bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospective cohort study of childhood behaviour problems and adolescent sexual risk-taking: gender matters
Authors: Skinner S. Rachel , Marino Jennifer , Rosenthal Susan L. , Cannon Jeffrey , Doherty Dorota A. , Hickey Martha
Published: June 2017

Background
Externalising (delinquent, aggressive) and internalising (anxious/depressed, withdrawn) behaviour problems are prevalent in childhood. Few studies have prospectively measured relationships between childhood behaviour problems and adolescent health risk behaviour, a major predictor of morbidity and mortality. This study sought to determine relationships, by gender, between childhood behaviour problems and adolescent risky sexual behaviours and substance use. Methods: In a population-based birth cohort [The Western Australian Pregnancy Cohort (Raine) Study], total, externalising and internalising behaviour problems (domain-specific T ≥ 60) were calculated from parent-reported Child Behavior Checklist at ages 2, 5, 8, 10 and 14 years. At age 17 years, 1200 (49% male) participants reported sexual and substance use activity Results: For both genders, those with earlier externalising behaviour problems were more likely to be sexually active (oral sex or sexual intercourse) by age 17 years. Males with childhood externalising behaviour problems were more likely to have multiple sexual partners by age 17 years than those without such problems [adjusted odds ratio (aOR) 2.96, 95% confidence interval (CI) 1.49–5.86]. Females with childhood externalising behaviour problems were more likely to have had unwanted sex (aOR 1.91, 95% CI 1.04–3.53). Externalising behaviour problems were associated with substance use for both genders. No association was found between internalising behaviour problems and risky behaviour. Conclusions: Externalising behaviour problems from as early as 5 years old in boys and 8 years old in girls predict a range of risky sexual behaviour in adolescence, which has important implications for targeting interventions in adolescence.
Primary Isolation and Characterization of Tenacibaculum maritimum from Chilean Atlantic Salmon Mortalities Associated with a Pseudochattonella spp. Algal Bloom
Authors: Apablaza Patricia , Frisch Kathleen , Brevik Øyvind Jakobsen , Småge Sverre Bang , Vallestad Camilla , Duesund Henrik , Mendoza Julio , Nylund Are
Published: June 2017

This study presents the first isolation of Tenacibaculum maritimum from farmed Atlantic Salmon Salmo salar in Chile. The isolate, designated T. maritimum Ch-2402, was isolated from gills of Atlantic Salmon at a farm located in region X, Los Lagos, Chile, during the harmful algal bloom caused by Pseudochattonella spp. in February 2016. The algal bloom is reported to have caused 40,000 metric tons of mortality in this salmon farming area. The bacterium T. maritimum, which causes tenacibaculosis, is recognized as an important pathogen of marine fish worldwide. Genetic, phylogenetic, and phenotypic characterizations were used to describe the T. maritimum Ch-2402 isolate. The isolate was similar to the type strain of T. maritimum but was genetically unique. Tenacibaculum dicentrarchi isolates were also recovered during sampling from the same farm. Based on the fact that T. maritimum has been shown to cause disease in Atlantic Salmon in other regions, the presence of this bacterium poses a potential risk of disease to fish in the Chilean aquaculture industry.

Received November 6, 2016; accepted May 29, 2017 Published online July 26, 2017
Low active loading of cargo into engineered extracellular vesicles results in inefficient miRNA mimic delivery
Authors: Sutaria Dhruvitkumar S. , Jiang Jinmai , Elgamal Ola A. , Pomeroy Steven M. , Badawi Mohamed , Zhu Xiaohua , Pavlovicz Ryan , Azevedo‐Pouly Ana Clara P. , Chalmers Jeffrey , Li Chenglong , Phelps Mitch A. , Schmittgen Thomas D.
Published: June 2017

Extracellular vesicles (EVs) hold great potential as novel systems for nucleic acid delivery due to their natural composition. Our goal was to load EVs with microRNA that are synthesized by the cells that produce the EVs. HEK293T cells were engineered to produce EVs expressing a lysosomal associated membrane, Lamp2a fusion protein. The gene encoding pre‐miR‐199a was inserted into an artificial intron of the Lamp2a fusion protein. The TAT peptide/HIV‐1 transactivation response (TAR) RNA interacting peptide was exploited to enhance the EV loading of the pre‐miR‐199a containing a modified TAR RNA loop. Computational modeling demonstrated a stable interaction between the modified pre‐miR‐199a loop and TAT peptide. EMSA gel shift, recombinant Dicer processing and luciferase binding assays confirmed the binding, processing and functionality of the modified pre‐miR‐199a. The TAT‐TAR interaction enhanced the loading of the miR‐199a into EVs by 65‐fold. Endogenously loaded EVs were ineffective at delivering active miR‐199a‐3p therapeutic to recipient SK‐Hep1 cells. While the low degree of miRNA loading into EVs through this approach resulted in inefficient distribution of RNA cargo into recipient cells, the TAT TAR strategy to load miRNA into EVs may be valuable in other drug delivery approaches involving miRNA mimics or other hairpin containing RNAs.
A stitch in time: Replicate early and escape dosage compensation to express more
Authors: Gómez María
Published: June 2017

