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1.
J Voice ; 2023 Aug 27.
Article in English | MEDLINE | ID: mdl-37643947

ABSTRACT

OBJECTIVES: Seeing Voices was an interprofessional, technology-enabled, large-scale, teaching and learning event developed to address the need to improve voice students' knowledge of laryngeal anatomy and physiology toward understanding and maintaining vocal health. Seeing Voices trialed a novel interprofessional educational approach, collected both quantitative and qualitative data about student experiences of laryngostroboscopic examination, and built a databank of laryngeal recordings for future student learning. METHODS: Seeing Voices involved two 3-hour seminars in a large, university lecture space, run by an interprofessional team (speech-language pathologists, vocal coach, Ear Nose and Throat consultant) with quality equipment projecting laryngeal images to large screens with expert commentary in real time. Participants were 18 students who volunteered for laryngeal examination (9 per seminar) and student attendees (n = 175) from performing arts courses (classical singing, contemporary, jazz, musical theater, acting) and a speech-language pathology course. A quantitative evaluation of knowledge gained was undertaken using a Qualtrics survey. Results from pre (n = 175; performing arts = 120; speech-language pathology (SLP) = 55) and postevent (n = 99; performing arts = 56; SLP = 43) questionnaires were received from the students who attended. Interviews were collected from 15 of the 18 student volunteers about their experiences of nasendoscopic evaluation and data were analyzed using qualitative description and qualitative content analysis. RESULTS: Quantitative results demonstrated a strong trend toward increased knowledge following attendance at the event across year cohorts for both student groups. Qualitative interviews highlighted the value in seeing multiple examples of normal laryngeal functioning across different vocal techniques in real time. For those undertaking nasendoscopic examination, simultaneously seeing and feeling laryngeal maneuvers used in training appeared to promote understanding of their own vocal mechanism and the purpose of different vocal techniques. CONCLUSIONS: Seeing Voices offers a novel way to improve interprofessional collaboration, and engagement with, and understanding of, laryngeal anatomy and vocal health by students in performing arts and speech-language pathology courses.

2.
Cancer Nurs ; 46(5): 344-353, 2023.
Article in English | MEDLINE | ID: mdl-37607370

ABSTRACT

BACKGROUND: Foreign-born Chinese American women (FBCAW) have the lowest mammography rates compared with other racial groups despite the overwhelming evidence of the benefits of screening. Message framing based on the prospect theory has shown significant but inconsistent effects on mammogram screening among ethnic minority groups. OBJECTIVE: Using data from a randomized controlled trial, this secondary analysis aims to identify factors that interact with message framing to improve mammography screening in FBCAW. METHODS: In the parent study, participants were randomized to receive either a gain- or loss-framed brochure that encouraged mammography screening. Data were collected at baseline and 2 months using validated questionnaires. For this secondary analysis, ordinal logistic regression was performed to identify moderation effects using both per-protocol and intention-to-treat principles. RESULTS: Participants predominantly had low income, a low level of English proficiency, and no insurance. Lack of access to mammography services, knowledge of making a mammogram appointment, knowledge of insurance coverage for breast cancer treatment, education levels, and mammogram history were significant moderators of the framing effects. Overall, the moderation effects were larger when using per-protocol analysis. Some moderation results under intention-to-treat analysis were different from those using per-protocol analysis. CONCLUSIONS: The persuasive effects of the loss- or gain-framed messages depend on the characteristics of FBCAW. Future studies can identify algorithms to select tailored messages that match individual FBCAW's characteristics to optimize the effects of framed messages. IMPLICATIONS FOR PRACTICE: Findings of this study can guide healthcare providers, especially nurses, to choose different wording when communicating with their clients.


