Trauma drives HIV epidemic in women

[ Back to EurekAlert! ] Public release date: 19-Mar-2012
[ | E-mail | Share Share ]

Contact: Jason Socrates Bardi
jason.bardi@ucsf.edu
415-502-6397
University of California - San Francisco

High rate of trauma among american women with HIV/AIDS and its public health consequences revealed in 2 UCSF studies

Physical violence, sexual abuse and other forms of childhood and adult trauma are major factors fueling the epidemic of HIV/AIDS among American women. Scientists have known for years that traumatized women are at greater risk of becoming infected.

Now, two new studies from the University of California, San Francisco (UCSF) and Harvard Medical School demonstrate that a high rate of trauma among women already infected with HIV also plays a role in the epidemic.

Described in back-to-back papers in the journal AIDS and Behavior, the new work demonstrates that women with HIV are exposed to trauma and suffer from posttraumatic stress disorder (PTSD) at rates far higher than those occurring in women in general.

The work may help to reframe many types of discussions about HIV/AIDS so that more clinicians take trauma into account when working with their patients.

Traumatized women fare worse in treatment for HIV/AIDS than women who have not suffered traumatic stress. Trauma also puts women in situations where they are more likely to spread the virus.

"For a long time we have been looking for clues as to why so many women are becoming infected with HIV and why so many are doing poorly despite the availability of effective treatment," said Edward Machtinger, MD, who directs the Women's HIV Program at UCSF and who was the co-principal investigator on both studies. "This work clearly shows that trauma is a major factor in the HIV epidemic among women."

American women with HIV are more than five times more likely to have PTSD and twice as likely to have been the victim of intimate partner violence compared to national samples of American women. The work also demonstrates the personal and public health consequences of trauma in HIV-positive women: women with HIV who report recent trauma are over four times more likely to fail their HIV treatment and almost four times more likely to engage in risky sexual behavior.

How Trauma Contributes to HIV/AIDS in Women

The proportion of U.S. women diagnosed with HIV/AIDS has grown steadily for the last 30 years. In 1985, only 8 percent of new U.S. cases occurred in women. By 1992, that number had risen to 14 percent of new cases. Today, women account for at least 27 percent of new U.S. cases.

The new work helps understand some of the problems helping to drive the epidemic among American women, an epidemic that particularly impacts women of color.

Previous studies have shown that trauma contributes to the HIV/AIDS epidemic among American women because it is associated with variety of risky situations and behaviors among at-risk HIV-negative women and girls. But until now, no definitive estimates existed of the rates of trauma and PTSD among women and girls already infected with HIV.

Machtinger and his colleagues used the statistical technique of meta-analysis to combine data from 29 prior studies that included 5,930 HIV-positive women to estimate the rates of trauma and PTSD in American woman with HIV. They found highly disproportionate rates of trauma exposure and PTSDmostly between two and six times higher rates of various types of child and adult sexual and physical abuse and PTSD in HIV-positive women. This is particularly striking because rates of trauma in the general population of women are already high. As an example, the estimated rate of recent PTSD among HIV-positive women is 30 percent while that of the general population is 5.2 percent.

In a companion paper, the scientists sought to determine why so many women with HIV fare so poorly when taking HIV/AIDS drugs and also why many end up in situations where they could transmit the virus to others. To do so, the scientists analyzed detailed clinical and behavioral data collected from 113 women and female-identified transgender women in San Francisco who have HIV/AIDS.

The analysis revealed that ongoing trauma was strongly associated with both treatment failure and with risky situations and behaviors. Specifically, the study demonstrated that HIV-positive women who report recent trauma had more than four times the odds of experiencing virologic failure, a situation where the HIV virus becomes detectable in the blood despite being on antiretroviral mediations. This situation can lead to HIV-related illnesses and to the virus developing resistance to the antiretroviral medications. The work also revealed that women who had suffered recent trauma were more almost four times more likely to have had sex with someone without the virus or whose HIV status was unknown to them, and to not always use condoms with these partners.

This has important public health consequences, said Machtinger. People failing their medications are particularly infectious because their virus is not suppressed. If they have unprotected sex with someone who does not already have HIV, there is a higher risk of further infection.

"Women who report experiencing trauma often do not have the power or self-confidence to protect themselves from acquiring HIV," Machtinger said. "Once infected, women who experience ongoing abuse are often not in positions of power to effectively care for themselves or to insist that their partners protect themselves. Effectively addressing trauma has the potential to both improve the health of HIV-positive women and that of the community."

The study was not large enough to determine exactly how recent trauma leads to treatment failure; one possibility is that suffering trauma interferes with a woman's ability to take her HIV medications as consistently as necessary. The authors also believe that, for some women, substance abuse and depression are closely related to trauma and that all may contribute to the poor outcomes seen in the study.

The work identified very simple screening questions for recent and lifetime trauma which could be readily used in clinical practice. According to Jessica Haberer, MD, MS of Harvard Medical School, "Our studies have the potential for immediate clinical impact in that we ascertained practical ways for clinicians to identify patients at risk."

For example, asking a simple question about recent trauma may help identify patients at higher risk for poor health outcomes and risk of further transmission. This may allow for a more effective allocation of scarce clinic and community resources, such as safety assessment, trauma-related therapy, medication-taking support and transmission-prevention counseling. The authors also believe that efforts to treat substance abuse and depression may be more effective if such counseling acknowledges that ongoing trauma may be contributing to both conditions.

"We have to learn to ask about trauma and to develop creative approaches to trauma-prevention and trauma-recovery," Machtinger said. "This is actually an amazing opportunity to have a significant impact on the HIV/AIDS epidemic, especially among minority women."