The biological significance of conserved replication timing patterns in eukaryotic genomes remains a mystery. In this issue, Müller and Nieduszynski (2017. J. Cell Biol. https://doi.org/10.1083/jcb.201701061) find that early replication is a requirement for the highest expression levels of certain genes.
HiHiMap: single-cell quantitation of histones and histone posttranslational modifications across the cell cycle by high-throughput imaging
Authors: Zane Linda , Chapus Fleur , Pegoraro Gianluca , Misteli Tom
Published: June 2017

We describe High-throughput Histone Mapping (HiHiMap), a high-throughput imaging method to measure histones and histone posttranslational modifications (PTMs) in single cells. HiHiMap uses imaging-based quantification of DNA and cyclin A to stage individual cells in the cell cycle to determine the levels of histones or histone PTMs in each stage of the cell cycle. As proof of principle, we apply HiHiMap to measure the level of 21 core histones, histone variants, and PTMs in primary, immortalized, and transformed cells. We identify several histone modifications associated with oncogenic transformation. HiHiMap allows the rapid, high-throughput study of histones and histone PTMs across the cell cycle and the study of subpopulations of cells.
rqt: an R package for gene-level meta-analysis
Authors: Zhbannikov Ilya Y , Arbeev Konstantin G , Yashin Anatoliy I
Published: June 2017

Motivation

Despite recent advances of modern GWAS methods, it is still remains an important problem of addressing calculation an effect size and corresponding p-value for the whole gene rather than for single variant.

Results

We developed an R package rqt, which offers gene-level GWAS meta-analysis. The package can be easily included into bioinformatics pipeline or used stand-alone. We applied this tool to the analysis of Alzheimer’s disease data from three datasets CHS, FHS and LOADFS. Test results from meta-analysis of three Alzheimer studies show its applicability for association testing.

Availability and implementation

The package rqt is freely available under the following link: https://github.com/izhbannikov/rqt.

Supplementary information

Supplementary data are available at Bioinformatics online.
Changes in the size structure of marine fish communities
Authors: Bell Richard J , Collie Jeremy S , Branch Trevor A , Fogarty Michael J , Minto Coilin , Ricard Daniel
Published: June 2017

Marine ecosystems have been heavily impacted by fishing pressure, which can cause major changes in the structure of communities. Fishing directly removes biomass and causes secondary effects such as changing predatory and competitive interactions and altering energy pathways, all of which affect the functional groups and size distributions of marine ecosystems. We conducted a meta-analysis of eighteen trawl surveys from around the world to identify if there have been consistent changes in size-structure and life history groups across ecosystems. Declining biomass trends for larger fish and invertebrates were present in nine systems, all in the North Atlantic, while seven ecosystems did not exhibit consistent declining trends in larger organisms. Two systems had alternative patterns. Smaller taxa, across all ecosystems, had biomass trends with time that were typically flat or slightly increasing. Changes in the ratio of pelagic taxa to demersal taxa were variable across the surveys. Pelagic species were not uniformly increasing, but did show periods of increase in certain regions. In the western Atlantic, the pelagic-to-demersal ratio increased across a number of surveys in the 1990s and declined in the mid 2000s. The trawl survey data suggest there have been considerable structural changes over time and region, but the patterns are not consistent across all ecosystems.
The Vaccine Handbook
Authors: Tan, MD, Tina Q. , Gerbie, MD, Melvin V. , Flaherty, MD, John P.
Published: June 2017

Vaccines are an integral part of routine preventative health care for persons of all ages and play an integral role in protecting individuals against vaccine-preventable diseases. This handbook provides easy-to-understand, practical information on routinely recommended preventative vaccines for persons of all ages. It is written to be an informative, easily accessible, quick resource that addresses common vaccine issues that may be encountered by busy health-care providers in different specialties and at all different levels of training and practice. The “Did you know that” sections at the beginning of each chapter provide interesting facts on vaccines and vaccine preventable diseases. The FAQ section at the end of each chapter provides answers to commonly encountered situations in clinical practice involving vaccines. Exploring the different sections of this handbook will arm the reader with the tools needed to discuss the importance of vaccines and recommend the appropriate vaccines for their patients in order to optimally protect them against vaccine preventable diseases.
Vaccine Overview
Authors: Tan Tina Q. , Flaherty John P. , Gerbie Melvin V.
Published: June 2017

This chapter introduces commonly used vaccines in a variety of clinical settings and provides information about proper administration and dosing. Details of types of immunizations such as active vs passive and inactivated vs live-attenuated vaccines are presented. CDC recommendations are noted including “routine” vs “permissive”. It also contains practical tips for addressing vaccine hesitancy and debunks common myths about vaccines such as the misconception that they cause autism or the diseases they are intended to prevent. Multiple other misconceptions are discussed and suggestions given to how to address patient and family concerns including natural vs vaccine induced immunity, risks of vaccines, and presence of toxins. The chapter concludes with multiple tables of vaccine types, dosages, adjuvants, and other useful information.
Travel Vaccines
Authors: Tan Tina Q. , Flaherty John P. , Gerbie Melvin V.
Published: June 2017

