nd day after ictal study(24), the 3rd day (18), the 4th day(16), the 5th day (23). Four among 24 interictal studies (17%) of the 2nd day and the other 4 among 57 of 3rd to 5th day revealed ictal hyperperfusion on interictal SPECT. Six interictal studies (2.7% among 221) acquired on the indifferent day showed also ictal hyperperfusion. We could suggest that the next day is not desirable for interictal SPECT after ictal study, as ictal hyperperfusion on interictal study confounded more than postictal findings of ictal SPECT in the discrete localization than reassuring ictal study.

  7. Birth weight and gestational age on retinopathy of prematurity in discordant twins in China

    Directory of Open Access Journals (Sweden)

    Zong-Hua Wang

    2014-08-01

    Full Text Available AIM:To assess the relative effect of birth weight and gestational age on retinopathy of prematurity (ROP using preterm twin pairs discordant for birth weigh in a tertiary neonatal intensive care unit in China.METHODS: Fifty-six discordant twin pairs of 112 preterm infants were retrospectively analyzed. The twin pairs were divided into two subgroups based on birth weight in each pair. The occurrence of ROP and severe ROP requiring treatment were compared between the lower birth weight infants and their co-twins with the higher birth weight. Some neonatal morbidities related to prematurity and neonatal characteristics were also compared between the twin pairs.RESULTS: Based on the univariate analysis, gestational age and birth weight were significantly associated with the occurrence and progression of ROP. But no significant differences in ROP between larger and smaller infants were observed in the twin-paired analysis. The incidence of neonatal morbidities regarding respiratory distress syndrome (RDS, patent ductus arteriosus (PDA, intraventricular hemorrhage (IVH, sepsis and neonatal characteristics regarding gender distribution, one- and five-minute Apgar score, postnatal steroid treatment, blood transfusion, supplemental oxygen therapy, and mechanical ventilation were not different between the twins. However, gestational age of ≤28wk was significantly associated with significantly higher rates of ROP and severe ROP.CONCLUSION: Gestational age is a better predictor of ROP than birth weight in the twin-paired study.

  8. Understanding the gender disparity in HIV infection across countries in sub-Saharan Africa: evidence from the Demographic and Health Surveys

    Science.gov (United States)

    Magadi, Monica Akinyi

    2011-01-01

    Women in sub-Saharan Africa bear a disproportionate burden of human immunodeficiency virus (HIV) infections, which is exacerbated by their role in society and biological vulnerability. The specific objectives of this article are to (i) determine the extent of gender disparity in HIV infection; (ii) examine the role of HIV/acquired immune deficiency syndrome (AIDS) awareness and sexual behaviour factors on the gender disparity and (iii) establish how the gender disparity varies between individuals of different characteristics and across countries. The analysis involves multilevel logistic regression analysis applied to pooled Demographic and Health Surveys data from 20 countries in sub-Saharan Africa conducted during 2003–2008. The findings suggest that women in sub-Saharan Africa have on average a 60% higher risk of HIV infection than their male counterparts. The risk for women is 70% higher than their male counterparts of similar sexual behaviour, suggesting that the observed gender disparity cannot be attributed to sexual behaviour. The results suggest that the risk of HIV infection among women (compared to men) across countries in sub-Saharan Africa is further aggravated among those who are younger, in female-headed households, not in stable unions or marital partnerships or had an earlier sexual debut. PMID:21545443

  9. Rapid Immuno-Chromatographic Assay for the Detection of Antibodies to HIV Compare with Elisa among Voluntary and Replacement Blood Donor of Mymensingh Medical College Hospital.

