Psychological Well-Being and Health Related Quality of Life among a Group of Low-Income Women Living with HIV/AIDS in South Africa

This study documented the relationships among biomedical factors, psychosocial factors, health related quality of life (HRQOL) and suicidality in respect of HIV positive women in KwaZulu-Natal. One hundred and thirty three (133) women over the age of 18 years (mean age 32.96 yrs; SD = 7.28) participated in the study. Participants completed a Suicidality Measure (SM: Sheebhan, Janavs, Amorim, Janavs, Weiller, Hergueta, Baker & Dunbar, 1998), Multidimensional Scale of Perceived Social Support (MPSS: Zimet, Dahlem, Zimet & Farley, 1988) and the Health Related Quality of Life Survey—SF-36 (Ware, Kosinski & Dewey, 2002). Information on social/contextual variables including income, marital status, employment status, number of children was obtained. Participants completed two biomedical measures, CD4 count and time since diagnosis information. The findings revealed a compromised level of HRQOL in the participants. After controlling for biomedical factors, psychosocial measures did not explain differences in quality of life. Perceived social support was inversely related to suicidality. Newly diagnosed patients were less likely to think of suicide as an option.     

Relationship between perceived health care quality and attitude toward substance abuse treatment

Despite the considerable investment made in recent years in Spain in substance abuse care, treatment adherence remains one of the aspects that determine the effectiveness of programs. Several authors have noted the importance of perceived service quality in this context. This paper is presented with dual purpose of highlighting the role that management of the quality of care for drug addicts has, both as a modulator of users' attitudes and perceptions about the treatment, and as a work philosophy, typical of an organization committed to continuous improvement. Conducting personal interviews with 670 users of drug abuse care services in Galicia and through the application of covariance structure analysis, the close relationship between two factors (perceived quality and attitude toward treatment) was revealed. This research also provides professionals and researchers with a new scale for service evaluation that is short, easy to use and with adequate psychometric properties.     

The role of the glutamatergic system in posttraumatic stress disorder

Antiglutamatergic agents, such as lamotrigine, have been used successfully for the treatment of posttraumatic stress disorder (PTSD). They could be potentially acting through the stabilization of the corticotropin-releasing factor (CRF) systems. Glutamate mediates CRF release in various brain regions involved in the pathophysiology of PTSD, antiglutamatergic agents could stabilize the CRF system and, thereby, improve the symptom complex of PTSD (reexperiencing, hyperarousal, and avoidance). The role of glutamate and CRF in PTSD and other anxiety disorders are still being elucidated. However, it is clear that the glutamatergic systems play a role in the pathophysiology of PTSD.     

The India Experience

This article featuring India constitutes one of five articles in a collection of essays on local capacity-building in research ethics by graduates from the University of Toronto’s Joint Centre for Bioethics MHSc in Bioethics, International Stream program funded by the Fogarty International Center for Advanced Study in the Health Sciences. Research ethics is a growing area of work and interest in India. Ethics review remains the weakest component in the mechanism of good clinical practice, and there is a severe dearth of professionals trained in ethics who can provide leadership. Although the Indian Good Clinical Practice Guidelines, the Indian Medical Council Act, and the Drugs and Cosmetics Act require that the Indian Council of Medical Research’s ethical guidelines be followed as a mandatory requirement for physicians who conduct research, there is a pervasive lack of awareness of basic requirements guiding the ethical conduct of research. There is a great need to strengthen India’s research ethics capacity and regulatory framework for research.     