Vaccines for travelers visiting countries or regions in which vaccine preventable infectious disease is endemic are discussed. This chapter also discusses vaccination recommendations for health-care workers, animal handlers, veterinarians, and others who are in regular contact with bodily fluids, human waste, live animals, or animal parts. Specific illnesses such as yellow fever, typhoid fever, cholera, and rabies are discussed in detail relating to their geographic sites, clinical courses, incubation periods, transmissibilities, treatments, and vaccine prophylaxes. Typhoid fever history in the US is discussed. The need and usefulness of certified Travel Clinics are emphasized. Each illness has specific FAQs providing useful responses to patient concerns.
Nuclear Cardiology (Oxford Specialist Handbooks in Cardiology)
Authors: Kelion Andrew , Arumugam Parthiban , Sabharwal Nikant
Published: June 2017

Readable, practical, and concise, the Oxford Specialist Handbook in Nuclear Cardiology is a self-contained guide to this cardiac imaging subspecialty. Including both technical and clinical aspects, it provides a foundation of essential knowledge common to practitioners from any background.This title covers radiation physics, biology and protection, and addresses all areas of imaging including the design and operation of the gamma camera (including solid-state cameras), single photon emission computed tomography (SPECT) acquisition and processing, and image interpretation and writing of reports. Stress testing and radiopharmaceuticals are explained in detail, as is the evidence base underpinning myocardial perfusion scintigraphy. Newer radionuclide imaging techniques are well covered (e.g. phosphate scintigraphy in cardiac amyloidosis), as is the expanding field of cardiac positron emission tomography (PET). Fully updated with coverage of new indications for gamma camera imaging, increased focus on attenuation correction and SPECT-CT, and detail on the design use and clinical implications of solid-state gamma cameras throughout, this second edition of the essential text for nuclear cardiology trainees and practitioners is fully illustrated with colour plates to aid clinical practice. Presented in the bestselling Oxford Handbook format, Nuclear Cardiology provides core knowledge for those training in the subspecialty, whether at a basic or advanced level or from a medical or technical background, and is a key resource for those seeking to accredit in the subspecialty.
Other nuclear cardiological investigations
Authors: Sabharwal Nikant , Arumugam Parthiban , Kelion Andrew
Published: June 2017

This chapter explains the imaging protocol physiological properties and clinical value of other nuclear cardiological investigations. It covers iodine-123-labelled radiopharmaceuticals, iodine-123-meta-iodo-benzyl-guanidine (123I-MIBG), β‎-methyl-p-[123I]iodo-phenyl-pentadecanoic acid (123I-BMIPP), and Tc-phosphate scintigraphy for cardiac amyloidosis, exploring both practical and clinical aspects. Specific prognoses and diagnoses are also detailed for the relevant investigation, including systolic heart failure, coronary artery disease, and cardiac amyloidosis.
Cardiac positron emission tomography (PET)
Authors: Sabharwal Nikant , Arumugam Parthiban , Kelion Andrew
Published: June 2017

As in single photon emission computed tomography (SPECT), positron emission tomography (PET) involves the injection of a radiopharmaceutical, the physiological properties of which determine its distribution within the patient. The labelling radionuclide then allows this distribution to be imaged. The value of cardiac PET as a routine clinical tool, particularly for perfusion imaging, was previously limited by the expense and scarcity of cameras and the short half-lives of the radionuclides with complex radiochemistry. The need for an on-site cyclotron to produce these radiopharmaceuticals made a clinical service non-viable. A number of recent developments, however, have led to renewed interest in cardiac PET. This chapter covers PET instrumentation, detail on the radiopharmaceuticals used in cardiac PET, and a number of sections on F-fluorodeoxyglucose (F-FDG) PET covering infection and inflammation imaging.
Epidemiology of Psychiatric Disorders Associated with HIV and AIDS
Authors: Cournos Francine , McKinnon Karen , Wainberg Milton
Published: June 2017

This chapter presents the prevalence of common and severe mental illnesses among people with HIV infection, as well as the prevalence of HIV infection among people with severe mental illness. It begins with a look at population-based studies, which are limited in number, then discusses specific disorders studied in smaller studies with selected populations. While the chapter is largely focused on epidemiology in the United States, selected studies from other regions are cited. Taken together, studies show that people with HIV infection have high rates of HIV-associated neurocognitive disorders, although these disorders tend to be milder than they were before effective antiretroviral therapy. The rates of current alcohol- and drug-related disorders mirror those for the general population, but lifetime rates among people with HIV infection are higher, as are rates of depression, anxiety disorders, posttraumatic stress disorder, bipolar disorder, psychosis and personality disorder. Rates of HIV infection among people with severe mental illness in the U.S. are clearly elevated in comparison to those for the general population. Despite scientific advances, the absence of a strong focus on mental disorders remains a glaring omission in progress on HIV prevention, care, and treatment.
Global Aspects of the HIV Pandemic
Authors: Letang Emilio , Cournos Francine , Prybylski Dimitri , Colby Donn , Dokubo E. Kainne , Lee Chuan-Mei , del Amo Julia , Blanch Jordi , Martínez Esteban , Noy Gaddy , Ahmad-Stout Farah , Forstein Marshall , Gorman Sara
Published: June 2017