    Science.gov (United States)

    Chakrabarty, P; Rudra, S; Hossain, M A; Begum, S A; Mirza, T T; Rudra, M

    2015-04-01

    Suitable algorithms based on a combination of two or more simple rapid HIV assays have been shown to have a diagnostic accuracy comparable to double enzyme-linked immunosorbent assay (ELISA) or double ELISA with Western Blot strategies. The aims of this study were to evaluate the performance of five simple rapid HIV assays using whole blood samples from voluntary and replacement blood donors & HIV-infected patients (positive samples from BSMMU, Dhaka). Five rapid HIV assays: Determine™ HIV-1/2 (Inverness Medical), SD Bioline HIV 1/2 3.0 (Standard Diagnostics Inc.), First Response HIV Card 1-2.0 (PMC Medical India Pvt Ltd.), HIV1/2 Stat-Pak Dipstick (Chembio Diagnostic System, Inc) and Uni-Gold™ HIV-1/2 (Biotech) were evaluated between 1st February to 30th June, 2013 using 400 whole blood samples from voluntary and replacement blood donors. All samples that were reactive on all or any of the five rapid assays and 10% of non-reactive samples were tested on a confirmatory Inno-Lia HIV I/II immunoblot assay (Immunogenetics). Only 01 sample including ten positive samples from BSMMU were confirmed HIV-1 antibody positive, while 399 were HIV negative. The sensitivity at initial testing of Determine, SD Bioline and Uni-Gold™ was 100% (95% CI; 99.1-100) while First Response and Stat-Pak had sensitivity of 99.5% (95% CI; 98.2-99.9) and 97.7% (95% CI; 95.7-98.9) respectively, which increased to 100% (95% CI; 99.1-100) on repeat testing. The initial specificity of the Uni-Gold™ assay was 100% (95% CI; 99.6-100) while specificities were 99.6% (95% CI; 99-99.9), 99.4% (95% CI; 98.8-99.7), 99.6% (95% CI; 99-99.9) and 99.8% (95% CI; 99.3-99.9) for Determine, SD Bioline, First Response and Stat-Pak assays, respectively. There was no any sample which was concordantly false positive in Uni-Gold™, Determine and SD Bioline assays. An alternative confirmatory HIV testing strategy based on initial testing on either SD Bioline or Determine assays followed by testing of reactive

  10. Morphometric analysis of craniofacial features in mono- and dizygotic twins discordant for unilateral cleft lip and palate.

    Science.gov (United States)

    Tessler, Alexis Y; Franchi, Lorenzo; McNamara, James A; Baccetti, Tiziano

    2011-09-01

    To compare craniofacial differences between twins discordant for surgically repaired unilateral cleft lip and palate (CLP) during the developmental ages and to test the effect of zygosity on the shape and size of the craniofacial skeleton of the same twins by means of thin plate spline (TPS) analysis. Lateral and posteroanterior (PA) cephalometric films from 19 sets of monozygotic (MZ) twins (15 male and 4 female) and 10 dizygotic (DZ) twins (7 male and 3 female) were analyzed. TPS analysis evaluated statistically significant differences in the craniofacial shape and size between affected and unaffected twins within MZ and DZ twin couples. No statistically significant differences in craniofacial shape or size between CLP and non-CLP MZ or DZ twins were observed. The level of morphological similarity in CLP vs non-CLP MZ twins was statistically greater than in DZ twins. Morphometric analysis showed that surgically repaired CLP does not produce significant shape or size differences in the craniofacial features of MZ or DZ twins discordant for unilateral CLP.

  11. Union Gas Ltd. : 1998 annual report

    International Nuclear Information System (INIS)

    1999-01-01

    Consolidated annual financial information from Union Gas Ltd. was presented along with a review of their 1998 operations. On January 1, 1998, Union Gas Ltd. amalgamated with Centra Gas Ontario Inc. Both are wholly-owned subsidiaries of Westcoast Energy Inc., and had operated under a shared services arrangement since 1994. The assets, liabilities and shareholders equity of Union and Centra were combined and accounted for at their carrying amounts. In 1998, the customer base grew by 3.3 per cent. The distribution service area of Union Gas extends across northern Ontario from the Manitoba border to the North Bay/Muskoka area and through certain parts of southern Ontario. The company also provides natural gas storage and transportation services for other utilities and energy market participants in Ontario, Quebec and the United States. This report gives full account of the company's energy resource activities, presents a detailed operations review as well as the company's consolidated financial statements. Revenue for 1998 was $1.6 billion, net income was 109 million, and assets were $4 billion. Total throughput for 1998 was 31.8 billion cubic metres of natural gas. tabs., figs

