The New Biology and its Impact in Biomedical Strategies Against HIV/AIDS

Abstract. The sequencing of the human genome and the initiation of the structural genomics projects have ushered in a new age of biology that involves multi‐lab, high‐cost projects with broad task‐oriented goals rather than the more conventional hypothesis‐driven approach of the past. The new biology has led to the development of new sets of tools for the scientist to use in the quest to solve mysteries of human disease, biomolecular structure‐function relationships, and other burning biological questions. Nevertheless, the impact of the new biology on the field of AIDS investigation has been minimal, predominantly because many of the tools in the HIV field of study were developed before the full advance of the new biology was felt in the biomedical community. Many of the high‐cost megaprojects that involve large technological advances and are marketed as projects of promise to the biomedical community are not likely to significantly impact the field of HIV/AIDS research and cannot serve as a substitute for direct funding to the HIV/AIDS scientists working for vaccine development, an understanding of mechanisms of disease causation, and new tools for therapeutic intervention.     

The Necessity for a Theology of Disease: Reflections on Totalities and Fragments

Abstract. Our ideas of disease try to explain it, and they aim at facilitating cures. In the process, they become entwined in sociocultural networks that have totalizing effects. Disease, however, counters this totalizing effect by revealing to us that our lives are fragments. Unless we engage this fragment character of disease and of our lives, we cannot properly understand disease or deal with it. HIV/AIDS clarifies these issues in an extraordinarily powerful fashion. Medical, legal, commercial, political, and institutional approaches to disease overlook the fragment character of disease in favor of totalizing world‐ views. A theology of disease is necessary in order to maintain the focus on fragments. Unless we recognize this fragment character, we do not really understand our lives, and we do not really understand either disease or healing.     

论医学人文精神的历史走向

医学人文精神和医学科学精神的整合交融,是医学走向成熟的标志,对生命的终极关怀,是医学人文精神的基本内涵;对医患关系的理解和介入方式,是医学人文精神切入实践的关键;医学人文品格是医学人文精神的良性载体和职业表征。是医生理想的职业人格。这四个问题从不同角度,不同层面凸现了医学人文精神的实质,反映了在新医学模式背景下医学人文精神的历史走向。     

护理扩展培训在艾滋病干预模式中的探讨

新疆艾滋病形势严峻,艾滋病重点疫区的护理人员普遍存在着对艾滋病知识的缺乏,对艾滋病患者持有歧视、恐惧的心理及缺乏基本的防护知识等现状,艾滋病护理扩展培训项目的实施,通过对护理人员进行的艾滋病知识培训,对艾滋病干预模式进行了有益的探索和实践。     

Cognitive Neuropsychology of HIV-Associated Neurocognitive Disorders

Advances in the treatment of the human immunodeficiency virus (HIV) have dramatically improved survival rates over the past 10 years, but HIV-associated neurocognitive disorders (HAND) remain highly prevalent and continue to represent a significant public health problem. This review provides an update on the nature, extent, and diagnosis of HAND. Particular emphasis is placed on critically evaluating research within the realm of cognitive neuropsychology that aims to elucidate the component processes of HAND across the domains of executive functions, motor skills, speeded information processing, episodic memory, attention/working memory, language, and visuoperception. In addition to clarifying the cognitive mechanisms of HAND (e.g., impaired cognitive control), the cognitive neuropsychology approach may enhance the ecological validity of neuroAIDS research and inform the development of much needed novel, targeted cognitive and behavioral therapies. The research described was supported by MH73419 and MH62512 from the National Institutes of Health. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the United States Government.     

