Non-clinical outcomes of antiretroviral therapy for HIV/AIDS in developing countries: a systematic literature review

The impacts of antiretroviral therapy on quality of life, mental health, labor productivity, and economic wellbeing for people living with HIV/AIDS in developing countries are only beginning to be measured. We conducted a systematic literature review to analyze the effect of antiretroviral therapy (ART) on these non-clinical indicators in developing countries and assess the state of research on these topics. Both qualitative and quantitative studies were included, as were peer-reviewed articles, gray literature, and conference abstracts and presentations. Findings are reported from 12 full-length articles, 7 abstracts, and 1 presentation (representing 16 studies). Compared to HIV-positive patients not yet on treatment, patients on ART reported significant improvements in physical, emotional and mental health and daily function. Work performance improved and absenteeism decreased, with the most dramatic changes occurring in the first three months of treatment and then leveling off. Little research has been done on the impact of ART on household wellbeing, with modest changes in child and family wellbeing within households where adults are receiving ART reported so far. Studies from developing countries have not yet assessed non-clinical outcomes of therapy beyond the first year; therefore, longitudinal outcomes are still unknown. As ART roll out extends throughout high HIV prevalence, low-resource countries and is sustained over years and decades, both positive and adverse non-clinical outcomes need to be empirically measured and qualitatively explored in order to support patient adherence and maximize treatment benefits.

Systematic Review of Supported Housing Literature 1993 – 2008

Supported housing for individuals with severe mental illness strives to provide the services necessary to place and keep individuals in independent housing that is integrated into the community and in which the consumer has choice and control over his or her services and supports. Supported housing can be contrasted to an earlier model called the “linear residential approach” in which individuals are moved from the most restrictive settings (e.g., inpatient settings) through a series of more independent settings (e.g., group homes, supervised apartments) and then finally to independent housing. This approach has been criticized as punishing the client due to frequent moves, and as being less likely to result in independent housing. In the supported housing model (Anthony & Blanch, 1988) consumers have choice and control over their living environment, their treatment, and supports (e.g., case management, mental health and substance abuse services). Supports are flexible and faded in and out depending on needs. Results of this systematic review of supported housing suggest that there are several well-controlled studies of supported housing and several studies conducted with less rigorous designs. Overall, our synthesis suggests that supported housing can improve the living situation of individuals who are psychiatrically disabled, homeless and with substance abuse problems. Results show that supported housing can help people stay in apartments or homes up to about 80% of the time over an extended period. These results are contrary to concerns expressed by proponents of the linear residential model and housing models that espoused more restrictive environments. Results also show that housing subsidies or vouchers are helpful in getting and keeping individuals housed. Housing services appear to be cost effective and to reduce the costs of other social and clinical services. In order to be most effective, intensive case management services (rather than traditional case management) are needed and will generally lead to better housing outcomes. Having access to affordable housing and having a service system that is well-integrated is also important. Providing a person with supported housing reduces the likelihood that they will be re-hospitalized, although supported housing does not always lead to reduced psychiatric symptoms. Supported housing can improve clients’ quality of life and satisfaction with their living situation. Providing supported housing options that are of decent quality is important in order to keep people housed and satisfied with their housing. In addition, rapid entry into housing, with the provision of choices is critical. Program and clinical supports may be able to mitigate the social isolation that has sometimes been associated with supported housing.

Between the worlds: otherworld women as intermediaries in early Irish literature

This thesis examines the ways in which Otherworldly women acted as intermediaries between the Otherworld and mortal world in early Irish literature. First it establishes the position of women in early Ireland so that appropriate comparisons can be made between mortal and Otherworld women throughout the thesis. Also, it defines what is meant by the ‘Otherworld’ and its relevence to the early Irish. It then goes on to discuss the differing goals of various intermediaries in early Irish texts, and in what manner they interact with mortals. It briefly looks at how Otherworld male intermediaries are treated differently in the literature, and why early authors might have used women in these roles as often as they did.