Subject(s)
Breast Neoplasms , Ethnicity , Female , Humans , East Asian People , Minority Groups , Mammography , Breast Neoplasms/prevention & control
3.
FEMS Microbes ; 4: xtad002, 2023.
Article in English | MEDLINE | ID: mdl-37333439

ABSTRACT

Saccharomyces cerevisiae can undergo filamentous growth in response to specific environmental stressors, particularly nitrogen-limitation, whereby cells undergo pseudohyphal differentiation, a process where cells transition from a singular ellipsoidal appearance to multicellular filamentous chains from the incomplete scission of the mother-daughter cells. Previously, it was demonstrated that filamentous growth in S. cerevisiae is co-regulated by multiple signaling networks, including the glucose-sensing RAS/cAMP-PKA and SNF pathways, the nutrient-sensing TOR pathway, the filamentous growth MAPK pathway, and the Rim101 pathway, and can be induced by quorum-sensing aromatic alcohols, such as 2-phenylethanol. However, the prevalent research on the yeast-pseudohyphal transition and its induction by aromatic alcohols in S. cerevisiae has been primarily limited to the strain Σ1278b. Due to the prospective influence of quorum sensing on commercial fermentation, the native variation of yeast-to-filamentous phenotypic transition and its induction by 2-phenylethanol in commercial brewing strains was investigated. Image analysis software was exploited to enumerate the magnitude of whole colony filamentation in 16 commercial strains cultured on nitrogen-limiting SLAD medium; some supplemented with exogenous 2-phenylethanol. The results demonstrate that phenotypic switching is a generalized, highly varied response occurring only in select brewing strains. Nevertheless, strains exhibiting switching behavior altered their filamentation response to exogenous concentrations of 2-phenylethanol.

4.
JMIR Res Protoc ; 12: e42691, 2023 Feb 14.
Article in English | MEDLINE | ID: mdl-36787165

ABSTRACT

BACKGROUND: Despite substantial investments in ending the HIV epidemic, disparities in HIV care persist, and there is an urgent need to evaluate novel and scalable approaches to improving HIV care engagement and viral suppression in real-world settings. OBJECTIVE: This paper aims to describe a study protocol for a pragmatic type II hybrid effectiveness-implementation randomized controlled trial comparing existing standard of care clinic HIV linkage, adherence, and retention (LAR) protocols to a mobile health (mHealth)-enhanced linkage, adherence, and retention (mLAR) intervention. METHODS: The study will enroll 450 participants from clinics in Baltimore City. Eligibility criteria include being ≥18 years of age, having a new HIV diagnosis or being HIV-positive and out of care, or being HIV-positive and deemed by clinic staff as someone who could benefit from linkage and retention services. Participants randomized to the intervention receive mHealth-supported patient navigation for 12 months. Participants in the control group receive the referring clinic's standard of care patient support. The primary outcome is HIV virologic suppression at 12 months. A subset of participants will be interviewed at 12 months to learn about their HIV care experiences and, for those in the intervention arm, their experiences with the mLAR intervention. This protocol was developed in collaboration with the Baltimore City Health Department (BCHD) and the Maryland Department of Health (MDH) and with input from a community advisory board. RESULTS: Enrollment began on February 25, 2020. As of August 11, 2022, 411 of the 450 target participants had been enrolled. CONCLUSIONS: Pragmatic implementation science trials designed with input from key stakeholders, including health departments and community members, can help evaluate the evidence for mHealth interventions to reduce HIV health disparities. TRIAL REGISTRATION: ClinicalTrials.gov NCT03934437; https://clinicaltrials.gov/ct2/show/NCT03934437. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42691.

5.
Int J Speech Lang Pathol ; 25(1): 147-151, 2023 02.
Article in English | MEDLINE | ID: mdl-36412124

ABSTRACT

PURPOSE: Colonisation and continuing discrimination have significantly and negatively impacted the physical, social and emotional wellbeing of First Nations peoples globally. In Australia, Aboriginal cultures thrive despite ongoing barriers to health care. This paper describes challenges and new initiatives for Australian Aboriginal people with acquired communication disability after brain injury and their alignment with the global aims forming the Sustainable Development Goals. RESULT: Research undertaken by an Aboriginal and non-Aboriginal multidisciplinary team over a decade in Western Australia identified and responded to mismatches between community needs and services. Initiatives described include the Missing Voices, Healing Right Way, Brain Injury Yarning Circles and Wangi/Yarning Together projects. Recommendations implemented related to (a) greater incorporation of Aboriginal cultural protocols and values within services, (b) more culturally secure assessment and treatment tools, (c) support after hospital discharge, (d) Aboriginal health worker involvement in support. Implementation includes cultural training of hospital staff, trialling new assessment and treatment methods, and establishing community-based Aboriginal Brain Injury Coordinator positions and relevant peer support groups. CONCLUSION: Culturally secure brain injury rehabilitation in Australia is in its infancy. Our initiatives challenge assumptions about worldviews and established Western biomedical models of healthcare through incorporating Indigenous methodologies and leadership, and community-driven service delivery. This commentary paper focuses on Sustainable Development Goals 3, 16 and 17.


