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Background. Little is known about the trends in the incidence and outcomes of patients with end-stage renal disease (ESRD) attributed to human immunodeficiency virus-associated nephropathy (HIVAN). We sought to define relative incidence among ESRD patients, changes in mortality among patients with ESRD attributed to HIVAN, as well as changes in the excess mortality experienced by patients with ESRD attributed to HIVAN compared with otherwise similar ESRD patients with non-HIVAN causes. Methods. We used the US Renal Data System to identify all individuals with reported HIVAN who initiated treatment for ESRD between 1989 and 2011.We plotted their counts and proportions among all incident ESRD patients and tabulated their characteristics across years. We then compared mortality within the HIVAN group across years using Cox regression. In addition, we studied the trends in relative mortality of HIVAN patients versus those with ESRD not reported as HIVAN. Results. Overall, 14 719 individuals with HIVAN-ESRD were recorded, with significant reductions in recent years (893 in 2006; 525 in 2011). Compared with patients initiating dialysis between 1989 and 1992, mortality declined by 40% (HR = 0.60; 95% CI, 0.55-0.65) and 64% (HR = 0.36; 95% CI, 0.32-0.40) for patients initiating dialysis in 1999/2000 and 2009-11, respectively. The adjusted excess mortality of HIVAN-ESRD patients versus incident ESRD patients from other causes was >5-fold in 1989-92 (HR = 5.21; 95% CI, 4.84-5.60); this excess mortality has subsequently declined but remained at almost 3-fold in recent years (e.g. HR = 2.58; 95% CI, 2.37-2.80, 2009-11 incidence cohort). Conclusions. Concurrent with the increasing availability of highly active antiretroviral therapy (HAART), both the incidence of ESRD due to HIVAN and the mortality of such patients have decreased substantially. However, HIVAN patients reaching ESRD continue to experience substantial excess mortality compared with other ESRD patients even in the current era of modern HAART. [ABSTRACT FROM AUTHOR]

This paper explores the use of social media by self-help/mutual aid groups that meet on a regular face-to-face basis. It draws on data from the ESTEEM project, which ran from 2010 to 2013 with the overall aim of developing a range of resources for health and social care practitioners on how to support self-help/mutual aid groups. A re-examination of the interviews and discussions that were undertaken with 21 groups in two UK sites indicated that groups' use of social media was becoming an increasingly important resource. The findings highlight a range of benefits and limitations with selfhelp/mutual aid groups using social media and suggest a blurring of boundaries between online and face-to-face groups. For groupworkers involved with self-help/mutual aid groups opportunities in developing groups' online presence are raised. [ABSTRACT FROM AUTHOR]

Self-help groups in the United Kingdom continue to grow in number and address virtually every conceivable health condition, but they remain the subject of very little theoretical analysis. The literature to date has predominantly focused on their therapeutic effects on individual members. And yet they are widely presumed to fulfil a broader civic role and to encourage democratic citizenship. The article uses Habermas' model of the public sphere as an analytical tool with which to reconsider the literature on self-help groups in order to increase our knowledge of their civic functions. In doing this it also aims to illustrate the continuing relevance of Habermas' work to our understanding of issues in health and social care. We consider, within the context of current health policies and practices, the extent to which self-help groups with a range of different forms and functions operate according to the principles of communicative rationality that Habermas deemed key to democratic legitimacy. We conclude that self-help groups' civic role is more complex than is usually presumed and that various factors including groups' leadership, organisational structure and links with public agencies can affect their efficacy within the public sphere. [ABSTRACT FROM AUTHOR]

This paper draws on evidence from a local Sure Start evaluation of low participation rates among ethnic minority families. It reflects national concerns regarding the low use of children's services among ethnic minority families. The evaluation aimed to improve understanding of the factors that affect families' participation in Sure Start services. A sample of 34 ethnic minority parents, six Sure Start outreach workers and four community workers from allied local agencies were interviewed in 2006. The interviews revealed an unexpected disparity between the views of the majority of the workers and those of local, Sure Start-eligible parents. The workers felt that the main factor discouraging participation was too little focus on multiculturalism. However, parents focused on practical barriers, concerns around age and the perceived indiscipline of some Sure Start families. Parents generally saw their own ethnic culture as being compatible with Sure Start values. While most workers viewed minority communities as having homogeneous needs, parents discussed the heterogeneity of' communities. .Ethnicity and cultural factors do not have a simple or straightforward impact on people's decisions over whether to access Sure Start services.