RESUMO
In this study, we assessed the feasibility of collecting standardized nasal and salivary samples at centers in Nairobi (Kenya), Kigali (Rwanda), and London (United Kingdom) using different collection devices and media (synthetic absorptive matrices versus flocked swabs, and Salimetrics oral swabs versus whole oral fluid collection). We detected anti-Gag (p24) and envelope (gp140) antibodies in both nasal fluid and salivary collections from all HIV-infected individuals, and cross-reactive anti-p24 antibodies were detected in 10% of HIV-uninfected individuals enrolled at one site. Collections from the nasal turbinates were comparable with samples collected deeper in the nasopharyngeal tract, and the yield of anti-p24 IgA in the whole oral fluid samples was higher than in samples collected from the parotid gland. We noted a trend toward reduced levels of anti-HIV antibody in the volunteers receiving anti-retroviral therapy. Levels of antibodies were stable over multiple collection visits. Overall, this study shows that nasal and salivary samples can be collected in a standardized manner over repeated visits in both low- and high-resource settings. These methods may be used in support for future HIV vaccine clinical trials.
Assuntos
Anticorpos Anti-HIV/análise , Infecções por HIV/virologia , HIV-1/imunologia , Boca/virologia , Cavidade Nasal/virologia , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Infecções por HIV/imunologia , Humanos , Quênia , Limite de Detecção , Ruanda , Reino UnidoRESUMO
This paper investigated ways to increase the participation of direct care staff in the functional rehabilitation activities (FRAs) of adults with acquired brain injuries (ABIs). FRAs were rehabilitation agendas written by clinical staff for delivery by paraprofessionals. Increases in FRA completion were believed to be directly related to clinical success. These FRAs had been identified as key components in the rehabilitation programmes of the adults living within the residential facilities. Increases in FRAs were crucial in improving the quality of the rehabilitation programmes of the participants involved. The study observed four residential settings serving adults with ABIs using a multiple baseline design. The treatment approach consisted of public posting of weekly FRA documentation, incorporation of staff input, and reinforcement for documentation of FRAs. The results indicated a positive impact on the participation of staff in all of the residences in the study, consistent with implementation of the treatment package.