29 resultados para AIDS LATE DIAGNOSIS IMPACT

em CentAUR: Central Archive University of Reading - UK


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The impact that “Romanization” and the development of urban centers had on the health of the Romano-British population is little understood. A re-examination of the skeletal remains of 364 nonadults from the civitas capital at Roman Dorchester (Durnovaria) in Dorset was carried out to measure the health of the children living in this small urban area. The cemetery population was divided into two groups; the first buried their dead organized within an east–west alignment with possible Christian-style graves, and the second with more varied “pagan” graves, aligned north–south. A higher prevalence of malnutrition and trauma was evident in the children from Dorchester than in any other published Romano-British group, with levels similar to those seen in postmedieval industrial communities. Cribra orbitalia was present in 38.5% of the children, with rickets and/or scurvy at 11.2%. Twelve children displayed fractures of the ribs, with 50% of cases associated with rickets and/or scurvy, suggesting that rib fractures should be considered during the diagnosis of these conditions. The high prevalence of anemia, rickets, and scurvy in the Poundbury children, and especially the infants, indicates that this community may have adopted child-rearing practices that involved fasting the newborn, a poor quality weaning diet, and swaddling, leading to general malnutrition and inadequate exposure to sunlight. The Pagan group showed no evidence of scurvy or rib fractures, indicating difference in religious and child-rearing practices but that both burial groups were equally susceptible to rickets and anemia suggests a shared poor standard of living in this urban environment.

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Palaeoecological analysis of peat deposits from a small bog, combined with pollen analysis of sediments infilling the moat of the nearby Teutonic Order castle at Malbork, have been used to examine the ecological impact of the Crusades on the late-medieval landscape of Northern Poland. Studies of the environmental impact of the Crusades have been almost exclusively informed by written sources; this study is the first of its type to directly investigate the environmental context of Crusading as a force of ecological transformation on the late-medieval Baltic landscape. The pollen evidence from Malbork Castle and its hinterland demonstrate that the 12th/13th–15th centuries coincide with a marked transformation in vegetation and land-use, characterized by clearance of broadleaved woodland and subsequent agricultural intensification, particularly during the 14th/15th centuries. These changes are ascribed to landscape transformations associated with the Teutonic Order’s control of the landscape from the mid-13th century. Human activity identified in the pollen record prior to this is argued to reflect the activities of Pomeranian settlers in the area. This paper also discusses the broader palaeoecological evidence for medieval landscape change across Northern Poland.

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This study examines the efficacy of published δ18O data from the calcite of Late Miocene surface dwelling planktonic foraminifer shells, for sea surface temperature estimates for the pre-Quaternary. The data are from 33 Late Miocene (Messinian) marine sites from a modern latitudinal gradient of 64°N to 48°S. They give estimates of SSTs in the tropics/subtropics (to 30°N and S) that are mostly cooler than present. Possible causes of this temperature discrepancy are ecological factors (e.g. calcification of shells at levels below the ocean mixed layer), taphonomic effects (e.g. diagenesis or dissolution), inaccurate estimation of Late Miocene seawater oxygen isotope composition, or a real Late Miocene cool climate. The scale of apparent cooling in the tropics suggests that the SST signal of the foraminifer calcite has been reset, at least in part, by early diagenetic calcite with higher δ18O, formed in the foraminifer shells in cool sea bottom pore waters, probably coupled with the effects of calcite formed below the mixed layer during the life of the foraminifera. This hypothesis is supported by the markedly cooler SST estimates from low latitudes—in some cases more than 9 °C cooler than present—where the gradients of temperature and the δ18O composition of seawater between sea surface and sea bottom are most marked, and where ocean surface stratification is high. At higher latitudes, particularly N and S of 30°, the temperature signal is still cooler, though maximum temperature estimates overlap with modern SSTs N and S of 40°. Comparison of SST estimates for the Late Miocene from alkenone unsaturation analysis from the eastern tropical Atlantic at Ocean Drilling Program (ODP) Site 958—which suggest a warmer sea surface by 2–4 °C, with estimates from oxygen isotopes at Deep Sea Drilling Project (DSDP) Site 366 and ODP Site 959, indicating cooler than present SSTs, also suggest a significant impact on the δ18O signal. Nevertheless, much of the original SST variation is clearly preserved in the primary calcite formed in the mixed layer, and records secular and temporal oceanographic changes at the sea surface, such as movement of the Antarctic Polar Front in the Southern Ocean. Cooler SSTs in the tropics and sub-tropics are also consistent with the Late Miocene latitude reduction in the coral reef belt and with interrupted reef growth on the Queensland Plateau of eastern Australia, though it is not possible to quantify absolute SSTs with the existing oxygen isotope data. Reconstruction of an accurate global SST dataset for Neogene time-slices from the existing published DSDP/ODP isotope data, for use in general circulation models, may require a detailed re-assessment of taphonomy at many sites.

