Evaluation of the uptake of tuberculosis preventative therapy for people living with HIV in Namibia: a multiple methods analysis.

Background: In 2016, Namibia had ~ 230,000 people living with HIV (PLHIV) and 9154 new tuberculosis (TB) cases, including 3410 (38%) co-infected cases. TB preventative therapy (TPT), consisting of intensive case finding and isoniazid preventative therapy, is critical to reducing TB disease and mortality.

Methods: Between November 2014 and February 2015, data was abstracted from charts of PLHIV enrolled in HIV treatment.

Sedentary behavior and sleep efficiency in active community-dwelling older adults.

Objectives: Previous studies have demonstrated that aerobic exercise interventions have a positive impact on sleep efficiency in older adults. However, little work has been done on the impact of sedentary behavior (sitting, watching television, etc.) on sleep efficiency.

Aerobic training in older adults with type 2 diabetes and vasodepressive carotid sinus hypersensitivity.

Background And Aims: Vasodepressive carotid sinus hypersensitivity (V-CSH) is a common but incurable etiology for fainting in older adults with diabetes (OADM), and is diagnosed by carotid sinus massage (CSM). Aerobic exercise has been shown to be an effective therapy for other neuroautonomic etiologies of syncope (such as orthostatic hypotension), but the effectiveness of aerobic training in V-CSH remains unknown. We examined whether aerobic training could attenuate the vasodepressive response to CSM in OADM (older adults with type 2 diabetes) subjects complicated by V-CSH.

Short-term aerobic exercise reduces nitroglycerin-induced orthostatic intolerance in older adults with type 2 diabetes.

Aims/hypothesis: Older adults are at a high risk for syncope due to orthostatic intolerance (OI), and this risk increases with comorbid type 2 diabetes and vasoactive medications. Despite many benefits, previous investigations have shown worsening OI with aerobic training. We examined whether aerobic exercise reduced OI in older adults with type 2 diabetes who were given a short-acting vasoactive agent (nitroglycerin).

Aerobic training restores arterial baroreflex sensitivity in older adults with type 2 diabetes, hypertension, and hypercholesterolemia.

Objective: Lowered baroreflex sensitivity (BRS) predicts mortality and occurs with increasing age and diabetes. We examined whether aerobic exercise could restore arterial BRS in adults at high cardiovascular risk (diabetes, geriatric age group, hypercholesterolemia, and hypertension).

Design: Randomized, controlled, single-blind study.

Arterial stiffness and the response to carotid sinus massage in older adults.

Background And Aims: Carotid sinus hypersensitivity (CSH) is a common cause of fainting and falls in the older adult population and is diagnosed by carotid sinus massage (CSM). Previous work has suggested that age-related stiffening of blood vessels reduces afferent input from the carotid sinus leading to central upregulation of the overall arterial baroreflex response. We examined the differences in arterial stiffness and baroreflex function in older adults at high cardiovascular risk (advanced age, Type 2 diabetes, hypertension and hyperlipidemia) with and without CSH.

Short-term aerobic exercise reduces arterial stiffness in older adults with type 2 diabetes, hypertension, and hypercholesterolemia.

OBJECTIVE The relationship between increased arterial stiffness and cardiovascular mortality is well established in type 2 diabetes. We examined whether aerobic exercise could reduce arterial stiffness in older adults with type 2 diabetes complicated by comorbid hypertension and hyperlipidemia. RESEARCH DESIGN AND METHODS A total of 36 older adults (mean age 71.

Arterial baroreflex function in older adults with neurocardiogenic syncope.

Purpose: Neurocardiogenic syncope (formerly vasovagal) accounts for large numbers of falls in older adults and the mechanisms are poorly understood. This study examined the differences in baseline arterial baroreflex function in older adults with and without a neruocardiovascular response to orthostatic stress.

Methods: Subjects were divided into two groups based on the presence (TT+ group) or absence (TT- group) of a neurocardiovascular response to upright tilting (70 degree head-up tilt for 10 minutes after 400 micrograms of sublingual nitroglycerin).

Euglycemic hyperinsulinemia alters the response to orthostatic stress in older adults with type 2 diabetes.

Objective: Insulin has opposing influences on blood pressure by simultaneously increasing adrenergic activity and vasodilatating peripheral blood vessels. In this study, we sought to determine whether hyperinsulinemia affects tilt table responses in older adults with type 2 diabetes not complicated by orthostatic hypotension.

Research Design And Methods: Twenty-two older adults (mean age 71.

The life and death of a street boy in East Africa: everyday violence in the time of AIDS.

This article focuses on the life history of a single street boy in northwestern Tanzania, whom I name Juma. I suggest that Juma's experiences and the life trajectory of himself and of significant individuals around him (particularly his mother) were structured by everyday violence. I describe everyday violence in terms of a conjuncture between macrostructural forces in East Africa (including a history of failed development schemes and the contemporary political economy of neoliberalism) and the lived experience of individuals as they negotiate local, contextual factors (including land-tenure practices, the power dynamics between immediate and extended kin, life on the streets, and constructions of gender and sexuality).

Oral glucose tolerance test reduces arterial baroreflex sensitivity in older adults.

Although postprandial decreases in blood pressure are a common cause of syncope in the older adult population, the postprandial effects of the oral glucose tolerance test on blood pressure and the arterial baroreflex remain poorly characterized in older adults. Therefore, arterial blood pressure and the arterial baroreflex were studied in 19 healthy older adults (mean age 71.7 +/- 1.

The oral glucose tolerance test induces myocardial ischemia in healthy older adults.

Purpose: Postprandial myocardial ischemia has been observed in frail older adults with postprandial hypotension and in patients with severe coronary artery disease, especially after high doses of carbohydrates. The impact of oral glucose on myocardial oxygen supply and demand in healthy older adults without postprandial hypotension or postprandial angina remains unexamined. We hypothesized that oral glucose would result in decreased myocardial oxygen supply relative to demand in a healthy older subject pool free of postprandial hypotension, reversible coronary risk factors and postprandial angina.

Collaboration and referral practices of general practitioners and community mental health workers in rural and remote Australia.

Objective: To assess an important part of Australia's National Mental Health Strategy by examining the collaboration and referral practices between general practitioners and community mental health workers in rural and remote areas.

Design: Semistructured interviews.

Setting: Rural and remote health service region in Australia.

A review of community consultation in the development of a multi purpose service in rural and remote Australia.

This paper examines the role of community consultation and participation in the process of establishing a Multi Purpose Service (MPS) program in two towns in Western Australia. Information was gathered through written documents and semi-structured interviews with individuals who were integral to the process. Consumer involvement in health care is increasing, and while claims of being community driven underpinned the MPS program, our findings suggest otherwise.

Experiencing "change" from within: situating the transition to primary health care in a remote Australian context.

The transition to primary health care (PHC) is often described in an idealized manner, which either ignores or obscures the experiences associated with its implementation at the local level. By adopting an anthropological perspective, this article highlights some of these experiences and the context within which they occur for one health care organisation in remote Western Australia. It specifically focuses on problems associated with economic rationalism, managerialism, and the inherently fragmented character of health service organisations.

Kunyenga, "real sex," and survival: assessing the risk of HIV infection among urban street boys in Tanzania.

This article examines possible avenues of HIV infection among urban street boys in Tanzania. In doing so, it questions the ways that AIDS researchers have defined and approached the phenomenon of "survival sex" in East and Central Africa. The article specifically examines the boys' sexual networks, sexual practices, and attitudes regarding their own sexual behavior, including their perceived risk of HIV/AIDS infection.