###

The article, "Psychological Trauma and PTSD in HIV- Positive Women: A Meta-Analysis" by E. L. Machtinger, T. C. Wilson, J. E. Haberer and D. S. Weiss was published online by the journal AIDS and Behavior on January 17, 2012. See: http://dx.doi.org/10.1007/s10461-011-0127-4

The article, "Recent Trauma is Associated with Antiretroviral Failure and HIV Transmission Risk Behavior among HIV-positive Women and Female-identified Transgenders" by E. L. Machtinger, J. E. Haberer, T. C. Wilson, and D. S. Weiss will be published online by the journal AIDS and Behavior this month. Once the article appears online, it will be accessible at: http://dx.doi.org/10.1007/s10461-012-0158-5

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.

HIV/AIDS and American Women

  • 50 percent of all people living with HIV/AIDS worldwide are women
  • 27 percent of all U.S. HIV/AIDS diagnoses today are in women
  • 77 percent of all U.S. women with HIV/AIDS are black or Latina
  • #3 cause of death for U.S. Black women, age 30-44 is HIV/AIDS
  • 30 percent of American women with HIV/AIDS suffer PTSD (5 times national rate)
  • 55.3 percent American women with HIV/AIDS suffer intimate partner violence (more than twice the national rate)

Follow UCSF
UCSF.edu | Facebook.com/ucsf | Twitter.com/ucsf | YouTube.com/ucsf


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?


AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


[ Back to EurekAlert! ] Public release date: 19-Mar-2012
[ | E-mail | Share Share ]

Contact: Jason Socrates Bardi
jason.bardi@ucsf.edu
415-502-6397
University of California - San Francisco

High rate of trauma among american women with HIV/AIDS and its public health consequences revealed in 2 UCSF studies

Physical violence, sexual abuse and other forms of childhood and adult trauma are major factors fueling the epidemic of HIV/AIDS among American women. Scientists have known for years that traumatized women are at greater risk of becoming infected.

Now, two new studies from the University of California, San Francisco (UCSF) and Harvard Medical School demonstrate that a high rate of trauma among women already infected with HIV also plays a role in the epidemic.

Described in back-to-back papers in the journal AIDS and Behavior, the new work demonstrates that women with HIV are exposed to trauma and suffer from posttraumatic stress disorder (PTSD) at rates far higher than those occurring in women in general.

The work may help to reframe many types of discussions about HIV/AIDS so that more clinicians take trauma into account when working with their patients.

Traumatized women fare worse in treatment for HIV/AIDS than women who have not suffered traumatic stress. Trauma also puts women in situations where they are more likely to spread the virus.

"For a long time we have been looking for clues as to why so many women are becoming infected with HIV and why so many are doing poorly despite the availability of effective treatment," said Edward Machtinger, MD, who directs the Women's HIV Program at UCSF and who was the co-principal investigator on both studies. "This work clearly shows that trauma is a major factor in the HIV epidemic among women."

American women with HIV are more than five times more likely to have PTSD and twice as likely to have been the victim of intimate partner violence compared to national samples of American women. The work also demonstrates the personal and public health consequences of trauma in HIV-positive women: women with HIV who report recent trauma are over four times more likely to fail their HIV treatment and almost four times more likely to engage in risky sexual behavior.

How Trauma Contributes to HIV/AIDS in Women

The proportion of U.S. women diagnosed with HIV/AIDS has grown steadily for the last 30 years. In 1985, only 8 percent of new U.S. cases occurred in women. By 1992, that number had risen to 14 percent of new cases. Today, women account for at least 27 percent of new U.S. cases.

The new work helps understand some of the problems helping to drive the epidemic among American women, an epidemic that particularly impacts women of color.

Previous studies have shown that trauma contributes to the HIV/AIDS epidemic among American women because it is associated with variety of risky situations and behaviors among at-risk HIV-negative women and girls. But until now, no definitive estimates existed of the rates of trauma and PTSD among women and girls already infected with HIV.

Machtinger and his colleagues used the statistical technique of meta-analysis to combine data from 29 prior studies that included 5,930 HIV-positive women to estimate the rates of trauma and PTSD in American woman with HIV. They found highly disproportionate rates of trauma exposure and PTSDmostly between two and six times higher rates of various types of child and adult sexual and physical abuse and PTSD in HIV-positive women. This is particularly striking because rates of trauma in the general population of women are already high. As an example, the estimated rate of recent PTSD among HIV-positive women is 30 percent while that of the general population is 5.2 percent.

In a companion paper, the scientists sought to determine why so many women with HIV fare so poorly when taking HIV/AIDS drugs and also why many end up in situations where they could transmit the virus to others. To do so, the scientists analyzed detailed clinical and behavioral data collected from 113 women and female-identified transgender women in San Francisco who have HIV/AIDS.

The analysis revealed that ongoing trauma was strongly associated with both treatment failure and with risky situations and behaviors. Specifically, the study demonstrated that HIV-positive women who report recent trauma had more than four times the odds of experiencing virologic failure, a situation where the HIV virus becomes detectable in the blood despite being on antiretroviral mediations. This situation can lead to HIV-related illnesses and to the virus developing resistance to the antiretroviral medications. The work also revealed that women who had suffered recent trauma were more almost four times more likely to have had sex with someone without the virus or whose HIV status was unknown to them, and to not always use condoms with these partners.

This has important public health consequences, said Machtinger. People failing their medications are particularly infectious because their virus is not suppressed. If they have unprotected sex with someone who does not already have HIV, there is a higher risk of further infection.

"Women who report experiencing trauma often do not have the power or self-confidence to protect themselves from acquiring HIV," Machtinger said. "Once infected, women who experience ongoing abuse are often not in positions of power to effectively care for themselves or to insist that their partners protect themselves. Effectively addressing trauma has the potential to both improve the health of HIV-positive women and that of the community."