Literaturvermittlung auf dem Weg von gestern nach morgen - eine auslandsgermanistische Perspektive

Literaturvermittlung in der Auslandsgermanistik ist traditionell die Domäne der Literaturwissenschaft, die allerdings eine Antwort darauf schuldig bleibt, was jemanden zu einem guten Literaturvermittler macht und worin die besondere Qualität von Lernprozessen besteht, die Studierende im Laufe der Semester anhand von deutschsprachiger Literatur machen. Angesichts der Tatsache, dass Literatur als Bildungsgut und ihr Stellenwert im Curriculum heutzutage nicht mehr so selbstverständlich akzeptiert ist wie vor Jahrzehnten, sollte sich die Auslandsgermanistik solchen und ähnlichen Fragen bereitwilliger stellen und offen diskutieren, wie in künftigen Jahren das studentische Interesse an Literatur wach gehalten bzw. neu entfacht werden kann. Ein wichtiger Schritt in diese Richtung wäre ein Ernster-Nehmen literaturdidaktischer Fragestellungen und insbesondere der Erforschung von Aspekten der vernachlässigten Lehrund Lernpraxis. Es wird dafür plädiert, sich in der Literaturvermittlung künftig nicht ausschließlich an wissenschaftlichen Kategorien zu orientieren, sondern diese auch als eine Form ästhetischer Praxis zu begreifen.

Medieval Irish vision literature: a genre study

This dissertation examines medieval literary accounts of visions of the afterlife with an origin or provenance in Ireland from the perspective of genre, analysing their structural and literary characteristics both synchronically and diachronically. To this end, I have developed a new typology of medieval vision literature. I address the question in what manner the internationally attested genre of vision literature is adapted and developed in an Irish literary milieu. I explore this central research question through an interrogation of the typological unity of the key texts, both in formal arrangement and in the eschatological themes they express. My analysis of the structure and rhetoric of these narratives reveals the primary role of identity strategies, question-and-answer patterns and exhortation for their narrative cohesion and didactic function. In addition, I was able to make a formal distinction at text-level between the adaptation of the genre as an autonomous unit and the adaptation of thematic motifs as topoi. This further enabled me to nuance the distribution of characteristic features in the genre. My analysis of the spatial and temporal aspects of the eschatological journey confirms a preoccupation with personal eschatology. It reveals a close connection between the development of the aspects of graded access and trial in the genre and a growing awareness of an interim state of the soul after death. Finally, my dissertation provides new editions, translations and analyses of primary sources. My research breaks new ground in the hitherto underexplored area of genre adaptation in Ireland. In addition, it contributes significantly to our understanding of the nature of vision literature both in an Irish and a European context, and to our knowledge of the transmission of eschatological thought in the Latin West. Discusses the visions of: Laisrén, Fursa, Adomnán, Lóchán, Tnugdal, Owein and Visio Sancti Pauli Redactions VI and XI.

Quaternary geology of the German North Sea and Western Irish Sea Mud Belt: revised stratigraphies, geotechnical properties, sedimentology and anthropogenic impacts

The climatic development of the Mid to Late Quaternary (last 400,000 years) is characterised by fluctuation between glacial and interglacial periods leading to the present interglacial, the Holocene. In comparison to preceding periods it was believed the Holocene represented a time of relative climatic stability. However, recent work has shown that the Holocene can be divided into cooler periods such as the Little Ice Age alternating with time intervals where climatic conditions ameliorated i.e. Medieval Warm Period, Holocene Thermal Optimum and the present Modern Optimum. In addition, the Holocene is recognised as a period with increasing anthropogenic influence on the environment. Onshore records recording glacial/interglacial cycles as well as anthropogenic effects are limited. However, sites of sediment accumulation on the shallow continental shelf offer the potential to reconstruct these events. Such sites include tunnel valleys and low energy, depositional settings. In this study we interrogated the sediment stratigraphy at such sites in the North Sea and Irish Sea using traditional techniques, as well as novel applications of geotechnical data, to reconstruct the palaeoenvironmental record. Within the German North Sea sector a combination of core, seismic and in-situ Cone Penetration Testing (CPT) data was used to identify sedimentary units, place them within a morphological context, relate them to glacial or interglacial periods stratigraphically, and correlate them across the German North Sea. Subsequently, we were able to revise the Mid to Late Quaternary stratigraphy for the North Sea using this new and novel data. Similarly, Holocene environmental changes were investigated within the Irish Sea at a depositional site with active anthropogenic influence. The methods used included analyses on grain-size distribution, foraminifera, gamma spectrometry, AMS 14C and physical core logging. The investigation revealed a strong fluctuating climatic signal early in the areas history before anthropogenic influence affects the record through trawling.

Not published, not indexed: issues in generating and finding hospice and palliative care literature.