This chapter presents the complex and diverse nature of the HIV/AIDS epidemic on a global scale, as well as a global epidemiology of HIV. The hardest-hit region of the world is sub-Saharan Africa, where heterosexual transmission dominates. Here the overall rate of new HIV infections has decreased in 25 countries by 50% between 2001 and 2011, coupled with scale-up of antiretroviral therapy and prevention of mother-to-child transmission. The Asia-Pacific region has the second highest burden of HIV in the world and, despite a decline in the annual number of new infections, is also seeing increasing HIV prevalence in high-risk groups. In Europe there is a clear division between the epidemics in eastern and western countries. Although antiretroviral therapy has led to great advances in health in this region, late identification of illness and barriers to care for stigmatized populations are a ubiquitous problem in the European Union. In the United States, despite reasonably good access to care, the incidence of HIV has not declined significantly since the advent of effective treatment. Substantial efforts and new strategies in the United States and the Americas have been developed to meet the goals of prevention and care engagement. The chapter also identifies the work needed to address the nuanced challenges to HIV prevention and treatment in different subpopulations across the world.
AIDS Orphans and Other Children Affected by HIV
Authors: Makurumidze Getrude , Gamell Anna , Letang Emili
Published: June 2017

Since the beginning of the HIV/AIDS epidemic, the number of deaths in reproductive age groups has led to nearly 18 million children being left orphaned. Orphans are not only faced with the loss of one or both parents but may also suffer loss of property and inheritance, disruption from school, and psychosocial distress from the stigma associated with HIV/AIDS. This chapter explores the psychological, social, and cultural aspects of HIV/AIDS orphanhood. It addresses the financial and emotional support that orphans and their caregivers need, as well as key strategies shown to be effective to protect, support, and empower orphans and vulnerable children (OVC). Such strategies include providing education, psychosocial care and support, household economic strengthening, social protection, health and nutrition, child and legal protection, and capacity building. However, despite the considerable progress achieved, multiple challenges still prevent many OVC from receiving effective care and support. These aspects need to be urgently addressed in order to build evidence-based programs, respond to the needs of all AIDS-affected children, and achieve the dream of an AIDS-free generation.
HIV Advocacy
Authors: Collins Simon , Horn Tim , Gangte Loon , Trenado Emmanuel , Dubula Vuyiseka
Published: June 2017

Community responses to the AIDS crisis have changed traditional approaches to medicine, healthcare, health systems, and research. Earlier approaches were rooted in widespread discrimination against key affected populations who were already socially marginalized. The background of community responses, first in the United States and then in other regions, each has a special history. This chapter provides an overview of historical community responses to HIV and is written by activists from the United States, India, South Africa and Western Europe. Examples of key projects include the role of peer advocacy and treatment literacy, which have enabled people living with HIV to learn more about HIV and treatment, adherence, treatment choice, drug resistance, and pipeline research for better drugs in the future. The outcome of this advocacy is that people living with HIV have been empowered to take an active role in their healthcare. HIV advocacy also provides an example of how the international activism that has changed the face of global healthcare is rooted in similar principles developed by early HIV-positive activists and is just as relevant today.
A Biopsychosocial Approach to Psychiatric Consultation in Persons with HIV and AIDS
Authors: Ashley Kenneth , Safin Daniel , Cohen Mary Ann
Published: June 2017

Persons with HIV and other severe and complex medical illness referred for psychiatric evaluation deserve a comprehensive and empathic psychosocial assessment. A biopsychosocial approach to care considers each individual in the context of family, community, and society. Such an evaluation may have implications regarding health, coordinated care, adherence, and risk reduction. This chapter provides a review of the elements and process of a comprehensive psychiatric consultation in both the inpatient and outpatient settings. Some elements discussed include assessment of history and current psychiatric symptoms, illness, and care; alcohol and other drug use; suicidality; childhood and later trauma and intimate partner violence; spirituality; sexuality; sexual orientation; gender identity; sexual pleasure; and sexual health promotion. A comprehensive psychosocial and psychiatric examination also includes a complete cognitive evaluation and cultural formulation interview, and history of discrimination. Also addressed is the potential role of HIV-associated neurocognitive disorders in an individual’s psychiatric health.
Neuropsychological Evaluation for Persons with HIV and AIDS
Authors: Oladeji Bibilola D. , Robertson Kevin R.
Published: June 2017

With recent developments in the classification and definitions for HIV-associated neurocognitive disorders (HAND), neuropsychological assessments have become central to the diagnostic process. The pattern and manifestation of neurocognitive dysfunction associated with HIV have changed since the introduction of effective antiretroviral medications and their increasingly widespread use. Prior to the introduction of antiretroviral therapy, severe cognitive disorder presenting as HIV-associated dementia (HAD) was a common manifestation of HIV-associated neurocognitive disorders. In more recent times, however, milder forms of neurocognitive impairment have become more common, often being asymptomatic and difficult to recognize without formal neuropsychological testing. Hence, recognizing individuals at most risk for cognitive decline through neuropsychological testing will offer opportunities for developing targeted interventions that could delay disease progression and improve individual functioning and quality of life.
Trauma and Posttraumatic Stress Disorder—The Special Role in HIV Transmission
Authors: Douaihy Antoine , Grubisha Melanie , Lyon Maureen , Cohen Mary Ann
Published: June 2017

