Imbalance of naive and memory T lymphocytes with sustained high cellular activation during the first year of life from uninfected children born to HIV-1-infected mothers on HAART

The immune consequences of in utero HIV exposure to uninfected children whose mothers were submitted to highly active antiretroviral therapy (HAART) during gestation are not well defined. We evaluated 45 HIV-exposed uninfected (ENI) neonates and 45 healthy unexposed control (CT) neonates. All HIV-infected mothers received HAART during pregnancy, and the viral load at delivery was <50 copies/mL for 56.8%. Twenty-three ENI neonates were further evaluated after 12 months and compared to 23 unexposed healthy age-matched infants. Immunophenotyping was performed by flow cytometry in cord and peripheral blood. Cord blood lymphocyte numbers did not differ between groups. However, ENI neonates had a lower percentage of naive T cells than CT neonates (CD4+, 76.6 vs 83.1%, P < 0.001; CD8+, 70.9 vs 79.6%, P = 0.003) and higher percentages of central memory T cells than CT neonates (CD4+, 13.9 vs 8.7%, P < 0.001; CD8+, 8.6 vs 4.8%, P = 0.001). CD38 mean fluorescence intensity of T cells was higher in ENI neonates (CD4+, 62.2 vs 52.1, P = 0.007; CD8+, 47.7 vs 35.3, P < 0.001). At 12 months, ENI infants still had higher mean fluorescence intensity of CD38 on T cells (CD4+, 34.2 vs 23.3, P < 0.001; CD8+, 26.8 vs 19.4, P = 0.035). Despite effective maternal virologic control at delivery, HIV-exposed uninfected children were born with lower levels of naive T cells. Immune activation was present at birth and remained until at least 12 months of age, suggesting that in utero exposure to HIV causes subtle immune abnormalities.

Relationship between disease severity and quality of life in patients with chronic obstructive pulmonary disease

Few studies have evaluated the relationship between Airways Questionnaire 20 (AQ20), a measure of the quality of life, scores and physiological outcomes or with systemic markers of disease in patients with chronic obstructive pulmonary disease (COPD). The aim of the present study was to investigate the relationship of forced expiratory volume in 1 s (FEV1), body mass index, fat-free mass index, 6-min walk test (6MWT) results, dyspnea sensation and peripheral oxygen saturation (SpO2) with the quality of life of COPD patients. Ninety-nine patients with COPD (mean age: 64.2 ± 9.2 years; mean FEV1: 60.4 ± 25.2% of predicted) were evaluated using spirometry, body composition measurement and the 6MWT. The baseline dyspnea index (BDI) and the Modified Medical Research Council (MMRC) scale were used to quantify dyspnea. Quality of life was assessed using the AQ20 and the St. George's Respiratory Questionnaire (SGRQ). The Charlson index was used to determine comorbidity. The body mass index/airflow obstruction/dyspnea/exercise capacity (BODE) index was also calculated. AQ20 and SGRQ scores correlated significantly with FEV1, SpO2, 6MWT, MMRC and BDI values as did with BODE index. In the multivariate analyses, MMRC or BDI were identified as predictors of AQ20 and SGRQ scores (P < 0.001 in all cases). Thus, the relationship between AQ20 and disease severity is similar to that described for SGRQ. Therefore, the AQ20, a simple and brief instrument, can be very useful to evaluate the general impact of disease when the time allotted for measurement of the quality of life is limited.

Relationship between the quality of life and the severity of obstructive sleep apnea syndrome

The effects of sleep disorders on the quality of life (QOL) have been documented in the literature. Excessive sleepiness and altered circadian rhythms may negatively affect ability to learn, employment, and interpersonal relations, and directly degrade QOL. The objective of the present study was to evaluate the impact of obstructive sleep apnea syndrome of varying severity on QOL. The study was conducted on 1892 patients aged 18 years or older referred by a physician to the Sleep Institute, São Paulo, with complaints related to apnea (snoring, excessive daytime sleepiness, hyperarousal, and fatigue). They were submitted to overnight polysomnography for the diagnosis of sleep disorders from August 2005 through April 2006. The patients completed the Epworth Sleepiness Scale and QOL SF-36 sleep questionnaires. They were classified as non-physically active and physically active and not-sleepy and sleepy and the results of polysomnography were analyzed on the basis of the apnea hypopnea index (AHI). The apneic subjects showed a reduction in QOL which was proportional to severity. There was a significant decrease in all domains (physical functioning, role physical problems, bodily pain, general health perceptions, vitality, social functioning, emotional problems, general mental health) for apneics with AHI >30, who generally were sleepy and did not participate in physical activities (P < 0.05). The present study provides evidence that the impact of sleep disorders on QOL in apneics is not limited to excessive daytime sleepiness and that physical activity can contribute to reducing the symptoms. Thus, exercise should be considered as an adjunct interventional strategy in the management of obstructive sleep apnea syndrome.