Neuropsychological Functioning and Antiretroviral Treatment in HIV/AIDS: A Review

This article presents a review of studies that have investigated the neuropsychological effects of antiretroviral treatment (ART) for HIV-1 infection. It provides a brief overview of the era of monotherapy, dual-therapy, and an extended overview of the current era of combination antiretroviral therapy (CART). This review highlights that while CART has had a dramatic effect on the incidence and the severity of HIV-associated neurocognitive disorders (HAND), HAND, in its mild form, still remains prevalent. New causes of this sustained prevalence are poor CNS penetration of some antiretroviral agents, drug resistance, poor adherence, potential neurotoxicity, co-morbidities such as the long-term CART side effects in relation to cardio-vascular disease, and chronic HIV brain infection that may facilitate the expression of new forms of neurodegenerative processes. The review emphasizes the need to address methodological limitations of published studies and the need for large and representative cross-disciplinary longitudinal investigations across the HIV illness span.     

Parents Living with HIV in China: Family Functioning and Quality of Life

In China, HIV shifts the lifestyle of not only parents living with HIV/AIDS, but also their children, partners, and extended families. We examined factors related to the quality of life of parents living with HIV and the relation between family functioning and individual quality of life. Interviews were conducted with a total of 116 parents living with HIV/AIDS. Analyses of variance, Pearson correlations, and multiple regression analyses were performed to examine the relation between family functioning and quality of life. We found a significant association between family functioning and individual quality of life for parents living with HIV. In particular, family sociability had a strong relationship with the quality of life of parents living with HIV. Parents living with HIV from families where both parents are HIV-positive reported a lower level of family sociability than those from families with only one HIV-positive parent. HIV disclosure, family sociability, and number of children per family were found to be significant predictors of overall quality of life for the population. Study findings underscore the importance of developing interventions that improve family functioning for people living with HIV/AIDS in China.     

The Social Conditions for Successful Peer Education: A Comparison of Two HIV Prevention Programs Run by Sex Workers in India and South Africa

Peer education is a community-based intervention being implemented worldwide as an approach to HIV prevention. However, its results are inconsistent, with little consensus on why some projects succeed while others fail. Considering peer education as an ‘intervention-in-context’, we systematically compare the context and the implementation of two peer education interventions run by sex workers, one in India and one in South Africa, which produced contrasting outcomes. In so doing, we aim to identify key factors in the projects’ successes or failures that may inform future peer education efforts. The Indian project’s relative success was facilitated (1) by a more stable and supportive social, material and political context, and (2) by a community development ethos which devoted significant resources to sex workers’ involvement, ownership and empowerment, as opposed to a biomedical approach which marginalised sex workers’ concerns. We conclude with lessons learned and implications for current trends in peer education.     

Assessment of 'subcortical dementia' in patients with Huntington's disease, Parkinson's disease, multiple sclerosis and AIDS by a neuropsychological screening battery

Four diagnostic groups categorized as 'subcortical dementia' were studied using a neuropsychological screening battery. The specificity of the battery in disclosing characteristic patterns of impairment in subgroups within the category, and the correspondence between natural subgroups generated by an unsupervised statistical classification technique and the diagnostic labels were investigated. All cognitive affected subgroups demonstrated impairment on tests of sensomotor function, congnitive efficiency and/or memory, and were characterized in terms of severity of impairment as well as a progressive involvement of functional areas. The diagnostic groups were not evenly represented in all natural subgroups. Affected AIDS-patients seemed to resemble patients with Huntington's disease more than the other diagnostic groups. The screening battery could give a general characterization of the pattern of 'subcortical dementia' and different levels of impairment, but more specific process-oriented tasks are needed to contrast diagnostic groups within the concept of 'subcortical dementia'.     

AIDS-related stigma,personal risks and career objectives among makerere medical students

The aims of this study were to investigate variables that influence AIDS-related stigma and to assess occupational risks, behavioural change, and career objectives of students in face of the AIDS epidemic. Data available on 150 randomly selected medical students were analysed statistically. Results indicated that sex and year of study significantly influenced AIDS-related stigma while age, religion and tribe did not. The majority of students recommended screening and health education for high-risk people and reported high levels of perceived risk. Various occupational hazards and behavioural changes were reported, but students still wanted to remain in the medical profession. Implications of these findings are discussed.