Schizophrenia, AIDS and the decision to prescribe HAART: results of a national survey of HIV clinicians

Individuals with schizophrenia are at risk of developing HIV and are known to experience barriers to optimal medical care. Our goal was to determine, among a cohort of HIV clinicians, whether or not the diagnosis of schizophrenia affected the clinical decision to offer highly active antiretroviral therapy (HAART) to AIDS patients. This is a cross-sectional study of a random, national sample of HIV experts drawn from the membership of the American Academy of HIV Medicine. Participants were mailed a self-administered questionnaire with a case vignette of a new onset AIDS patient and were specifically asked whether or not they would recommend HAART treatment. Vignettes were randomly assigned to include a diagnosis of schizophrenia or not. We located 649 clinicians (93%); 347 responded (53.4%). Responders and non-responders did not differ in demographics or work characteristics. Recommendation of antiretroviral treatment did not differ between those who received a case vignette with schizophrenia versus those who did not(95.8% vs. 96.6%, p=0.69). Compared to those who received a case vignette without schizophrenia, those who received vignettes with schizophrenia were more likely to avoid prescribing efavirenz, a medication with known neuropsychiatric side effects(17.7% vs. 45.5%, p < 0.01), more likely to agree to be helped by a specialist(34.5% vs. 12.9%, p < 0.01), and more likely to recommend directly observed therapy (20% vs.10%, p = 0.01). HIV clinicians recognize the importance of recommending HAART treatment to individuals with schizophrenia and AIDS and avoid using antiretroviral medication with known neuropsychiatric side effects.     

Retrospective and Prospective Performance Assessments during the 2004 Election Campaign: Tests of Mediation and News Media Priming

According to many theoretical accounts of the vote choice, distal determinants (e.g., party identification) influence proximal determinants (e.g., perceptions of candidates), which in turn shape candidate preferences. Yet almost no research on voting has formally tested such mediational hypotheses. Using national survey data collected between February and September of 2004, this paper begins by illustrating how to conduct such investigations. We explored whether public approval of President Bush’s handling of a series of specific national problems (e.g., the Iraq war) influenced overall assessments of his job performance and evaluations of his likely future performance versus John Kerry’s, which in turn shaped vote choices. The results are consistent with the claim of mediation and shed additional light on the impact of various issues on the 2004 election outcome. We also tested what we term the “dosage hypothesis,” derived from news media priming theory, which posits that changes in the amount of media coverage of an issue during the course of a campaign should precipitate changes in the weight citizens place on that issue when evaluating the president’s overall job performance, particularly among citizens most exposed to the news. Surprisingly, this analysis did not yield consistent support for the venerable dosage hypothesis, suggesting that the conditions under which priming occurs should be specified much more precisely in future work.

Characterization of the triacylglycerol crystal formation in adipose tissue during a vehicle collision

The unusual appearance of crystalline fat structures was observed during the postmortem examination of a motor vehicle accident victim. The crystal structures were characterized using Fourier transform infrared spectroscopy and x-ray diffractometry. The structures were found to be made of triacylglycerols, a dominant lipid structure found in human adipose tissue, capable of forming various polymorphic structures. The morphology of the crystalline material was found using both techniques to be predominantly the beta' form of triacylglycerols. The accelerated growth of such triacylglycerol morphology has been observed as a result of shear stresses in other studies involving edible fats. As a result of the findings of this study, it is proposed that increased shear forces may be responsible for the formation of the unusual fat structure found in the victim. An understanding of the effect of forces on the structure of body fat in high-impact collisions can potentially assist in verifying a high-velocity impact.