The study was not large enough to determine exactly how recent trauma leads to treatment failure; one possibility is that suffering trauma interferes with a woman's ability to take her HIV medications as consistently as necessary. The authors also believe that, for some women, substance abuse and depression are closely related to trauma and that all may contribute to the poor outcomes seen in the study.

The work identified very simple screening questions for recent and lifetime trauma which could be readily used in clinical practice. According to Jessica Haberer, MD, MS of Harvard Medical School, "Our studies have the potential for immediate clinical impact in that we ascertained practical ways for clinicians to identify patients at risk."

For example, asking a simple question about recent trauma may help identify patients at higher risk for poor health outcomes and risk of further transmission. This may allow for a more effective allocation of scarce clinic and community resources, such as safety assessment, trauma-related therapy, medication-taking support and transmission-prevention counseling. The authors also believe that efforts to treat substance abuse and depression may be more effective if such counseling acknowledges that ongoing trauma may be contributing to both conditions.

"We have to learn to ask about trauma and to develop creative approaches to trauma-prevention and trauma-recovery," Machtinger said. "This is actually an amazing opportunity to have a significant impact on the HIV/AIDS epidemic, especially among minority women."

###

The article, "Psychological Trauma and PTSD in HIV- Positive Women: A Meta-Analysis" by E. L. Machtinger, T. C. Wilson, J. E. Haberer and D. S. Weiss was published online by the journal AIDS and Behavior on January 17, 2012. See: http://dx.doi.org/10.1007/s10461-011-0127-4

The article, "Recent Trauma is Associated with Antiretroviral Failure and HIV Transmission Risk Behavior among HIV-positive Women and Female-identified Transgenders" by E. L. Machtinger, J. E. Haberer, T. C. Wilson, and D. S. Weiss will be published online by the journal AIDS and Behavior this month. Once the article appears online, it will be accessible at: http://dx.doi.org/10.1007/s10461-012-0158-5

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.

HIV/AIDS and American Women

  • 50 percent of all people living with HIV/AIDS worldwide are women
  • 27 percent of all U.S. HIV/AIDS diagnoses today are in women
  • 77 percent of all U.S. women with HIV/AIDS are black or Latina
  • #3 cause of death for U.S. Black women, age 30-44 is HIV/AIDS
  • 30 percent of American women with HIV/AIDS suffer PTSD (5 times national rate)
  • 55.3 percent American women with HIV/AIDS suffer intimate partner violence (more than twice the national rate)

Follow UCSF
UCSF.edu | Facebook.com/ucsf | Twitter.com/ucsf | YouTube.com/ucsf


[ Back to EurekAlert! ] [ | E-mail | Share Share ]

?


AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


Source: http://www.eurekalert.org/pub_releases/2012-03/uoc--tdh031412.php

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Lifestyle study highlights key differences in relapsing and progressive onset MS

[ Back to EurekAlert! ] Public release date: 19-Mar-2012
[ | E-mail | Share Share ]

Contact: Annette Whibley
annette.wizard@gmail.com
Wiley-Blackwell

Researchers looked at disease progression in people who did and did not consume alcohol, wine, coffee and fish

Patients with relapsing onset Multiple Sclerosis (MS) who consumed alcohol, wine, coffee and fish on a regular basis took four to seven years longer to reach the point where they needed a walking aid than people who never consumed them. However the study, published in the April issue of the European Journal of Neurology, did not observe the same patterns in patients with progressive onset MS.

The authors say that the findings suggest that different mechanisms might be involved in how disability progresses in relapsing and progressive onset MS.

Researchers asked patients registered with the Flemish MS Society to take part in a survey, which included questions on themselves, their MS and their current consumption of alcohol, wine, coffee, tea, fish and cigarettes.

The 1,372 patients who agreed to take part were also asked to indicate whether they had reached stage six on the zero to ten stage Expanded Disability Status Scale (EDSS) and, if so, when this had happened.

"MS is a chronic, often disabling disease that attacks the central nervous system" explains lead author Dr Marie D'hooghe from the National MS Center at Melsbroek, Belgium. "The clinical symptoms, progression of disability and severity of MS are unpredictable and vary from one person to another.

"Two major MS onset types can be distinguished. Progressive onset MS is characterised by a gradual worsening of neurological function from the beginning, whereas patients with relapsing onset MS patients experience clearly defined attacks of worsening neurologic function with partial or full remission.

"EDSS 6 is an important milestone in the development of MS as it is the point at which patients need support to walk a reasonable distance."

The patients who took part were aged between 17 and 89 years-of-age:

  • 65% (893) had relapsing onset MS. 76% were female, with an average age of 50 years. Age at MS onset averaged 31.5 years and disease duration averaged 19 years.
  • 35% (479) had progressive onset MS. 62% were female, with an average age of 59 years. Age at MS onset averaged 37 years and disease duration averaged 21 years.

The researchers analysed how long it had taken people to reach EDSS 6 and compared those who reported moderate consumption of fish, alcoholic and non-alcoholic drinks and cigarettes with those who reported occasional or no consumption. This showed that:

  • Just over half (51%) had reached EDSS 6 after an average disease duration of 20 years. The percentage was much higher for people with progressive onset MS (80%) than relapsing onset (36%).
  • Patients with relapsing onset MS who consumed moderate amounts of alcohol (one drink a week or more) reached EDSS 6 seven years later than people who did not drink at all and wine drinkers reached it four years later than those who did not drink wine. The time differences were insignificant in people with progressive onset MS.
  • Daily coffee consumption delayed reaching EDSS 6 by five years in people with relapsing onset MS, but there were no significant differences in people with progressive onset MS. Drinking tea daily produced insignificant results in both groups.
  • People with relapsing onset MS who ate fish two or more times a week reached EDSS 6 seven years later than those who ate it less than once a month. It made no difference whether the fish was lean or fatty.