Diastolic function is associated with quality of life and exercise capacity in stable heart failure patients with reduced ejection fraction

Exercise capacity and quality of life (QOL) are important outcome predictors in patients with systolic heart failure (HF), independent of left ventricular (LV) ejection fraction (LVEF). LV diastolic function has been shown to be a better predictor of aerobic exercise capacity in patients with systolic dysfunction and a New York Heart Association (NYHA) classification ≥II. We hypothesized that the currently used index of diastolic function E/e' is associated with exercise capacity and QOL, even in optimally treated HF patients with reduced LVEF. This prospective study included 44 consecutive patients aged 55±11 years (27 men and 17 women), with LVEF<0.50 and NYHA functional class I-III, receiving optimal pharmacological treatment and in a stable clinical condition, as shown by the absence of dyspnea exacerbation for at least 3 months. All patients had conventional transthoracic echocardiography and answered the Minnesota Living with HF Questionnaire, followed by the 6-min walk test (6MWT). In a multivariable model with 6MWT as the dependent variable, age and E/e' explained 27% of the walked distance in 6MWT (P=0.002; multivariate regression analysis). No association was found between walk distance and LVEF or mitral annulus systolic velocity. Only normalized left atrium volume, a sensitive index of diastolic function, was associated with decreased QOL. Despite the small number of patients included, this study offers evidence that diastolic function is associated with physical capacity and QOL and should be considered along with ejection fraction in patients with compensated systolic HF.

Negative emotions affect postoperative scores for evaluating functional knee recovery and quality of life after total knee replacement

This study aimed to determine whether psychological factors affect health-related quality of life (HRQL) and recovery of knee function in total knee replacement (TKR) patients. A total of 119 TKR patients (male: 38; female: 81) completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), Eysenck Personality Questionnaire-revised (EPQR-S), Knee Society Score (KSS), and HRQL (SF-36). At 1 and 6 months after surgery, anxiety, depression, and KSS scores in TKR patients were significantly better compared with those preoperatively (P<0.05). SF-36 scores at the sixth month after surgery were significantly improved compared with preoperative scores (P<0.001). Preoperative Physical Component Summary Scale (PCS) and Mental Component Summary Scale (MCS) scores were negatively associated with extraversion (E score) (B=-0.986 and -0.967, respectively, both P<0.05). Postoperative PCS and State Anxiety Inventory (SAI) scores were negatively associated with neuroticism (N score; B=-0.137 and -0.991, respectively, both P<0.05). Postoperative MCS, SAI, Trait Anxiety Inventory (TAI), and BAI scores were also negatively associated with the N score (B=-0.367, -0.107, -0.281, and -0.851, respectively, all P<0.05). The KSS function score at the sixth month after surgery was negatively associated with TAI and N scores (B=-0.315 and -0.532, respectively, both P<0.05), but positively associated with the E score (B=0.215, P<0.05). The postoperative KSS joint score was positively associated with postoperative PCS (B=0.356, P<0.05). In conclusion, for TKR patients, the scores used for evaluating recovery of knee function and HRQL after 6 months are inversely associated with the presence of negative emotions.

Psychological well-being of the parents and child development, behavior, and quality of life in very low birth weight infants

The parents of premature infants, especially the mothers, are at increased risk for distress. Infants born prematurely are at risk for developmental problems. The aim of this study was to investigate whether the psychological well-being of both parents is associated with child development in very low birth weight (VLBW, ≤1500g) children. The burden of prematurity-related morbidity to the children and to the family was also assessed. A cohort of 201 VLBW infants born during 2001–2006 in the Turku University Hospital, Finland, and their parents were studied (I–IV). One study included a control group (n=166) of full-term infants (IV). The psychological well-being of the parents was evaluated by assessments of depressive symptoms, parenting stress, the sense of coherence and general family functioning. Cognitive, behavioral, and socio-emotional development, and the health-related quality of life (HRQoL) of the children were determined when the children were 2 to 8 years old. The psychological well-being of the parents was associated with the cognitive, behavioral and social development of the VLBW children. The VLBW infants with prematurity-related morbidities had a poorer HRQoL and the general functioning of the family was inferior compared to the control children and their families. 64.5% of the VLBW children survived without morbidities. Most of the VLBW children did not have significant behavior problems (93%), had normal social skills (63%), had no emotional problems (64%), and had no problems in executive functioning (62%). Only 3% of the surviving VLBW infants had significant cognitive delay. In conclusion, the depressive symptoms and stress of the parents can be risk factors for disadvantageous child development, while a strong sense of coherence can be protective. Parents of the premature children with developmental delays might also experience more depressive symptoms and stress than other parents. Prematurity-related morbidities were a burden to the VLBW child as well as to the family.