Subject(s)
Brain Injuries, Traumatic , Health Services, Indigenous , Stroke , Humans , Australia , Australian Aboriginal and Torres Strait Islander Peoples , Communication , Sustainable Development
6.
FEMS Yeast Res ; 22(1)2022 11 25.
Article in English | MEDLINE | ID: mdl-36398755

ABSTRACT

The yeast Saccharomyces cerevisiae, also known as brewer's yeast, can undergo a reversible stress-responsive transition from individual ellipsoidal cells to chains of elongated cells in response to nitrogen- or carbon starvation. Whole colony morphology is frequently used to evaluate phenotypic switching response; however, quantifying two-dimensional top-down images requires each pixel to be characterized as belonging to the colony or background. While feasible for a small number of colonies, this labor-intensive assessment process is impracticable for larger datasets. The software tool HYPHAEdelity has been developed to semi-automate the assessment of two-dimensional whole colony images and quantify the magnitude of peripheral whole colony yeast filamentation using image analysis tools intrinsic to the OpenCV Python library. The software application functions by determining the total area of filamentous growth, referred to as the f-measure, by subtracting the area of the inner colony boundary from the outer-boundary area associated with hyphal projections. The HYPHAEdelity application was validated against automated and manually pixel-counted two-dimensional top-down images of S. cerevisiae colonies exhibiting varying degrees of filamentation. HYPHAEdelity's f-measure results were comparable to areas determined through a manual pixel enumeration method and found to be more accurate than other whole colony filamentation software solutions.


Subject(s)
Carbon , Saccharomyces cerevisiae , Gene Library , Hyphae , Image Processing, Computer-Assisted
7.
BMC Med Educ ; 22(1): 724, 2022 Oct 14.
Article in English | MEDLINE | ID: mdl-36242004

ABSTRACT

BACKGROUND: Medical schools in Sub-Saharan Africa have adopted competency based medical education (CBME) to improve the quality of graduates trained. In 2015, Makerere University College of Health Sciences (MaKCHS) implemented CBME for the Bachelor of Medicine and Bachelor of Surgery (MBChB) programme in order to produce doctors with the required attributes to address community health needs. However, no formal evaluation of the curriculum has been conducted to determine whether all established competencies are being assessed. OBJECTIVE: To evaluate whether assessment methods within the MBChB curriculum address the stated competencies. METHODS: The evaluation adopted a cross-sectional study design in which the MBChB curriculum was evaluated using an Essential Course Evidence Form (ECEF) that was developed to collect information about each assessment used for each course. Information was collected on: (1) Assessment title, (2) Description, (3) Competency domain (4) Sub-competency addressed, (5) Student instructions, and (6) Grading method/details. Data were entered into a structured Access data base. In addition, face-to-face interviews were conducted with faculty course coordinators. RESULTS: The MBChB curriculum consisted of 62 courses over 5 years, focusing on preclinical skills in years 1-2 and clinical skills in years 3-5. Fifty-nine competencies were identified and aggregated into 9 domains. Fifty-eight competencies were assessed at least one time in the curriculum. Faculty cited limited training in assessment as well as large student numbers as hindrances to designing robust assessments for the competencies. CONCLUSION: CBME was successfully implemented evidenced by all but one of the 59 competencies within the nine domains established being assessed within the MBChB curriculum at MaKCHS. Faculty interviewed were largely aware of it, however indicated the need for more training in competency-based assessment to improve the implementation of CBME.


