Reductions in depressed mood and denial coping during cognitive behavioral stress management with hiv-positive gay men treated with haart

Background: Stress management interventions for HIV-positive persons have been designed to enhance coping skills and encourage health-promoting behaviors with the hope of decreasing distress and slowing disease progression.Purpose: We examined the efficacy of a cognitive behavioral stress management (CBSM) intervention in combination with medication adherence training (MAT) in 130 gay and bisexual men living with HIV infection.Methods: Participants were randomized to either a 10-week CBSM+MAT intervention (n = 76) or a MAT-only condition (n = 54). Measures of self-reported adherence, active cognitive coping (i.e., acceptance and positive reinterpretation), avoidant coping (i.e., denial and behavioral disengagement), and depressed mood were examined over the 10-week intervention period.Results: Men in CBSM+MAT reported reductions in depressed mood and denial coping during the 10-week intervention period, but no changes in active cognitive coping or self-reported adherence were observed. Using path analysis, greater reliance on denial coping at baseline was associated with decreased depressed mood at 10 weeks. We also determined that CBSM+MAT may decrease depressed mood by reducing reliance on denial coping over the 10-week intervention period.Conclusions: Although denial may be an effective means of distress reduction in the short term, reliance on this coping strategy may result in a decreased capacity to effectively manage a variety of disease-related stressors in the long term. CBSM+MAT addresses this potentially detrimental pattern by teaching stress reduction skills that may decrease depressed mood via reduced reliance on denial coping. This research was supported by National Institute of Mental Health Grants P01 MH49548 and T32 MH18917.     

A REPRODUCIBLE MODEL OF CHRONIC REJECTION IN RAT RENAL ALLOGRAFTS

A reproducible animal model is essential for the study of the pathogenesis of chronic rejection. This study investigates: (i) the optimal pre-transplant blood transfusion conditions to induce tolerance in a strongly rejecting rat kidney allograft model (Dark Agouti to Albino-Surgery) and avoiding post-transplant immunosuppression; (ii) the functional and histological changes that occur in long-term surviving kidneys and their similarity to chronic rejection; and (iii) the maintenance of tolerance. Prolonged survival occurred after administration of at least two donor blood transfusions with concomitant cyclosporin A (5 mg/kg per day). The time-span between transfusions appeared to be critical: 4 days was more effective than 2 or 7 days. Ineffective treatment led to death within the first 2 weeks post-transplant with histological evidence of acute graft rejection. Seventy-five per cent of long-term survivors experienced impaired renal function in the first week which improved spontaneously and remained stable in 93% of the surviving animals after 100 days and in 668 after 200 days. The morphology of long-term allografts was extremely variable from minor to extensive tubular atrophy, interstitial fibrosis, glomerular hypertrophy, focal and segmental glomerulosclerosis and vascular changes. Glomerular hypertrophy occurred in uninephrectomized controls and probably denoted a response to uninephrectomy. Glomerulosclerosis increased with time and was absent in controls. Although chronic damage was evident, the rats remained tolerant to fresh donor skin. Replacement of the original kidney allograft with a fresh donor kidney resulted in 70% survival. These second grafts showed less severe renal dysfunction and morphological damage than the original allografts in the long-term follow up.     

Urinary and fecal excretions and absorption of a large supplement of selenium: superiority of selenate over selenite

A correction needs to be made to the form of selenium used in earlier studies; what was believed to be selenite-Se in solution is now known to have been selenate-Se. In the present study, excretion of Se was followed in 13 women after ingestion of 1 mg Se as selenite or selenate in solution. Fecal excretion of selenate-Se was less than for selenite-Se reflecting a higher apparent absorption [94 +/- 4% (SD), 62 +/- 14%, respectively]. Peak excretion of Se occurred 3 h earlier for selenate-Se than for selenite-Se and was 6 times higher. Total urinary excretion of selenate-Se was 3 times that of selenite-Se and still 2 times as high when expressed as % absorbed dose. Total recovery of Se in urine and feces was similar for both forms. There was remarkable agreement between these results and those reported earlier for selenate-Se (Selovet-1) and selenite-Se.     

