Labor Pains: Work-Related Barriers to Access to Health Care for People Living with HIV in Hyderabad, India.

To explore themes regarding work-related barriers to access to health care, we conducted 32 interviews, 16 with third gender people and 16 with cisgender women, all of whom were all living with HIV in Hyderabad, India. Most respondents were members of Dalit castes and had been living with HIV for several years at the time of the interview. Using thematic content analysis, interviews were coded by two researchers using a social determinants of health conceptual framework. Themes highlighted in this study include the burden of taking time off from work, the loss of pay associated with missing work, and the interruption of gendered care work responsibilities that respondents faced when seeking treatment. Findings from this study support the claim that equitable work policies and practices for marginalized laborers can increase access to medical care for people living with HIV.

Comparison of the mechanical behaviors of locked and nonlocked plate/screw fixation applied to experimentally induced rotational osteotomies in canine ilia.

OBJECTIVE: To compare the mechanical behaviors of 2 locked (parallel and diverging screws) and 1 nonlocked (NL) version of triple pelvic osteotomy (TPO) plate/screw fixation. STUDY DESIGN: In vitro biomechanical evaluation. ANIMALS: Cadaveric canine hemipelves. METHODS: Comparison 1-NL screws 20° TPO (NL-20) construct versus locked parallel (LP) screws 20° TPO (LP-20) construct (n = 7). Comparison 2-LP-20 construct versus locked diverging (LD) screws 20° TPO (LD-20) construct (n = 6). Condition 1-Nondestructive loading to determine stiffness. Condition 2-Cyclic loading to determine stiffness, screw loosening, and osteotomy gap displacement. Condition 3-Load to failure (yield load, yield displacement, maximum load, load to failure, failure mode). RESULTS: Stiffness was not significantly different for NL-20 versus LP-20 constructs (P = .48) or for LP-20 versus LD-20 constructs (P = .83). Screw loosening was significantly more frequent for NL-20 versus LP-20 (P = .01) and for LD-20 versus LP-20 constructs (P = .02). The relative risk for screw loosening with NL-20 constructs versus LP-20 constructs was 1.4 (95% CI: 1.1-1.8). The relative risk for screw loosening with LD-20 versus LP-20 was 1.6 (95% CI: 1.1-2.2). Yield load was significantly greater for LP-20 versus NL-20 and LD-20 constructs (P = .04, P = .03), respectively. CONCLUSIONS: No TPO constructs tested maintained complete integrity after cyclic loading; however, screw loosening was significantly reduced and yield loads were significantly larger for LP-20 plate/screw constructs.