Background: Medications for opioid use disorder (MOUD) are a crucial intervention for pregnant and postpartum individuals with opioid use disorder (OUD). However, there is paucity of data on the factors associated with MOUD treatment success in this population. This scoping review aimed to evaluate factors associated with MOUD success during the pregnancy and postpartum period.
View Article and Find Full Text PDFThere is recognition in the field of emergency medicine (EM) that social determinants of health (SDoH) are key drivers of patient care outcomes. Leaders in EM are calling for curricula integrating SDoH assessment and intervention, public health, and multidisciplinary approaches to EM care throughout medical school and residency. This intersection of SDoH and the emergency care system is known as social emergency medicine (SEM).
View Article and Find Full Text PDFBackground: HIV, opioid use disorder (OUD), and mental health challenges share multiple syndemic risk factors. Each can be effectively treated with routine outpatient appointments, medication management, and psychosocial support, leading implementers to consider integrated screening and treatment for OUD and mental health in HIV care. Provider perspectives are crucial to understanding barriers and strategies for treatment integration.
View Article and Find Full Text PDFCancer stigma presents a critical barrier to care seeking, contributing to delayed presentation and poor cancer outcomes worldwide. The burden of cancer in Tanzania is on the rise, with cancer being the third-leading cause of death in the country. Despite rising incidence and poor outcomes of cancer, cancer-related stigma interventions have received low prioritization.
View Article and Find Full Text PDFThe transition of HIV into a chronic illness has brought to the forefront the pressing need to address the complex web of social determinants of HIV outcomes. A structured literature search and narrative review of studies describing intervention strategies for mental health among sexual/gender minority (SGM) older adults living with HIV (OALWH) published in the last decade identified 2 studies for inclusion. This narrative review identifies age-sensitive and culturally adapted therapies, mindfulness and meditation-based stress reduction, group therapy, digital mental health resources, and psilocybin-assisted group therapy as emerging intervention models tailored to meet the unique needs of SGM OALWH.
View Article and Find Full Text PDFBackground: Unhealthy alcohol use negatively impacts many components of health and wellness, including mental health conditions like major depressive disorder (MDD). Globally, gender differences are common for both alcohol use behaviors and MDD, but these differences have not been studied within Moshi, Tanzania. To provide more effective and culturally appropriate mental health treatments, gender nuances around these conditions must be known.
View Article and Find Full Text PDFBackground: Tanzania does not have a formalized prehospital Emergency Medical Services (EMS) response. As a result, traffic police play an integral role in the emergency response system. This study examines the potential impact of a brief training program in prehospital trauma care and mental health to improve knowledge, self-efficacy, and practice intentions related to trauma care among police officers.
View Article and Find Full Text PDFBackground: The COVID-19 pandemic has been a catalyst for telehealth services for people who use opioids; however, the data show dramatic increases in opioid overdose deaths and ongoing lack of treatment options in North Carolina, particularly among rural residents.
Methods: We conducted a listening session and qualitative interviews with 10 health care professionals, administrators, and community partners providing services for individuals who use opioids in Granville and Vance counties. Data were analyzed with an applied thematic approach.
Background: Depression is particularly common among people living with Human Immunodeficiency Virus (HIV), with some studies showing a prevalence of depression three times higher among people living with HIV as compared to the general public. The stress associated with being diagnosed with HIV can be quite impactful, including concerns about one's long-term health, stigma, and the burden of long-term treatment. Therefore, it is common for a new HIV diagnosis to contribute to the onset of depressive symptoms.
View Article and Find Full Text PDFPurpose: Cancer is now the leading cause of non-AIDS death in the US population with HIV. People living with HIV (PLWH) are known to have lower cancer treatment rates and worse cancer outcomes. Disparate cancer treatment is driven by health system, patient, and clinician factors.
View Article and Find Full Text PDFThis study aimed to evaluate the frequency at which postintubation sedation is administered following use of long-acting paralytic agents compared to short-acting paralytic agents during rapid sequence intubation performed in the emergency department. This retrospective, single-center study of intubated patients in the emergency department analyzed the difference in time to administration of additional sedation following use of a short-acting paralytic (succinylcholine) compared to use of a long-acting paralytic (rocuronium or vecuronium). A total of 387 patients were available for analysis.
View Article and Find Full Text PDFBackground: Stigma is an underlying cause of health inequities, and a major barrier to HIV prevention, care, and treatment. Experiences of HIV stigma have been shown to reduce engagement in care across the HIV care continuum, from testing and diagnosis to long-term retention in care and anti-retroviral therapy adherence. In Rwanda, approximately 130,000 women are living with HIV, representing a prevalence rate (3.
View Article and Find Full Text PDFIntroduction: Antenatal depression in low-and middle-income countries is under-diagnosed and leads to poorer outcomes in the pregnancy and postpartum periods. The aim of this study was to quantify depressive symptoms among pregnant women in Moshi, Tanzania, and identify factors associated with probable depression.
Methods: Between March and December 2019, we enrolled 1039 pregnant women attending their first antenatal care appointment at two government health facilities to complete an audio computer-assisted self-interview.
In an effort to reduce maternal and neonatal mortality, a rural health system in Papua New Guinea implemented a two-week midwifery training program for 47 nurses and community health workers. We evaluated this program by administering pre- and post-training knowledge tests, focus group discussions, a clinical vignette task, and key informant interviews. Participants improved significantly in their midwifery knowledge and demonstrated effective care in the clinical vignettes.
View Article and Find Full Text PDFIn this study, we explored determinants of "researcher-observed" patient-initiated antiretroviral therapy (ART) repackaging practices among people living with HIV (PLHIV) in Northern Tanzania. We used a quasi-experimental design to describe the prevalence of ART self- repackaging; we conducted face-to-face surveys to determine factors associated with ART self- repackaging practices. Data collection sites included the Kilimanjaro Christian Medical Centre and the Mawenzi Referral Hospital.
View Article and Find Full Text PDFPurpose Of Review: The objective of this study was to describe the increasing incidence and risk of cardiovascular disease among persons living with HIV (PLWH) in Sub-Saharan Africa. We also used data to compare hypertension (a common NCD among PLWH) outcomes between PLWH and HIV-uninfected individuals among older adults in Northwestern Tanzania.
Recent Findings: Hypertension is increasingly common in Sub-Saharan Africa and a leading cause of cardiovascular disease for PLWH.
Traumatic brain injuries (TBI) are a critical global health challenge, with disproportionate negative impact in low- and middle-income countries (LMICs). People who suffer severe TBI in LMICs are twice as likely to die than those in high-income countries, and survivors experience substantially poorer outcomes. In the hospital, patients with severe TBI are typically seen in intensive care units (ICU) to receive advanced monitoring and lifesaving treatment.
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