Prevalence and predictors of HIV-related stigma among institutional- and community-based caregivers of orphans and vulnerable children living in five less-wealthy countries.

BACKGROUND: In the face of the HIV/AIDS epidemic that has contributed to the dramatic increase in orphans and abandoned children (OAC) worldwide, caregiver attitudes about HIV, and HIV-related stigma, are two attributes that may affect caregiving. Little research has considered the relationship between caregiver attributes and caregiver-reported HIV-related stigma. In light of the paucity of this literature, this paper will describe HIV-related stigma among caregivers of OAC in five less wealthy nations. METHODS: Baseline data were collected between May 2006 through February 2008. The sample included 1,480 community-based and 192 institution-based caregivers. Characteristics of the community-based and institution-based caregivers are described using means and standard deviations for continuous variables or counts and percentages for categorical variables. We fit logistic regression models, both for the full sample and separately for community-based and institution-based caregivers, to explore predictors of acceptance of HIV. RESULTS: Approximately 80% of both community-based and institution-based caregivers were female; and 84% of institution-based caregivers, compared to 66% of community-based caregivers, said that they would be willing to care for a relative with HIV. Similar proportions were reported when caregivers were asked if they were willing to let their child play with an HIV-infected child. In a multivariable model predicting willingness to care for an HIV-infected relative, adjusted for site fixed effects, being an institution-based caregiver was associated with greater willingness (less stigma) than community-based caregivers. Decreased willingness was reported by older respondents, while willingness increased with greater formal education. In the adjusted models predicting willingness to allow one's child to play with an HIV-infected child, female gender and older age was associated with less willingness. However, willingness was positively associated with years of formal education. CONCLUSIONS: The caregiver-child relationship is central to a child's development. OAC already face stigma as a result of their orphaned or abandoned status; the addition of HIV-related stigma represents a double burden for these children. Further research on the prevalence of HIV-related acceptance and stigma among caregivers and implications of such stigma for child development will be critical as the policy community responds to the global HIV/AIDS orphan crisis.

Improving mental health among people living with HIV: a review of intervention trials in low- and middle-income countries.

People living with HIV (PLWH) experience greater psychological distress than the general population. Evidence from high-incomes countries suggests that psychological interventions for PLWH can improve mental health symptoms, quality of life, and HIV care engagement. However, little is known about the effectiveness of mental health interventions for PLWH in low and middle-income countries (LMICs), where the large majority of PLWH reside. This systematized review aims to synthesize findings from mental health intervention trials with PLWH in LMICs to inform the delivery of mental health services in these settings. A systematic search strategy was undertaken to identify peer-reviewed published papers of intervention trials addressing negative psychological states or disorders (e.g., depression, anxiety) among PLWH in LMIC settings. Search results were assessed against pre-established inclusion and exclusion criteria. Data from papers meeting criteria were extracted for synthesis. Twenty-six papers, published between 2000 and 2014, describing 22 unique interventions were identified. Trials were implemented in sub-Saharan Africa (n=13), Asia (n=7), and the Middle East (n=2), and addressed mental health using a variety of approaches, including cognitive-behavioral (n=18), family-level (n=2), and pharmacological (n=2) treatments. Four randomized controlled trials reported significant intervention effects in mental health outcomes, and eleven preliminary studies demonstrated promising findings. Among the limited mental health intervention trials with PLWH in LMICs, few demonstrated efficacy. Mental health interventions for PLWH in LMICs must be further developed and adapted for resource-limited settings to improve effectiveness.

Micromagnetic simulation of domain walls in iron films

The micromagnetic structure and energy of 180° domain walls spanning laminar crystals of iron having (100) or (110) surfaces and ranging in thickness from 145 to 580 nm have been investigated by numerical integration of the Landau-Lifshitz-Gilbert equation. Stable equilibrium structures with two flux symmetries were obtained for both crystal orientations at all thicknesses studied.

Living sustainably: changing cultures and behaviours

2007 was a turning point on what sustainability meant for the construction industry with its new regulation and initiatives. The Government defined sustainability in terms of environmental objectives that can be measured, monitored and met. Last year was also the introduction of the Code for Sustainable Homes. This seminar explores the lessons learnt and the next stage of sustainability in terms of policy and practice.