  12. Practice Parameter on Gay, Lesbian, or Bisexual Sexual Orientation, Gender Nonconformity, and Gender Discordance in Children and Adolescents

    Science.gov (United States)

    Medicus, Jennifer

    2012-01-01

    Children and adolescents who are growing up gay, lesbian, bisexual, gender nonconforming, or gender discordant experience unique developmental challenges. They are at risk for certain mental health problems, many of which are significantly correlated with stigma and prejudice. Mental health professionals have an important role to play in fostering…

  13. Immigration and the transformation of American unionism

    NARCIS (Netherlands)

    Burgoon, B.; Fine, J.; Jacoby, W.; Tichenor, D.

    2010-01-01

    Does immigration hamper union organizing in the United States? The prevailing literature strongly suggests that it does and for two reasons: first, immigrants increase the labor pool and diminish union influence over the labor market. And second, immigrants may be harder to organize than native

  14. The Effects of Corruption in a Monetary Union

    OpenAIRE

    Garcia Fortuny, Judit

    2015-01-01

    Many countries around the world suffer from corruption. In a monetary union, corruption varies from one country to another. It is possible corruption in one country may affect another country in a monetary union. We demonstrate that this feature has important implications in a monetary union with two asymmetric countries. Country 1 has a corrupted government while country 2 does not. Within this framework, we determine under which conditions corruption damages or benefits both countr...

  15. A decade of African Union and European Union trans-national ...

    African Journals Online (AJOL)

    The first decade of the new millennium saw the European Union deploy nine security missions to the African continent, quoting the European Security and. Defence Policy. Unlike the numerous United Nations security missions that. European states had previously contributed to, these were part of a grand strategy designed ...

  16. Ritonavir-boosted darunavir combined with raltegravir or tenofovir-emtricitabine in antiretroviral-naive adults infected with HIV-1

    DEFF Research Database (Denmark)

    Raffi, François; Babiker, Abdel G; Richert, Laura

    2014-01-01

    BACKGROUND: Standard first-line antiretroviral therapy for HIV-1 infection includes two nucleoside or nucleotide reverse transcriptase inhibitors (NtRTIs), but these drugs have limitations. We assessed the 96 week efficacy and safety of an NtRTI-sparing regimen. METHODS: Between August, 2010......-inferior to standard treatment and represents a treatment option for patients with CD4 cell counts higher than 200 cells per μL. FUNDING: European Union Sixth Framework Programme, Inserm-ANRS, Gilead Sciences, Janssen Pharmaceuticals, Merck Laboratories....

  17. Assessment of spatial discordance of primary and effective seed dispersal of European beech (Fagus sylvatica L.) by ecological and genetic methods.

    Science.gov (United States)

    Millerón, M; López de Heredia, U; Lorenzo, Z; Alonso, J; Dounavi, A; Gil, L; Nanos, N

    2013-03-01

    Spatial discordance between primary and effective dispersal in plant populations indicates that postdispersal processes erase the seed rain signal in recruitment patterns. Five different models were used to test the spatial concordance of the primary and effective dispersal patterns in a European beech (Fagus sylvatica) population from central Spain. An ecological method was based on classical inverse modelling (SSS), using the number of seed/seedlings as input data. Genetic models were based on direct kernel fitting of mother-to-offspring distances estimated by a parentage analysis or were spatially explicit models based on the genotype frequencies of offspring (competing sources model and Moran-Clark's Model). A fully integrated mixed model was based on inverse modelling, but used the number of genotypes as input data (gene shadow model). The potential sources of error and limitations of each seed dispersal estimation method are discussed. The mean dispersal distances for seeds and saplings estimated with these five methods were higher than those obtained by previous estimations for European beech forests. All the methods show strong discordance between primary and effective dispersal kernel parameters, and for dispersal directionality. While seed rain was released mostly under the canopy, saplings were established far from mother trees. This discordant pattern may be the result of the action of secondary dispersal by animals or density-dependent effects; that is, the Janzen-Connell effect. © 2013 Blackwell Publishing Ltd.

