Background: Long-acting cabotegravir and long-acting rilpivirine constitute a completely intramuscular antiretroviral therapy (ART) regimen for adults with HIV. We aimed to assess the safety, antiviral activity, and pharmacokinetics of oral cabotegravir and rilpivirine followed by a combination of long-acting cabotegravir and long-acting rilpivirine in virologically suppressed adolescents with HIV.
Methods: The IMPAACT 2017/MOCHA study is a phase 1/2, multicentre, open-label, non-comparative, dose-finding trial being conducted at 18 sites across Botswana, South Africa, Thailand, Uganda, and the USA.
Background: In Zambia, the true extent of SARS-CoV-2 infections is unknown because initial surveillance focused on patients with symptoms or severe disease. Antenatal sentinel surveillance had not been used to assess infection trends. The ANC COVID-19 surveillance study sought to determine SARS-CoV-2 seroprevalence and COVID-19 vaccine uptake among pregnant women.
View Article and Find Full Text PDFMinimally invasive surgery (MIS) has demonstrated significant clinical and economic benefits that have been consistently validated and reproduced in practice and the literature for the past few decades. These benefits include improved patient outcomes, reduced complications, shorter hospital stays, decreased narcotic use, quicker recovery times, and lower rates of wound infections. However, safety-net hospitals, which historically serve a larger percentage of underserved and marginalized populations, often lack the resources to invest in high capital equipment.
View Article and Find Full Text PDFIntroduction: This study aimed to estimate the prevalence of undernutrition and risk of feeding difficulties and describe common feeding practices for children from birth to 10 years of age living in residential care in Zambia.
Methods: This was a secondary analysis of de-identified cross-sectional data on 397 children living in 22 residential care facilities in four provinces. Child demographics, anthropometrics, hemoglobin levels, risk for feeding difficulties, and facility-level feeding practices were collected by a trained study team using , a digital health app.
Objectives: The objective of this study is to assess the outcomes of children, adolescents and young adults with HIV reported as lost to follow-up, correct mortality estimates for children, adolescents and young adults with HIV for unascertained outcomes in those loss to follow-up (LTFU) based on tracing and linkage data separately using data from the International epidemiology Databases to Evaluate AIDS in Southern Africa.
Methods: We included data from two different populations of children, adolescents and young adults with HIV; (1) clinical data from children, adolescents and young adults with HIV aged ≤24 years from Lesotho, Malawi, Mozambique, Zambia and Zimbabwe; (2) clinical data from children, adolescents and young adults with HIV aged ≤14 years from the Western Cape (WC) in South Africa. Outcomes of patients lost to follow-up were available from (1) a tracing study and (2) linkage to a health information exchange.
Background: Workplace behaviours of healthcare staff impact patient safety, staff well-being and organisational outcomes. A whole-of-hospital culture change programme, Ethos, was implemented by St. Vincent's Health Australia across eight hospitals.
View Article and Find Full Text PDFBackground: Low back pain (LBP) is a complex condition that is widespread among older Black adults. Nonpharmacologic interventions are recommended as first-line therapy, but their use in practice is limited, possibly due to misunderstanding of their analgesic characteristics.
Aim: To determine the feasibility and acceptability of listening to preferred music at home to relieve pain in older Black adults aged 65 years or older with LBP.
Introduction: Implementation of patient-centred care (PCC) practices in HIV treatment depends on healthcare workers' (HCWs) perceptions of the acceptability, appropriateness and feasibility of such practices (e.g. use of intentional, metric-driven activities to improve patient experiences).
View Article and Find Full Text PDFThe concept of self-care for music therapists is not a new topic in the literature, yet music therapy students' perspectives have largely been excluded from formal discussions and research studies. For this reason, this study aimed to examine music therapy students' conceptualizations of self-care and identify practices that students frequently engage in for self-care. As part of a national survey, music therapy students currently enrolled in an academic degree program for music therapy within the United States defined self-care and identified up to three of their most frequent self-care practices.
View Article and Find Full Text PDFIntroduction: Traditional patient-provider relationships privilege the providers, as they possess the formal authority and clinical knowledge applied to address illness, but providers also have discretion over how they exercise their power to influence patients' services, benefits, and sanctions. In this study, we assessed providers' exercise of discretionary power in implementing patient-centered care (PCC) practices in Lusaka, Zambia.
Methods: HIV clinical encounters between patients on antiretroviral therapy (ART) and providers across 24 public health facilities in Lusaka Province were audio recorded and transcribed verbatim.
This study estimated the prevalence of cardiovascular disease (CVD) risk factors, cardiometabolic (CM) risk factors, and cardiovascular health metrics (CVHMs) among US adults and across race/ethnicity groups. The study comprised 8370 US adults aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) 2011-2018, free of coronary heart disease/heart failure, angina/angina pectoris, heart attack, and stroke, who provided complete data for the outcome variables of interest. Age-adjusted prevalence of CVD and CM risk factors, and CVHMs were computed for all adults and across race/ethnicity groups.
