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Noor, M. N., Shaw, S. Y., Linton, J., Lorway, R.
BMJ Open, 8.02.2024
Tilføjet 8.02.2024
IntroductionSexually diverse Muslim men are seen to be at a higher risk for HIV and other sexually transmitted infections due to their limited access to sexual healthcare services. We outline a protocol to conduct a scoping review of research on the barriers that may impede these men’s access to sexual healthcare. Methods and analysisTo conduct this scoping review, we will follow the methodological framework developed by Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ extension for scoping reviews. To classify the barriers to sexual healthcare, we will employ Bronfenbrenner’s socioecological model as a conceptual framework. We will conduct a literature search via Medline, Embase and Global Health (OVID); Scopus; CINAHL on EBSCOhost along with several other EBSCOhost databases (Academic Search Complete, Canadian Reference Centre, Alternative Press Index, Family & Society Studies Worldwide, Social Work Abstracts) and Google Scholar, published until November 2023. Journal articles, published in the English language, describing quantitative and qualitative research on sexual healthcare access barriers for sexually diverse Muslim men will be included in the review. Commentaries and correspondences, along with grey literature including research reports and conference abstracts, as well as studies that do not include men with the Muslim faith, will be considered ineligible. Following screening of titles and abstracts, we will conduct a full-text screening to determine the final number of studies to be included in the review. A Microsoft Excel spreadsheet will be used to extract study characteristics, and information on sexual healthcare access barriers will be classified according to the socioecological model’s core concepts. Ethics and disseminationOur review does not require ethics approval. We will disseminate the review findings through peer-reviewed academic journals, seminars and conference presentations.
Læs mere Tjek på PubMedDAlessandro, M., Fricano, C., Abdulsatar, F., Bechard, N., Brar, J. S., Drouin, O., Foulds, J. L., Giglia, L., Gill, P. J., Gupta, R., Li, P., McConnery, J., Metcalf, J., Sakran, M., Seaton, C., Sehgal, A., Sirizzotti, N., Mbuagbaw, L., Wahi, G., On behalf of the Canadian Pediatric Inpatient Research Network (PIRN) CanFLO Study team, On behalf of the PIRN CanFLO Study team, Krasevich, Khadija, Afzal, Aprioku, Balleny, Khondoker, Wolfstadt, Silva, Paliotti, Stoesz, Mohamed, Ogwuru, Laferriere, Okpaladigbo
BMJ Open, 8.02.2024
Tilføjet 8.02.2024
IntroductionBronchiolitis is the most common viral lower respiratory tract infection in children under 2 years of age. Respiratory support with high-flow nasal cannula (HFNC) is increasingly used in this patient population with limited understanding of the patients most likely to benefit and considerable practice variability of use. This study aims to understand the factors associated with failure of HFNC support among patients with bronchiolitis and to describe the current practice variations of HFNC use in patients with bronchiolitis in Canadian hospitals including fluid management and parameters to initiate, escalate and discontinue HFNC support. Methods and analysisThis is a multicentre retrospective cohort study including hospitalised patients aged 0–24 months with bronchiolitis requiring support with HFNC between January 2017 and December 2021. Clinical data will be collected from patient medical records from Canadian hospitals (n=12), including academic and community centres. HFNC failure will be defined as the need for escalation to non-invasive or invasive mechanical ventilation. Factors associated with HFNC failure will be analysed using logistic regression. Descriptive statistics will be used to describe practice variations of HFNC utilisation and management. Ethics and disseminationApproval from the Research Ethics Boards (REBs) has been obtained for each participating study site prior to onset of data collection including Clinical Trials Ontario for all Ontario hospital sites and REBs from British Columbia Children’s Hospital, Stollery Children’s Hospital, Montreal Children’s Hospital and CHU Sainte-Justine. Study results will be disseminated through presentation at national/international conferences and publication in high-impact, peer-reviewed journals.
Læs mere Tjek på PubMedDemirchyan, A., Dudareva, S., Sahakyan, S., Aslanyan, L., Muradyan, D., Musheghyan, L., Mozalevskis, A., Sargsyants, N., Ghukasyan, G., Petrosyan, V.