The prevalent cohort study and the acquired immunodeficiency syndrome

The acquired immunodeficiency syndrome (AIDS) is caused by a retrovirus, the human immunodeficiency virus (HIV). A rapid and convenient method to identify additional cofactors or risk modifiers and markers of disease progression is to study a cohort prevalent with HIV antibody. However, because the time of viral infection is usually unknown in the cohort, there are several potential sources of bias. Three sources of bias in a prevalent cohort study are identified assuming a proportional hazards model: onset confounding, differential length-biased sampling, and frailty selection. A number of problems in the interpretation of results on markers from a prevalent cohort also are considered. It is concluded that risk estimates derived from a prevalent cohort are not directly comparable to risk estimates derived from an incident cohort.     

Communities coping with change: A conceptual model

Changing economic, political, environmental, and social conditions continue to have a cumulative impact on Australian regional communities, and in many instances, rural communities are being forced to initiate their own strategies in order to remain economically and socially viable. However, while communities respond in differing ways to similar change events, as do individuals, research examining the change process has largely been undertaken at the individual level. This article reports on an investigation of the characteristics that moderate a community's ability to manage change and the types of collective coping strategies communities employ to deal with change events. A model of community change process was used as the framework to examine the links between community characteristics, appraisal of change events (forest restructuring and tourism), and the use of collective strategies in three communities in Western Australia. Findings suggest that a community's mobilization of strategies is dependent on the collective assessment of the change event, the nature of the event, and the characteristics of the community. The implications for intervention through policy and community development are discussed briefly. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 201–216, 2004.     

High intensity focused ultrasound: physical principles and devices.

High intensity focused ultrasound (HIFU) is gaining rapid clinical acceptance as a treatment modality enabling non-invasive tissue heating and ablation for numerous applications. HIFU treatments are usually carried out in a single session, often as a day case procedure, with the patient either fully conscious, lightly sedated or under light general anaesthesia. A major advantage of HIFU over other thermal ablation techniques is that there is no necessity for the transcutaneous insertion of probes into the target tissue. The high powered focused beams employed are generated from sources placed either outside the body (for treatment of tumours of the liver, kidney, breast, uterus, pancreas and bone) or in the rectum (for treatment of the prostate), and are designed to enable rapid heating of a target tissue volume, while leaving tissue in the ultrasound propagation path relatively unaffected. Given the wide-ranging applicability of HIFU, numerous extra-corporeal, transrectal and interstitial devices have been designed to optimise application-specific treatment delivery. Their principle of operation is described here, alongside an overview of the physical mechanisms governing HIFU propagation and HIFU-induced heating. Present methods of characterising HIFU fields and of quantifying HIFU exposure and its associated effects are also addressed.     

Immunological changes in normal pregnancy.

During pregnancy the mother must tolerate intra-uterine allogenic fetal tissue. Failure of this tolerance may cause spontaneous abortion. The immunological changes occurring in normal pregnancy are poorly understood. The aim of this study was to investigate the immunological changes occurring in pregnancy. Thirty women in the first trimester; 10 in the second and 10 in the third trimester of pregnancy were studied and compared to age matched non-pregnant controls. In normal pregnancy there was an increase in the total white cell count with no change in the lymphocyte count. There was a fall in total T cell numbers and activated T cell numbers, with no change in helper/inducer or suppressor/cytotoxic T cell numbers. [3H]Thymidine uptake in response to three different mitogens was increased. This implies an increase in potential for the cells to respond to mitogens. There was no change in interleukin-2 receptor levels, suggesting that despite this increased potential there was no general activation of the immune system. A rise in IgM and IgG was found after mitogen stimulation of peripheral blood lymphocytes, suggesting an increase in potential antibody production. These results demonstrate that lymphocytes from pregnant women have an increased potential rather than an increased activity.     

A quantitative analysis of eye movements during the cover test – a preliminary report

The aim of this study was to carry out quantitative analyses of eye movements during the cover test on a group ( n = 57) of asymptomatic emmetropes. Eye movements were recorded during an automated cover test while subjects fixated a distance (3.4 m) and near (0.4 m) target. There was a significant difference between the amplitude of phoria measured after 2 s of occlusion compared to 10 s ( P < 0.01). The mean phoria after 10 s of occlusion was 0.1° (eso) for distance fixation and 1.6° (exo) for near fixation. The distribution was approximately normal for both distance and near fixation but the standard deviation was greater for near (2.0°) than distance fixation (1.4°). The pattern of eye movements during the recovery phase was more complex than is often assumed, in many cases consisting of a variety of saccadic and vergence movements involving both the covered and 'fixing' eye. The latency of the first recovery movement was significantly shorter for exophoric than esophoric deviations ( P < 0.01) and the latency of some recovery movements were very short (< 150 ms).