ABSTRACT
Persons living with Human immunodeficiency virus (HIV) are living longer, healthier lives due to advancements in antiretroviral therapies and access to lifelong treatment. Yet, in rural Appalachia, access to adequate medical care is complicated by factors such as geography and lack of access to resources. The purpose of this study was to explore the perceptions of advance care planning (ACP) needs of persons living with HIV (PLWH) in Appalachian Tennessee and Alabama. Using a qualitative-descriptive design, we analyzed patterns of responses to face-to-face, semi-structured interviews of 40 PLWH as part of a larger multi-site mixed method study. Data demonstrated high patient satisfaction with medical care and good relationships with providers. However, common themes arose surrounding stigma, inadequate finances, and dislike of the term "end-of-life." Findings from this study fill a gap in the extant science pertaining to the focus of ACP in the unique population of rural Appalachia.
Subject(s)
Advance Care Planning , HIV Infections , Humans , HIV Infections/drug therapy , Social Stigma , Qualitative Research , Appalachian RegionABSTRACT
As part a body donation program, blood samples were collected and stored on untreated (non-FTA) blood cards. The blood cards were evaluated in terms of DNA preservation and STR typing success with resulting profiles assessed with special consideration given to profile matching for positive identification and biogeographic ancestry estimation. While STR profiles were successfully generated for all samples, results indicate that the time interval between date of death and sample collection have an impact on DNA quantity and quality. There is a statistically significant decrease in relative fluorescent unit (RFU) values with increasing time interval between date of death and sample collection, indicating degradation in the blood card samples related to the post-mortem interval prior to sample collection. The STR profiles were used to estimate ancestry and admixture using the program STRUCTURE, demonstrating utility of these markers beyond individual identification purposes, with caveats for application based on population history.
ABSTRACT
OBJECTIVES: Ancient DNA (aDNA) and standard osteological analyses applied to 11 skeletons at a late 17th to early 18th century farmstead site in Delaware to investigate the biological and social factors of settlement and slavery in colonial America. MATERIALS AND METHODS: Osteological analysis and mitochondrial DNA (mtDNA) sequencing were conducted for all individuals and the resulting data contextualized with archaeological and documentary evidence. RESULTS: Individuals of European and African descent were spatially separated in this colonial cemetery. The skeletal remains exhibited differences in osteological features and maternal genetic ancestry. A specific mtDNA haplotype appeared in a subset of the European-descended individuals suggesting they were maternally related. Individuals of African descent were not maternally related, and instead showed a diversity of haplotypes affiliated with present-day Western, Central, and Eastern regions of Africa. DISCUSSION: Along with the bioarchaeological and documentary evidence, the aDNA findings contribute to our understanding of life on the colonial Delaware frontier. Evidence of maternal relatedness among European-descended individuals at the site demonstrates kin-based settlements in 17th century Delaware and provides preliminary identifications of individuals. The maternal genetic diversity of the individuals with African descent aligns with the routes of the trans-Atlantic slave trade but broadens our understanding of the ancestries of persons involved in it. Burial positioning, osteological pathology, and lack of maternal kinship among individuals of African descent provide tangible evidence for the emergence of racialized labor and society in Delaware during the late 17th century.