Law in the community: the University of Greenwich/Greenwich Association of Disabled People Centre for Independent Living (GAD) research project

The GAD Advocacy Service is funded by the London Borough of Greenwich Directorate of Neighbourhood Services; its remit to support disabled people experiencing Hate Crime, Domestic Violence and Harassment. Run by disabled personnel and giving advice to all disabled people it is unique in London. Since its inception in 2004, the Advocacy Service has been stretched to its limit - there is a need to extend the remit of the Advocacy Service to give specialist legal advice on other issues. In 2003, the CEDRM-UK project was set up in the University of Greenwich Law Department as part of the Disability Rights Promotion International Legal Education and Research Project; its objectives were firstly, to facilitate the collection of data on the effectiveness of legislation in promoting the rights of disabled persons; and secondly, to pilot new methods in teaching and training in Human Rights Law – students acquire an expertise in Human Rights Law through research into the practical application of legislation relating to civil and human rights in the daily life of the community. In July 2007, GAD and CEDRM-UK embarked on a joint project to report on the work of the Advocacy Service and to create a database to support its caseload. The 2008-9 Project team will report on their work and findings relating to facilitating equality in the workplace; the inclusion of cancer, HIV and multiple sclerosis within the legal definition of disability and the implications of the statutory duty to promote disability equality for the provision of extracurricular activities for schoolchildren. [From the Author]

Fact, fiction and nostalgia: an assessment of heritage interpretation at living museums

This paper aims to explore and discuss the role of nostalgia (a concept that is inherently grounded within a psychological framework) in heritage interpretation from both provider and consumer perspectives. Whilst many cultural practitioners recognise the relationship between sentimentality and authenticity, particularly within a folk-heritage context, few have sought to examine the effect this has on the visitor experience. This paper questions visitors’ ability to objectively assess objects and experiences at heritage sites, and the role of practitioners in presenting often blurred views of social history that may sometimes negate historical fact. Drawing on case study research at two UK living museums, Blists Hill Victorian Town in Shropshire, England, and the Big Pit: National Coal Museum in Wales, notions of reminiscence, authenticity, myth and intangibility are considered within the framework of the interpretive experience. Findings suggest that the visitor experience is inherently subjective, highly individual and that the concept of intangibility is integral to an understanding of the nostalgia-authenticity debate.

Ecological And Metabolic Studies On Free-Living Nematodes From An Estuarine Mud-Flat

Nematodes from a mud-flat in the river Lynher estuary, Cornwall, U.K., have a population density ranging between 8 and 9 × 106 m−2 in the winter months, corresponding to a dry weight of 1·4 and 1·6 g m−2. They reach a peak abundance of 22·86 × 106 m−2 (3·4 g) in May. About 40 species are present, and the species composition remained seasonally stable over the period of study. Analysis of age-structure suggests that the major species have continuous asynchronous reproduction. Respiration rates of 16 species have been determined at 20 °C using Cartesian diver respirometry. For five species, respiration/body size regressions were obtained in the form log10R = log10a+b log10V, where R = respiration in nl O2 ind−1 h−1 and V = body volume in nl: Mesotheristus setosus (log10a = −0·04,b = 0·74), Sphaerolaimus hirsutus (log10a = 0·11, b = 0·68), Axonolaimus paraspinosus (log10a = 0·00, b = 0·79), Metachromadora vivipara (log10a = −0·59, b = 1·07), Praeacanthonchus punctatus (log10a = 0·00, b = 0·55). For the remaining 11 species, several animals were used in each diver and, by assuming b = 0·75, log10a′ values were calculated: Viscosia viscosa (log10a′ = 0·188), Innocuonema tentabundum (−0·012), Ptycholaimellus ponticus (−0·081), Odontophora setosa (−0·092), Sphaerolaimus balticus (−0·112), Dichromadora cephalata (−0·133), Atrochromadora microlaima (−0·142), Cylindrotheristus normandicus (−0·150), Terschellingialongicaudata (−0·170), Sabatieria pulchra (−0·197), Terschellingia communis (−0·277). These values are compared with recalculated values for other species from the literature. Annual respiration of the nematode community is 28·01 O2 m−2, equivalent to 11·2 g carbon metabolised. Community respiration is compared with figures from N. American saltmarshes. At 20 °C, a respiration of about 61 O2 m−2 year−1 g−1 wet weight of nematodes appears to be typical. Annual production is estimated to be 6·6 g C m−2. The correlation between feeding-group, body-size, habitat and the repiration rate of individual species is discussed.