BMJ Open, 8.02.2024
Tilføjet 8.02.2024
ObjectivesThis study sought to determine the prevalence and associated factors of hepatitis B virus (HBV) infection ever in life and chronic HBV infection in Armenia. DesignA population-based cross-sectional seroprevalence study combined with a phone survey of tested individuals. SettingAll administrative units of Armenia including 10 provinces and capital city Yerevan. ParticipantsThe study frame was the general adult population of Armenia aged ≥18 years. Primary and secondary outcome measuresThe participants were tested for anti-HBV core antibodies (anti-HBc) and HBV surface antigen (HBsAg) using third-generation enzyme immunoassays. In case of HBsAg positivity, HBV DNA and hepatitis D virus (HDV) RNA PCR tests were performed. Risk factors of HBV infection ever in life (anti-HBc positivity) and chronic HBV infection (HBsAg positivity) were identified through fitting logistic regression models. ResultsThe seroprevalence study included 3838 individuals 18 years and older. Of them, 90.7% (3476 individuals) responded to the phone survey. The prevalence of anti-HBc positivity was 14.1% (95% CI 13.1% to 15.2%) and HBsAg positivity 0.8% (95% CI 0.5% to 1.1%). The viral load was over 10 000 IU/mL for 7.9% of HBsAg-positive individuals. None of the participants was positive for HDV. Risk factors for HBsAg positivity included less than secondary education (aOR=6.44; 95% CI 2.2 to 19.1), current smoking (aOR=2.56; 95% CI 1.2 to 5.6), and chronic liver disease (aOR=8.44; 95% CI 3.0 to 23.7). In addition to these, risk factors for anti-HBc positivity included age (aOR=1.04; 95% CI 1.04 to 1.05), imprisonment ever in life (aOR=2.53; 95% CI 1.41 to 4.56), and poor knowledge on infectious diseases (aOR=1.32; 95% CI 1.05 to 1.67), while living in Yerevan (vs provinces) was protective (aOR=0.74; 95% CI 0.59 to 0.93). ConclusionThis study provided robust estimates of HBV markers among general population of Armenia. Its findings delineated the need to revise HBV testing and treatment strategies considering higher risk population groups, and improve population knowledge on HBV prevention.
Læs mere Tjek på PubMedMeehan, S.-A., Hesseling, A. C., von Delft, A., Marx, F. M., Hughes, J. A., Bock, P., Banke-Thomas, A., Dunbar, R., Phelanyane, F., Smith, M., Osman, M.
BMJ Open, 8.02.2024
Tilføjet 8.02.2024
BackgroundTuberculosis (TB) remains a leading cause of mortality among women of childbearing age and a significant contributor to maternal mortality. Pregnant women with TB are at high risk of adverse pregnancy outcomes. This study aimed to determine risk factors for an adverse pregnancy outcome among pregnant women diagnosed with TB. MethodsUsing TB programmatic data, this retrospective cohort analysis included all women who were routinely diagnosed with TB in the public sector between October 2018 and March 2020 in two health subdistricts of Cape Town, and who were documented to be pregnant during their TB episode. Adverse pregnancy outcome was defined as either a live birth of an infant weighing
Læs mere Tjek på PubMedWinkler, N. E., Koirala, A., Kaur, G., Prasad, S., Hirani, R., Baker, J., Hoad, V., Gosbell, I. B., Irving, D. O., Hueston, L., O'Sullivan, M. V., Kok, J., Dwyer, D. E., Macartney, K., on behalf of the Australian Japanese Encephalitis Virus Serosurvey Group, on behalf of the Australian Japanese encephalitis virus serosurvey group, Lambert, Williamson, Baker, Snelling, Glasgow, Hope, Luscombe, Notaras, Baldwin, Case, Thomson, Marsland, OBrien, Deborah Friedman, Carroll, Holland, Kitchener, Ratsch, Chor, Sykes, Khandaker, Smoll, Walker, Flynn, Krause, Williams, Hinchcliff, Nelson, Currie, Flood, Beazley, Spurrier, Hayward, Worley
BMJ Open, 8.02.2024
Tilføjet 8.02.2024
IntroductionJapanese encephalitis virus (JEV) is a mosquito-borne flavivirus that causes encephalitis and other morbidity in Southeast Asia. Since February 2022, geographically dispersed JEV human, animal and vector detections occurred on the Australian mainland for the first time. This study will determine the prevalence of JEV-specific antibodies in human blood with a focus on populations at high risk of JEV exposure and determine risk factors associated with JEV seropositivity by location, age, occupation and other factors. MethodSamples are collected using two approaches: from routine blood donors (4153 samples), and active collections targeting high-risk populations (convenience sampling). Consent-based sampling for the latter includes a participant questionnaire on demographic, vaccination and exposure data. Samples are tested for JEV-specific total antibody using a defined epitope-blocking ELISA, and total antibody to Australian endemic flaviviruses Murray Valley encephalitis and Kunjin viruses. AnalysisTwo analytic approaches will occur: descriptive estimates of seroprevalence and multivariable logistic regression using Bayesian hierarchical models. Descriptive analyses will include unadjusted analysis of raw data with exclusions for JEV-endemic country of birth, travel to JEV-endemic countries, prior JEV-vaccination, and sex-standardised and age-standardised analyses. Multivariable logistic regression will determine which risk factors are associated with JEV seropositivity likely due to recent transmission within Australia and the relative contribution of each factor when accounting for effects within the model. EthicsNational Mutual Acceptance ethical approval was obtained from the Sydney Children’s Hospitals Network Human Research Ethics Committee (HREC). Local approvals were sought in each jurisdiction. Ethical approval was also obtained from the Australian Red Cross Lifeblood HREC. DisseminationFindings will be communicated to participants and their communities, and human and animal health stakeholders and policy-makers iteratively and after final analyses. Understanding human infection rates will inform procurement and targeted allocation of limited JEV vaccine, and public health strategies and communication campaigns, to at-risk populations.
