Negotiating and Struggling for a New Life: Stigma, Spirituality, and Coping Strategies of People Living with HIV in Myanmar.

Although enacted and internalized stigma is a continuing problem for people living with HIV (PLWH) in Southeast Asia, there is little understanding of how PLWH cope with discrimination, exclusion, and other negative outcomes caused by HIV-related stigmatization. This article aims to bridge this gap by analyzing the lived experiences of HIV-related stigmatization and coping strategies among 30 people with HIV in Myanmar, a country heavily influenced by religion, especially Buddhism. Among the 30 study participants, 20 were female and 10 were male, with ages ranging from 18 to 50 years. Through the lens of Bourdieu's concepts of habitus, field, and capital, this article first elucidates the various forms of stigmatization in family, work, social, and other settings as symbolic violence on people with HIV. The present article shows that spirituality serves as a perceptual and action framework for people with HIV to generate reflexivity toward their HIV infection and related stigmatization and to further engage in agentic responses. More importantly, this article demonstrates how people with HIV draw on spirituality to support peers in reclaiming control over their lives and how they are perceived by society. The findings indicate that the local context, especially cultural and religious resources, should be considered when developing interventions to mitigate HIV-related stigmatization in Southeast Asia.

The acute effects of cigarette smoke exposure on muscle fiber type dynamics in rats.

Reduced exercise capacity is common in people with chronic obstructive pulmonary diseases (COPD) and chronic smokers and is suggested to be related to skeletal muscle dysfunction. Previous studies using human muscle biopsies have shown fiber-type shifting in chronic smokers particularly those with COPD. These results, however, are confounded with aging effects because people with COPD tend to be older. In the present study, we implemented an acute 7-day cigarette smoke-exposed model using Sprague-Dawley rats to evaluate early effects of cigarette smoking on soleus muscles. Rats (n = 5 per group) were randomly assigned to either a sham air (SA) or cigarette smoking (CS) groups of three different concentrations of total particulate matters (TPM) (CSTPM2.5, CSTPM5, CSTPM10). Significantly lower percentages of type I and higher type IIa fiber were detected in the soleus muscle in CS groups when compared with SA group. Of these, only CSTMP10 group exhibited significantly lower citrate synthase activity and higher muscle tumor necrosis factor-α level than that of SA group. Tumor necrosis factor-α level was correlated with the percentage of type I and IIa fibers. However, no significant between-group differences were found in fiber cross-sectional area, physical activities, or lung function assessments. In conclusion, acute smoking may directly trigger the onset of glycolytic fiber type shift in skeletal muscle independent of aging.

The Effectiveness of Aromatherapy for Depressive Symptoms: A Systematic Review.

Background. Depression is one of the greatest health concerns affecting 350 million people globally. Aromatherapy is a popular CAM intervention chosen by people with depression. Due to the growing popularity of aromatherapy for alleviating depressive symptoms, in-depth evaluation of the evidence-based clinical efficacy of aromatherapy is urgently needed. Purpose. This systematic review aims to provide an analysis of the clinical evidence on the efficacy of aromatherapy for depressive symptoms on any type of patients. Methods. A systematic database search was carried out using predefined search terms in 5 databases: AMED, CINHAL, CCRCT, MEDLINE, and PsycINFO. Outcome measures included scales measuring depressive symptoms levels. Results. Twelve randomized controlled trials were included and two administration methods for the aromatherapy intervention including inhaled aromatherapy (5 studies) and massage aromatherapy (7 studies) were identified. Seven studies showed improvement in depressive symptoms. Limitations. The quality of half of the studies included is low, and the administration protocols among the studies varied considerably. Different assessment tools were also employed among the studies. Conclusions. Aromatherapy showed potential to be used as an effective therapeutic option for the relief of depressive symptoms in a wide variety of subjects. Particularly, aromatherapy massage showed to have more beneficial effects than inhalation aromatherapy.

[Risk factors for massive ascites after living donor liver transplantation in adult and impact of massive ascites on patient survival].

OBJECTIVE: To analyze the risk factors relate to massive ascites after the living donor liver transplantation (LDLT) in adult and the impact of massive ascites on patient survival. METHODS: Clinical data of 105 adult patients undergone LDLT from 2005 to 2011 in West China Hospital were retrospectively analyzed. The risk factors for massive ascites were firstly determined with univariate analysis, then with two logistic regression analysis if P< 0.1 by univariate analysis. Kaplan-Meier survival curve was used to investigate the association between massive ascites and patient survival. RESULTS: The average amount of ascites within seven days postoperatively in 105 LDLT cases was 5 362 mL (766 mL per day), and massive ascites developed in 27 patients (25.7%). The variables, including receptor age, liver disease, preoperative MELD score, Child-Pugh score, preoperative ascites, preoperative INR, preoperative total bilirubin, preoperative serum albumin, operative time, postoperative SOFA score, postoperative total bilirubin, showed significant difference between massive ascites group and non-massive ascites group. Another variable that P < 0.1 was graft to recipient weight ratio (GRWR) (P = 0.069). The two logistic regression showed that preoperative ascites (OR = 3.33, P < 0.001), postoperative SOFA score (OR = 1.25, P = 0.027) were independent risk factors for massive ascites after LDLT. The results of Kaplan-Meier analysis showed that the 3-month, 6-month, 1-year survival rates of control group were 89.6%, 81.2%, 79.5% respectively, and those rates of massive ascites group were 80.8%, 80.8%, 74.1% respectively. The survival of the patients who developed massive ascites after LDLT was reduced when compared with control group, but it was not statistically significant. CONCLUSION: Preoperative ascites, postoperative SOFA score were independent risk factors for massive ascites after LDLT. The impact of massive ascites on patients survival need further investigation.