In the previous OCTO longitudinal study, we identified an immune risk phenotype (IRP) of high CD8 and low CD4 numbers and poor proliferative response. We also demonstrated that cognitive impairment constitutes a major predictor of nonsurvival. In the present NONA longitudinal study, we simultaneously examine in a model of allostatic load IRP and compromised cognition in 4-year survival in a population-based sample (n = 138, 86-94 years). Immune system measurements consisted of determinations of T-cell subsets, plasma interleukin 6 and cytomegalovirus and Epstein-Barr virus serology. Interleukin 2 responsiveness to concanavalin A, using data from the previous OCTO (octogenarians) immune study, hereafter OCTO immune, was also examined. Cognitive status was rated using a battery of neuropsychological tests. Logistic regression indicated that the IRP and cognitive impairment together predicted 58% of observed deaths. IRP was associated with late differentiated CD8+CD28-CD27- cells (p < .001), decreased interleukin 2 responsiveness (p < .05) and persistent viral infection (p < .01). Cognitive impairment was associated with increased plasma interleukin 6 (p < .001). IRP individuals with cognitive impairment were all deceased at the follow-up, indicating an allostatic overload.

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Questions related to social justice are often considered frivolous or irrelevant in the context of people who come into conflict with the law. Young (1990, Justice and the politics of difference, Princeton University Press) has pointed to the importance of social justice, especially in societies where the dominant perspective of the privileged is regarded as neutral (and presumably fair), while others remain oppressed and excluded. We investigate the relevance of social justice in the treatment of women who are in prison. Based on more than a decade of practice and four years of research with women in one of Canada's federal prisons for women, we explore the question of social justice in the context of a recreation and leisure initiative whose aim is to assist women not only while they are incarcerated but most especially on release. The social recreation program is brought into the prison by a restorative justice community-based organization. Men and women from the community come into the prison to recreate together and, in that context of natural conversation, relaxation and dialogue, Circles of support may develop. If a Circle is formed, volunteer members then follow the woman into the community and support her efforts to live as a participating citizen on release. The relevance of the work of Circles in furthering social justice within a system that, despite recent potentially innovative approaches to incarcerating women, has struggled to move beyond traditional practices of punishment and exclusion, which tend not to encourage strong and healthy community life, will be explored.

Background Pregnancy-associated malaria (PAM) has been associated with adverse pregnancy outcomes like preterm birth (PTB) and low birthweight (LBW), which are among the leading causes of infant mortality globally. Rates of PTB and LBW are high in countries with a high burden of malaria. PAM may be a contributing factor to PTB and LBW, but is not well understood. Methods We conducted a systematic review and meta-analysis of studies examining the relationship between PAM and PTB or LBW using PubMed. The title and abstract of all studies were screened by two reviewers, and the full text of selected studies was reviewed to ensure they met inclusion criteria. Information regarding study characteristics and of PTB and LBW births among women with and without PAM was abstracted for included studies. Results Our search terms yielded 2237 articles, of which 18 met our final inclusion criteria. Eight studies examined associations between PAM and PTB, and 10 examined associations between PAM and LBW (population size ranging from 35 to 9956 women). The overall risk of LBW was 63% higher among women with PAM compared with women without PAM (95% CI = 1.48–1.80) and the risk of PTB was 23% higher among women with PAM compared with women without PAM (95% CI = 1.07–1.41). Conclusions These results indicate that infection with PAM is associated with PTB and LBW. Further understanding of the pathogenesis of disease and the immunologic changes that occur during pregnancy is essential for reducing the disproportional effects this disease has on this vulnerable population.

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