Impact of infralimbic inputs on intercalated amygdala neurons: a biophysical modeling study

Intercalated (ITC) amygdala neurons regulate fear expression by controlling impulse traffic between the input (basolateral amygdala; BLA) and output (central nucleus; Ce) stations of the amygdala for conditioned fear responses. Previously, stimulation of the infralimbic (IL) cortex was found to reduce fear expression and the responsiveness of Ce neurons to BLA inputs. These effects were hypothesized to result from the activation of ITC cells projecting to Ce. However, ITC cells inhibit each other, leading to the question of how IL inputs could overcome the inter-ITC inhibition to regulate the responses of Ce neurons to aversive conditioned stimuli (CSs). To investigate this, we first developed a compartmental model of a single ITC cell that could reproduce their bistable electroresponsive properties, as observed experimentally. Next, we generated an ITC network that implemented the experimentally observed short-term synaptic plasticity of inhibitory inter-ITC connections. Model experiments showed that strongly adaptive CS-related BLA inputs elicited persistent responses in ITC cells despite the presence of inhibitory interconnections. The sustained CS-evoked activity of ITC cells resulted from an unusual slowly deinactivating K(+) current. Finally, over a wide range of stimulation strengths, brief IL activation caused a marked increase in the firing rate of ITC neurons, leading to a persistent decrease in Ce output, despite inter-ITC inhibition. Simulations revealed that this effect depended on the bistable properties and synaptic heterogeneity of ITC neurons. These results support the notion that IL inputs are in a strategic position to control extinction of conditioned fear via the activation of ITC neurons.     

Intersectional Consciousness in Collective Victim Beliefs: Perceived Intragroup Differences Among Disadvantaged Groups

Although our experiences are shaped by multiple social identities such as race, class, and gender, most research has focused on single‐identity groups (e.g., race). This includes research on collective victimization, which assumes that violence impacts group members uniformly. Conversely, work on intersectional consciousness examines awareness of how multiple social identities intersect and create within‐group differences. Integrating and expanding the research on intersectional consciousness and on collective victimhood, this article investigates perceived intragroup differences in experiences of victimization stemming from intersecting identities of gender and class among two disadvantaged groups in the understudied context of India. We conducted individual interviews (N = 33) and focus groups (K = 12; N = 66) among Muslims and Dalits (lower‐caste Hindus). Thematic analysis revealed that—even though ingroup cohesion (i.e., intragroup similarity) is often enhanced by external threat— people expressed awareness of intragroup differences in experiences of victimization in three distinct ways: highlighting relative privilege, engaging in competitive victimhood, or describing qualitative differences. We discuss the implications for conflict and solidarity within minority groups in the context of political developments in India, where there have been attempts to polarize intragroup divisions.     

Mechanisms linking height to early child development among infants and preschoolers in rural India

Stunting has been negatively associated with children's development. We examined the range of height by testing hypotheses: (a) height is positively associated with children's development, with associations moderated by inflammation and (b) home environments characterized by nurturance and early learning opportunities is positively associated with children's development over time and attenuate associations with height. Data included 513 infants (mean age 8.6 months) and 316 preschoolers (mean age 36.6 months) in rural India from a randomized controlled trial of multiple micronutrient powders (MNPs). Measures included height (height‐for‐age z‐scores based on WHO standards), inflammation (C‐reactive protein concentration >5 mg/L), nurturance (HOME Inventory), child development (Mullens Scales of Early Learning), and inhibitory control (preschoolers). Linear mixed effects models accounting for repeated measures, clustering, and confounders were used to assess associations between height and child development over time (infants: enrollment, 6 and 12 months; preschoolers: enrollment and 8 months). Moderating effects of inflammation and nurturance were tested with interaction terms. Among infants and preschoolers, height and nurturance were positively associated with all domains of child development over time, with the exception of inhibitory control. Among preschoolers, in the presence of inflammation, height was not associated with child development. Among infants, but not preschoolers, a nurturant home environment attenuated significant associations between height with fine motor and receptive language development. The mechanisms associated with children's development over time are multifactorial and include direct and indirect associations among nutrition, health, and the home environment, as supported by the Nurturing Care Framework.     

Correction to: Quality of Life and Spirituality in Indian University Students

Applied Research in Quality of Life - After the publication of this article, Dr. Deb noted he had mistakenly omitted two authors from the authorship, Dr. Mani and Dr. Vempaty.