Læs mere Tjek på PubMedBidhendi-Yarandi, R., Biglarian, A., Bakhshi, E., Khodaei-Ardakani, M.-R., Behboudi-Gandevani, S.
BMJ Open, 8.02.2024
Tilføjet 8.02.2024
BackgroundIt is well known that the COVID-19 pandemic has had a devastating impact on mental health, especially among individuals with long COVID. This systematic review and meta-analysis aims to investigate the prevalence of depression, stress and suicide tendencies among individuals with long COVID, as well as to explore the factors that contribute to these conditions. Methods and analysisA comprehensive review of literature will be conducted in various databases of including PubMed, including Medline, Embase, PsycINFO, CINAHL and Cochrane Library. The studies to be included in this review will be published in the English language, and the time frame of included studies will be from the date of inception of COVID-19 until 30 December 2023. Two independent reviewers will identify studies for inclusion based on a screening questionnaire, and the JBI standardised critical appraisal checklist for studies reporting prevalence data will be used to assess the methodological quality. The strength of the body of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. To analyse the data, a robust Bayesian approach will be applied using the STATA software package (V.14; STATA) and JASP software. The findings of this systematic review and meta-analysis will provide valuable insights into the prevalence of depression, stress and suicide tendencies among individuals with long COVID, as well as the factors that contribute to these conditions. Ethics and disseminationThere is no research ethics board approval required. The dissemination plan is to publish results in a peer-reviewed academic journal. PROSPERO registration numberCRD42022346858.
Læs mere Tjek på PubMedDoran, C., Duits, A. J., Gerstenbluth, I., Tami, A., Bailey, A.
BMJ Open, 8.02.2024
Tilføjet 8.02.2024
ObjectiveLong-term chikungunya disease is characterised by persistent rheumatic symptoms following chikungunya virus infection. As there is no specific treatment available, affected individuals need strategies to adapt. However, research on these is scarce. This study aimed to explore which adaptive coping strategies are employed to manage persistent rheumatic symptoms in daily life. SettingThe study was conducted in Curacao. Design and participantsAn explorative qualitative study was conducted between September and October 2020, among a purposive sample of adults, 19 women and 4 men affected by long-term chikungunya disease. In-depth interviews were semi-structured and transcribed verbatim. The data were analysed using inductive thematic analysis. ResultsThe disease duration for all participants ranged between 68 and 74 months (6 years). In narrating their experiences of coping with long-term chikungunya disease, four themes were identified: (1) learning to live with the disease; (2) resilience for dealing with pain; (3) maintaining positive self-image and attitude; and (4) coping through spirituality. ConclusionTo live with long-term chikungunya disease with dignity in spite of physical pain and discomfort, participants tried to retain a sense of control of oneself and one’s lives, to not let the disease take over, focusing on the positive in their lives, and finding strength and remain hopeful. Interventions such as cognitive–behavioural therapy and mindfulness exercises may be effective in strengthening or regain affected individual’s sense of competence and control by fostering adaptive coping skills and resilience. Subsequently, these interventions may improve health-related quality of life when rheumatic symptoms persist following chikungunya virus infection.
Læs mere Tjek på PubMedGautham, M., Bhattacharyya, S., Maity, S., Roy, M. B., Balasubramaniam, P., Ebata, A., Bloom, G.