View Article and Find Full Text PDFThe purpose of this study was to explore barriers Texas Woman's University (TWU) students face in accessing on-campus food pantries. This cross-sectional, survey-based study was conducted in Fall 2021. Students' use of the food pantries and barriers to utilization, including qualitative questions, were evaluated using descriptive statistics and thematic analyses.
View Article and Find Full Text PDFObjective: To investigate what factors are associated with food insecurity (FI) among freshman students and identify potential solutions.
Participants: 73 freshman students.
Methods: Cross-sectional, Internet survey-based study.
Background: Infants born HIV-exposed yet remain uninfected (HEU) are at increased risk of poorer growth and health compared to infants born HIV-unexposed (HU). Whether maternal antiretroviral treatment (ART) in pregnancy ameliorates this risk of poorer growth is not well understood. Furthermore, whether risks are similar across high burden HIV settings has not been extensively explored.
View Article and Find Full Text PDFIntroduction: Patients who are disadvantaged socioeconomically or live in rural areas may not pursue surgery at high-volume centers where outcomes are better for some complex procedures. The objective of this study was to compare rural and urban patient differences directly by location of residence and outcomes after undergoing esophagectomy for cancer.
Methods: An analysis of the Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) database was performed, capturing adult patients with esophageal cancer who underwent esophagectomy.
The COVID-19 pandemic restrictions sent college students online and off campus, potentially reducing access to healthy food. The objective of this cross-sectional, internet-based study was to use qualitative and quantitative survey methods to evaluate whether COVID-19 pandemic restrictions in Texas, USA affected college students' ability to buy food, how/what they shopped for, how they prepared food, what they ate, how they felt about eating, and overall dietary quality (assessed using Healthy Eating Index [HEI] scores). Survey responses from 502 students (87.
View Article and Find Full Text PDFPurpose: To investigate the role of music listening in reducing pain in adults undergoing colonoscopy.
Design: This is a systematic review and meta-analysis of randomized control trials (RCTs) that evaluated the effect of music in reducing pain in adults undergoing colonoscopy.
Methods: We searched CINAHL, Embase, MEDLINE, PsycINFO, and PubMed for RCTs that reported on the effects of music listening in reducing pain in adult patients undergoing colonoscopy from database inception to March 15, 2020, when the search was completed.
To determine the impact of a new food scholarship program on nutrient intake and dietary quality. College students ( = 49), female (78%), single (76%), average age 28 years, and white (49%). Fruits, vegetables, dairy, meat products and nonperishable foods were distributed twice a month.
View Article and Find Full Text PDFBackground: Dynamic movement of patients in and out of HIV care is prevalent, but there is limited information on patterns of patient re-engagement or predictors of return to guide HIV programs to better support patient engagement.
Methods: From a probability-based sample of lost to follow-up, adult patients traced by peer educators from 31 Zambian health facilities, we prospectively followed disengaged HIV patients for return clinic visits. We estimated the cumulative incidence of return and the time to return using Kaplan-Meier methods.
The coronavirus disease (COVID-19) pandemic has increased unemployment and food insecurity in the United States (US). Prior to the pandemic, college students exhibited higher rates of food insecurity than nonstudent households. The objectives of this study were to assess the prevalence and determinants of food insecurity among college students during the COVID-19 pandemic.
View Article and Find Full Text PDFBackground: The major histocompatibility complex (MHC) is responsible for detecting and addressing foreign pathogens inside the body. While the general structure of MHC genes is relatively well conserved among mammalian species, it is notably different among ruminants due to a chromosomal inversion that splits MHC type II genes into two subregions (IIa, IIb). Recombination rates are reportedly high between these subregions, and a lack of linkage has been documented in domestic ruminants.
View Article and Find Full Text PDFBackground: The aim of this study was to examine the relationship between diet quality and weight gain in kidney transplant recipients from pretransplant baseline through posttransplant at 3 months and 1 year.
Methods: Data from a prospective, observational cohort study of kidney transplant patients (n = 26) were analyzed. Participants were adult (aged 18-65 years), living donor kidney transplant recipients who were participating in a prospective body composition study.
PLoS Med
May 2020
Background: Men in sub-Saharan Africa have lower engagement and retention in HIV services compared to women, which may result in differential survival. However, the true magnitude of difference in HIV-related mortality between men and women receiving antiretroviral therapy (ART) is incompletely characterized.
Methods And Findings: We evaluated HIV-positive adults ≥18 years old newly initiating ART in 4 Zambian provinces (Eastern, Lusaka, Southern, and Western).
Introduction: Accurate costing is key for programme planning and policy implementation. Since 2011, there have been major changes in eligibility criteria and treatment regimens with price reductions in ART drugs, programmatic changes resulting in clinical task-shifting and decentralization of ART delivery to peripheral health centres making existing evidence on ART care costs in Zambia out-of-date. As decision makers consider further changes in ART service delivery, it is important to understand the current drivers of costs for ART care.
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