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Refugee adolescents resettling in a new country face many challenges, and being part of a supportive family is a critical factor in assisting them to achieve wellbeing and create positive futures. This longitudinal study documents experiences of family life in the resettlement context of 120 young people with refugee backgrounds living in Melbourne, Australia. Family instability was a core feature of the early settlement period. In this paper, we focus specifically on changing household composition, and levels of trust, attachment, discipline and conflict in family settings during young people's first years of resettlement. Our results suggest that while families are central to the wellbeing of these young people, changing family dynamics can also pose a threat to wellbeing and successful settlement. We argue that youth focused settlement services must explicitly engage with family contexts in assisting refugee youth to achieve wellbeing and successfully resettle. (Contains 3 figures.)

A prospective, randomized, double-blinded, placebo-controlled trial is used to examine the immunological, metabolic and clinical effects of broad-spectrum micronutrient supplementation in HIV-infected patients taking highly active antiretroviral therapy (HAART). Micronutrient supplementation is found to improve the CD4 cell count reconstitution in HIV-infected patients taking HAART.

Zidovudine, formerly called AZT, has been found to slow the clinical progression of AIDS and inhibit the cellular replication of HIV (human immunodeficiency virus, which causes AIDS). Unfortunately, the benefits of zidovudine treatment are not without significant risk of side effects, such as anemia (diminished population of red blood cells), and neutropenia (fewer white blood cells). These side effects can severely compromise the health status of patients with AIDS. The present standard dose of zidovudine is 1,500 milligrams (mg) per day. This clinical trial documents the effects of reduced dose levels of zidovudine in patients with AIDS. Individuals who had experienced their first bout of Pneumocystis carinii pneumonia at least two weeks earlier were eligible for entrance into the study. However, patients who had previously been treated with zidovudine or had experienced multiple episodes of Pneumocystis carinii pneumonia, or Kaposi's sarcoma (a lung tumor that affects AIDS patients) were ineligible. The participants (524) were equally divided into two groups: the standard-treatment group received 250 mg of zidovudine every 4 hours; and the reduced-treatment group was given 200 mg of zidovudine every 4 hours for four weeks, when the dose was reduced to 100 mg of zidovudine every 4 hours. The patients were followed for a period of up to 25.6 months. Blood specimens were examined for the presence of HIV antigen (a protein associated with HIV infection), and the number of CD4-T lymphocytes (a specific class of white blood cells that decreases in number as AIDS worsens). The survival rates at 18 months were 52 percent for the standard-treatment group and 63 percent for the reduced-treatment group. The percentage of patients who developed opportunistic infections was the same in both groups (82 percent). Zidovudine transiently improved the CD4-T lymphocyte count in both treatment groups. Patients treated with the reduced dose strategy experienced significantly less anemia and neutropenia. The findings demonstrate that reducing the daily dose of zidovudine provides effective treatment for AIDS patients, and is associated with a reduction of some side effects. (Consumer Summary produced by Reliance Medical Information, Inc.)

The most frequent cause of death among patients infected with HIV (human immunodeficiency virus, the agent associated with AIDS) is Pneumocystis carinii pneumonia (PCP). Although certain drugs prevent this disease in some AIDS patients and individuals whose immune systems are compromised by other disorders, HIV-infected people cannot tolerate these medications on a long-term basis. An agent that shows promise in this regard is aerosolized pentamidine; a report of a controlled, randomized trial of this drug is presented. Three dosages of aerosolized pentamidine (30 milligrams every two weeks, 150 milligrams every two weeks, or 300 milligrams every four weeks) were administered to 408 patients at 12 treatment centers in the San Francisco Bay area. The majority of patients (237) had one prior episode of PCP; other groups included patients with Kaposi's sarcoma (an AIDS-related condition) who had never had PCP (55), and patients with AIDS or AIDS-related complex who had never had PCP or Kaposi's sarcoma (116). Patients were followed from their first treatment on or near July 1, 1987 until their death or December 31, 1988. The results revealed that the number of PCP episodes was lowest for patients who received the 300 milligram dose of aerosolized pentamidine (8 episodes), and that this number differed significantly from the number of PCP episodes among patients who were given the 30 milligram dose (22 episodes). Although the difference between the 150 milligram and 300 milligram doses was not significant, the lower dose was less effective when compared with the 30 milligram dose of aerosolized pentamidine. Patients who began the study within three months of a previous episode of PCP had less chance of having another episode than those who started later. Participants who had never taken zidovudine (a drug for treating AIDS) had higher mortality than those who had taken it, and zidovudine itself had an independent preventive effect on PCP. Those with a previous history of PCP and CD4 cell counts (a type of T cell) below 200 per cubic millimeter had the highest risk of contracting PCP again. Overall, aerosolized pentamidine at certain doses was an effective prophylactic treatment for preventing PCP in high-risk HIV-infected people. The most effective therapeutic regimen included zidovudine. (Consumer Summary produced by Reliance Medical Information, Inc.)