The prevalence of posttraumatic stress disorder (PTSD) in persons with HIV is higher than in the general population. Adults with HIV are likely to have experienced traumatic events that place them at risk for developing PTSD. Among women with HIV, PTSD may be more common than depression, suicidality, and substance use. The high prevalence of PTSD is related to increased exposure to traumatic experiences such as physical violence and sexual assault, including intimate partner violence and childhood sexual abuse. The co-occurrence of PTSD and HIV creates complex challenges for both the management of HIV and treatment of PTSD. Individuals with PTSD and HIV experience more rapid illness progression and poorer health-related quality of life, with health-compromising behaviors such as substance use, high-risk sexual behavior, poor utilization of services, and low adherence to antiretroviral therapy. This chapter addresses the complexities of HIV, trauma, and PTSD and recommends trauma-informed care in the treatment of people living with HIV and AIDS.
Anxiety Disorders
Authors: Douaihy Antoine , Spada Meredith , Bates Nicole , Macedo Julia , Gorman Jack M.
Published: June 2017

HIV practitioners are increasingly confronted with complex co-occurring medical and psychiatric disorders among their patients. Depressive and anxiety disorders are among the most commonly diagnosed in HIV-infected individuals and can complicate the overall management of HIV illness. Anxiety may be experienced as a symptom, as a manifestation of an anxiety disorder, as a consequence of HIV-associated or other illness, or as a result of one of its treatments. It can occur at any stage, from the realization of being at risk, to the anxiety about a possible symptom, to the time of HIV testing and the experience of HIV-associated stigma and discrimination, diagnosis, disclosure, illness progression, late- and end-stage illness, and dying. This chapter explores the complexities of anxiety as it relates to HIV and AIDS and discusses the prevalence, diagnosis, and assessment of anxiety disorders. The impact of anxiety on medical management of HIV is also addressed, including adherence to antiretroviral regimen, psychotherapeutic and pharmacological interventions, and coexisting medical and psychiatric disorders.
The Role of Personality in HIV Risk Behaviors: Implications for Treatment
Authors: Hutton Heidi E. , Treisman Glenn J.
Published: June 2017

The risk behaviors that transmit HIV and complicate HIV treatment are often influenced by Axis II personality disorders and personality traits. There has been relatively little research, however, on the role of personality traits and disorders in HIV despite their stable, durable, and heritable influence on thoughts, feelings, and behavior. Certain traits, such as various types of extroversion and sensation seeking, appear to increase the likelihood of engaging in HIV risk behaviors, having poorer quality of life, and adhering to treatment regimens. Effective HIV prevention and treatment programs should consider specific personality traits that render some individuals more vulnerable to engaging in behaviors that endanger their health and the health of others. Recognizing these personality traits or disorders is useful in developing more specific, effective risk reduction strategies and improving overall health outcomes. This chapter describes personality traits and personality disorders that occur among HIV at-risk and HIV-infected individuals and the implications for HIV care.
Insomnia and HIV: A Biopsychosocial Approach
Authors: O’Dowd Mary Alice , Gomez Maria Fernanda
Published: June 2017

Insomnia is a common complaint across populations and can influence health in many ways. Individuals with HIV may be at higher risk for insomnia owing to direct effects of the virus, pain, psychiatric comorbidities, and other health- and treatment-related issues and lifestyles. This chapter reviews the physiology of healthy sleep and sleep hygiene and addresses assessment and treatment of insomnia in persons with HIV. Careful interview of a patient and accompanying family or friends with the Epworth Sleepiness Scale or Pittsburg Sleep Quality Index may help define the nature of the insomnia and target interventions. Treatment for insomnia can include a form of cognitive-behavioral therapy designed specifically for insomnia as well as education aimed at restructuring bedtime habits in order to promote better sleep. Medication use, such as benzodiazepines, melatonin, orexin, and non-benzodiazepine hypnotics, in this population must take into consideration the specific risks and benefits these medications may present in persons with HIV.
Suicide and HIV
Authors: Alfonso César A. , Stern-Rodríguez Eva , Cohen Mary Ann
Published: June 2017

HIV is a risk factor for suicide. Even after developing effective treatments and reducing mortality of HIV in countries with access to care, psychological and medical multimorbidities continue to create distress. This chapter reviews the global epidemiology of suicide in persons with HIV and describes the known predisposing and protective factors, as well as the psychodynamics of suicide. Predisposing factors include course of illness, symptomatic multimorbidities, physical incapacity, history of trauma, past attempts, hopelessness, family suicide, bereavement, poor social support and family relations, unemployment, unstable housing, detectable viral load, and access to lethal means. Protective factors include positive-reappraisal coping skills, treatment adherence, responsibility toward family, having reasons for living, religiosity, higher emotional expression, experiential involvement, and secure attachments. By identifying protective and risk factors clinicians can be more cognizant of persons at risk and better equipped to treat them. Timely application of psychotherapeutic, pharmacological, and psychosocial interventions can treat suicidality and may prevent death by suicide.
Neurological Complications of HIV in The Central Nervous System
Authors: Woldstad Christopher , Boska Michael , Gendelman Howard E.
Published: June 2017