Subject(s)
Curriculum , Schools, Medical , Clinical Competence , Competency-Based Education/methods , Cross-Sectional Studies , Humans
8.
Am J Trop Med Hyg ; 105(6): 1552-1562, 2021 10 04.
Article in English | MEDLINE | ID: mdl-34610572

ABSTRACT

Zika virus (ZIKV) is transmitted primarily through infected Aedes aegypti or Aedes albopictus mosquitoes. ZIKV infection during pregnancy was linked to adverse fetal/infant outcomes, including microcephaly, brain anomalies, ocular disorders, intrauterine growth restriction, and other congenital malformations. Human anti-Zika virus immunoglobulin (ZIKV-Ig) is being developed for prophylaxis of ZIKV in at-risk populations, including women of childbearing potential and pregnant women. A phase 1 single-center, double-blind, randomized, placebo-controlled study was conducted to assess the safety and pharmacokinetics (PK) of a single 50.0-mL ZIKV-Ig intravenous dose in healthy adult male or non-pregnant female subjects 18 to 55 years of age. Subjects received either ZIKV-Ig (n = 19) or saline placebo (n = 11). Safety was evaluated based on adverse events (AEs), laboratory test results, physical examinations, and vital signs. Overall, there were 11 subjects (36.7%) with treatment-related AEs including eight subjects (42.1%) in the ZIKV-Ig group and three subjects (27.3%) in the placebo group. Of the AEs considered treatment related, three subjects (15.8%) experienced headache (mild). There were no serious AEs, no deaths, and no discontinuations resulting from AEs. Overall, the safety profile of ZIKV-Ig in this study population of healthy adult subjects appeared to be safe and well tolerated. The results of the pharmacokinetic analysis determined that ZIKV-Ig had a maximum observed concentration of 182.3 U/mL (coefficient of variation, 21.3%), the time at which Cmax occurred of 2.3 hours ± 1.0 (SD), an area under the concentration-time curve0-∞ of 77,224 h × U/mL (coefficient of variation, 17.9%), and a half-life of 28.1 days, which is similar to other human-derived commercial Ig intravenous products.


Subject(s)
Immunization, Passive/methods , Immunoglobulin G/therapeutic use , Zika Virus Infection/therapy , Adult , Double-Blind Method , Female , Humans , Immunoglobulin G/immunology , Male , Middle Aged , Pharmacokinetics , Young Adult , Zika Virus/immunology
9.
BMJ Open ; 11(9): e046042, 2021 09 28.
Article in English | MEDLINE | ID: mdl-34588232

ABSTRACT

INTRODUCTION: Aboriginal and Torres Strait Islander (hereafter respectfully referred to as Aboriginal) people are Australia's First Peoples, having the longest continuous culture in the world and deep spiritual connections with ancestral land. Improvements in their health and well-being is a major policy goal of Australian governments, as the legacy of colonisation and disruption of cultural practices contribute to major health challenges. Lack of culturally secure services impacts participation of Aboriginal people in health services. Aboriginal people with a brain injury typically experience poor access to rehabilitation and support following hospital discharge. 'Healing Right Way' (HRW) is a randomised control trial aiming to improve access to interdisciplinary and culturally secure rehabilitation services for Aboriginal people after brain injury in Western Australia, improve health outcomes and provide the first best practice model. This protocol is for the process evaluation of the HRW trial. METHODS AND ANALYSIS: A prospective mixed methods process evaluation will use the Consolidated Framework for Implementation Research to evaluate implementation and intervention processes involved in HRW. Data collection includes qualitative and quantitative data from all sites during control and intervention phases, relating to three categories: (1) implementation of trial processes; (2) cultural security training; and (3) Aboriginal Brain Injury Coordinator role. Additional data elements collected from HRW will support the process evaluation regarding fidelity and intervention integrity. Iterative cross-sectional and longitudinal data synthesis will support the implementation of HRW, interpretation of findings and inform future development and implementation of culturally secure interventions for Aboriginal people. ETHICS AND DISSEMINATION: This process evaluation was reviewed by The University of Western Australia Human Research Ethics Committee (RA/4/20/4952). Evaluation findings will be disseminated via academic mechanisms, seminars at trial sites, regional Aboriginal health forums, peak bodies for Aboriginal health organisations and the Australian Indigenous HealthInfoNet (https://healthinfonet.ecu.edu.au/). TRIAL REGISTRATION NUMBER: ACTRN12618000139279.