  18. The Defense of Teachers' Trade Union Rights.

    Science.gov (United States)

    Pepin, Luce

    1990-01-01

    The author sees cause for concern in the number of complaints to the International Labour Organisation alleging violations of teachers' union rights. She examines the right of public employees to organize and strike and government interference, concluding that greater protection for teachers' unions may be needed. (SK)

  19. Control of HIV-1 in Elite Suppressors despite Ongoing Replication and Evolution in Plasma Virus▿

    Science.gov (United States)

    O'Connell, Karen A.; Brennan, Timothy P.; Bailey, Justin R.; Ray, Stuart C.; Siliciano, Robert F.; Blankson, Joel N.

    2010-01-01

    A subset of HIV-1-infected patients known as elite controllers or suppressors (ES) control the virus naturally. We have previously demonstrated sequence discordance between proviral and plasma gag clones in ES, much of which can be attributed to selective pressure from the host (J. R. Bailey, T. M. Williams, R. F. Siliciano, and J. N. Blankson, J. Exp. Med. 203:1357-1369, 2006). However, it is not clear whether ongoing viral replication continues in ES once the control of viremia has been established or whether selective pressure impacts this evolution. The cytotoxic T-lymphocyte (CTL) response in ES often targets Gag and frequently is superior to that of HIV-1 progressors, partially due to the HLA class I alleles B*57/5801 and B*27, which are overrepresented in ES. We therefore examined longitudinal plasma and proviral gag sequences from HLA-B*57/5801 and -B*27 ES. Despite the highly conserved nature of gag, we observed clear evidence of evolution in the plasma virus, largely due to synonymous substitutions. In contrast, evolution was rare in proviral clones, suggesting that ongoing replication in ES does not permit the significant reseeding of the latent reservoir. Interestingly, there was little continual evolution in CTL epitopes, and we detected de novo CTL responses to autologous viral mutants. Thus, some ES control viremia despite ongoing replication and evolution. PMID:20444904

  20. Discordance in histopathologic evaluation of melanoma sentinel lymph node biopsy with clinical follow-up: results from a prospectively collected database.

    Science.gov (United States)

    Dandekar, Monisha; Lowe, Lori; Fullen, Douglas R; Johnson, Timothy M; Sabel, Michael S; Wong, Sandra L; Patel, Rajiv M

    2014-10-01

    Sentinel lymph node (SLN) status currently represents the single most important prognostic factor in clinically localized melanoma and is widely used in patients with melanoma at significant risk for nodal micrometastasis. Although several studies have looked at the rates and implications of inaccuracies in the histopathologic diagnosis of melanocytic lesions, accuracy in the histologic interpretation of the SLN in melanoma has not been addressed. The goal of this study was to determine the rates of discordance in the histopathologic evaluation of the SLN and the potential clinical impact on patients referred to a comprehensive melanoma center. A prospectively collected database was queried for melanoma patients who had SLN biopsies performed at outside institutions before referral to the University of Michigan Multidisciplinary Melanoma Program between 2006 and 2009. These cases were reviewed and clinical follow-up obtained. After internal review of the SLN material, 13 (8 %) of 167 cases had major discrepancies in diagnosis that impacted patient management and prognosis. The disease of five patients was subsequently downstaged and the disease of eight patients was upstaged after internal review of the SLNs and reversal in diagnoses. There appears to be a small yet significant rate of discordance in diagnosis of the SLN for melanoma after expert histopathologic review. The implications of this discordance and revision of diagnosis is substantial. Expert histopathologic review of the SLN warrants consideration to provide the most accurate prognostic information and optimal patient care.