This chapter serves to highlight both the research advances made in understanding the effects of HIV on the nervous system and what lies ahead. Particular focus is given to both the effects HIV can play on the nervous system at the molecular and cellular levels and the comorbid conditions that affect neural function. Attention is also given to specific biomarkers to be used for increasing the effectiveness and availability of therapies. The pathogenesis of HIV-associated neurocognitive disorders (HAND) is comparable to that of several other neurodegenerative disorders, and their mechanistic similarities are also discussed in detail. With the introduction of antiretroviral therapy the life expectancy of persons with HIV has increased, with a concomitant decrease in the incidence of severe dementia. There has been a remarkable improvement in cognitive function with almost a complete reversal of associated symptoms of disease. Past and present disease manifestations and the implications for treatment are outlined in the chapter.
Psychiatric Aspects of Care Engagement and Medication Adherence in Antiretroviral-Based HIV Treatment and Prevention
Authors: Weiss Jeffrey J. , Stirratt Michael J.
Published: June 2017

Care engagement and treatment adherence are directly related to HIV treatment outcomes and to mortality. Active drug use and psychiatric illness such as depressive and addictive disorders are significant barriers to care engagement and treatment adherence among persons living with HIV and those at high risk for HIV infection and eligible for pre-exposure prophylaxis (PrEP). This chapter addresses (1) psychiatric aspects of PrEP for HIV prevention, (2) the care continuum for individuals living with HIV infection, (3) psychiatric determinants of HIV care engagement, (4) behavioral interventions to improve HIV care engagement, (5) psychiatric determinants of antiretroviral (ART) adherence, (6) interventions to improve ART adherence, and (7) implications of research findings for the medical and mental health clinician working with patients with psychiatric illness who are living with HIV or at risk for infection.
Young Adulthood and Serodiscordant Couples
Authors: Forstein Marshall , Ahmad-Stout Farah , Noy Gaddy
Published: June 2017

Advances in HIV medical care and antiretroviral therapy transformed AIDS from a rapidly devastating fatal illness into a chronic illness for persons with access to care, leading to vast changes in the health of individuals, couples, their children, extended families, and social networks. In addition, adherence to antiretroviral therapy and viral suppression have reduced the likelihood of transmission of HIV, and the use of pre-exposure prophylaxis (PrEP) in an HIV-negative partner offers an additional option to prevent seroconversion. Significant biopsychosocial challenges remain, however, for couples who are dissimilar (serodiscordant) in HIV serological status and young adults with HIV. Many young adults and serodiscordant couples who are engaged in care and virally suppressed need support as they plan to have children or re-enter careers and social networks. There are few studies of couples with similar (seroconcordant) or serodiscordant HIV serological status. This chapter focuses on the impact of HIV on serodiscordant couples in which only one member is infected. After reviewing some of the literature, clinical issues that emerge in evaluating and treating couples are presented.
Psychotherapeutic Interventions
Authors: Soffer Jocelyn , Alfonso César A. , Grimaldi John , Gorman Jack M.
Published: June 2017

Psychotherapeutic care for persons with HIV is an important component of overall treatment, helping people to cope and decreasing the psychological suffering that may be attendant when navigating the complex array of biopsychosocial stresses and challenges of living with HIV. A combination of psychotherapeutic and psychosocial interventions can effectively address psychological aspects of functioning and reduce psychiatric symptoms, as well as improve adherence to risk reduction and medical care. This chapter reviews several psychotherapeutic interventions, including supportive, psychodynamic, and interpersonal psychotherapy, cognitive-behavioral therapy, and motivational interviewing. Both individual and group settings are discussed, as well as the particular settings of spiritual care, family therapy, and couples therapy.
SOcial Service Interventions
Authors: Malone Mary Ann
Published: June 2017

As with other professions involved with the care of persons with HIV/AIDS, social work is undergoing changes that have had a positive effect on the quality of care for patients. This chapter presents some of the changes in social work practice and provides references from literature citing innovative work to support the current trends. The need for interdisciplinary teamwork among the disciplines involved, with emphasis on patients’ adherence to their medical care, is highlighted. A New York State–sponsored program to help promote adherence is discussed. A biopsychosocial approach to patient care is evident throughout the chapter. This biopsychosocial approach, implemented through collaboration among disciplines, has been a mainstay of social work practice over the years and is likely to remain so for years to come.
Nursing Support
Authors: Kirton Carl
Published: June 2017

