Publications by authors named "Emily Barr"

Use of cannabis and alcohol were common during pregnancy and the first year postpartum among people with HIV in the United States (2007-2019), but there were no major differences in substance use during pregnancy based on mode of HIV acquisition. The relatively high prevalence of substance use in this population, particularly postpartum alcohol and cannabis use, warrants further attention.

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Giant cell arteritis (GCA) is an inflammatory vasculitis affecting large and medium-sized arteries, leading to complications such as arterial dissection, blindness, and stroke. Rarely, GCA presents with Horner's syndrome due to sympathetic neuron involvement from arterial inflammation. This case report discusses an 82-year-old female with hypertension, atrial fibrillation, and arthritis who presented with a 24 h history of right eye ptosis, blurred vision, dizziness, and aching eye pain.

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Clinical guidelines for infant feeding among people with HIV in the U.S. were updated in 2023 to encourage providers to utilize a shared decision-making approach that includes breastfeeding/chestfeeding (B/CF) when appropriate.

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Article Synopsis
  • The IMPAACT 2002 trial found that combining cognitive behavioral therapy (CBT) with a medication management algorithm (COMB-R) significantly reduced depression among youth with HIV compared to standard care.
  • Participants and clinicians reported higher acceptability and satisfaction with the COMB-R approach, indicating it was less burdensome regarding visits.
  • Despite positive outcomes, further research is needed to confirm the broader applicability of these findings.
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More than 100 million children and 13% of the adult population suffer from obesity globally. People with obesity experience higher risks of chronic illness, poor mental health outcomes, and premature death. Exposure to natural environments, including green spaces, encourages regular physical activity and cardiovascular exercise to combat obesity.

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Purpose Of Review: The aim of this review is to aggregate currently available literature as it pertains to treating surgical shoulder pathology in patients with osteoporosis.

Recent Findings: Emerging data surrounding perioperative use of anti-osteoporosis medications for patients undergoing shoulder surgery have not shown definitively favorable or unfavorable outcomes. Similar evaluations in animal studies have shown promising results as a biologic augment to tendon and bone healing, especially with newer, anabolic agents.

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This article addresses the challenge of vaccine hesitancy among people with HIV (PWH), emphasizing the need for research on the potential impact of trust and intellectual humility in health care. It underscores the complexity of vaccine acceptance in PWH and the urgency of addressing hesitancy in PWH ahead of a future HIV vaccine. The article identifies trust in health care providers as a critical factor influencing vaccine uptake and proposes that providers who demonstrate intellectual humility-openly recognizing the limits of their knowledge-might enhance patient trust.

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Introduction: Over 265 000 women are living with HIV in the USA, but limited research has investigated the physical, mental and behavioural health outcomes among women living with HIV of reproductive age. Health status during the reproductive years before, during and after pregnancy affects pregnancy outcomes and long-term health. Understanding health outcomes among women living with HIV of reproductive age is of substantial public health importance, regardless of whether they experience pregnancy.

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Purpose: Postpartum depression (PPD) affects one in eight women in the United States. Women with HIV may be at higher risk for PPD. This systematic review examined factors related to PPD in those with HIV.

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Context: Fryette's mechanics is taught as a simplistic model of coupled vertebral movement, fundamental in osteopathic practice. This study seeks to better understand the likelihood of Fryette's model by calculating vertebral orientation in computed tomography (CT) scans. Given previous findings of low angular coupled movements during overall spinal motion, static calculations provide a unique perspective on the likelihood of Fryette's mechanics.

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In the complex landscape of health care, the relationship between medical practice and health insurance is increasingly crucial for effective care delivery. This paper emphasises the importance of integrating health insurance education into medical training, focusing on its impact on patient outcomes, health care accessibility, and system sustainability. It posits that health care providers with a comprehensive understanding of health insurance can offer more informed, efficient care by adeptly navigating coverage complexities.