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Rockshelter Baaz in the Damascus region of Syria provided a variety of botanical remains from the Late Pleistocene and Early Holocene period. These remains provide new information about the vegetation evolution in this region. The earliest occupational levels correspond with a moisture peak during the Late Pleistocene, between ca. 34-32 kyr b.p., when pine expanded. The next occupations took place during extreme arid conditions, ca. 23-21 kyr b.p., and probably during the Last Glacial Maximum when a steppe vegetation was established. The occupation level of the Younger Dryas, represented by Natufian remains, suggests that the area had been covered by almond-pistachio steppe, similar to later periods of the Early Holocene, and was probably located just outside the range of dense wild cereal stands. There is no drastic impact of the Younger Dryas visible on the vegetation in the botanical remains. The lack of fruits and seeds at Baaz indicates that the site was more likely to have been a temporary hunting post rather than a plant processing site for much of its history. It is ideally suited to this purpose because of its location over the Jaba'deen Pass and the associated springs. However, archaeological remains from the Natufian period, suggest that the site was more permanently occupied during this time.

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Against a background of rising adult mortality and morbidity in the context of the HIV/AIDS pandemic in sub-Saharan Africa, this paper provides both quantitative and qualitative evidence for the existence of a largely neglected group of young people with increased responsibility for caregiving. Using questionnaire surveys, focus groups, storyboards and in-depth interviews in three studies across Southern and Eastern Africa some young people in Lesotho, Tanzania and Zimbabwe are found to devote considerable time and energy to caring for sick members of their households. Examination of the tasks carried out by these youngsters finds them to be burdened beyond usual familial and societal expectations of children's 'normal' contributions to the reproduction of households via domestic chores and suchlike. It is concluded that these young people can be described as 'young carers'. The three studies are presented to illuminate different sociospatial aspects of caregiving by young people. First, using qualitative data from Lesotho the range of caring tasks young caregivers; perform for care recipients - usually a grandmother, parent, or sibling - is identified. Second, the impact caregiving responsibilities have on children's primary school attendance is examined using survey data from Tanzania. Third, the wider negative and positive impacts of caregiving including loss of friends and gaining of emotional maturity for young carers and their households is explored with in-depth individual interviews from Zimbabwe. Finally, suggestions are made for further research to deepen understanding of the geographies of caring within the context of the population geographies of the HIV/AIDS pandemic in sub-Saharan Africa and beyond. Copyright (c) 2006 John Wiley & Sons, Ltd.

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During deglaciation of the North American Laurentide Ice Sheet large proglacial lakes developed in positions where proglacial drainage was impeded by the ice margin. For some of these lakes, it is known that subsequent drainage had an abrupt and widespread impact on North Atlantic Ocean circulation and climate, but less is known about the impact that the lakes exerted on ice sheet dynamics. This paper reports palaeogeographic reconstructions of the evolution of proglacial lakes during deglaciation across the northwestern Canadian Shield, covering an area in excess of 1,000,000 km(2) as the ice sheet retreated some 600 km. The interactions between proglacial lakes and ice sheet flow are explored, with a particular emphasis on whether the disposition of lakes may have influenced the location of the Dubawnt Lake ice stream. This ice stream falls outside the existing paradigm for ice streams in the Laurentide Ice Sheet because it did not operate over fined-grained till or lie in a topographic trough. Ice margin positions and a digital elevation model are utilised to predict the geometry and depth of proglacial takes impounded at the margin at 30-km increments during deglaciation. Palaeogeographic reconstructions match well with previous independent estimates of lake coverage inferred from field evidence, and results suggest that the development of a deep lake in the Thelon drainage basin may have been influential in initiating the ice stream by inducing calving, drawing down ice and triggering fast ice flow. This is the only location alongside this sector of the ice sheet where large (>3000 km(2)), deep lakes (similar to120 m) are impounded for a significant length of time and exactly matches the location of the ice stream. It is speculated that the commencement of calving at the ice sheet margin may have taken the system beyond a threshold and was sufficient to trigger rapid motion but that once initiated, calving processes and losses were insignificant to the functioning of the ice stream. It is thus concluded that proglacial lakes are likely to have been an important control on ice sheet dynamics during deglaciation of the Laurentide Ice Sheet. (C) 2004 Elsevier B.V. All rights reserved.