Subject(s)
Brain Injuries , Health Services, Indigenous , Australia , Cross-Sectional Studies , Humans , Native Hawaiian or Other Pacific Islander , Prospective Studies , Randomized Controlled Trials as Topic
10.
BMJ ; 374: n2060, 2021 09 01.
Article in English | MEDLINE | ID: mdl-34470747

ABSTRACT

OBJECTIVE: To determine the risk of hospital admission with covid-19 and severe covid-19 among teachers and their household members, overall and compared with healthcare workers and adults of working age in the general population. DESIGN: Population based nested case-control study. SETTING: Scotland, March 2020 to July 2021, during defined periods of school closures and full openings in response to covid-19. PARTICIPANTS: All cases of covid-19 in adults aged 21 to 65 (n=132 420) and a random sample of controls matched on age, sex, and general practice (n=1 306 566). Adults were identified as actively teaching in a Scottish school by the General Teaching Council for Scotland, and their household members were identified through the unique property reference number. The comparator groups were adults identified as healthcare workers in Scotland, their household members, and the remaining general population of working age. MAIN OUTCOME MEASURES: The primary outcome was hospital admission with covid-19, defined as having a positive test result for SARS-CoV-2 during hospital admission, being admitted to hospital within 28 days of a positive test result, or receiving a diagnosis of covid-19 on discharge from hospital. Severe covid-19 was defined as being admitted to intensive care or dying within 28 days of a positive test result or assigned covid-19 as a cause of death. RESULTS: Most teachers were young (mean age 42), were women (80%), and had no comorbidities (84%). The risk (cumulative incidence) of hospital admission with covid-19 was <1% for all adults of working age in the general population. Over the study period, in conditional logistic regression models adjusted for age, sex, general practice, race/ethnicity, deprivation, number of comorbidities, and number of adults in the household, teachers showed a lower risk of hospital admission with covid-19 (rate ratio 0.77, 95% confidence interval 0.64 to 0.92) and of severe covid-19 (0.56, 0.33 to 0.97) than the general population. In the first period when schools in Scotland reopened, in autumn 2020, the rate ratio for hospital admission in teachers was 1.20 (0.89 to 1.61) and for severe covid-19 was 0.45 (0.13 to 1.55). The corresponding findings for household members of teachers were 0.91 (0.67 to 1.23) and 0.73 (0.37 to 1.44), and for patient facing healthcare workers were 2.08 (1.73 to 2.50) and 2.26 (1.43 to 3.59). Similar risks were seen for teachers in the second period, when schools reopened in summer 2021. These values were higher than those seen in spring/summer 2020, when schools were mostly closed. CONCLUSION: Compared with adults of working age who are otherwise similar, teachers and their household members were not found to be at increased risk of hospital admission with covid-19 and were found to be at lower risk of severe covid-19. These findings should reassure those who are engaged in face-to-face teaching.


Subject(s)
COVID-19/epidemiology , Health Personnel/statistics & numerical data , School Teachers/statistics & numerical data , Adult , Aged , Case-Control Studies , Communicable Disease Control/methods , Datasets as Topic , Female , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Pandemics , Risk Assessment , SARS-CoV-2 , Scotland/epidemiology , Young Adult
11.
Issues Ment Health Nurs ; 42(12): 1084-1094, 2021 Dec.
Article in English | MEDLINE | ID: mdl-34170801

ABSTRACT

This study's aim was to understand nurses' caring experiences during the recent pandemic in the United States. Using an interpretive phenomenological approach, 15 participants provided the meaning of the care they provided. Five major themes were interpreted: If not us, then who?; Accepting uncertainty; It was never enough; Finding self and our voices in a new role; and Believing it was worth it. The study results have implications for psychiatric-mental health nurse clinicians as they identify and meet the needs of individuals of this vulnerable group. Research that uncovers the meaning of the caring experiences of front line nurses can illuminate the discipline's current understanding of this phenomena.


Subject(s)
COVID-19 , Nurses , Humans , Pandemics , Patient Care , SARS-CoV-2 , United States
12.
J Nurs Manag ; 29(6): 1525-1534, 2021 Sep.
Article in English | MEDLINE | ID: mdl-33690928