BMJ Open, 8.02.2024
Tilføjet 8.02.2024
ObjectivesTo understand community antibiotic practices and their drivers, comprehensively and in contextually sensitive ways, we explored the individual, community and health system-level factors influencing community antibiotic practices in rural West Bengal in India. DesignQualitative study using focus group discussions and in-depth interviews. SettingTwo contrasting village clusters in South 24 Parganas district, West Bengal, India. Fieldwork was conducted between November 2019 and January 2020. Participants98 adult community members (42 men and 56 women) were selected purposively for 8 focus group discussions. In-depth interviews were conducted with 16 community key informants (7 teachers, 4 elected village representatives, 2 doctors and 3 social workers) and 14 community health workers. ResultsSignificant themes at the individual level included sociodemographics (age, gender, education), cognitive factors (knowledge and perceptions of modern antibiotics within non-biomedical belief systems), affective influences (emotive interpretations of appropriate medicine consumption) and economic constraints (affordability of antibiotic courses and overall costs of care). Antibiotics were viewed as essential fever remedies, akin to antipyretics, with decisions to halt mid-course influenced by non-biomedical beliefs associating prolonged use with toxicity. Themes at the community and health system levels included the health stewardship roles of village leaders and knowledge brokering by informal providers, pharmacists and public sector accredited social health activists. However, these community resources lacked sufficient knowledge to address people’s doubts and concerns. Qualified doctors were physically and socially inaccessible, creating a barrier to seeking their expertise. ConclusionsThe interplay of sociodemographic, cognitive and affective factors, and economic constraints at the individual level, underscores the complexity of antibiotic usage. Additionally, community leaders and health workers emerge as crucial players, yet their knowledge gaps and lack of empowerment pose challenges in addressing public concerns. This comprehensive analysis highlights the need for targeted interventions that address both individual beliefs and community health dynamics to promote judicious antibiotic use.
Læs mere Tjek på PubMedAli, F., Garfield, S., Murdan, S.
BMJ Open, 8.02.2024
Tilføjet 8.02.2024
IntroductionThe COVID-19 pandemic demonstrated how vaccine hesitancy impacts are translated nationally and internationally. A predictor of vaccine hesitancy is religious beliefs (eg, the body being sacred and should be healed by God). Additionally, the perceived content of vaccines can conflict with religious dietary restrictions. Despite the main faith organisations in the UK endorsing COVID-19 vaccination, vaccine hesitancy remains a challenge. Most faith-based research and interventions have been investigated in individual faiths, in isolation from others. Therefore, the aim of our research is to inform the development of interfaith interventions to address COVID-19 vaccine hesitancy, following the identification of potential facilitators and barriers and codesign of interfaith intervention(s). Methods and analysisWe will facilitate six face-to-face focus groups in London, each comprising eight participants. There will also be the option of joining an online focus group. A semistructured topic guide will include questions on experiences around interfaith, vaccine hesitancy, facilitators and barriers, and potential interfaith interventions to increase vaccine acceptance. Focus group participants will be invited to join a subsequent interfaith codesign workshop where the researchers will share the tentative findings and facilitate discussion to develop one or more interventions. Purposive sampling will be used to recruit 48 participants from different faith groups, ethnicities and backgrounds to capture diversity in the sample. Reflexive thematic analysis will guide a systematic process of constant comparison, coding data into categories and refining into overarching themes. Ethics and disseminationThe University College London (UCL) Research Ethics Committee granted ethics approval (Project ID 4359.006) on 3 May 2022. Minor amendments to the study were approved on 15 May 2023 to accommodate participants’ requests for online or face-to-face focus groups at a UCL venue. Informed consent is required from all participants. The findings will be disseminated in journals and to the public and key stakeholders.
Læs mere Tjek på PubMedNora Strong, Grant Meeks, Sunil A. Sheth, Louise McCullough, Julian A. Villalba, Chunfeng Tan, Andrew Barreto, Audrey Wanger, Michelle McDonald, Peter Kan, Hashem Shaltoni, Jose Campo Maldonado, Victoria Parada, Ameer E. Hassan, Sarah Reagan-Steiner, Tom Chiller, Jeremy A.W. Gold, Dallas J. Smith, Luis Ostrosky-Zeichner
New England Journal of Medicine, 8.02.2024
Tilføjet 8.02.2024
New England Journal of Medicine, Volume 390, Issue 6, Page 522-529, February 2024.
Læs mere Tjek på PubMedEdward T. Ryan, Marc D. Succi, Molly L. Paras, Erik H. Klontz
New England Journal of Medicine, 8.02.2024
Tilføjet 8.02.2024
New England Journal of Medicine, Volume 390, Issue 6, Page 549-556, February 2024.
Læs mere Tjek på PubMedNew England Journal of Medicine, 8.02.2024
Tilføjet 8.02.2024
New England Journal of Medicine, Volume 390, Issue 6, Page 576-578, February 2024.
Læs mere Tjek på PubMedInfection, 8.02.2024
Tilføjet 8.02.2024
Abstract Purpose Gut barrier dysfunction is a pivotal pathophysiological alteration in cirrhosis and end-stage liver disease, which is further aggravated during and after the operational procedures for liver transplantation (LT). In this review, we analyze the multifactorial disruption of all major levels of defense of the gut barrier (biological, mechanical, and immunological) and correlate with clinical implications. Methods A narrative review of the literature was performed using PubMed, PubMed Central and Google from inception until November 29th, 2023. Results Systemic translocation of indigenous bacteria through this dysfunctional barrier contributes to the early post-LT infectious complications, while endotoxin translocation, through activation of the systemic inflammatory response, is implicated in non-infectious complications including renal dysfunction and graft rejection. Bacterial infections are the main cause of early in-hospital mortality of LT patients and unraveling the pathophysiology of gut barrier failure is of outmost importance. Conclusion A pathophysiology-based approach to prophylactic or therapeutic interventions may lead to enhancement of gut barrier function eliminating its detrimental consequences and leading to better outcomes for LT patients.