  1. Serodiagnostic profiles of HIV and HIV pathogenesis in vivo

    NARCIS (Netherlands)

    Goudsmit, J.; Lange, J. M.; Smit, L.; Bakker, M.; Klaver, B.; Danner, S. A.; Coutinho, R. A.

    1988-01-01

    Different stages of HIV infection are marked by expression of HIV genes, production of HIV antibodies, formation of antigen/antibody complexes and clearance of such complexes. Transient HIV antigenemia appearing generally 6-8 weeks prior to HIV antibody (HIV-Ab) seroconversion and lasting 3-4 months

  2. How EU Economic Integration Advances on the Way of Some Important Unions

    Directory of Open Access Journals (Sweden)

    PETRE PRISECARU

    2015-05-01

    Full Text Available Economic union and monetary union are deeply connected: two dimensions of the third stage of European integration. But achieving monetary union without a complete single market in the field of financial services proved the vulnerability of Eurozone to external shocks and the need to a further economic integration. While banking union has advanced quite fast in the last two years, capital markets union is only a project, also the fiscal union, which is the basic foundation of a true political union. A complete financial union will take a long time to accomplish due to many political, financial and bureaucratic obstacles facing such an ambitious project. Energy Union is another important project meant to remove market fragmentation, to enhance energy security and to reduce environmental impact of energy sector. Finally the political union, the last stage of European integration, the dream of many famous politicians and scholars, will be only possible on the long run as a new type of federation of nation states, provided that all components of economic union will be fully attained.

  3. 12 CFR 704.17 - State-chartered corporate credit unions.

    Science.gov (United States)

    2010-01-01

    ... provided under the laws of the state in which it was chartered. (b) A state-chartered corporate credit... 12 Banks and Banking 6 2010-01-01 2010-01-01 false State-chartered corporate credit unions. 704.17... CORPORATE CREDIT UNIONS § 704.17 State-chartered corporate credit unions. (a) This part does not expand the...

  4. Cultured gut microbiota from twins discordant for obesity modulate adiposity and metabolic phenotypes in mice

    OpenAIRE

    Ridaura, Vanessa K.; Faith, Jeremiah J.; Rey, Federico E.; Cheng, Jiye; Duncan, Alexis E.; Kau, Andrew L.; Griffin, Nicholas W.; Lombard, Vincent; Henrissat, Bernard; Bain, James R.; Muehlbauer, Michael J.; Ilkayeva, Olga; Semenkovich, Clay F.; Funai, Katsuhiko; Hayashi, David K.

    2013-01-01

    The role of specific gut microbes in shaping body composition remains unclear. We transplanted fecal microbiota from adult female twin pairs discordant for obesity into germ-free mice fed low-fat mouse chow, as well as diets representing different levels of saturated fat and fruit and vegetable consumption typical of the USA. Increased total body and fat mass, as well as obesity-associated metabolic phenotypes were transmissible with uncultured fecal communities, and with their corresponding ...

  5. Socioeconomic and cultural features of consensual unions in Brazil

    Directory of Open Access Journals (Sweden)

    Maira Covre-Sussai

    2016-04-01

    Full Text Available Consensual unions are a well-known practice among the lower social strata in Latin America. However, this type of union is increasing in the region, among higher educated groups and in countries where they were never widespread, such as in Brazil. This study uses couples' data from the demographic census available at IPUMS (N=193,689 to identify the socioeconomic and cultural features of consensual unions in Brazil. The effects of women's education, couples' income, children, and religion on nuptial behavior are analyzed. Utilizing logistic multilevel analysis, special attention is paid to the effect of differences in the cultural environment of states in the five major regions in which these unions occur. Results indicate that socioeconomic factors affect the incidence of consensual unions in Brazil. Consensual unions are more common among lower income couples and less educated women, but are also found among the upper classes. Cultural diversity between Brazilian states is also reflected in nuptial behavior. Significant variance at the state level is partially explained by the ethnic composition of each state.