ABSTRACT

AIM: To understand the experiences of hospital nurse managers and assistant nurse managers during the COVID-19 pandemic in the United States. BACKGROUND: Little research has been published about the experiences of nurse managers during the COVID-19 pandemic. Experiences of front-line nurses have been well documented. This is the first phenomenological study to date in the United States on experiences of hospital nurse managers during the COVID-19 pandemic. DESIGN: Phenomenological qualitative approach. METHODS: Thirteen managers, seven nurse managers and six assistant nurse managers were interviewed about their experiences using audio-video teleconferencing and a semi-structured interview guide. Consolidated Criteria for Reporting Qualitative Research criteria for reporting qualitative research were used. RESULTS: The four major themes that emerged were as follows: being there for everyone; leadership challenges; struggles, support and coping; and strengthening my role. There were 11 subthemes. CONCLUSIONS: A major focus of nurse managers during the pandemic was psychosocial support of front-line nurses while at the same time experiencing stress and exhaustion themselves. IMPLICATIONS FOR NURSING MANAGEMENT: More attention on the psychosocial needs of nurse managers, interventions to allay their exhaustion and provisions for readily available support are warranted.


Subject(s)
COVID-19 , Nurse Administrators , Humans , Leadership , Pandemics , Qualitative Research , SARS-CoV-2 , United States
13.
Issues Ment Health Nurs ; 42(7): 628-638, 2021 Jul.
Article in English | MEDLINE | ID: mdl-33166230

ABSTRACT

This study investigated the recovery process for individuals engaged in treatment for substance use disorders (SUDs) who had co-occurring anxiety and depression. The participants were eight individuals engaged in treatment. The results of a Grounded Theory design and methods revealed the core category and substantive theory, Stumbling toward Vulnerability. Four phases in which the participants progressed in a linear way emerged. The study results have implications for the role of the advance practice psychiatric-mental health nurse in the early assessment of mental illness for clients with SUDs by providing integrated treatment for these individuals, and focusing on health and wellness as a recovery outcome. Based on the findings, hypotheses for further research are recommended.


Subject(s)
Mental Disorders , Psychiatric Nursing , Substance-Related Disorders , Anxiety , Anxiety Disorders , Grounded Theory , Humans , Substance-Related Disorders/complications
14.
Nurs Adm Q ; 44(4): E12-E24, 2020.
Article in English | MEDLINE | ID: mdl-32881808

ABSTRACT

A significant number of quantitative studies have associated a positive or healthy work environment with job satisfaction. Nurses, patients, and organizational characteristics have been studied as contributing factors. Other studies have focused on structural or physical environmental factors such as noise, space, or lighting as influencing to satisfaction. Little research has focused on how a changed work environment initiated by an organization for improved patient care affected the nurses' perceptions of how their practice had changed. The purpose of this qualitative study was to determine nurses' perceptions of a changed work environment on their practice, specifically patient care. Twelve nurses participated in the semistructured interviews. Interviews were transcribed verbatim and content analysis was used to identify categories of phrases and the resulting major themes. Most importantly, and the significant overall theme of patient- and family-centered improved care described their perceptions of this change. Other themes included camaraderie, nurse-patient relationships, being valued by the organization, and efficiency for decreasing stress. The results illuminate and extend some of the findings from prior quantitative studies on professional practice environments. A major contribution of this research is the perception of the nurses, often overlooked in quantitative studies. Significant was the nurses' view that the changed environment improved patient- and family-centered care although, as in other study findings, there was a view that peer camaraderie decreased.


Subject(s)
Job Satisfaction , Nurses/psychology , Perception , Adult , Attitude of Health Personnel , Female , Humans , Male , Middle Aged , Nurse-Patient Relations , Qualitative Research
15.
J Int AIDS Soc ; 23(7): e25555, 2020 07.
Article in English | MEDLINE | ID: mdl-32618115