The time differences quoted above did not take into account gender, age at onset and treatment, which are known to affect disability progression in MS. But even after adjusting for these factors, the hazard risk analysis for time to sustained EDSS 6 (where 1.0 was the reference number for zero consumption) showed that:

  • The hazard risks for relapsing onset MS were significantly lower for a number of factors: moderate alcohol (0.61), moderate wine (0.67), daily coffee (0.60), occasional coffee (0.60), fish at least twice a week (0.60) and fish at least once a month (0.63).
  • Daily cigarette smoking raised the risk to 1.35 in relapsing onset MS.
  • The only hazard risk of any statistical significance for progressive onset MS was 1.56 for patients who preferred fatty fish, compared with those who preferred lean fish.

The paper contains full details of the suggested mechanisms that may be involved in the links between consumption and disease progression.

"Although our findings show a number of associations between consumption and disease progression, it is important that patients recognise that this does not imply that certain food and drinks provide a protective effect as other factors may be involved" stresses Dr D'hooghe.

"Our study does, however, provide valuable pointers for future research as it reinforces the theory that different mechanisms may be involved in the progression of disability in relapsing and progressive onset MS."

###

Notes to editors

  • Alcohol, coffee, fish, smoking and disease progression in multiple sclerosis. D'hooghe et al. European Journal of Neurology. 19, pp616-624. (April 2012). doi:10.1111/j.1468-1331.2011.03596.x
  • The European Journal of Neurology covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases or large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).?The journal provides a forum for European activity in clinical neuroscience and medical practice and helps strengthen the links between research workers and clinicians in Europe and other parts of the world. The journal also publishes the official EFNS taskforce papers. http://wileyonlinelibrary.com/journal/ENE
  • Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit www.wileyblackwell.com or our new online platform, Wiley Online Library (wileyonlinelibrary.com), one of the world's most extensive multidisciplinary collections of online resources, covering life, health, social and physical sciences, and humanities.

[ Back to EurekAlert! ] [ | E-mail | Share Share ]

?


AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


[ Back to EurekAlert! ] Public release date: 19-Mar-2012
[ | E-mail | Share Share ]

Contact: Annette Whibley
annette.wizard@gmail.com
Wiley-Blackwell

Researchers looked at disease progression in people who did and did not consume alcohol, wine, coffee and fish

Patients with relapsing onset Multiple Sclerosis (MS) who consumed alcohol, wine, coffee and fish on a regular basis took four to seven years longer to reach the point where they needed a walking aid than people who never consumed them. However the study, published in the April issue of the European Journal of Neurology, did not observe the same patterns in patients with progressive onset MS.

The authors say that the findings suggest that different mechanisms might be involved in how disability progresses in relapsing and progressive onset MS.

Researchers asked patients registered with the Flemish MS Society to take part in a survey, which included questions on themselves, their MS and their current consumption of alcohol, wine, coffee, tea, fish and cigarettes.

The 1,372 patients who agreed to take part were also asked to indicate whether they had reached stage six on the zero to ten stage Expanded Disability Status Scale (EDSS) and, if so, when this had happened.

"MS is a chronic, often disabling disease that attacks the central nervous system" explains lead author Dr Marie D'hooghe from the National MS Center at Melsbroek, Belgium. "The clinical symptoms, progression of disability and severity of MS are unpredictable and vary from one person to another.

"Two major MS onset types can be distinguished. Progressive onset MS is characterised by a gradual worsening of neurological function from the beginning, whereas patients with relapsing onset MS patients experience clearly defined attacks of worsening neurologic function with partial or full remission.

"EDSS 6 is an important milestone in the development of MS as it is the point at which patients need support to walk a reasonable distance."

The patients who took part were aged between 17 and 89 years-of-age:

  • 65% (893) had relapsing onset MS. 76% were female, with an average age of 50 years. Age at MS onset averaged 31.5 years and disease duration averaged 19 years.
  • 35% (479) had progressive onset MS. 62% were female, with an average age of 59 years. Age at MS onset averaged 37 years and disease duration averaged 21 years.

The researchers analysed how long it had taken people to reach EDSS 6 and compared those who reported moderate consumption of fish, alcoholic and non-alcoholic drinks and cigarettes with those who reported occasional or no consumption. This showed that:

  • Just over half (51%) had reached EDSS 6 after an average disease duration of 20 years. The percentage was much higher for people with progressive onset MS (80%) than relapsing onset (36%).
  • Patients with relapsing onset MS who consumed moderate amounts of alcohol (one drink a week or more) reached EDSS 6 seven years later than people who did not drink at all and wine drinkers reached it four years later than those who did not drink wine. The time differences were insignificant in people with progressive onset MS.
  • Daily coffee consumption delayed reaching EDSS 6 by five years in people with relapsing onset MS, but there were no significant differences in people with progressive onset MS. Drinking tea daily produced insignificant results in both groups.
  • People with relapsing onset MS who ate fish two or more times a week reached EDSS 6 seven years later than those who ate it less than once a month. It made no difference whether the fish was lean or fatty.

The time differences quoted above did not take into account gender, age at onset and treatment, which are known to affect disability progression in MS. But even after adjusting for these factors, the hazard risk analysis for time to sustained EDSS 6 (where 1.0 was the reference number for zero consumption) showed that:

  • The hazard risks for relapsing onset MS were significantly lower for a number of factors: moderate alcohol (0.61), moderate wine (0.67), daily coffee (0.60), occasional coffee (0.60), fish at least twice a week (0.60) and fish at least once a month (0.63).
  • Daily cigarette smoking raised the risk to 1.35 in relapsing onset MS.
  • The only hazard risk of any statistical significance for progressive onset MS was 1.56 for patients who preferred fatty fish, compared with those who preferred lean fish.