  6. Gray and white matter density changes in monozygotic and same-sex dizygotic twins discordant for schizophrenia using voxel-based morphometry

    DEFF Research Database (Denmark)

    Hulshoff Pol, HE; Schnack, HG; Mandl, RC

    2006-01-01

    Global gray matter brain tissue volume decreases in schizophrenia have been associated to disease-related (possibly nongenetic) factors. Global white matter brain tissue volume decreases were related to genetic risk factors for the disease. However, which focal gray and white matter brain regions...... best reflect the genetic and environmental risk factors in the brains of patients with schizophrenia remains unresolved. 1.5-T MRI brain scans of 11 monozygotic and 11 same-sex dizygotic twin-pairs discordant for schizophrenia were compared to 11 monozygotic and 11 same-sex dizygotic healthy control...... twin-pairs using voxel-based morphometry. Linear regression analysis was done in each voxel for the average and difference in gray and white matter density separately, in each twin-pair, with group (discordant, healthy) and zygosity (monozygotic, dizygotic) as between subject variables, and age, sex...

  7. Computing Coherence Vectors and Correlation Matrices with Application to Quantum Discord Quantification

    Directory of Open Access Journals (Sweden)

    Jonas Maziero

    2016-01-01

    Full Text Available Coherence vectors and correlation matrices are important functions frequently used in physics. The numerical calculation of these functions directly from their definitions, which involves Kronecker products and matrix multiplications, may seem to be a reasonable option. Notwithstanding, as we demonstrate in this paper, some algebraic manipulations before programming can reduce considerably their computational complexity. Besides, we provide Fortran code to generate generalized Gell-Mann matrices and to compute the optimized and unoptimized versions of associated Bloch’s vectors and correlation matrix in the case of bipartite quantum systems. As a code test and application example, we consider the calculation of Hilbert-Schmidt quantum discords.

  8. Non-unions force wage cut-backs in pipeline industry

    Energy Technology Data Exchange (ETDEWEB)

    Bain, D

    1984-03-01

    Faced with another year of high unemployment and shrinking markets, Western Canada's unionized pipeline construction trades have taken a step toward stabilizing the industry. The unions have struck a bargain to combat an increasing number of non-union open shops. Management and labor cooperated to insure that the unions regain their share of the pipeline construction market. The pipeline construction boom has ended, with an overcapacity, a downturn in sales, and few major projects on the drawing boards. The bargains included wage reductions of 30%, daily living allowance reductions of nearly 50%, the elimination of double time, and the use of composite crews.

  9. SEXUALITY AND REPRODUCTION: PERCEPTIONS OF WOMEN LIVING WITH HIV / AIDS

    Directory of Open Access Journals (Sweden)

    D. A. Souza

    2018-04-01

    Full Text Available The acquired immunodeficiency syndrome (AIDS is a disease that brings with it the need for changes in sexual and reproductive behavior. Family planning is a great ally in promoting sexual and reproductive health of women living with HIV. This sought to understand the perceptions experienced by HIV-positive women in the treatment and monitoring in the specialized care (SAE Sinop-MT with respect to their sexual and reproductive behavior after diagnosis of HIV / AIDS. This is a descriptive and exploratory qualitative approach, performed with seven women, data collection occurred from June to July, 2013, through interviews semi-structured data analysis were based on the method of Bardin, 1977. Inclusion criteria: be between 18 and 45 years, be aware of the diagnosis more than six months, does not have mental problems and agree to participate voluntarily in the study. The results were divided into four categories, namely: 1st characterize the participants; 2nd sexuality after infection with HIV / AIDS; Reproduction after HIV / AIDS; Knowledge about planning familar. Regarding cartcterização of participants, these were between 19 and 41 years, 57.1% had regular employment and 42.9% of the household chores performed only; Regarding marital status 57.1% had stable relationship, 28.6% were married and 14.3% separated; Regarding serology partner 42.9% had discordant relationship, 28.5% had a relationship soroconcordante, 14, 3% had no partner and 14.3% did not inform their partner's serology. As for contraception 14.3% used oral contraceptives and condoms, 71.4% used only condoms and 14.3% used sterilization and condoms. Regarding the number of child 14.28% had no children, 14.28% had children, 28.58% had two children, 14.28% had three children and 28.58% had four children. Regarding sexuality demonstrated changes as the use of condoms, abstinence, craving for soroconcordant relationship, fear of abandonment and rejection by the partner, primarily

