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Community health workers (CHWs) play a significant role in supporting health services delivery in communities with few trained health care providers. There has been limited research on ways to optimize the role of CHWs in HIV prevention service delivery. This study explored CHWs' experiences with offering HIV prevention services [HIV testing and HIV pre- and post-exposure prophylaxis (PrEP and PEP)] during three pilot studies in rural communities in Kenya and Uganda, which aimed to increase biomedical HIV prevention coverage via a structured patient-centered HIV prevention delivery model.

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Factors Associated With Semaglutide Initiation Among Adults With Obesity.

JAMA Netw Open

January 2025

Department of Global Health, School of Public Health, Boston University, Boston, Massachusetts.

Importance: Semaglutide, a novel glucagon-like peptide-1 (GLP-1) receptor agonist medication, was approved for weight management in individuals with obesity in June 2021. There is limited evidence on factors associated with uptake among individuals in this subgroup without diabetes.

Objective: To explore factors associated with semaglutide initiation among a population of commercially insured individuals with obesity but no diagnosed diabetes.

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Use of Albumin-Adjusted Calcium Measurements in Clinical Practice.

JAMA Netw Open

January 2025

Division of Endocrinology and Metabolism, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.

Importance: Using albumin-adjusted calcium is commonly recommended for for measuring calcium, but with little empirical evidence to support the practice.

Objective: To assess the correlation between total calcium measurements (with or without adjustment) vs the ionized calcium level as a reference standard.

Design, Setting, And Participants: This was a population-based cross-sectional study in the province of Alberta, Canada, including adults tested for serum total calcium and ionized calcium simultaneously between January 1, 2013, and October 31, 2019.

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Importance: Timely access to care is a key metric for health care systems and is particularly important in conditions that acutely worsen with delays in care, including surgical emergencies. However, the association between travel time to emergency care and risk for complex presentation is poorly understood.

Objective: To evaluate the impact of travel time on disease complexity at presentation among people with emergency general surgery conditions and to evaluate whether travel time was associated with clinical outcomes and measures of increased health resource utilization.

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External Validation of a 5-Factor Risk Model for Breast Cancer-Related Lymphedema.

JAMA Netw Open

January 2025

Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Importance: Secondary lymphedema is a common, harmful side effect of breast cancer treatment. Robust risk models that are externally validated are needed to facilitate clinical translation. A published risk model used 5 accessible clinical factors to predict the development of breast cancer-related lymphedema; this model included a patient's mammographic breast density as a novel predictive factor.

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