The paper contains full details of the suggested mechanisms that may be involved in the links between consumption and disease progression.

"Although our findings show a number of associations between consumption and disease progression, it is important that patients recognise that this does not imply that certain food and drinks provide a protective effect as other factors may be involved" stresses Dr D'hooghe.

"Our study does, however, provide valuable pointers for future research as it reinforces the theory that different mechanisms may be involved in the progression of disability in relapsing and progressive onset MS."

###

Notes to editors

  • Alcohol, coffee, fish, smoking and disease progression in multiple sclerosis. D'hooghe et al. European Journal of Neurology. 19, pp616-624. (April 2012). doi:10.1111/j.1468-1331.2011.03596.x
  • The European Journal of Neurology covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases or large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).?The journal provides a forum for European activity in clinical neuroscience and medical practice and helps strengthen the links between research workers and clinicians in Europe and other parts of the world. The journal also publishes the official EFNS taskforce papers. http://wileyonlinelibrary.com/journal/ENE
  • Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit www.wileyblackwell.com or our new online platform, Wiley Online Library (wileyonlinelibrary.com), one of the world's most extensive multidisciplinary collections of online resources, covering life, health, social and physical sciences, and humanities.

[ Back to EurekAlert! ] [ | E-mail | Share Share ]

?


AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


Source: http://www.eurekalert.org/pub_releases/2012-03/w-lsh031912.php

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Plancast Founder Mark Hendrickson Joins Obvious-Incubated Lift As Head Of Product

Screen shot 2012-03-19 at 12.16.11 PMLast June, Biz Stone and Evan Williams teamed up with long-time collaborator (and early Twitter employee) Jason Goldman to dust off and re-start The Obvious Corporation — the very idea incubator that produced the micro-blogging service we know know as “The Twitters”. The goal with Obvious was to help develop new projects, lending seed funding, product support, and office space when needed. Several months later, the idea angels announced their first incubation project, a startup called Lift, an app development platform founded by Tony Stubblebine and Jon Crosby. And, today, the co-founders are officially announcing the addition of Mark Hendrickson as Head of Product. Since Obvious announced that it would be incubating the startup last August, Lift has been heads-down in stealth mode, building an app that aims to “unlock human potential through positive reinforcement.” At the time, Marshall Kirkpatrick did some poking around and pieced together the early history of Lift, which derived from an earlier app that the pair put together, called Mibbles. Though Stubblebine admits that the early app was inspiration, after more than six months in stealth, the app (we hear) now looks a lot different. That’s in part due to the influence of Hendrickson to the Lift team, who brings his experience as the founder and CEO of Plancast, a social site for planning events. Prior to founding Plancast, Hendrickson was a writer/developer at TechCrunch, where he served as our long-form analytical specialist from 2007 to 2009. Unfortunately, as it so often goes in the startup world, Plancast proved to be an uphill and ultimately unsuccessful battle, which Hendrickson detailed in a post-mortem on TechCrunch in January that is a must read for all product people. Since leaving Plancast, Hendrickson has been working with Stubblebine and Ev Williams to design Lift. The guys are still being vague about what they’re building, other than they are using positive reinforcement to help people achieve their goals, and, says Stubblebine, “it’ll be mobile friendly.” But collectively the group has a lot of entrepreneurial experience, as Stubblebine is the creator and former CEO of CrowdVine, and has previously worked at Wesabe, Odeo (where he teamed up with the Obvious trio), and O?Reilly Media. Furthermore, his longtime collaborator, Crosby, was the Engineering Director at Path before joining Lift, and is also a former employee of Engine Yard and Songbird. Hendrickson tells us that the team is combining its design and

Source: http://feedproxy.google.com/~r/Techcrunch/~3/fmRjqUUs8AU/

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Explosion near Syrian security building in Aleppo

DAMASCUS, Syria (AP) ? An explosion ripped through a residential neighborhood in the northern Syrian city of Aleppo on Sunday and the state news agency said it was a "terrorist bombing."

Reports by SANA said two were killed and 30 wounded in what appeared to be the second attack in two days on cities where President Bashar Assad's regime enjoys strong support. Three suicide bombings in the capital Damascus on Saturday killed 27 people. The government blamed those on the opposition, which it claims is made up of "terrorist" groups carrying out a foreign conspiracy.

No one claimed responsibility for any of the attacks.

Mohammed Saeed, an Aleppo resident, said a car bomb exploded near the Political Security Directorate in the city's central neighborhood of Suleimaniyeh. He said the neighborhood has a large Christian population. The Britain-based Syrian Observatory for Human Rights, which relies on an activist network in Syria, also said it was a car bomb. It said it had reports of dead and injured, but gave no numbers.

Saeed said the explosion went off around 1 p.m. and security forces started shooting in the air and cordoned off the area to prevent people from approaching. At that time of day, the area is usually crowded with people, especially on a Sunday, the first day of Syria's workweek, he added.

"It was a strong explosion. It shook parts of the city," Saeed said, citing nearby residents. "White smoke was billowing from the area."

Some opposition leaders accused the regime of orchestrating the attacks to tarnish the anti-government movement behind the year-old uprising against Assad.

Both cities are considered Assad strongholds and have remained relatively insulated from the unrest shaking much of the country since the start of the uprising.

Assad security forces have violently cracked down on dissent as protests have spread. Many in the opposition have taken up arms to defend their towns and neighborhoods and attack government troops, as the increasingly militarized conflict has become one of the bloodiest of the Arab Spring.

The U.N. says more then 8,000 people have been killed in a year.

There have been a string of large-scale bombings near government security buildings in Damascus and Aleppo that suggest a dangerous, wild-card element to the anti-government revolt. The regime has blamed the opposition, which denies any role or the capabilities to carry out sophisticated attacks.