Dyadic Relationship and Quality of Life Patients with Chronic Kidney Disease

AbstractIintroduction:Chronic Renal insufficiency (CRI) and dialysis treatment lead to a succession of situations for kidney chronic patient, which compromises his aspect, not only physically, and psychologically, with personal, family and social repercussions.Objective:(1) to verify the existence of differences of dyadic adjustment (DA) according to renal replacement treatment (RRT) and (2) verify the existence of differences quality of life (QOL) in accordance with the RRT.Methods:This is a cross-sectional study of a descriptive nature through surveys, exploratory and correlational. The sample consisted of 125 participants. Of these, 31 were to be made RRT by automated peritoneal dialysis (APD) and 94 hemodialysis (HD). Participants were selected from three renal centers: (1) Centro Renal da Prelada (Porto, Portugal), (2) Centrodial (S. João da Madeira, Portugal) and Centro Renal da Misericórdia de Paredes (Paredes, Portugal). The study was carried out for 6 months. The following instruments were applied: Socio-demographic and clinical questionnaire (SDCQ), Dyadic Adjustment Scale (DAS), World Health Organization Quality of Life (WHOQOL-Bref).Results:The results demonstrate the existence of statistically significant differences between the type of RRT and most areas of QOL, as well as the existence of statistically significant differences between the subscales of the DAS evaluated and the type of RRT.Conclusion:The present study demonstrates a greater commitment in terms of QOL of individuals undergoing treatment for HD when compared with those subjected to APD. It turns out, also, that DA is most strongly perceived by patients in APD than with HD.

Narratives of emergence: rising powers and the end of the Third World?

This article examines recent arguments from development economists, from historians and from international relations specialists that do challenge the continued relevance of the idea of the Third World. It then examines five reasons why these arguments are wrong. We can indeed understand much about emerging powers in terms of how they are seeking to navigate and best position themselves within an existing state-centric, liberal and capitalist order whilst accepting many of the underlying assumptions and values of that order. But the nature of that navigation has been shaped by their historical trajectory and by the developmental, societal and geopolitical context of their emergence.

Form(s)-of-life: agamben's reading of Wittgenstein and the potential uses of a notion

Giorgio Agamben and Ludwig Wittgenstein seem to have very little in common: the former is concerned with traditional ontological issues while the latter was interested in logics and ordinary language, avoiding metaphysical issues as something we cannot speak about. However, both share a crucial notion for their philosophical projects: form of life. In this paper, I try to show that, despite their different approaches and goals, form of life is for both a crucial notion for thinking ethics and life in-common. Addressing human existence in its constitutive relation to language, this notion deconstructs traditional dichotomies like bios and zoé, the cultural and the biological, enabling both authors to think of a life which cannot be separated from its forms, recognizing the commonality of logos as the specific trait of human existence. Through an analogical reading between both theoretical frameworks, I suggest that the notion of form-of-life, elaborated by Wittgenstein to address human production of meaning, becomes the key notion in Agamben's affirmative thinking since it enables us to consider the common ontologically in its relation to Human potentialities and to foresee a new, common use of the world and ourselves.

Performance Degradation Modelling and Techno-Economic Analysis of Lithium-Ion Battery Energy Storage Systems

Transmission system operators and distribution system operators are experiencing new challenges in terms of reliability, power quality, and cost efficiency. Although the potential of energy storages to face those challenges is recognized, the economic implications are still obscure, which introduce the risk into the business models. This thesis aims to investigate the technical and economic value indicators of lithium-ion battery energy storage systems (BESS) in grid-scale applications. In order to do that, a comprehensive performance lithium-ion BESS model with degradation effects estimation is developed. The model development process implies literature review on lifetime modelling, use, and modification of previous study progress, building the additional system parts and integrating it into a complete tool. The constructed model is capable of describing the dynamic behavior of the BESS voltage, state of charge, temperature and capacity loss. Five control strategies for BESS unit providing primary frequency regulation are implemented, in addition to the model. The questions related to BESS dimensioning and the end of life (EoL) criterion are addressed. Simulations are performed with one-month real frequency data acquired from Fingrid. The lifetime and cost-benefit analysis of the simulation results allow to compare and determine the preferable control strategy. Finally, the study performs the sensitivity analysis of economic profitability with variable size, EoL and system price. The research reports that BESS can be profitable in certain cases and presents the recommendations.