INTRODUCTION: Accessing new knowledge as the evidence base for hospice and palliative care grows has specific challenges for the discipline. This study aimed to describe conversion rates of palliative and hospice care conference abstracts to journal articles and to highlight that some palliative care literature may not be retrievable because it is not indexed on bibliographic databases. METHODS: Substudy A tracked the journal publication of conference abstracts selected for inclusion in a gray literature database on www.caresearch.com.au . Abstracts were included in the gray literature database following handsearching of proceedings of over 100 Australian conferences likely to have some hospice or palliative care content that were held between 1980 and 1999. Substudy B looked at indexing from first publication until 2001 of three international hospice and palliative care journals in four widely available bibliographic databases through systematic tracing of all original papers in the journals. RESULTS: Substudy A showed that for the 1338 abstracts identified only 15.9% were published (compared to an average in health of 45%). Published abstracts were found in 78 different journals. Multiauthor abstracts and oral presentations had higher rates of conversion. Substudy B demonstrated lag time between first publication and bibliographic indexing. Even after listing, idiosyncratic noninclusions were identified. DISCUSSION: There are limitations to retrieval of all possible literature through electronic searching of bibliographic databases. Encouraging publication in indexed journals of studies presented at conferences, promoting selection of palliative care journals for database indexing, and searching more than one bibliographic database will improve the accessibility of existing and new knowledge in hospice and palliative care.

Consistency of financial interest disclosures in the biomedical literature: the case of coronary stents.

BACKGROUND: Disclosure of authors' financial interests has been proposed as a strategy for protecting the integrity of the biomedical literature. We examined whether authors' financial interests were disclosed consistently in articles on coronary stents published in 2006. METHODOLOGY/PRINCIPAL FINDINGS: We searched PubMed for English-language articles published in 2006 that provided evidence or guidance regarding the use of coronary artery stents. We recorded article characteristics, including information about authors' financial disclosures. The main outcome measures were the prevalence, nature, and consistency of financial disclosures. There were 746 articles, 2985 authors, and 135 journals in the database. Eighty-three percent of the articles did not contain disclosure statements for any author (including declarations of no interests). Only 6% of authors had an article with a disclosure statement. In comparisons between articles by the same author, the types of disagreement were as follows: no disclosure statements vs declarations of no interests (64%); specific disclosures vs no disclosure statements (34%); and specific disclosures vs declarations of no interests (2%). Among the 75 authors who disclosed at least 1 relationship with an organization, there were 2 cases (3%) in which the organization was disclosed in every article the author wrote. CONCLUSIONS/SIGNIFICANCE: In the rare instances when financial interests were disclosed, they were not disclosed consistently, suggesting that there are problems with transparency in an area of the literature that has important implications for patient care. Our findings suggest that the inconsistencies we observed are due to both the policies of journals and the behavior of some authors.

Flashbulb memories and posttraumatic stress reactions across the life span: age-related effects of the German occupation of Denmark during World War II.

A representative sample of older Danes were interviewed about experiences from the German occupation of Denmark in World War II. The number of participants with flashbulb memories for the German invasion (1940) and capitulation (1945) increased with participants' age at the time of the events up to age 8. Among participants under 8 years at the time of their most traumatic event, age at the time correlated positively with the current level of posttraumatic stress reactions and the vividness of stressful memories and their centrality to life story and identity. These findings were replicated in Study 2 for self-nominated stressful events sampled from the entire life span using a representative sample of Danes born after 1945. The results are discussed in relation to posttraumatic stress disorder and childhood amnesia.

AUSTRO-GERMAN VIOLIN REPERTORIE FROM BAROQUE THROUGH ROMANTIC PERIOD

At the end of the sixteenth century, Germany had become one of the most active centers of early Baroque music, and therefore Austro-German music came to dominate Western music. An investigation of violin works written during this period reveals the ways in which Austro-German compositions are extraordinary contributions to the violin repertoire. This research warranted further study and performance of these works in order to determine what influence these composers had on the violin repertoire as a whole. For my dissertation recital project, I trace the history of works for violin focusing the violin concerto repertoire in particular. A genre which remained popular throughout the century, the nineteenth-century concerto served primarily as a vehicle for virtuosic display of the violin and piano as never before. For my research I studied and performed works selected from the Baroque through the Romantic period in three recorded recitals with collaborative pianists Ilya Sinaisky, Sun-ha Yun, and Seyon Lee at the Gildenhorn Recital Hall, Clarice Smith Performing Arts Center. I selected particularly prominent pieces which represent the work of significant composers from each period. The composers discussed include Johann Sebastian Bach (1685-1750), owing to the fact that his works are the culmination of the Baroque era during the first half of the eighteenth century; from the Classical period, Wolfgang Amadeus Mozart (1756-1791) all of whom emerged mixing German and Italian traditions into his own style, and Ludwig van Beethoven (1770-1827), the bridge composer between the Classical and the Romantic periods; Romantic composers, Franz Schubert (1979-1828), Johannes Brahms (1833-1897), Robert Schumann (1810-1856), Felix Mendelssohn (1809-1847), and Max Bruch (1838-1920), all who tended to mix Classic and Romantic elements. As a violinist, I learned that their own original sound, rich harmonies and unique expression made these works worthy of becoming masterpieces. I have relished the opportunity for musical and professional growth in exploring these substantial compositions.