After other similar attacks, U.S. officials suggested al-Qaida militants may be joining the fray.

A previously unknown Islamist group calling itself Al-Nusra Front to Protect the Levant claimed responsibility for previous attacks in a video posted online, saying it carried them out "to avenge the people of Homs." Homs is an opposition stronghold in central Syria that has been hard-hit in the government crackdown.

The last major suicide bombing in Aleppo was on Feb. 10, when twin blasts struck security compounds, killing 28 people. Damascus has seen a half dozen suicide bombings since December, most hitting intelligence and security buildings.

On Saturday, two suicide bombers detonated cars in near-simultaneous attacks on heavily guarded intelligence and security buildings, killing at least 27 people.

The explosions struck the heavily fortified air force intelligence building and the criminal security department, several miles apart, at approximately the same time, the Interior Ministry said. Much of the facade of the intelligence building appeared to have been ripped away.

State-run news agency SANA said a third blast went off near a military bus at the Palestinian refugee camp Yarmouk in Damascus, killing the two suicide bombers.

Source: http://news.yahoo.com/explosion-near-syrian-security-building-aleppo-122921546.html

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5 PPC Tools to Help Your Internet Business | The Web Executive

If you are just starting your online business, one of your main objectives maybe is to create an amazing promotional campaign that would improve your visibility all over the web. Many business owners, whether product or service related, make use of different marketing techniques to reach out their target consumers and one method which is often considered to be a credible option is the PPC (Pay Per Click) marketing.

PPC (Pay Per Click) usually appear in the form of ads in a colored box found on search results pages and are uniquely separated from the standard search results in most major search engines and portals, but in other cases like in AOL, these PPC ads are not separated from the standard search. PPC is considered to be one of the most preferred internet marketing advertisements. Here are 5 PPC tools that any start-up business could avail online free or with minimal costing:

1.????? Google Traffic Estimator

This PPC tool gives relevant information of the current leading 3 promotional slots as well as the forecasted percentage of clicks in a given day. Google Traffic Estimator acts as a guide to any entrepreneur doing internet business the actual amount of capital investment or bid he/she is willing to put on a specific keyword.

2.????? Google Keyword Research Tool

This PPC tool is often used by any businesses related in PPC or search engine optimization application. The role of the Google Keyword Research Tool is to help the online user search for the primary keywords and other relevant keywords. This tool promises effective marketing promotions by providing a monthly report of statistics for any given keyword and the advised cost-per-click bid for any keyword searched.

3.????? Keyword Niche Finder

Keyword Niche Finder is ideal for usage to all newbie to PPC (Pay Per Click) marketing strategy because of its powerful features in locating any keyword.

?4.????? PPC Generator

This tool allows any internet business owner the privilege to create advertisements that can be directly submitted to Google Adwords, Yahoo Search Marketing and Overture.

5.????? ROI Calculator

ROI calculator is considered to be a reliable tool in giving out full assessment to any form of ads based on their actual performance, whether they are doing good or not. This calculator accurately gauge the ROI (return of investment) of any business involved in PPC. It also provides any user an average conversion income together with their monthly traffic generation figures.

In every business, there is a trial period. If ever you decide to take the PPC marketing seriously, remember that you keep yourself totally informed on how the whole PPC system works. It is not always a win-win case scenario. You have to keep track your ads and learn to adjust your investment when results are not favorably doing well for your benefit. Search for the most reliable PPC tool and network to help you get started and apply the most suitable method for your particular business. Now is your chance to see the real power of PPC.

Tagged Pay per click, PPC marketing, PPC tool

About Doree Lyn Nuguid

Doree is an article writer and blogger by passion, an entrepreneur at the same time. At the moment, an active online freelance writer offering her expertise in writing related to the business, marketing and finance sectors.

View all posts by Doree Lyn Nuguid ?

Source: http://www.thewebexecutive.com/2012/03/5-ppc-tools-to-help-your-internet-business/

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Some of the Signs of ADHD ? At A Glance Family Parenting Kids

Introduction To ADHD As well as Its Signs and Symptoms One of the common health complaints that affect children around the globe is ADHD, also known as attention deficit hyperactivity disorder. This situation is a medical condition that affects a child?s mind. The child is not able to focus and pay attention as they need to and they are not able to keep still or pay attention in classes or at home.

Signs And Symptoms Of ADHD

Some of the signs of ADHD will often be divided into 3 main groups. These are hyperactivity, inattention and impulsivity. A child that is identified with ADHD should have these symptoms show in their lives over a period of not less than 6 months. These symptoms should detrimentally affect the child in more than one area of their lives, such as home, in class everyday living and sociable settings.

Hyperactivity symptoms

Symptoms that express themselves in a child whenever suffering from hyperactivity would include kids suffering with hyperactivity tend to fidget with their feet and hands. They also show the tendency to wiggle in their chair. The child runs around exceedingly and departs their chair if asked to remain in it. A child speaks excessively and is constantly moving about.

Impulsivity signs and difficulties

Symptoms that express themselves in a child whenever suffering with impulsivity would include the child blurting out feedback to question right before the question has resulted in being fully posed, interrupts or intrudes on different kids and can hardly wait for their turn.

Poor attention in kids suffering with ADHD demonstrates itself with the following kind of behavior. The child experiences lots of difficulty in sustaining understanding for the duration of learning or any other routines. The child does not follow any rules given to them and neither will they finish tasks. The child does not hear or appear to hear when talked to or equipped with instructions. The child also displays problems when trying or attempting to maintain understanding. A display of complications in arranging tasks and different activities is also a symptom that manifests whenever suffering from poor attention.

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    Be a Witness of Spectacular Change with Currency Derivative in ...

    Currency derivative in India has revolutionized the way of currency trading or Forex. Such innovative way of trading is highly preferred way of making money with huge profits.