A comparison of life satisfaction, job satisfaction, and happiness using demographic variables

This study examined the interrelationships among life satisfaction, job satisfaction, and happiness and the selected demographic variables of income, age, marital status, education, sex, job tenure, job title, type of school, and location of employment. Survey data were collected from 1,993 elementary, high school, and community college teachers in the southern Ontario area, representing ten public school boards, three Roman Catholic school boards and three community colleges. Several theories were utilized in developing thirteen hypotheses and eleven experimental hypotheses. A thorough review of the literature (to January, 1980) was undertaken and major conclusions noted. Hoppock's (1935) Job Satisfaction Measure, Gurin, Veroff, and Feld's (1960) Happiness Scale, and Converse and Robinson's (1965) Life Satisfaction Scale were used as the instrument. Chi-square analysis was employed as the statistical method. Indicative of the findings: the level of education taught was significantly related to all three organizational variables, sex was unrelated to life satisfaction though positively related to job satisfaction, and income was found not to be related to either happiness or life satisfaction. A minority of findings were contrary to hypothesized relationships. Specifically, age was found to be unrelated to any of the three organizational variables, and educational achievement was not significantly related to happiness. A model was developed to illustrate the interrelationships of the organizational and demographic variables. This model was designed specifically to reflect teacher attitudes, though it may have reasonable application for other relatively homogeneous groups of employees such as nurses, engineers, or social workers.

Effectiveness of life skills training on the total behaviour of six individuals in a job preparation program

In the first week of a Job preparation Program all twelve female members of the class were invited to be part of a study to determine the effect of Life Skills training on their behaviour over the twelve-week period of the program. Six females volunteered and each was interviewed four times during the Job preparation Program and once after the program ended. The interviews focused on three areas of skill deficiency addressed in Life Skills lessons: their knowledge about themselves and attitude towards themselves; their interpersonal relationships; and their problem-solving ability. The participants' comments over the sixteen-week period of the interviews were used to decide if the total behaviour of the participants, (i.e., what they did, thought, and felt) changed so that each became more effective in satisfying her needs. The study suggested that the total behaviour of three of the six women changed so that they became more effective in satisfying their needs. The fourth female's total behaviour changed in only two of the three areas focused on in the interviews, and the total behaviour of the fifth and sixth females showed no change.

The quality of life in the Master of Education program, Brock University

This study addressed the problem of the quality of life in the Brock Master of Education program. Survey and interview data were used to gain an understanding of satisfaction with the learning achieved and student life experienced. Eighty-seven percent of the study sample reported satisfaction with the program overall. Results suggested the higher the overall satisfaction with a program, the greater the likelihood learning and student life satisfaction were also more positive. Student reflections suggested satisfaction with the quality of life in the program was associated with the program's focus on the student, the use of self-directed learning, and the support of professors to meet student needs. Comparison of the Brock Master of Education survey with the Brock Pre-Service Teacher Education program showed both student groups shared a similar satisfaction with student life in the Faculty. Comparison of Master of Education programs suggested the difference between two programs, a difference which may be influenced by time in the program. The results from the three programs suggested that students beyond the first undergraduate degree favored the school domains of learning acquisition. Supplementary data on the relationship between cognitive and affective opinions suggested the more positive the affective dimension of learning, the greater the likelihood the cognitive dimensions of student life were also more positive. It was concluded that time was a chief factor influencing part-time student satisfaction with both learning and student life in the program. Part-time students, as. the majority in the survey, expressed comments about the need for clarity of communication between the organization and student to promote the effective use of limited time.

The quality of life as perceived by students in the Business Division, Niagara College

within the Business Division of Niagara College of Arts and Technology, 245 students were utilised for a convenience stratified sample of First, Second, and Third Year ,students. The students answered 33 items regarding their Quality of Program and 40 concerning their Quality of Life, along with demographic and motivational questions and open comments. The responses were classified using an SPSS/PC statistical package and frequency statistics extracted. The data were examined for the entire sample and also for each year within the Business Division. There were high positive responses to both QOP andQOL items. However, there was greater satisfaction for students in First Year Accelerated, Second Year and Third Year than First Year. All students noted high satisfaction for the overall assessment of the program. There were lower positive responses for Professor Items where students were unsure if teachers helped them to do their best or took a personal interest in helping students do their best. This may highlight problems which need attention in the Freshman year. The area where all students were most neutral was regarding how others view them which raises questions of the self-esteem of students at Niagara College. The implications from this study seem to suggest that well-motivated, small, closely identified groups with interactive teaching methods lead to positive QOL and QOP.