ABSTRACT

INTRODUCTION: India's national AIDS Control Organization implemented World Health Organization's option B+ HIV prevention of mother-to-child transmission (PMTCT) guidelines in 2013. However, scalable strategies to improve uptake of new PMTCT guidelines to reduce new infection rates are needed. This study assessed impact of Mobile Health-Facilitated Behavioral Intervention on the uptake of PMTCT services. METHODS: A cluster-randomized trial of a mobile health (mHealth)-supported behavioural training intervention targeting outreach workers (ORWs) was conducted in four districts of Maharashtra, India. Clusters (one Integrated Counselling and Testing Center (ICTC, n = 119), all affiliated ORWs (n = 116) and their assigned HIV-positive pregnant/postpartum clients (n = 1191)) were randomized to standard-of-care (SOC) ORW training vs. the COMmunity home Based INDia (COMBIND) intervention - specialized behavioural training plus a tablet-based mHealth application to support ORW-patient communication and patient engagement in HIV care. Impact on uptake of maternal antiretroviral therapy at delivery, exclusive breastfeeding at six months, infant nevirapine prophylaxis, and early infant diagnosis at six months was assessed using multi-level random-effects logistic regression models. RESULTS: Of 1191 HIV-positive pregnant/postpartum women, 884 were eligible for primary outcome assessment; 487 were randomized to COMBIND. Multivariable analyses identified no statistically significant differences in any primary outcome by study arm. COMBIND was associated with higher uptake of exclusive breastfeeding at two months (adjusted Odds Ratio (aOR), 2.10; 95% CI 1.06 to 4.15) and early infant diagnosis at six weeks (aOR, 2.19; 95% CI 1.05 to 3.98) than SOC. CONCLUSIONS: The COMBIND intervention was easily integrated into India's existing PMTCT programme and improved early uptake of two PMTCT components that require self-motivated health-seeking behaviour, thus providing preliminary evidence to support COMBIND as a potentially scalable PMTCT strategy. Further study would identify modifications needed to optimize other PMTCT outcomes.


Subject(s)
Behavior Therapy , Breast Feeding , Community Health Workers/education , HIV Infections/diagnosis , Telemedicine , Adult , Anti-HIV Agents/therapeutic use , Cluster Analysis , Counseling , Early Diagnosis , Female , HIV Infections/drug therapy , HIV Infections/transmission , Humans , India , Infant , Infant, Newborn , Infectious Disease Transmission, Vertical , Nevirapine/therapeutic use , Pregnancy
16.
ACS Omega ; 5(12): 6429-6440, 2020 Mar 31.
Article in English | MEDLINE | ID: mdl-32258878

ABSTRACT

Over 2.7 billion liters of pot ale is produced annually as a co-product of Scottish malt whisky, and apart from evaporation to pot ale syrup as a feed, it is primarily treated by anaerobic digestion or land/sea disposal. The aim of this study was to assess pot ale components and their potential applications. The insoluble solid fraction, mainly consisting of yeast, contained 55% protein, and as a protein feed ingredient, this could yield 32,400 tons of feed per annum, although the Cu content of this fraction would need to be monitored. The liquid fraction could yield 33,900 tons of protein per annum, and an SDS-PAGE profile of this fraction demonstrated that the proteins may be similar to those found in beer, which could extend their application as a food ingredient. This fraction also contained phosphorus, potassium, and polyphenols among other components, which could have added value. Overall, fractionation of pot ale could offer an alternative to evaporation to pot ale syrup while retaining the protein fraction in the food chain.

17.
BMJ Open ; 10(1): e030268, 2020 01 07.
Article in English | MEDLINE | ID: mdl-31915158

ABSTRACT

INTRODUCTION: Regardless of the healthcare setting, person-centred care and its implementation in caring for older people are a central issue for those who are responsible as professional caregivers and for those in need of care within the care process. Both aspects encompass the possibility of recognising personal preferences. To provide person-centred care, professional caregivers need to know about the individual preferences of the persons being cared for. Therefore, the PELI (an acronym for 'Preferences for Everyday Living Inventory') instrument was developed at the Polisher Research Institute (USA) for the systematic recording of individual preferences of older people in need of care. There is currently no comparable instrument available in the German language. METHODS: As part of the proposed project PELI-D, all versions of the original PELI instrument (nursing home version) were (1) culture-sensitively translated into German and will be (2) examined in a pilot study for their reliability, feasibility and practicability. For the project PELI-D, we worked together with our practice partners in Germany (Diaconia and Caritas in North Rhine-Westphalia) and collaborated with our partners in the USA who developed the PELI instrument. This study protocol focuses on the pilot study, which will be conducted by the German Center for Neurodegenerative Diseases (DZNE) (site Witten). ETHICS AND DISSEMINATION: This study was approved by the internal quality control committee of the DZNE (ID number: WI029 PELI-D) and by the ethics committee of the German Society of Nursing Science Duisburg branch office (ID number: 18-010). All personal information will be deidentified with a specific identification code and stored in a secured location apart from the rest of the study data. Only qualified and study-related staff will be allowed access to the data. The results of the study will be distributed nationally and internationally through peer-reviewed journals, conferences and journals for nursing care practice.