    Currency trading or Forex as the name implies, has revolutionized the trading world. And the result of this revolutionization can be seen in the tremendous growth in derivative trading in India. Some vital factors like incorporation and assimilation of the global economic market with the national ones as well as means of communication that have changed the concept of currency derivative in Indi. No doubt, such risk management tools have become more efficient as well as latest tools supporter to obtain latest risk management strategies.

    As far as the currency derivative in India is concerned, it has also futures contracts like stock and commodities. Apart from this, it also allows you to buy or sell the principal currency at a fixed price as well as at a future date. More interesting fact about the term derivative is that you can also execute contracts to buy or sell any other currency for your national currency at a future date. And the whole process of contracts is known as the derivatives of currency sell.

    Talking about the currency derivative in India deeply, it is really interesting and fruitful for those who invest in it. And the working process of currency derivative is also interesting as all future
    contracts on Exchanges are settled in cash; in this way, there is no need of any manual work or physical contract. Moreover, all the contributors on the currency exchange trading market can play a part all the way through trading members of the concerned Exchange.

    A nationwide electronic trading podium play a major role in the currency derivative in India as all trades on Currency Exchange come to pass on their related electronic trading podium. Interesting fact is that all the Exchanges in India like NSE, BSE, etc put forward Currency Future in India. However, in order to be a player of currency derivative in India, there are also some basic to keep in mind like having a trading account, deposit of the stipulated cash, collaterals
    with trading member and the list goes on.

    About the Author

    Kapsole provides detailed analytic research on Currency Derivative India.

    Source: http://www.uybaweb.com/2012/03/Be-a-Witness-of-Spectacular-Change-with-Currency-Derivative-in-India/

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    Two schools name new faculty chairs :: Creightonian

    March 17th, 2012 ?|? Published in News

    Two faculty members of Creighton University were recently named to fill chair vacancies at the annual convocation. Beverly Kracher, PH.D, professor of business ethics and society and executive director and president of the Omaha Alliance for Business Ethics was named the Robert B. Daugherty Endowed Chair in Business Ethics and Society. Terry W. Wilwerding, D.D.S., professor of prosthodontics was named the Dr. Oscar S. Belzer Endowed Chair in Dentistry.

    As the first female endowed chair in the history of the College of Business, Kracher is an international expert and speaker on business ethics.

    In addition to heading the Business Ethics Alliance, which is a partnership between Creighton?s College of Business, the Greater Omaha Chamber of Commerce, the Better Business Bureau and the whole business community, Kracher just co-authored the ?Ethinary,? a simple ethics dictionary.

    Kracher said she is proud to receive the honor.

    ?[I was] shocked, honored and happy,? Kracher said. ?And then it was let?s get back?to work.?

    The Robert B. Daugherty Endowed Chair?in Business Ethics and Society was established in 1981 to further scholarship in the field of business ethics and serve as a resource for business leaders in the community.

    Wilwerding served as chairman of the Department of fixed prosthodontics from 1992-2000.

    He now supervises dental students who staff the One World evening clinic, is co-director of the Institute for Latin American Concern (ILAC) dental program and oversees the bachelor?s degree program in dental hygiene. He is the director of the?dental history course and the preclinical fixed prosthodontics curriculum.

    Wilwerding said he didn?t expect the honor but was happy to receive it.

    ?It is a great honor to be recognized by your school and peers and I suppose it validates some of my projects,? Wilwerding said. ?So it is a nice feeling.?

    The Dr. Oscar S. Belzer Endowed Chair in Dentistry was established by Jerome Belzer, M.D., in honor of his father, a 1928 graduate of the school of dentistry. The chair recognizes and honors outstanding faculty members.

    Related posts:

    1. CU dentist receives alumni award
    2. Children to receive free exams from School of Dentistry
    3. Adobe co-chair gives business tips

    Source: http://www.creightonian.com/?p=4382&utm_source=rss&utm_medium=rss&utm_campaign=faculty-chairs-named

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    Attorney In Oklahoma City | Ole Miss Criminal Law Day Open Mic ...

    Attorney In Oklahoma

    Ryan Miller efficiency in Professor Hoffheimer?s Criminal Law Course at the University of Mississippi in 2006

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    Attorney in Oklahoma CityRegardless of no matter whether it is an problem of adaptation, individual bankruptcy, civil legal rights, medical malpractice or any issue else, if you are in Oklahoma and looking for some legal support, a skilled Legal professional In Oklahoma can occur at your services to conserve the day. Even so, thinking about the massive quantity of Legal professional In Oklahoma, locating the proper services supplier to serve the goal can be difficult if you do not have someone in your list previously.

    Attorney In Oklahoma

    So one particular of the effortless techniques to start off your research for an Lawyer In Oklahoma can be by consulting with somebody close to you who has some expertise about working with an Oklahoma attorney. You can also attempt and look for some online forums that could have a separate thread or area in which they examine about the renowned Lawyer In Oklahoma. On the web communities like the message boards or any other kinds of social networking internet sites can be a excellent resource of info in such circumstances.

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    Criminal Law is the name given to the branch of regulation that governs an individual?s connection to the state. It includes the definitions of criminal offenses, which are normally proven by Congress or state legislatures. The expression ?criminal law? also encompasses the rights of an accused and the criminal approach, including arrest, arraignment, grand juries, pleas, discovery, pretrial hearings, trials, jury assortment, evidence, motions, and posttrial cures. The major function of the criminal regulation is to set forth the punishment for criminal offenses. In get to confirm any crime, no issue how severe, the prosecutor ought to show that the accused committed a responsible act with a responsible brain outside of a affordable doubt.