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This study examines the efficacy of published δ18O data from the calcite of Late Miocene surface dwelling planktonic foraminifer shells, for sea surface temperature estimates for the pre-Quaternary. The data are from 33 Late Miocene (Messinian) marine sites from a modern latitudinal gradient of 64°N to 48°S. They give estimates of SSTs in the tropics/subtropics (to 30°N and S) that are mostly cooler than present. Possible causes of this temperature discrepancy are ecological factors (e.g. calcification of shells at levels below the ocean mixed layer), taphonomic effects (e.g. diagenesis or dissolution), inaccurate estimation of Late Miocene seawater oxygen isotope composition, or a real Late Miocene cool climate. The scale of apparent cooling in the tropics suggests that the SST signal of the foraminifer calcite has been reset, at least in part, by early diagenetic calcite with higher δ18O, formed in the foraminifer shells in cool sea bottom pore waters, probably coupled with the effects of calcite formed below the mixed layer during the life of the foraminifera. This hypothesis is supported by the markedly cooler SST estimates from low latitudes—in some cases more than 9 °C cooler than present—where the gradients of temperature and the δ18O composition of seawater between sea surface and sea bottom are most marked, and where ocean surface stratification is high. At higher latitudes, particularly N and S of 30°, the temperature signal is still cooler, though maximum temperature estimates overlap with modern SSTs N and S of 40°. Comparison of SST estimates for the Late Miocene from alkenone unsaturation analysis from the eastern tropical Atlantic at Ocean Drilling Program (ODP) Site 958—which suggest a warmer sea surface by 2–4 °C, with estimates from oxygen isotopes at Deep Sea Drilling Project (DSDP) Site 366 and ODP Site 959, indicating cooler than present SSTs, also suggest a significant impact on the δ18O signal. Nevertheless, much of the original SST variation is clearly preserved in the primary calcite formed in the mixed layer, and records secular and temporal oceanographic changes at the sea surface, such as movement of the Antarctic Polar Front in the Southern Ocean. Cooler SSTs in the tropics and sub-tropics are also consistent with the Late Miocene latitude reduction in the coral reef belt and with interrupted reef growth on the Queensland Plateau of eastern Australia, though it is not possible to quantify absolute SSTs with the existing oxygen isotope data. Reconstruction of an accurate global SST dataset for Neogene time-slices from the existing published DSDP/ODP isotope data, for use in general circulation models, may require a detailed re-assessment of taphonomy at many sites.

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Background and Objective: Dispensing medicines into compliance aids is a common practice in pharmacy contrary to manufacturers’ advice and studies have shown the appearance of light-sensitive tablets is compromised by such storage; we previously found evidence of reduced bioavailability at elevated temperature and humidity. Our objective was to examine the physicochemical stability of two generic atenolol tablets in different compliance aids and with aspirin co-storage at room temperature and at 40 °C/75% relative humidity. Methods: The physicochemical stability of atenolol tablets was evaluated after 28 days of storage and compared with controls by examining visual appearance, weight, disintegration, dissolution, friability and hardness to accepted standards and using a previously validated HPLC method for chemical assay. Results and Discussion: The response to storage was brand-dependent and not straightforward. With one make of atenolol (Alpharma), storage in compliance aids even at room temperature impacted on physical stability, reducing tablet hardness, with storage in Dosett® exerting a greater impact than storage in Medidos® (t-test P < 0·001). Co-storage at elevated temperature and humidity also impacted on the appearance of non-coated aspirin tablets (Angette™). The chemical stability of atenolol was not affected and we did not find evidence of changes to bioavailability with either make. Certainly data for one atenolol make (CP Pharmaceuticals) co-stored with aspirin (Angette™ and Nu-Seals) in both compliance aids at room temperature provided evidence of short-term stability. But medicines are dispensed into compliance aids in multi-factorial ways so our study highlights not only the lack of evidence but also a realization that evidence to support real practice may not be accomplished through research. Conclusion: Reassuring practitioners of the continued stability of medicines in compliance aids under the countless condition in which they are dispensed in practice may requires a different approach involving medical device regulators and more definitive professional guidance.