Læs mere Tjek på PubMedInfection, 8.02.2024
Tilføjet 8.02.2024
Abstract Introduction SARS-CoV-2 infection causes severe endothelial damage, an essential step for cardiovascular complications. Endothelial-colony forming cells (ECFCs) act as a biomarker of vascular damage but their role in SARS-CoV-2 remain unclear. The aim of this study was to assess whether the number of ECFCs and angiogenic biomarkers remained altered after 6 and 12-months post-infection and whether this imbalance correlated with the presence of long-COVID syndrome and other biological parameters measured. Methods Seventy-two patients were recruited at different time-points after overcoming COVID-19 and thirty-one healthy controls. All subjects were matched for age, gender, BMI, and comorbidities. ECFCs were obtained from peripheral blood and cultured with specific conditions. Results The results confirm the presence of a long-term sequela in post-COVID-19 patients, with an abnormal increase in ECFC production compared to controls (82.8% vs. 48.4%, P
Læs mere Tjek på PubMedInfection, 8.02.2024
Tilføjet 8.02.2024
Abstract Purpose Although dalbavancin is currently approved for the treatment of ABSSIs, several studies suggest its efficacy and tolerance as long-term therapy for other off-label indications requiring prolonged intravenous antibiotic administration. Methods We conducted a prospective nationwide study of dalbavancin use in real-life settings for both approved and off-label indications analysing for each case the clinical and microbiological characteristics of infection the efficacy and safety of treatments. Results During the study period (from December 2018 to July 2021), the ID specialists from 14 different centres enrolled 223 patients treated with dalbavancin [141 males (63%) and 82 females (37%); male/female ratio 1.72; mean age 59 (SD 17.2) years, (range 15–96). Most patients in the study population (136/223; 61.0%) came from community rather than health care facilities and most of them were visited in Infectious Diseases wards (93/223; 41.7%) and clinics (55/223; 24.7%) even though some patients were cured in other settings, such as surgery wards (18/223; 8.1%), orthopaedic wards (11/223; 4.9%), Emergency Rooms (7/223; 3.1%) and non-surgical other than ID wards (6/223; 2.7%). The most common ID diagnoses were osteomyelitis (44 cases/223; 19.7%; of which 29 acute and 15 chronic osteomyelitis), cellulitis (28/223; 12.5%), cutaneous abscess (23/223; 10.3%), orthopaedic prosthesis-associated infection (22/223; 9.9%), surgical site infection (20/223; 9.0%) and septic arthritis (15/223; 6.7%). Conclusion In conclusion, by virtue of its PK/PD properties, dalbavancin represents a valuable option to daily in-hospital intravenous or outpatient antimicrobial regimens also for off-label indications requiring a long-term treatment of Gram-positive infections.
Læs mere Tjek på PubMedInfection, 8.02.2024
Tilføjet 8.02.2024
Abstract Background and Objective Despite the significant burden of Plasmodium falciparum (Pf) malaria and the licensure of two vaccines for use in infants and young children that are partially effective in preventing clinical malaria caused by Pf, a highly effective vaccine against Pf infection is still lacking. Live attenuated vaccines using Pf sporozoites as the immunogen (PfSPZ Vaccines) hold promise for addressing this gap. Here we review the safety and efficacy of two of the most promising PfSPZ approaches: PfSPZ Vaccine (radiation attenuated PfSPZ) and PfSPZ-CVac (chemo-attenuated PfSPZ). Methods We conducted a systematic review and meta-analysis by searching PubMed, EMBASE, SCOPUS, CENTRAL, and WOS until 22nd December 2021. We included randomized controlled trials (RCTs) of these two vaccine approaches that measured protection against parasitaemia following controlled human malaria infection (CHMI) in malaria-naive and malaria-exposed adults or following exposure to naturally transmitted Pf malaria in African adults and children (primary outcome) and that also measured the incidence of solicited and unsolicited adverse events as indicators of safety and tolerability after vaccination (secondary outcome). We included randomized controlled trials (RCTs) that measured the detected parasitaemia after vaccination (primary outcome) and the incidence of various solicited and unsolicited adverse events (secondary outcome). The quality of the included RCTs using the Cochrane ROB 1 tool and the quality of evidence using the GRADE system were evaluated. We pooled dichotomous data using the risk ratio (RR) for development of parasitemia in vaccinees relative to controls as a measure of vaccine efficacy (VE), including the corresponding confidence interval (CI). This study was registered with PROSPERO (CRD42022308057). Results We included 19 RCTs. Pooled RR favoured PfSPZ Vaccine (RR: 0.65 with 95% CI [0.53, 0.79], P = 0.0001) and PfSPZ-table (RR: 0.42 with 95% CI [0.27, 0.67], P = 0.0002) for preventing parasitaemia, relative to normal saline placebo. Pooled RR showed no difference between PfSPZ Vaccine and the control in the occurrence of any solicited adverse event (RR: 1.00 with 95% CI [0.82, 1.23], P = 0.98), any local solicited adverse events (RR: 0.73 with 95% CI [0.49, 1.08], P = 0.11), any systemic solicited adverse events (RR: 0.94 with 95% CI [0.75, 1.17], P = 0.58), and any unsolicited adverse event (RR: 0.93 with 95% CI [0.78, 1.10], P = 0.37). Conclusion PfSPZ and PfSPZ-CVacs showed comparable efficacy. Therefore, they can introduce a promising strategy for malaria prophylaxis, but more large-scale field trials are required to sustain efficacy and yield clinically applicable findings.
