Increased cytotoxic T-lymphocyte epitope variant cross-recognition and functional avidity are associated with hepatitis C virus clearance

Hepatitis C virus (HCV) clearance has been associated with reduced viral evolution in targeted cytotoxic T-lymphocyte (CTL) epitopes, suggesting that HCV clearers may mount CTL responses with a superior ability to recognize epitope variants and prevent viral immune escape. Here, 40 HCV-infected subjects were tested with 406 10-mer peptides covering the vast majority of the sequence diversity spanning a 197-residue region of the NS3 protein. HCV clearers mounted significantly broader CTL responses of higher functional avidity and with wider variant cross-recognition capacity than nonclearers. These observations have important implications for vaccine approaches that may need to induce high-avidity responses in vivo.

Independent association between lower level of social support and higher coagulation activity before and after acute psychosocial stress

OBJECTIVE: To investigate the relationship between social support and coagulation parameter reactivity to mental stress in men and to determine if norepinephrine is involved. Lower social support is associated with higher basal coagulation activity and greater norepinephrine stress reactivity, which in turn, is linked with hypercoagulability. However, it is not known if low social support interacts with stress to further increase coagulation reactivity or if norepinephrine affects this association. These findings may be important for determining if low social support influences thrombosis and possible acute coronary events in response to acute stress. We investigated the relationship between social support and coagulation parameter reactivity to mental stress in men and determined if norepinephrine is involved. METHODS: We measured perceived social support in 63 medication-free nonsmoking men (age (mean +/- standard error of the mean) = 36.7 +/- 1.7 years) who underwent an acute standardized psychosocial stress task combining public speaking and mental arithmetic in front of an audience. We measured plasma D-dimer, fibrinogen, clotting Factor VII activity (FVII:C), and plasma norepinephrine at rest as well as immediately after stress and 20 minutes after stress. RESULTS: Independent of body mass index, mean arterial pressure, and age, lower social support was associated with higher D-dimer and fibrinogen levels at baseline (p < .012) and with greater increases in fibrinogen (beta = -0.36, p = .001; DeltaR(2) = .12), and D-dimer (beta = -0.21, p = .017; DeltaR(2) = .04), but not in FVII:C (p = .83) from baseline to 20 minutes after stress. General linear models revealed significant main effects of social support and stress on fibrinogen, D-dimer, and norepinephrine (p < .035). Controlling for norepinephrine did not change the significance of the reported associations between social support and the coagulation measures D-dimer and fibrinogen. CONCLUSIONS: Our results suggest that lower social support is associated with greater coagulation activity before and after acute stress, which was unrelated to norepinephrine reactivity.

Between Equity and Empathy: Social Professions and the New Accountability

This article explores the practical and ethical implications of the ‘new accountability’ (working to procedures, targets and standards) based on interviews with British social professionals. Although similar tendencies are present in other European countries, in Britain the rule-bound nature of social work is more intense. Practitioners who regard the ‘new accountability’ positively justify their views with reference to utilitarian and rights-based arguments relating to the promotion of good outcomes, the achievement of equity, respecting the consumer rights of service users and the rights of other stakeholders to information and value for money. Those practitioners who view the new accountability requirements negatively seem to speak in a different ‘moral voice’, which can be linked to more personal and situated approaches to ethics, stressing the importance of particular relationships in context, trust, sensitivity and a sense of ‘vocation’. Both ‘voices’ are part of professional practice, but the new accountability stresses the former at the expense of the latter. For social work to play the critical role identified by Walter Lorenz, maintaining a creative balance between equity and empathy will be important.

Enabling Access to Welfare Services - the Place of Social Solidarity and Dialogue

The welfare state in the UK presents immigrant communities with a set of institutions, which are potentially new and unknown. What is the best way to ensure that the questions of access to the welfare institutions are best managed? Trusting, understanding and feeling solidarity with the welfare state will obviously help with this problem. In order to shed light on this phenomenon, this paper presents a qualitative exploratory study dealing with elements of solidarity as perceived by members of the South Asian Community in the UK. Six indepth interviews with South Asian first generation immigrants who had never experienced mental health problems were conducted. They were asked questions about who their support networks would be in the event of them experiencing mental health problems. The thematic analysis of the interviews suggests that the respondents believed that solidarity and support ties are found to be present in families, within the south Asian community and also with welfare institutions. It is concluded that there although things are far from perfect, assimilation and integration based on dialogue is an observable positive aspect of mental health service provision in the UK.

Modernising Social Work and the Ethics of Care

Recent attempts to 'modernise' social work have emphasised the importance of collaboration, partnership, and participation with individual users of services and the wider community. However, technical-rational aspects of managerialism have proved dominant. Managerialist approaches to social service administration and delivery threaten important dimensions of social work; specifically its caring and democratic-transformative dimensions. However, social work theorists have only recently begun to re-engage with ideas of care. We argue that closer attention to feminist debates about the ethics of care can make a significant contribution to not only rehabilitating the ideal of care for social work but also to moving forward the modernisation agenda itself. We develop a feminist critique of managerialism, and argue that the discourse of the ethics of care offers useful ways of framing arguments to counter some damaging impacts of managerial reforms.

Social Work, Social Politics and Justice

"The disaster does not primarily lie in people and in the way that they perceive the circumstances, rather in the circumstances that doom people to powerlessness and apathy - circumstances which they could, however, change" (Adorno, 1966, p. 189). When Karl Marx writes to Friedrich Sorge in his letter of the 19.10.1877, regarding his critique of the opinion of his opponents Dühring & Co., that one must deal with "a whole crowd of immature students and pompous doctors who claim to give socialism a 'higher, ideal' turn, that is to say, to replace the materialistic basis (that demands serious, objective study if one wants to operate on it)… with modern mythology by means of their goddesses of justice, freedom, equality and fraternité" (Marx, 1973, p. 303; cf. Schiller, 1993, p. 199 onwards), this thus refers to fundamental problems with the concept of "justice" up until today. As the debate shows, it concerns the contextualization of the term "justice", its meaning in historically concrete as well as socio-political circumstances, and therefore a social analysis that is both representation and critique. Essentially it also concerns the question of the relationship between ideas and reality and the development of standards of historical systematic 'nature' out of social frameworks (see Frey, 1978; Theunissen, 1989).

Social Work and a New Social Order - Challenging Neo-liberalism's Erosion of Solidarity

The world in which social work operates today is a very different world from that in which most of us took their social work training, and the changes we are facing are profound. This paper argues that these changes are not merely a regime change in social policy but that they are essentially about a re-ordering of social relationships and attempt to model them on neo-liberal ideas. In view of these pressures it is understandable that social workers often try to ignore those changes and withdraw into a private world of therapeutic relationships in which the methods they trained in are made to be still valid, or they simply go along with new service delivery designs without asking too many questions. Both reactions fail to question what the "social" can still mean in the light of these changes and how social workers can fulfil their mandate to be responsible for the social dimension of public life. Nothing less than a head-on challenge of the basic presuppositions of neo-liberalism (Willke 2003) and their manifold applications to social service delivery systems will thereby suffice.