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Although in developing countries an apolipoprotein E4 (apoE4) genotype may offer an evolutionary advantage, as it has been shown to offer protection against certain infectious disease, in Westernised societies it is associated with increased morbidity and mortality, and represents a significant risk factor for cardiovascular disease, late-onset Alzheimer's disease and other chronic disorders. ApoE is an important modulator of many stages of lipoprotein metabolism and traditionally the increased risk was attributed to higher lipid levels in E4 carriers. However, more recent evidence demonstrates the multifunctional nature of the apoE protein and the fact that the impact of genotype on disease risk may be in large part due to an impact on oxidative status or the immunomodulatory/anti-inflammatory properties of apoE. An increasing number of studies in cell lines, targeted replacement rodents and human volunteers indicate higher oxidative stress and a more pro-inflammatory state associated with the F,4 allele. The impact of genotype on the antioxidant and immunomodulatory/anti-inflammatory properties of apoE is the focus of the current review. Furthermore, current information on the impact of environment (diet, exercise, smoking status, alcohol) on apoE genotype-phenotype associations are discussed with a view to identifying particular lifestyle strategies that could be adapted to counteract the 'at-risk' E4 genotype.

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Although the impact of autism spectrum disorders (ASDs) on the family is well recognized, the way mothers attempt to make sense of the diagnosis is largely unexplored. However, in other disabilities, attributions have been shown to predict a variety of outcomes including maternal wellbeing and engagement in treatment. Using Weiner's (198S) three-dimensional model, 16 mothers were interviewed to examine the nature and impact of their beliefs about their child's ASD using semi-structured interviews and measures of depression, parenting stress and expectations for their child's future. The findings suggested that mothers made a diverse and complex range of attributions that were consistent with Weiner's dimensions of locus of cause, stability and controllability. The nature of their attributions reflected particular difficulties associated with ASDs, such as uncertainties regarding cause and prognosis. Taking account of mothers' search for meaning will better enable professionals to support families following diagnosis.

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The Seille Valley in eastern France was home to one of Europe’s largest Iron Age salt industries. Sedimentology, palynology and geochronology have been integrated within ongoing archaeological investigations to reconstruct the Holocene palaeoenvironmental history of the Seille Valley and to elucidate the human–environment relationship of salt production. A sedimentary model of the valley has been constructed from a borehole survey of the floodplain and pollen analyses have been undertaken to reconstruct the vegetation history. Alluvial records have been successfully dated using optically stimulated luminescence and radiocarbon techniques, thereby providing a robust chronological framework. The results have provided an insight into the development of favourable conditions for salt production and there is evidence in the sedimentary record to suggest that salt production may have taken place during the mid-to-late Bronze Age. The latter has yet to be identified in the archaeological record and targeted excavation is therefore underway to test this finding. The development of the Iron Age industry had a major impact on the hydrological regime of the valley and its sedimentological history, with evidence for accelerated alluviation arising from floodplain erosion at salt production sites and modification of the local fluvial regime due to briquetage accumulation on the floodplain. This research provides an important insight into the environmental implications of early industrial activities, in addition to advancing knowledge about the Holocene palaeoenvironmental and social history of this previously poorly studied region of France.