  10. Should the 'Outs' Join the Banking Union?

    NARCIS (Netherlands)

    P. Hüttl (Pia); D. Schoenmaker (Dirk)

    2016-01-01

    textabstractThe Single Market stimulates cross-border banking throughout the European Union. This paper documents the banking linkages between the 9 ‘outs’ and 19 ‘ins’ of the Banking Union. We find that some of the major banks, based in Sweden and Denmark, have substantial banking claims across the

  11. Latin American astronomers and the International Astronomical Union

    Science.gov (United States)

    Torres-Peimbert, S.

    2017-07-01

    Selected aspects of the participation of the Latin American astronomers in the International Astronomical Union are presented: Membership, Governing bodies, IAU meetings, and other activities. The Union was founded in 1919 with 7 initial member states, soon to be followed by Brazil. In 1921 Mexico joined, and in 1928 Argentina also formed part of the Union, while Chile joined in 1947. In 1961 Argentina, Brazil, Chile, Mexico and Venezuela were already member countries. At present (October 2016) 72 countries contribute financially to the Union. The Union lists 12,391 professional astronomers as individual members; of those, 692 astronomers work in Latin America and the Caribbean, from 13 member states (Argentina, Bolivia , Brazil, Chile, Colombia, Costa Rica, Cuba, Honduras, Mexico, Panamá, Perú, Uruguay and Venezuela) as well as from Ecuador and Puerto Rico. This group comprises 5.58% of the total membership, a figure somewhat lower than the fraction of the population in the region, which is 8.6% of the world population. Of the Latin American members, 23.4% are women and 76.6% are men; slightly higher than the whole membership of Union, which is of 16.9%. In the governing bodies it can be mentioned that there have been 2 Presidents of the Union (Jorge Sahade and Silvia Torres-Peimbert), 7 VicePresidents (Guillermo Haro, Jorge Sahade, Manuel Peimbert Claudio Anguita, Silvia Torres-Peimbert, Beatriz Barbuy, and Marta G. Rovira). The IAU meetings held in the region, include 2 General Assemblies (the 1991 XXI GA took place in Buenos Aires, Argentina and the 2009 XXVIII GA, in Rio de Janeiro, Brazil), 15 Regional Meetings (in Argentina, Brazil, Chile, Colombia, Mexico, Venezuela and Uruguay), 29 Symposia (in Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Mexico), 5 Colloquia (in Argentina and Mexico), 8 International Schools for Young Astronomers (in Argentina, Brazil, Cuba, Honduras and Mexico), and 11 projects sponsored by the Office of Astronomy

  12. Discerning The Motivational Basis For Trade Unionism In Public And ...

    African Journals Online (AJOL)

    Discerning The Motivational Basis For Trade Unionism In Public And Private ... private businesses are very clear to the actors of industrial relations; those of their ... selfish interests; unions in the public sector ought to function as uplift unions, ...

  13. Side Effects of HIV Medicines: HIV and Diabetes

    Science.gov (United States)

    ... Children and Adolescents HIV and Women HIV and Gay and Bisexual Men HIV and Older Adults HIV ... throughout the body. A hormone called insulin helps move the glucose into the cells. Once in the ...