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    The time period divorce refers to the dissolution or the legal finish of a marriage. Each state has its own requirements governing when a divorce may possibly be granted, like a residency necessity and grounds or a reason for the divorce. There are the two fault-based and no-fault dependent grounds for divorce. These, also, fluctuate from state to state although ?irreconcilable variances? and ?irretrievable breakdown? are widespread no-fault grounds for divorce. The fifty states also fluctuate with regard to the division of the marital home, alimony, child custody and visitation, and youngster help.

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    Try attracting leprechauns with green food and drinks ? The Western ...

    We are almost through the winter season, so let?s start brightening things up by celebrating St. Patrick?s Day.

    Wear green to avoid a stinging pinch, enjoy Irish food, such as beef, potatoes and a green refreshment, and do not forget to decorate with lucky shamrocks.

    Our family?s most memorable St. Patrick?s Day was when my daughter decided to set a leprechaun trap.

    Her class had made one at school, and she had heard how the creatures could lead us to a pot of gold.

    She set up a course of Barbie furniture to entice a leprechaun.

    Well, St. Patrick?s Day came and went without an actual sighting, but we did find gold chocolate coins and strange marks outside the house, which was proof enough in her mind.

    Each year, we still toast with a green drink to good luck and consume a few chocolate coins to remind us to just have some fun. Laughter can cure so much at such a low cost.

    Limeade fizzy

    Try this tart green drink to celebrate Saint Patrick?s Day. It can be an accompaniment or alternative to green beer.

    In a tall glass, combine three heaping tablespoons of partially thawed limeade frozen concentrate with low sodium club soda. Add spirits such as gin, white rum or vodka if desired. For an even deeper green colour, add a few drops of green food colouring.

    Baked potato soup

    This can be a warming appetizer or main course. Serve with crackers. It?s great when the family wants homemade soup at the last minute.

    • 4 baking potatoes
    • 2 1/4 c. chicken broth 560 mL
    • 2 c. milk 500 mL
    • 1/2 c. cooked and chopped bacon or real bacon bits 125 mL
    • 2 c. grated cheddar cheese 500 mL
    • 2 green onions, chopped
    • 1/2 c. sour cream 125 mL
    • salt, pepper and paprika to desired taste

    Poke small holes in the potatoes and cook on high in the microwave for five minutes, turning halfway through, or bake in the oven until soft and tender.

    In a large microwavable bowl, mix the broth and milk and add the peeled cooked potatoes. Microwave for six minutes, stirring after three. When finished, gently mash the potatoes in the liquid. Reserve 1/4 c. (60 mL) of the bacon and cheese and one tbsp. (15 mL) of the chopped green onion and add the rest to the milk mixture and stir well. Season to your personal taste.

    Top with the reserved ingredients and a dollop of sour cream. Serves four.

    Note: You can make this soup on the stove top over medium heat if you prefer. Stir frequently.

    Source: www.kraftcanada.com.

    Beef and green pepper pasta skillet

    This is such a quick and easy meal that is sure to please. Add some fresh veggies and bread and the meal is complete.

    • 1 lb. ground beef 454 g
    • 1 green pepper, finely chopped
    • 1 onion, finely chopped
    • 1 c. fresh mushrooms, finely chopped 250 mL
    • 1/2 ?375 g box of oven ready lasagne noodles (approx 10), broken into pieces
    • 2 c. water 500 mL
    • 2 1/2 c. pasta sauce of your choice 625 mL
    • salt, pepper, seasoning salt and a dash of cayenne pepper
    • 1 c. grated cheese of your choice 250 mL

    In a large oiled skillet, cook the beef, pepper, onion and mushrooms over medium to high heat until the beef is browned. Drain. Stir in the water, pasta sauce, uncooked pasta and seasonings. Mix thoroughly.

    Heat to a slight boil, stirring often, and then turn down heat to low for 15 minutes or until the pasta is tender. Sprinkle with grated cheese and enjoy. Serves four.

    Pot of gold cupcakes

    Our local school organizes an annual bake sale fundraiser. Cupcakes were the hit, with beautiful coloured icings and sprinkles. The cupcakes with the glistening gold coins attached were a crowd pleaser.

    They are even more tasty served with jiggly green Jello.

    Use 24 prepared chocolate cupcakes or try this homemade version for your party. Garnish with fresh sliced kiwi fruit or crisp green grapes.

    • 1 1/3 c. flour 325 mL
    • 1/4 tsp. baking soda 1 mL
    • 2 tsp. baking powder 10 mL
    • 3/4 c. cocoa 175 mL
    • 1/8 tsp. salt 0.5 mL
    • 3 tbsp. softened butter 45 mL
    • 1 1/2 c. sugar 375 mL
    • 2 eggs
    • 3/4 tsp. vanilla 3 mL
    • 1 c. milk 250 mL

    Preheat the oven to 350 F (180 C) and prepare muffin tins.

    In a mixing bowl, combine the flour, baking soda, baking powder, cocoa and salt. Set aside.

    In a large mixing bowl, cream the butter and the sugar. Add the eggs one at a time, beating well after each addition, and stir in the vanilla. To this, add the flour mixture alternately with the milk until well combined and smooth.

    Fill muffin tins approximately half full. Bake for 15 minutes or until a toothpick comes out clean. Frost.

    Source: www.allrecipes.com.

    In a small mixing bowl, beat two tbsp. (30 mL) of softened butter with 1/2 c.(125 mL) softened cream cheese until smooth.

    Add 2 c. (500 mL) icing sugar a bit at a time until well combined. Spread over the prepared cupcakes and decorate with chocolate coins or green jujube shaped into a shamrock.

    Source: http://www.producer.com/2012/03/try-attracting-leprechauns-with-green-food-and-drinks/

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    Source: http://ato-wsu.com/187/try-attracting-leprechauns-with-green-food-and-drinks-the-western/

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