124 research outputs found
Modeling the Impact of Antiretroviral Use in Developing Countries
Bertozzi and Bautista-Arredondo discuss the implications of a new PLoS Medicine study that models the impact of antiretroviral drugs upon HIV transmission in developing countries
Pilot Study of a Multi-pronged Intervention using Social Norms and Priming to Improve Adherence to Antiretroviral Therapy and Retention in Care among Adults Living with HIV in Tanzania.
Interventions incorporating constructs from behavioral economics and psychology have the potential to enhance HIV 'treatment as prevention' (TasP) strategies. To test this hypothesis, we evaluated an intervention to improve antiretroviral therapy (ART) adherence based on the concepts of social norms and priming. We used tools from marketing research and patient-centered design to develop a combination intervention that included visual feedback about clinic-level retention in care, a self-relevant prime, and useful take-home items with the priming image. The intervention was implemented at two HIV primary clinics in Shinyanga, Tanzania in 2-week intervals for six months. We conducted a quasi-experimental pilot study with a random sample of exposed and unexposed adult patients living with HIV infection (PLHIV) to compare retention and the proportion of patients with medication possession ratio (MPR) ≥95% after six months. Intervention acceptability was determined with a convenience sample of 405 PLHIV at baseline (n = 189) and endline (n = 216). Medical records were reviewed for 438 PLHIV (320 intervention, 118 standard of care). In adjusted analyses, PLHIV exposed to the intervention were significantly more likely to be in care after 6 months (87% vs. 79%, adjusted odds ratio (ORa) = 1.73, 95% CI: 1.08, 2.78, p<0.05) and were more likely to achieve MPR≥95% (70% vs. 59%, OR = 1.51, 95% CI: 0.96, 2.37, p = 0.07). The intervention was associated with increases in staff support of treatment goals (100% vs. 95%, p = 0.01) and life goals (66% vs. 50%, p<0.01), the perceived likelihood of other patients' adherence (54% vs. 32%, p<0.01), support from other patients (71% vs. 60%, p = 0.03), and being very satisfied with care (53% vs. 35%, p<0.01). This novel intervention has the potential to improve the clinic experience, short-term retention in care, and ART adherence. Future studies are needed to expand the generalizability of the approach and evaluate effectiveness on clinical outcomes
Coordinación y cooperación de las redes formadas detrás del continuo de atención a personas que viven con VIH en México
Objective. To describe and characterize HIV care service networks in Mexico. Materials and methods. We analyzed the relationships established by actors involved in prevention and care services under a social network analysis approach. Results. Service provision networks comprise governmental as well as non-governmental actors. Across the service continuum, fragmentation and low connectivity increase. Conclusions. The provision of HIV services in Mexico is a multi-governance process. The configuration of the networks does not imply that the provision of services is optimal. However, specialized care units have established collaborative networks to offer timely care in a context of limited resources and results-based public management
Bocashi y Lombricompuesto en el crecimiento y producciĂłn de Coriandrum sativum L. bajo manejo agroecolĂłgico