Læs mere Tjek på PubMedShade, Starley B.; Gutin, Sarah A.; Agnew, Emily; Grignon, Jessica S.; Gilmore, Hailey; Ratlhagana, Mary-Jane; Sumitani, Jeri; Steward, Wayne T.; Lippman, Sheri A.
Journal of Acquired Immune Deficiency Syndromes, 8.02.2024
Tilføjet 8.02.2024
Introduction: Large proportions of people living with HIV (PLHIV) in sub-Saharan Africa are not linked to or retained in HIV care. There is a critical need for cost-effective interventions to improve engagement and retention in care and inform optimal allocation of resources. Methods: We estimated costs associated with: a short message service (SMS) plus peer navigation (SMS+PN) intervention; an SMS-only intervention; and standard of care (SOC), within the I-Care cluster-randomized trial to improve HIV care engagement for recently diagnosed PLHIV. We employed a uniform cost data-collection protocol to quantify resources used and associated costs for each intervention. Results: Compared to SOC, the SMS+PN intervention cost $1284 ($828-$2859) more per additional patient linked to care within 30 days and $1904 ($1158-$5343) more per additional patient retained in care at 12 months, while improving linkage by 24% (95% CI=11%,36%) and retention by 16% (95% CI=6%,26%). In contrast, the SMS-only intervention cost $198 ($93-dominated) more per additional patient linked to care and $697 ($171-dominated) more per additional patient retained in care, but was not significantly associated with improvements in linkage (12%; 95% CI=-1,25) or retention (3%; 95% CI=-7,14) compared to SOC. The efficiency of the SMS+PN intervention could be improved by 46%, to $690 more per additional patient linked and $1023 more per additional patient retained in care, if implemented within the Department of Health (DoH) using more efficient distribution of staff resources. Discussion: Findings suggest scale-up of the SMS+PN intervention could benefit patients, improving care and health outcomes while being cost-effective. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedPoku, Ohemaa; Attoh-Okine, Naa-Djama; Corbeil, Thomas; Chen, Ying; Kluisza, Luke; Ahmed, Afifa; Liotta, Lucy; Morrison, Corey; Dolezal, Curtis; Robbins, Reuben N.; Mellins, Claude A.
Journal of Acquired Immune Deficiency Syndromes, 8.02.2024
Tilføjet 8.02.2024
Background: With few psychometrically evaluated HIV related stigma measures for adolescents and young adults (AYA) living with HIV, we examined the developmental applicability (i.e., validity) of two subscales of the commonly used stigma measure, the Social Impact Scale (SIS), among a cohort of adolescents and young adults with perinatally-acquired HIV. Setting: Data came from a New York City longitudinal study (N=340). This study primarily comprises Black and Latinx AYA with either perinatally-acquired HIV (PHIV) or those with perinatal exposure but who are uninfected. Data for this analysis came from the PHIV population and spanned approximately a 15-year survey period (2003-2018). Methods: A confirmatory factor analysis was used at seven time points to assess if the Social Rejection and Internalized Shame subscales were consistent in this cohort over time. Overall and individual Cronbach’s alphas were reported to show the strength of the internal consistency. Results: Mean age from Baseline to Follow-Up 6 ranged from 12-23 years over the study period. The Social Rejection subscale was acceptably valid across follow-up periods with strong factor loadings and Cronbach’s alphas higher than 0.70. However, the Internalized Shame subscale was less valid among younger adolescents. Starting at Follow-Up 2, we observed better validity with the Internalized Shame subscale performance. Conclusion: Future research must consider mechanisms for developing and adapting measures from a developmental perspective to best measure the experiences of HIV-related stigma among younger populations. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedTurk, Teja; Labarile, Marco; Braun, Dominique L.; Rauch, Andri; Stöckle, Marcel; Cavassini, Matthias; Hoffmann, Matthias; Calmy, Alexandra; Bernasconi, Enos; Notter, Julia; Pasin, Chloé; Günthard, Huldrych F.; Kouyos, Roger D.; the Swiss HIV Cohort Study