IMPROMPTU: FROM PUBLISHER'S IMPULSE TO AN ESTABLISHED SMALL­ SCALE GENRE IN PIANO LITERATURE

The word 'impromptu' began to appear in music literature in the early 19th century, specifically as title for a relatively short composition written for solo piano. The first impromptus appear to have been named so by the publishers. However, the composers themselves soon embraced the title to indicate, for the most part, fairly short character pieces. Impromptus do not follow any specific structural pattern, although many are cast in ternary form. The formal design ranges from strict compound ternary in the early impromptus to through-composed and variation forms. The peak of impromptu's popularity undoubtedly came during the middle and late19th century. However, they are still being composed today, albeit much less frequently. Although there have been many variants of impromptus in relation to formal design and harmonic language over the years, the essence of impromptu remains the same: it is still a short character piece with a general feeling of spontaneity. Overall, impromptus may be categorized into several different groups: some appear as part of a larger cycle, such as Dvorak's G minor Impromptu from his Piano Pieces, B. 110; many others use an element of an additional genre that enhances the character ofthe impromptu, such as Liszt's Valse-Impromptu and Antonio Bibalo's Tango Impromptu; yet another group consists of works based on opera themes, such as Liszt's Impromptu Brillant sur des themes de Rossini et Spontini and Czerny's Impromptus et variations sur Oberon, Op. 134. My recording project includes well-known impromptus, such as Schubert's Op. 142 and the four by Chopin, as well as lesser known works that have not been performed or recorded often. There are four impromptus that have been recorded here for the first time, including those written by Leopold Godowsky, Antonio Bibalo, Altin Volaj, and Nikolay Mazhara. I personally requested the two last named composers to contribute impromptus to this project. My selection represents works by twenty composers and reflects the different types of impromptus that have been encountered through almost three hundred years of the genre's existence, from approximately 1817 (VoriSek) to 2008 (Volaj and Mazhara).

Evolutionary characters, phenotypes and ontologies: curating data from the systematic biology literature.

BACKGROUND: The wealth of phenotypic descriptions documented in the published articles, monographs, and dissertations of phylogenetic systematics is traditionally reported in a free-text format, and it is therefore largely inaccessible for linkage to biological databases for genetics, development, and phenotypes, and difficult to manage for large-scale integrative work. The Phenoscape project aims to represent these complex and detailed descriptions with rich and formal semantics that are amenable to computation and integration with phenotype data from other fields of biology. This entails reconceptualizing the traditional free-text characters into the computable Entity-Quality (EQ) formalism using ontologies. METHODOLOGY/PRINCIPAL FINDINGS: We used ontologies and the EQ formalism to curate a collection of 47 phylogenetic studies on ostariophysan fishes (including catfishes, characins, minnows, knifefishes) and their relatives with the goal of integrating these complex phenotype descriptions with information from an existing model organism database (zebrafish, http://zfin.org). We developed a curation workflow for the collection of character, taxonomic and specimen data from these publications. A total of 4,617 phenotypic characters (10,512 states) for 3,449 taxa, primarily species, were curated into EQ formalism (for a total of 12,861 EQ statements) using anatomical and taxonomic terms from teleost-specific ontologies (Teleost Anatomy Ontology and Teleost Taxonomy Ontology) in combination with terms from a quality ontology (Phenotype and Trait Ontology). Standards and guidelines for consistently and accurately representing phenotypes were developed in response to the challenges that were evident from two annotation experiments and from feedback from curators. CONCLUSIONS/SIGNIFICANCE: The challenges we encountered and many of the curation standards and methods for improving consistency that we developed are generally applicable to any effort to represent phenotypes using ontologies. This is because an ontological representation of the detailed variations in phenotype, whether between mutant or wildtype, among individual humans, or across the diversity of species, requires a process by which a precise combination of terms from domain ontologies are selected and organized according to logical relations. The efficiencies that we have developed in this process will be useful for any attempt to annotate complex phenotypic descriptions using ontologies. We also discuss some ramifications of EQ representation for the domain of systematics.