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This article summarizes the updated guidelines on breastfeeding with HIV with an emphasis on using relational decision-making and intellectual humility to support the conversation around infant feeding choices. The complex cultural experiences and historical disparities that influence these decisions are highlighted, along with an overview of the recent changes to recommendations for breastfeeding in people with HIV. The article describes individualized clinical scenarios that consider infant feeding decisions, outlines communication and support strategies for health care providers, and proposes a relational decision-making model to guide discussions on infant feeding options.

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Introduction: The pediatric nurse practitioner (PNP) workforce was designed to improve child health equity. We aimed to systematically review the evidence on facilitators and barriers to PNP practice.

Method: We included empirical studies on PNP practice in the United States and excluded studies with non-identifiable PNP data.

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The pediatric nurse practitioner (PNP) workforce shortage has begun to limit access to providers participating in Medicaid and/or the Children's Health Insurance Program, threatening child health equity in the United States. The following are key contributors: an emphasis on adult-focused NP programs and subsequent reduction in undergraduate pediatric content, common practice of student advisement to choose family NP programs, decreased PNP student enrollment leading to nonurban pediatric program closures, an acute shortage of PNP preceptors, and invisibility of the PNP workforce in national workforce data and strategic planning. We outline feasible action steps that nurses, NPs, educators, physicians, and policymakers can take to support PNP workforce growth to advance child health equity in the United States.

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To investigate open science practices in research published in the top 5 sports medicine journals from May 1, 2022, and October 1, 2022. A meta-research systematic review. Open science practices were searched in MEDLINE.

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Background: Antiretroviral therapy (ART) decreases perinatal HIV transmission, but concerns exist regarding maternal and infant safety. We compared the incidence of congenital malformations and other adverse outcomes in pregnancies exposed to integrase inhibitor (INSTI) versus non-INSTI ART.

Setting: Single-site review of all pregnancies among women living with HIV between 2008 and 2018.

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Background: Women with HIV in high-income settings have increasingly expressed a desire to breastfeed their infants. Although national guidelines now acknowledge this choice, detailed recommendations are not available. We describe the approach to managing care for breastfeeding women with HIV at a single large-volume site in the United States.

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Prospective studies suggest that child maltreatment substantially increases the risk for depression in adulthood. However, the mechanisms underlying this association require further elucidation. In recent years, DNA methylation has emerged as a potential mechanism by which maltreatment experiences (a) could partly explain the emergence or aggravation of depressive symptoms (i.

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The COVID-19 pandemic has seen a considerable expansion in the way work settings are structured, with a continuum emerging between working fully in-person and from home. The pandemic has also exacerbated many risk factors for poor mental health in the workplace, especially in public-facing jobs. Therefore, we sought to test the potential relationship between work setting and self-rated mental health.

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Background: This United States-based study compared 2 candidate vaccines: RSV/ΔNS2/Δ1313/I1314L, attenuated by NS2 gene-deletion and temperature-sensitivity mutation in the polymerase gene; and RSV/276, attenuated by M2-2 deletion.

Methods: RSV-seronegative children aged 6-24 months received RSV/ΔNS2/Δ1313/I1314L (106 plaque-forming units [PFU]), RSV/276 (105 PFU), or placebo intranasally. Participants were monitored for vaccine shedding, reactogenicity, and RSV serum antibodies, and followed over the subsequent RSV season.

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Background: Tenofovir alafenamide (TAF) is a key component of HIV treatment, but pharmacokinetic data supporting the use of TAF during pregnancy are limited. In this study, we report pharmacokinetic, safety, and birth outcomes for TAF 25 mg with a boosted protease inhibitor in pregnant women living with HIV.

Methods: IMPAACT P1026s was a multicenter, nonrandomized, open-label, phase IV prospective study.

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Importance: Amid the opioid epidemic and evolving legal and social changes with marijuana, little is known about substance use among pregnant and postpartum people living with HIV.

Objectives: To evaluate trends in marijuana, alcohol, and opioid use during pregnancy and the first year postpartum among US people living with HIV and the differences in substance use based on marijuana legalization status.

Design, Setting, And Participants: Data from the Surveillance Monitoring for Antiretroviral Toxicities (SMARTT) study of the Pediatric HIV/AIDS Cohort Study were analyzed.

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