Journal of Acquired Immune Deficiency Syndromes, 8.02.2024
Tilføjet 8.02.2024
Objective. We developed a robust characterization of immune recovery trajectories in people living with HIV (PWH) on antiretroviral treatment (ART) and relate our findings to epidemiological risk factors and bacterial pneumonia. Methods. Using data from the Swiss HIV Cohort Study and the Zurich Primary HIV Infection Cohort Study (n = 5907), we analyzed the long-term trajectories of CD4 cell and CD8 cell counts and their ratio in PWH on ART for at least eight years by fitting nonlinear mixed effects models. The determinants of long-term immune recovery were investigated using generalized additive models. In addition, prediction accuracy of the modeled trajectories and their impact on the fit of a model for bacterial pneumonia was assessed. Results. Overall, our population showed good immune recovery (median plateau [IQR]-CD4: 718 [555, 900] cells/µl, CD8: 709 [547, 893] cells/µl, CD4/CD8: 1.01 [0.76, 1.37]). The following factors were predictive of recovery: Age, sex, nadir/zenith value, pre-ART HIV-1 viral load, Hepatitis C, ethnicity, acquisition risk and timing of ART-initiation. The fitted models proved to be an accurate and efficient way of predicting future CD4+ and CD8+ cell recovery dynamics: Compared to carrying forward the last observation, mean squared errors of the fitted values were lower by 1.3% to 18.3% across outcomes. When modeling future episodes of bacterial pneumonia, using model-derived predictors improved most model fits. Conclusion. We described and validated a method to characterize individual immune recovery trajectories of PWH on suppressive ART. These trajectories accurately predict long-term immune recovery and the occurrence of bacterial pneumonia. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedNguyen, Vu-Thuy; Nagavedu, Kshema; Morrison, Monica; Chen, Tom; Randall, Liisa M.; Landazabal, Claudia; John, Betsey; Klompas, Michael; Cocoros, Noelle M.
Journal of Acquired Immune Deficiency Syndromes, 8.02.2024
Tilføjet 8.02.2024
Background: People with HIV (PWH) may be at risk for more severe COVID-19 outcomes. We compared risk for severe COVID-19 in PWH to matched individuals without HIV. Methods: We identified adults in Massachusetts with a positive SARS-CoV-2 test, March 2020-July 2022, using electronic medical record data from three large clinical practice groups. We then used regression models to compare outcomes among PWH versus propensity score-matched people without HIV (matched 20:1) for severe COVID-19 (pneumonia or acute respiratory distress syndrome), hospitalization, and hospital length-of-stay (LOS). Results: We identified 171,058 individuals with COVID-19; among them, 768 PWH were matched to 15,360 individuals without HIV. Overall, severe COVID-19 and hospitalization was similar in PWH and those without HIV (severe COVID-19: 3.8% vs 3.0%, adjusted OR 1.27, 95% CI 0.86-1.87; hospitalization:12.1% vs 11.3%, adjusted OR 1.08, 95% CI 0.87-1.35). Compared to people without HIV, PWH with low CD4 T-cell counts (
Læs mere Tjek på PubMedJournal of the American Medical Association, 8.02.2024
Tilføjet 8.02.2024
In the Original Investigation titled “Prone Positioning During Extracorporeal Membrane Oxygenation in Patients With Severe ARDS: The PRONECMO Randomized Clinical Trial,” published in the December 26, 2023, issue of JAMA, errors in percentages occurred. In the Results of the Abstract and in the Results, Secondary Outcomes, section of the text, the risk difference for 90-day mortality should have been 3.5% with a 95% CI of −12.7% to 19.7%. In Table 1, the numbers of female participants reported were correct but the percentages should have been 27.9% and 42.8% for the prone ECMO and supine ECMO groups, respectively; the number of patients with COVID-19 pneumonia in the supine ECMO group was correct but the percentage should have been 94.0%. This article was corrected online.