  14. Injuries in Australian school-level rugby union.

    Science.gov (United States)

    Leung, Felix T; Franettovich Smith, Melinda M; Hides, Julie A

    2017-11-01

    There is a high incidence of injuries in rugby union due to the physical nature of the game. In youth rugby union, there are large variations in injury rates reported. Our study investigated the rates of injuries in school-level rugby union players in Australia using the consensus statement for rugby union injuries. Injury surveillance was conducted on 480 rugby players from 1 school in Queensland, Australia. Injury data were collected using paper-based injury recording forms during the 8-week rugby season using a "medical-attention" injury definition. In total, 76 players sustained one or more injuries, with a total of 80 injuries recorded. The overall injury rate was 31.8 injuries/1000 match player hours (95% CI, 25.4-39.4). Concussion had an incidence rate of 6.0/1000 match player hours (95% CI, 3.5-9.6). The incidence of upper limb and lower limb injuries were 9.1 and 9.9/1000 match player hours, respectively (95% CI, 5.9-13.5 and 6.6-14.5). The older age divisions had higher injury rates and most injuries occurred while tackling or being tackled. The injury rates observed in this sample of Australian school rugby union players provides direction for future studies to enable informed decisions relating to development of injury prevention programmes at this level of rugby.

  15. 78 FR 18798 - Amendment of Class E Airspace; West Union, IA

    Science.gov (United States)

    2013-03-28

    ...-1434; Airspace Docket No. 11-ACE-27] Amendment of Class E Airspace; West Union, IA AGENCY: Federal... West Union, IA. Decommissioning of the West Union non-directional beacon (NDB) at George L. Scott... Federal Register a notice of proposed rulemaking (NPRM) to amend Class E airspace for the West Union, IA...

  16. Correlates of HIV stigma in HIV-positive women.

    Science.gov (United States)

    Wagner, Anne C; Hart, Trevor A; Mohammed, Saira; Ivanova, Elena; Wong, Joanna; Loutfy, Mona R

    2010-06-01

    We examined the variables associated with HIV stigma in HIV-positive women currently living in Ontario, Canada. Based on previous literature, we predicted that variables of social marginalization (e.g., ethnicity, income, education), medical variables (e.g., higher CD4 count, lower viral load), and increased psychological distress would be associated with higher perceived HIV stigma among HIV-positive women. One hundred fifty-nine HIV-positive women between the ages of 18 and 52 in Ontario completed self-report measures of the aforementioned variables. Women were recruited through 28 AIDS service organizations, eight HIV clinics, and two community health centers. In multiple regression analyses, for women born in Canada, lower educational level and higher anxiety were associated with higher HIV stigma. For women born outside of Canada, having been judged by a physician in Canada for trying to become pregnant was associated with higher HIV stigma. For HIV-positive women born outside of Canada, negative judgment by a physician regarding intentions to become pregnant should be addressed to reduce perceived HIV stigma and vice versa. Health care providers should be trained in the provision of sensitive and effective health care for women living with HIV, especially when providing reproductive health care.

  17. New "Right to Work" Laws Could Hobble Faculty Unions

    Science.gov (United States)

    Schmidt, Peter

    2013-01-01

    Faculty unions outside Michigan have reason to be concerned with its passage of legislation barring unions from collecting fees from workers who do not join them. But the experiences of faculty unions in states that adopted such laws years ago suggest that while the measures can be a major hindrance to their work, they are not a death blow.…

  18. HIV Testing

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... All Collapse All Should I get tested for HIV? CDC recommends that everyone between the ages of ...

  19. Cyclicality of Wages and Union Power

    DEFF Research Database (Denmark)

    Morin, Annaïg

    This paper examines how trade unions shape the volatility of wages over the business cycle. I present a dynamic stochastic model of the labor market that integrates two main features: search frictions and trade unions. Because of search frictions, each job match yields an economic surplus...... that is shared by the bargained wage. Therefore, I can decompose the volatility of wages into two components: the volatility of the match surplus and the volatility of the worker share of the surplus. Starting from the unions' objective function, I demonstrate that, under collective wage bargaining, the worker...... share is endogenous and countercyclical. Consequently, when the economy is hit by a shock, the dynamics of the worker share partially counteract the dynamics of the match surplus and this mechanism delivers endogenous wage rigidity. The model thus sheds new insights into two business cycle features...

  20. Former Soviet Union Hydrological Snow Surveys, 1966-1996

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Former Soviet Union Hydrological Snow Surveys are based on observations made by personnel at 1,345 sites throughout the Former Soviet Union between 1966 and...