Subject(s)
Activities of Daily Living/psychology , Cultural Competency , Patient Preference , Patient-Centered Care/methods , Surveys and Questionnaires , Aged , Feasibility Studies , Germany , Health Services Research , Health Services for the Aged , Humans , Nursing Homes , Pilot Projects , Translations
18.
J Aging Phys Act ; 28(1): 104-113, 2020 01 01.
Article in English | MEDLINE | ID: mdl-31629363

ABSTRACT

Regular physical activity has multiple benefits for older adults, including improved physical, cognitive, and psychosocial health. This exploratory study investigated the benefits of a 12-week exercise program for older adults (n = 11 control and n = 13 intervention) living in a residential aged care facility in Perth, Western Australia. The program, prescribed and delivered by an accredited exercise physiologist, aimed to maintain or improve participants' physical capacity. It comprised one-on-one exercise sessions (1 hr × 2 days/week × 12 weeks), involving a components-approach intervention. Physical performance measures (balance, strength, flexibility, and mobility) were assessed preintervention and postintervention. Qualitative interviews postintervention with residents participating in the exercise intervention, and with family members, staff, and research team members, explored barriers and enablers to participation and perceived psychosocial outcomes. Findings indicate the program provided physical benefits and enhanced social engagement for participants, illustrating the value of providing exercise physiology services in the aged care sector.


Subject(s)
Exercise Therapy , Exercise , Aged , Aged, 80 and over , Female , Geriatric Assessment , Humans , Male , Middle Aged , Outcome Assessment, Health Care , Residential Facilities , Treatment Outcome , Western Australia
19.
Lancet HIV ; 7(6): e443-e448, 2020 06.
Article in English | MEDLINE | ID: mdl-31870675

ABSTRACT

The first long-acting formulations of HIV drugs are undergoing regulatory review for use in maintenance of viral suppression in people with HIV. Although these novel drug formulations could contribute greatly to HIV treatment and prevention efforts, their lack of activity against hepatitis B virus (HBV) could limit their global impact, particularly in populations with high burdens of both HIV and HBV. An urgent need for greater investment in research and development of long-acting drugs with dual activity against HIV and HBV exists. Access to long-acting HIV drug formulations with dual activity against HBV would be transformative and have a great impact on efforts to prevent, treat, and eradicate both of these important global epidemics.


Subject(s)
Antiviral Agents/pharmacology , HIV Infections/drug therapy , Hepatitis B/drug therapy , Antiviral Agents/therapeutic use , Coinfection , Delayed-Action Preparations , Global Health , HIV Infections/prevention & control , HIV-1/drug effects , Hepatitis B/prevention & control , Hepatitis B virus/drug effects , Humans , Injections , Viral Load/drug effects
20.
Lancet HIV ; 6(8): e552-e558, 2019 08.
Article in English | MEDLINE | ID: mdl-31307946

ABSTRACT

Antiretroviral agents with long-acting properties have potential to improve treatment outcomes substantially for people living with HIV. In November 2017, the Long acting/Extended Release Antiretroviral Resource Program (LEAP) convened a workshop with the aim of shaping the research agenda and promoting early development of long-acting or extended release products for key populations: pregnant and lactating women, children aged up to 10 years, and adolescents aged 10-19 years. Goals included strategies and principles to ensure that the needs of children, adolescents, and pregnant and lactating women are considered when developing long-acting formulations. Research should focus not only on how best to transition long-acting products to these populations, but also on early engagement across sectors and among stakeholders. A parallel rather than sequential approach is needed when establishing adult, adolescent, and paediatric clinical trials and seeking regulatory approval. Pregnant and lactating women should be included in adult clinical trials. Adolescent-friendly trial design is needed to improve recruitment and retention of young people.


Subject(s)
Anti-Retroviral Agents/administration & dosage , HIV Infections/drug therapy , Research , Adolescent , Breast Feeding , Child , Child, Preschool , Delayed-Action Preparations , Female , HIV Infections/prevention & control , Humans , Infant , Infant, Newborn , Pregnancy , Retention in Care , Young Adult
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