Læs mere Tjek på PubMedJournal of the American Medical Association, 8.02.2024
Tilføjet 8.02.2024
“Rickets is indeed a price paid by man for his abandonment of a life out-of-doors and a natural diet for a life in houses and a diet of denatured foodstuffs; it is a sign of the operation of the immutable law of nature that nothing out of accord with her shall flourish.” These are the words with which Professor Park of Yale University has summarized his conclusions. They indicate a reconciliation between the long contending views regarding the etiology of rickets. There can no longer be any doubt that dietary factors may assume a determining rôle; but it is equally evident that such environmental conditions as are represented by lack of sunlight outdoors may lead to imperfections in the metabolism of the bones even when the food supply is seemingly satisfactory. The fact that diet can exert a determining influence for or against the development of rickets in human beings does not furnish conclusive proof that diet always does exhibit this potency. It has been stated by Park that, in the great majority of instances, variations in the calcium and phosphorus and in the reaction of the diets fall within limits which, according to present standards, must be regarded as normal. The point that stands out with great clearness in the study of the diets of children suffering from rickets is that no single fault can be found which is common to all. The defects appear to be of various kinds and of such nature as rather to predispose to the development of rickets than actually to cause its development. It is true also that the diets on which some children develop rickets seem to be well constituted and do not cause rickets in others. Of course, one must bear in mind that, after all, our knowledge of the relationship of different food substances to the organism is far from complete. There may be as yet unrecognized deficiencies common to the diets of rachitic persons.
Læs mere Tjek på PubMedJournal of the American Medical Association, 8.02.2024
Tilføjet 8.02.2024
This cohort study evaluates the risks of neonatal adverse events after exposure to COVID-19 vaccination during pregnancy.
Læs mere Tjek på PubMedJournal of the American Medical Association, 8.02.2024
Tilføjet 8.02.2024
This study uses data from 3 prospective cohort studies conducted in the US to assess vaccine effectiveness of bivalent COVID-19 vaccines against SARS-CoV-2 infection and symptomatic COVID-19 among children and adolescents.
Læs mere Tjek på PubMedJournal of the American Medical Association, 8.02.2024
Tilføjet 8.02.2024
From November to December 2023, US hospitalization rates increased by 200% for influenza, 51% for COVID-19, and 60% for respiratory syncytial virus (RSV) among all age groups, according to a Centers for Disease Control and Prevention (CDC) advisory. Amid growing concern, the CDC issued the advisory about the low vaccination rates for all 3 respiratory illnesses and developed a vaccination conversation guide with talking points to help clinicians encourage uptake.
Læs mere Tjek på PubMedJournal of the American Medical Association, 8.02.2024
Tilføjet 8.02.2024
Screening women for human papillomavirus (HPV) every 5 years might reduce more cervical cancer deaths in a more cost-effective way than other screening methods like colposcopies, according to 2 studies involving women from 78 low- and lower-middle–income countries.
Læs mere Tjek på PubMedJournal of the American Medical Association, 8.02.2024
Tilføjet 8.02.2024
Receiving doxycycline after sex did not lead to fewer chlamydia or gonorrhea infections among cisgender women compared with standard care, according to results from a randomized clinical trial involving 449 participants aged 18 to 30 years in Kenya who were also receiving preexposure prophylaxis against HIV. These findings contrast previous research that showed taking doxycycline within 72 hours after a sexual encounter protects cisgender men who have sex with men and transgender women from sexually transmitted infections (STIs).
Læs mere Tjek på PubMedJournal of the American Medical Association, 8.02.2024
Tilføjet 8.02.2024
This Medical News story discusses JN.1, recently classified as a SARS-CoV-2 “variant of interest” by the World Health Organization.
Læs mere Tjek på PubMedJournal of the American Medical Association, 8.02.2024
Tilføjet 8.02.2024
This Medical News story discusses the relationship between the COVID-19 pandemic and recent increases in other respiratory diseases.
Læs mere Tjek på PubMedJournal of the American Medical Association, 8.02.2024
Tilføjet 8.02.2024
This Viewpoint discusses 3 key lessons from the mpox response that can help better manage infectious disease outbreaks in the future.
Læs mere Tjek på PubMedJournal of the American Medical Association, 8.02.2024
Tilføjet 8.02.2024
This issue includes a JAMA Insights article titled “Introduction to JAMA Climate Change and Health Series” that discusses how climate change has been linked to changes in the prevention, incidence, and treatment of human diseases. The article by Drs Ebi and Hess represents the first in a series of JAMA Insights articles intended to inform clinicians about how changes in climate can affect the practice of medicine. The effects of climate change on human health are increasingly evident. Extreme weather events such as ice storms and tornadoes have caused traumatic human injuries. Changes in climate have been associated with migration of animals and insects that carry disease, resulting in emergence of certain infections in geographic areas not previously known to be associated with these infectious diseases. Climate change can adversely affect mental health, such as when it forces human migration or threatens livelihood, such as for people working in agriculture whose employment is negatively affected by flooding or drought.
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 295-302
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 303-310
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 311-319
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 320-322
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 323-330
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 331-338
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 339-345
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 346-355
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 356-363
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 364-369
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 370-378
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 379-386
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 387-390
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 391-398
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 399-403
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 404-411
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 412-412
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 413-416
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