EARLY TWENTIETH CENTURY VIOLA MUSIC FROM ENGLAND AND GERMANY: FROM POST-ROMANTICISM TO MODERNISM

In the early twentieth century, the viola began to gain status as a solo instrument with the appearance in England of the virtuosic violist Lionel Tertis. Because of a lack of music for viola at that time, such English composers as York Bowen, Arnold Bax, Ralph Vaughan Williams, Arthur Bliss and William Walton began to write viola music for Tertis. Meanwhile, in Germany, the well-known composer and virtuosic violinist and violist Paul Hindemith wrote and premiered several viola sonatas and concertos. Viola music became even more developed later with William Primrose, the legendary Scottish violist, and all the works written in the early twentieth century have remained significant in the viola literature. Although this new viola music appeared in both countries during same period, it developed along different lines in each country. Because they were under the influence of earlier periods and traditions, the English composers who associated with Tertis wrote their music in a Romantic style, with expanded harmony, various colors of sound and timbre, and lyrical melodies. Hindemith, as a composer himself, employed a more Modernist style, using atonality and angular melodies, which represented German trends at that time. I have given three recitals, of which the first two were divided between selected English music and German music. Although I originally intended to focus solely on music by Hindemith and music written for Terts, I decided that in order to give a more complete view of the national trends of those two countries, I included Rebecca Clarke's Sonata, Lachrymae by Benjamin Britten (dedicated to William Primrose), and Max Reger's Suite for Viola. Rebecca Clarke was herself a fine violist, and her sonata's Romantic style is also representative of the English trends of viola music. Lachrymae was written with a different concept and shows more modernity than had ever before occurred in England, though it still differs from the modernity of other countries. Max Reger's Suite is in a truly Romantic style, yet it is old fashioned in ways that differ not only from Wagner or Strauss, but also from English music of the period. In my last recital I wished to pay homage to Tertis, with a program consisting entirely of music written for him. For the finale, Arthur Bliss's Viola Sonata was especially chosen because it provides interesting similarities and contrasts with earlier English music in the Romantic style.

MUSICAL EXOTICISM EXPLORED IN PIANO WORKS FROM THE EIGHTEENTH CENTURY THROUGH THE EARLY TWENTIETH CENTURY

Musical exoticism is the evocation of a culture different from that of the composer. It occurs anytime a composer tries to conjure up the music of a country not his own. Although there have been studies of exoticism in the piano works of an individual composer, namely Debussy, there has not been a comprehensive study of musical exoticism in the piano literature as a whole. Upon chronological examination of the piano repertoire, general trends exhibiting exoticism become evident. The first general trend is the emergence of the Turkish style (alia turca) in the eighteenth century. Turkish style soon transmuted to the Hungarian-Gypsy style (all 'ongarese or style hongrois). [In Beethoven's Op. 129, it is alia ingharese.] Composers often alternated between the two styles even in the same composition. By the late nineteenth century, style hongrois was firmly entrenched in the musical language of Austro-German composers, as seen in the works of Brahms. In the nineteenth century, composers turned to the Middle East, North Africa and Spain for inspiration. In particular are several compositions emulating Spanish dance music, culminating in the Spanish works of Debussy and Ravel. The gamelans from Indonesia and objects from the Far East of Japan and China, brought by advances in trade and transportation, captivated the imagination of composers at the turn of the twentieth century. Also in the early twentieth century, composers tried emulating dance and jazz music coming from the Americas, such as the cakewalk, minstrelsy, and the blues. One sees the ever widening sphere of exotic inspiration for western music composers: from the Turkish invasions to the traveling Gypsies of Hungary; to the captivating dance rhythms, soulful cante jondo sections, and guitar flourishes of Spain; expanding further to the far reaches of Asia and the jazzy rhythms of the Americas. This performance dissertation consists of three recitals presented at the University of Maryland, and is documented on compact disc recordings which are housed within the University of Maryland Library System. The recordings present the music of Balakirev, Beethoven, Brahms, Chopin, Debussy, Haydn, Hummel, Milhaud, Moszkowski, Mozart, Ravel, and Schubert.