Ponencia presentada en 1Âş Congreso Argentino de AgroecologĂa. "Otra agricultura es posible: Cultivando interacciones para el mañana". Mendoza, Argentina, 18 al 20 de septiembre de 2019.Fil: Villanueva, Bautista. Universidad Nacional de CĂłrdoba. Facultad de Ciencias Agropecuarias; Argentina.Fil: Arredondo, Sergio. Universidad Nacional de CĂłrdoba. Facultad de Ciencias Agropecuarias; Argentina.Fil: Cabanillas, Carmen. Universidad Nacional de CĂłrdoba. Facultad de Ciencias Agropecuarias. Departamento de Desarrollo Rural; Argentina.Fil: Tablada, Elena Margot. Universidad Nacional de CĂłrdoba. Facultad de Ciencias Agropecuarias; Argentina.Fil: Locati, Luciano. Universidad Nacional de CĂłrdoba. Facultad de Ciencias Agropecuarias. Cátedra de EcologĂa AgrĂcola; Argentina.Frente a la problemática ambiental generada por fertilizantes sintĂ©ticos, una alternativa es utilizar bioinsumos en los sistemas agroecolĂłgicos. Su incorporaciĂłn en el manejo de la fertilidad implica un aporte benĂ©fico para crecimiento y producciĂłn de cultivos. El objetivo fue evaluar crecimiento y producciĂłn de Coriandrum sativum L. mediante bocashi, lombricompuesto y testigo sin bioinsumo bajo manejo agroecolĂłgico en la CLAYSA-UNC. A la siembra se aplicĂł 51,92 g de bocashi por planta, 62,65 g de lombricompuesto por planta y testigo sin bioinsumo. Alturas de plantas con lombricompuesto presentaron media mayor que el testigo, pero no hubo diferencias entre plantas con bioinsumos. A los 154 dĂas desde la siembra, con bioinsumos hubo mayor fructificaciĂłn que el testigo. No hubo diferencias en el peso de frutos. En el marco de un manejo agroecolĂłgico, estos bioinsumos aplicados al coriandro permiten conservar recursos naturales y contribuyen al equilibrio y salud de los agroecosistemas.Facing environmental problems generated by synthetic fertilizers, an alternative is the use of bio-inputs on agro-eco-logical systems. Its incorporation into the fertility management implies a beneficial contribution to growth and crop production. The objective was to evaluate growth and production of Coriandrum sativum L. under agro-ecological mana-
gement by using bokashi, vermicompost and control at CLAYSA-UNC. At seeding was applied 51,92 g bokashi per plant, 62,65 g of vermicompost per plant and control. Heights of plants with vermicompost had an average higher than the control, while plants with bio-inputs were not significantly differed. 154 days from sowing, plants with bio-inputs had
more fruit than the control. There were no differences in weight of fruits. In the framework of an agroecological management, these bio-inputs applied to coriander can conserve natural resources and contribute to balance and health of agroecosystems.Fil: Villanueva, Bautista. Universidad Nacional de CĂłrdoba. Facultad de Ciencias Agropecuarias; Argentina.Fil: Arredondo, Sergio. Universidad Nacional de CĂłrdoba. Facultad de Ciencias Agropecuarias; Argentina.Fil: Cabanillas, Carmen. Universidad Nacional de CĂłrdoba. Facultad de Ciencias Agropecuarias. Departamento de Desarrollo Rural; Argentina.Fil: Tablada, Elena Margot. Universidad Nacional de CĂłrdoba. Facultad de Ciencias Agropecuarias; Argentina.Fil: Locati, Luciano. Universidad Nacional de CĂłrdoba. Facultad de Ciencias Agropecuarias. Cátedra de EcologĂa AgrĂcola; Argentina
Migration Decision-Making Among Mexican Youth: Individual, Family, and Community Influences
We explored migration decisions using in-depth, semi-structured interviews with male and female youth ages 14 to 24 (n=47) from two Mexican communities, one with high and one with low U.S. migration density. Half were return migrants and half were non-migrants with relatives in the U.S. Migrant and non-migrant youth expressed different preferences, especially in terms of education and their ability to wait for financial gain. Reasons for migration were mostly similar across the two communities; however, the perceived risk of the migration journey was higher in the low density migration community while perceived opportunities in Mexico were higher in the high density migration community. Reasons for return were related to youths’ initial social and economic motivations for migration. A greater understanding of factors influencing migration decisions may provide insight into the vulnerability of immigrant youth along the journey, their adaptation process in the U.S., and their reintegration in Mexico
A Cross-Sectional Study of Prisoners in Mexico City Comparing Prevalence of Transmissible Infections and Chronic Diseases with That in the General Population.