Nurses are an integral part of the interdisciplinary team caring for patients with HIV/AIDS. Since the start of the epidemic nurses have provided care across the healthcare spectrum, serving as care coordinators, clinical nurse specialists, and nurse practitioners. To competently care for people with HIV or AIDS, nurses have to provide care that is advanced and specialized. Nurses working in the field of HIV or AIDS care require advanced knowledge of virology and infectious disease to address the clinical needs of persons with HIV-related illness. This chapter describes the historical engagement of nurses in the epidemic and the nursing strategies that support interprofessional work. It addresses the key aspects of nursing care of the HIV-infected adult throughout the spectrum of HIV illness. The chapter focuses on the nurse’s role in minimizing risk, preventing HIV transmission, caring for persons with HIV, helping individuals to cope with illness, and negotiating the healthcare system.
Palliative Care and Spiritual Care of Persons with HIV and AIDS
Authors: Dickerman Anna L. , Alici Yesne , Breitbart William , Chochinov Harvey Max
Published: June 2017

The meaning and role of palliative and spiritual care have evolved over the last decades, along with the dramatically changing clinical picture of AIDS. Although advances in antiretroviral therapy and medical interventions have allowed persons with HIV/AIDS and access to care to live longer and healthier lives, many persons in the United States and throughout the world continue to die of AIDS. There is an increased need for a comprehensive, multidisciplinary approach to care including psychosocial and family support. Curative, palliative, and spiritual care should be integrated, without dichotomizing curative and palliative approaches, in order to meet the challenges of AIDS throughout the course of illness. This chapter reviews basic concepts of palliative and spiritual care, as well as specific challenges facing clinicians involved in HIV palliative care. Finally, issues such as bereavement, demoralization, dignity, meaning, cultural sensitivity, doctor–patient communication, and psychiatric contributions to physical symptom control are reviewed.
HIV-Associated Nephropathy, End-Stage Renal Disease, Dialysis, and Kidney Transplant
Authors: Winston Jonathan , Zeldis Etti , Grimaldi John A. , Martínez Esteban
Published: June 2017

Antiretroviral therapy has changed the phenotype of HIV-related kidney disease to a more chronic disease model. In addition to HIV-associated nephropathy (HIVAN), patients with HIV may experience kidney dysfunction related to other chronic illnesses, such as diabetes, hypertension, and hepatitis C. Patients with HIV should be monitored for the development of chronic kidney disease and the potential nephrotoxicity of antiretroviral therapy. For patients with HIV who progress to end-stage renal disease, the outcomes on dialysis and management of the dialysis procedure are similar to the outcomes of patients without HIV. Renal transplantation is a promising treatment option for HIV patients with end-stage renal disease, despite certain barriers inherent in the transplant evaluation process. Concomitant HIV and end-stage renal disease, with the stress of dialysis, can exacerbate psychiatric illness.
Clinician Burnout in HIV/AIDS Healthcare
Authors: Aladjem Asher D. , Cohen Mary Ann
Published: June 2017

Caring for persons with any severe and complex illness in increasingly complex healthcare environments can lead to clinician distress and burnout and at times bereavement overload. The physicians, nurses, social workers, case managers, mental health clinicians, counselors, and other caregivers of persons with HIV are faced with additional factors, including potential for needle sticks and other occupational hazards. This chapter defines and describes the multifactorial nature of burnout as it pertains to clinicians caring for persons with HIV and AIDS and provides a summary of predisposing factors, protective factors, preventive strategies, and ways to provide support and eliminate burnout. Assessment for burnout via the Maslach Burnout Inventory is also addressed. The chapter also addresses the question of whether changes in healthcare, including pressures for productivity, increasing workloads, and increasing use of technology in documentation, have had more or less of an impact on HIV physicians than on other physicians. The prevalence and impact of burnout among HIV physicians is also compared to that of other physicians as well as to that of the general population.
End-Of-Life Issues, Ethical Issues, Advance Directives, and Surrogate Decision-Making in The Care of Persons With HIV
Authors: Geppert Cynthia , Cohen Mary Ann , Brendel Rebecca Weintraub
Published: June 2017

HIV and AIDS, perhaps more than any other illness during any other time, contributed to the end of a “collusion of silence” and parentalism that characterized medicine prior to the era of civil rights and patient rights. The bioethical aspects of both healthcare delivery and care at the end of life changed dramatically during the beginning of the AIDS epidemic when young persons and their dedicated teams of caregivers were faced with a new infectious illness associated with both sexual transmission and intravenous drug use. This chapter delineates the ethical aspects of HIV and exceptionalism, screening, routine testing, informed consent, advance care planning through advance directives, confidentiality, criminalization, the duty to warn, and pre- and post-exposure prophylaxis (PrEP and PEP).
The Painted Mind
Authors: Troisi Alfonso
Published: June 2017