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1] We apply a novel computational approach to assess, for the first time, volcanic ash dispersal during the Campanian Ignimbrite (Italy) super-eruption providing insights into eruption dynamics and the impact of this gigantic event. The method uses a 3D time-dependent computational ash dispersion model, a set of wind fields, and more than 100 thickness measurements of the CI tephra deposit. Results reveal that the CI eruption dispersed 250–300 km3 of ash over ∼3.7 million km2. The injection of such a large quantity of ash (and volatiles) into the atmosphere would have caused a volcanic winter during the Heinrich Event 4, the coldest and driest climatic episode of the Last Glacial period. Fluorine-bearing leachate from the volcanic ash and acid rain would have further affected food sources and severely impacted Late Middle-Early Upper Paleolithic groups in Southern and Eastern Europe

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Records of Atlantic basin tropical cyclones (TCs) since the late nineteenth century indicate a very large upward trend in storm frequency. This increase in documented TCs has been previously interpreted as resulting from anthropogenic climate change. However, improvements in observing and recording practices provide an alternative interpretation for these changes: recent studies suggest that the number of potentially missed TCs is sufficient to explain a large part of the recorded increase in TC counts. This study explores the influence of another factor—TC duration—on observed changes in TC frequency, using a widely used Atlantic hurricane database (HURDAT). It is found that the occurrence of short-lived storms (duration of 2 days or less) in the database has increased dramatically, from less than one per year in the late nineteenth–early twentieth century to about five per year since about 2000, while medium- to long-lived storms have increased little, if at all. Thus, the previously documented increase in total TC frequency since the late nineteenth century in the database is primarily due to an increase in very short-lived TCs. The authors also undertake a sampling study based upon the distribution of ship observations, which provides quantitative estimates of the frequency of missed TCs, focusing just on the moderate to long-lived systems with durations exceeding 2 days in the raw HURDAT. Upon adding the estimated numbers of missed TCs, the time series of moderate to long-lived Atlantic TCs show substantial multidecadal variability, but neither time series exhibits a significant trend since the late nineteenth century, with a nominal decrease in the adjusted time series. Thus, to understand the source of the century-scale increase in Atlantic TC counts in HURDAT, one must explain the relatively monotonic increase in very short-duration storms since the late nineteenth century. While it is possible that the recorded increase in short-duration TCs represents a real climate signal, the authors consider that it is more plausible that the increase arises primarily from improvements in the quantity and quality of observations, along with enhanced interpretation techniques. These have allowed National Hurricane Center forecasters to better monitor and detect initial TC formation, and thus incorporate increasing numbers of very short-lived systems into the TC database.

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During Oceanic Anoxic Event 1a (OAE 1a, 120 Ma; Li et al., 2008), organic carbon-rich layers were deposited in marine environments under anoxic conditions on a global scale. In this study, palaeoenvironmental conditions leading to this event are characterised by studying the Upper Barremian to the Lower Aptian succession of the Gorgo a Cerbara section (central Italy). For this, an integrated multi-proxy approach (δ13Ccarb; δ13Corg; δ18O; phosphorus; Total Organic Carbon, TOC; bulk-rock mineralogy, as well as redox-sensitive trace elements — RSTEs) has been applied. During the LateBarremian, thin organic-rich layers occur episodically, and associated Corg:Ptot ratios indicate the presence of intermittent dysoxic to anoxic conditions. Coarse correlations are observed between TOC, P and biogenic silica contents, indicating links between P availability, productivity, and TOC preservation. However, the corresponding δ13Ccarb and δ18O records remain quite stable, indicating that these brief periods of enhanced TOC preservation did not have sufficient impact on the marine carbon reservoir to deviate δ13C records. Around the Barremian–Aptian boundary, TOC-enriched layers become more frequent. These layers correlate with negative excursions in the δ13Ccarb and δ13Corg records, possibly due to a warming period as indicated by the δ18O record. During the earliest Aptian, this warming trend is reverted into a cooling trend, which is then followed by an important warming step near the onset of Oceanic Anoxic Event 1a (OAE 1a). During this time period, organic-rich intervals occur, which are characterised by the progressive increase in RSTE. The warming step prior the onset of OAE 1a is associated with the well-known negative spike in δ13Ccarb and δ13Corg records, an important peak in P accumulation, RSTE enrichments and Corg:Ptot ratios indicating the prevalence of anoxic conditions. The Selli Level itself may document a cooling phase. RSTE enrichments and Corg:Ptot ratios confirm the importance of anoxic conditions during OAE 1a at this site. The Gorgo a Cerbara section is interpreted to reflect the progressive impact of palaeoenvironmental change related to the formation of the Ontong-Java plate-basalt plateau, which started already around the Barremian–Aptian boundary and culminated into OAE 1a.