ObjectivesTo describe patterns of transmissible infections, chronic illnesses, socio-demographic characteristics and risk behaviors in Mexico City prisons, including in comparison to the general population, to identify those currently needing healthcare and inform policy.Materials and methodsA cross-sectional study among 17,000 prisoners at 4 Mexico City prisons (June to December 2010). Participation was voluntary, confidential and based on informed consent. Participants were tested for HIV, Hepatitis B & C, syphilis, hypertension, obesity, and, if at risk, glucose and cholesterol. A subset completed a questionnaire on socio-demographic characteristics and risk behaviors. Positive results were delivered with counseling and treatment or referral.Results76.8% (15,517/20,196) of men and 92.9% (1,779/1,914) of women participated. Complete data sets were available for 98.8%. The following prevalence data were established for transmissible infections: HIV 0.7%; syphilis: Anti-TP+/VDRL+ 2.0%; Hepatitis B: HBcAb 2.8%, HBsAg 0.15%; Anti-HCV 3.2%. Obesity: 9.5% men, 33.8% women. Compared with national age- and sex-matched data, the relative prevalence was greater for HIV and syphilis among women, HIV and Hepatitis C in men, and all infections in younger participants. Obesity prevalence was similar for women and lower among male participants. The prevalence of previously diagnosed diabetes and hypertension was lower. Questionnaire data (1,934 men, 520 women) demonstrated lower educational levels, increased smoking and substance use compared to national data. High levels of non-sterile tattooing, physical abuse and histories of sexual violence were found.ConclusionThe study identified that health screening is acceptable to Mexico City prisoners and feasible on a large-scale. It demonstrated higher prevalence of HIV and other infections compared to national data, though low rates compared to international data. Individual participants benefited from earlier diagnosis, treatment and support. The data collected will also enable the formulation of improved policy for this vulnerable group
Availability, prices, and affordability of selected essential cancer medicines in a middle-income country - the case of Mexico
BACKGROUND: More alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. We assessed the availability and affordability of essential cancer medicines in Mexico, and compared their prices against those in other countries of the region. METHODS: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO's Strategic Fund. RESULTS: Of the various medicines, mean availability in public and private sector outlets was 61.2 and 67.5%, respectively. In the public sector, medicines covered by the public health insurance "People's Health Insurance" were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. CONCLUSIONS: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization's 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector
Did Universal Access to ARVT in Mexico Impact Suboptimal Antiretroviral Prescriptions?
Background. Universal access to antiretroviral therapy (ARVT) started in Mexico in 2001; no evaluation of the features of ARVT prescriptions over time has been conducted. The aim of the study is to document trends in the quality of ARVT-prescription before and after universal access. Methods. We describe ARVT prescriptions before and after 2001 in three health facilities from the following subsystems: the Mexican Social Security (IMSS), the Ministry of Health (SSA), and National Institutes of Health (INS). Combinations of drugs and reasons for change were classified according to current Mexican guidelines and state-of-the-art therapy. Comparisons were made using χ (2) tests. Results. Before 2001, 29% of patients starting ARVT received HAART; after 2001 it increased to 90%. The proportion of adequate prescriptions decreased within the two periods of study in all facilities (P value < 0.01). The INS and SSA were more likely to be prescribed adequately (P value < 0.01) compared to IMSS. The distribution of reasons for change was not significantly different during this time for all facilities (P value > 0.05). Conclusions. Universal ARVT access in Mexico was associated with changes in ARVT-prescription patterns over time. Health providers' performance improved, but not homogeneously. Training of personnel and guidelines updating is essential to improve prescription
Management practices in community-based HIV prevention organizations in Nigeria
Background: Nigeria has one of the largest Human Immunodeficiency Virus (HIV) epidemics in the world. Addressing the epidemic of HIV in such a high-burden country has necessitated responses of a multidimensional nature. Historically, community-based organizations (CBOs) have played an essential role in targeting key populations (eg. men who have sex with men, sex workers) that are particularly burdened by HIV. CBOs are an essential part of the provision of health services in sub-Saharan Africa, but very little is known about the management practices of CBOs that provide HIV prevention interventions. Methods: We interviewed 31 CBO staff members and other key stakeholders in January 2017 about management practices in CBOs. Management was conceptualized under the classical management process perspective; these four management phases—planning, organizing, leading, and evaluating—guided the interview process and code development. Data analysis was conducted thematically using Atlas.ti software. The protocol was approved by the ethics committees of the National Institute of Public Health of Mexico (INSP), the National Agency for the Control of AIDS in Nigeria (NACA), and the Nigerian Institute for Medical Research (NIMR). Results: We found that CBOs implement variable management practices that can either hinder or facilitate the efficient provision of HIV prevention services. Long-standing CBOs had relatively strong organizational infrastructure and capacity that positively influenced service planning. In contrast, fledgling CBOs were deficient of organizational infrastructure and lacked program planning capacity. The delivery of HIV services can become more efficient if management practices are taken into account. Conclusions: The delivery of HIV services by CBOs in Nigeria was largely influenced by inherent issues related to skills, organizational structure, talent retention, and sanction application. These, in turn, affected management practices such as planning, organizing, leading, and evaluating. This study shows that KP-led CBOs are evolving and have strong potentials and capacity for growth, and can become more efficient and effective if attention is paid to issues such as hierarchy, staff recruitment, and talent retention
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