The scientific focus of this book is on the human mind and behavior viewed from an evolutionary perspective. The author is a clinical psychiatrist but his research background ranges from primate ethology to neuroscience, behavioral biology to molecular genetics, and Darwinian psychiatry to evolutionary psychology. Discussion of emotions, cognitive capacities, and behaviors integrates a variety of research and clinical findings that, ultimately, can be reduced to the evolutionary distinction between proximate mechanisms and adaptive functions. An original feature of the book is that it combines science and art. Each chapter is inspired by a painting masterpiece, and a substantial portion of the text is devoted to introducing the reader to the artistic significance of the works and to biographical notes concerning the painters who made them. In addition, each painting is accurately reproduced in a full-page color plate. Description of the evolutionary theories that explain how the human mind works are intermixed with the critical discussion of the perspectives of humanistic disciplines such as philosophy, sociology, religion, or literature. In order to give the reader lively examples of psychological and behavioral patterns, the chapters are filled with stories of people—stories of literary characters, stories of historical characters, and clinical cases.
Deception
Authors: Troisi Alfonso
Published: June 2017

For a long time, biological studies of communication have been based on the postulate that communication has evolved to ensure the transmission of veridical information between conspecifics. Ethological studies of a variety of animal species have demonstrated that transmission of false information is a relevant component of intraspecific signals and that the adaptive benefit of deceiving others was a driving force in the evolution of communication. In primate species, evolving a larger neocortex was a viable evolutionary strategy to respond to environmental challenges that demand enhanced capacities of social manipulation. Among all animal species, humans are the masters of social deception. This chapter focuses on the cognitive abilities related to voluntary deception in humans, with special regard to the role of theory of mind (i.e. the capacity to infer the mental states of other individuals). Different aspects of theory of mind are discussed, including the evolution of social brain, the distinction between mentalizing and empathizing, and the abnormalities of social cognition in clinical syndromes such as autistic spectrum disorders and primary psychopathy.
Care
Authors: Troisi Alfonso
Published: June 2017

This chapter focuses on the impact of the doctor–patient relationship on patients’ physiology and well-being. The core of the chapter reports recent data on the physiological changes associated with placebo and nocebo effects and relates these findings to the impact of social relationships on health and disease. On average, the placebo effect’s relative weight in therapeutic improvement is around 40%. The most important component of the placebo effect is the doctor–patient relationship, and this is addressed by looking at the evolution of the behavior that underlies any medical act: care of the sick. Natural selection favored the evolution of behaviors aimed at helping group companions who were wounded or sick, through two different mechanisms: kin selection and reciprocal altruism. For a long period of human evolutionary history, care of the sick followed the path of intimate and affectionate relationships. Delegation to unfamiliar experts trained in medical science came much later. The take-home message of the chapter is that the opposition between humanistic and scientific medicine fades if one looks with an open mind at what we currently know about the biological dynamics that regulate the doctor–patient relationship.
Diversity
Authors: Troisi Alfonso
Published: June 2017

From the perspective of evolutionary biology, diversity is an intrinsic feature of any living species and a target on which natural selection can act in opposite ways: either decreasing it (stabilizing selection) or increasing it (diversifying selection). This duality is reflected in our emotional attitude toward diversity. This chapter summarizes current knowledge on the evolutionary origins of emotional reactions to physical and behavioral diversity in human cultures. After a preliminary discussion of “alternative strategies” observed by ethologists in primate species, the chapter explores the biological roots of intolerance, xenophobia, racism, discrimination, and other forms of rejection of diversity. Findings that have linked ethnocentrism to primitive defenses against infectious diseases are reviewed. Subsequently, the chapter describes how a bias toward “normality” has always lived alongside a powerful attraction to diversity. The chapter closes with reflections based on recent psychiatric and anthropological reports that show how the issue of tolerance of cultural diversity is an unsolved problem, in spite of reassuring claims of the advocates of cultural relativism.
Power
Authors: Troisi Alfonso
Published: June 2017

This chapter focuses on social control obtained through coercion. To answer the question of why some people strive for power, evolutionary behavioral biologists look at the phylogeny of dominance systems. Sociophysiology has unveiled the physiological correlates, such as levels of serotonin and testosterone, of dominant and subordinate status in monkeys and humans, and comparative studies have shown the impact of social hierarchies on health and disease vulnerability. Unlike most human societies that arose after the agricultural revolution of 12,000 years ago, groups of hunter-gatherers actively ostracized any individual attempt to attain dominant status. This ecological condition was wiped out by the agricultural revolution, and the more primitive predisposition toward hierarchical relationships re-emerged in human societies. The final section of the chapter illustrates recent data from psychological studies showing the personality correlates of two types of power that coexist in contemporary social groups: power based on intimidation and oppression, and power based on prestige and self-esteem.
The Geminga pulsar wind nebula in the mid-infrared and submillimetre
Authors: Greaves J. S. , Holland W. S.
Published: June 2017

The nearby middle-aged Geminga pulsar has crossed the Galactic plane within the last ∼0.1 Myr. We present archival data from Wide-field Infrared Survey Explorer and from SCUBA and SCUBA-2 on the James Clerk Maxwell Telescope to assess whether any mid-infrared and submillimetre emission arises from interaction of the pulsar wind nebula with the interstellar medium. A candidate shell and bow shock are reported. Given the low pulsar velocity and local density, dust grains appear able to penetrate into the nebula. A compact source seen towards the pulsar is fitted with a dust spectrum. If confirmed as a real association at higher resolution, this could be a circum-pulsar disc of at least a few Earth-masses, in which future planets could form.