Antiretroviral treatment adherence among HIV patients in KwaZulu-Natal, South Africa

<p>Abstract</p> <p>Background</p> <p>Successful antiretroviral treatment is dependent on sustaining high rates of adherence. In the southern African context, only a handful of studies (both quantitative and qualitative) have looked at the determinants including a health behaviour theory of adherence to antiretroviral therapy. The aim of this study is to assess factors including the information, motivation and behavioural skills model (IMB) contributing to antiretroviral (ARV) adherence six months after commencing ARVs at three public hospitals in KwaZulu-Natal, South Africa.</p> <p>Methods</p> <p>Using systematic sampling, 735 HIV-positive patients were selected prior to commencing on ART from outpatient departments from three hospitals and followed-up at six months and interviewed with a questionnaire.</p> <p>Results</p> <p>A good proportion of patients were found to be adherent using both adherence instruments (visual analog scale = VAS 82.9%; Adult AIDS Clinical Trials Group = AATCG 70.8%). After adjusting for significant socio-economic variables, both the VAS and the dose, schedule and food adherence indicator found levels of adherence amongst urban residents to be almost 3 times greater than that of rural residents. After adjusting for health-related variables, for both indicators better adherence was associated with low depression and poorer adherence was associated with poor environmental factors. Adjusted odds ratios for adherence when taking into account different behavioural variables were for both adherence indicators, discrimination experiences were associated with lower adherence, and higher scores in adherence information and behavioural skills were associated with higher adherence. For the VAS adherence indicator, higher social support scores were associated with higher adherence. For the dose, schedule and food adherence indicator, using herbal medicines for HIV was associated with lower adherence.</p> <p>Conclusion</p> <p>For the patients in this study, particularly those not living in urban areas, additional support may be needed to ensure patients are able to attend appointments or obtain their medications more easily. Adherence information and behavioural skills as part of the IMB model should be strengthened to improve adherence. Further psychological support is also required and patients' perceived need for ARTs should be routinely assessed.</p

A História da Alimentação: balizas historiográficas

Os M. pretenderam traçar um quadro da História da Alimentação, não como um novo ramo epistemológico da disciplina, mas como um campo em desenvolvimento de práticas e atividades especializadas, incluindo pesquisa, formação, publicações, associações, encontros acadêmicos, etc. Um breve relato das condições em que tal campo se assentou faz-se preceder de um panorama dos estudos de alimentação e temas correia tos, em geral, segundo cinco abardagens Ia biológica, a econômica, a social, a cultural e a filosófica!, assim como da identificação das contribuições mais relevantes da Antropologia, Arqueologia, Sociologia e Geografia. A fim de comentar a multiforme e volumosa bibliografia histórica, foi ela organizada segundo critérios morfológicos. A seguir, alguns tópicos importantes mereceram tratamento à parte: a fome, o alimento e o domínio religioso, as descobertas européias e a difusão mundial de alimentos, gosto e gastronomia. O artigo se encerra com um rápido balanço crítico da historiografia brasileira sobre o tema

Factors Associated with Unintentional Injury among University Students in 26 Countries

The aim of this study was to determine estimates of the incidence and social correlates of nonfatal injury among university students in 26 low-, middle-, and high income countries. Design and Sample: Using anonymous questionnaires, data were collected in a cross-sectional survey of 19,111 undergraduate university students (mean age 20.8, SD = 2.8) from 27 universities in 26 countries across Asia, Africa, and the Americas. Measures: Questionnaire on health risk behaviors, psychological distress, personality, social variables, and injury requiring medical treatment or missing at least one day of usual activities. Results: The percentage of university students reporting one or more serious injuries within the past 12 months was 25.2% for all countries, in men 28.8% and women 21.1%. In multivariate logistic regression among men, socio-demographic variables, health risk behaviors, posttraumatic stress (PTSD) symptoms, lack of personal control and lack of social support, and among women, residing on campus, health risk behaviors, PTSD symptoms, lack of personal control, and lack of social support were associated with injury incidence. Conclusions: Several risk factors were identified which will increase the understanding of public health nurses of injuries in university communities to design programs for injury prevention programs specifically targeting university students, staff, and university health center professionals.

Prevalence of overweight/obesity and central obesity and its associated factors among a sample of university students in India

Obesity and the lifestyle characteristic of Indian society lead young people to conditions of potential cardiovascular risk. The purpose of this study waste assess the prevalence of overweight/obesity and central obesity and its associated factors in a sample of Indian university students. In a cross-sectional survey assessed anthropometric measurements and a self-administered questionnaire among a sample of randomly selected university students. The sample included 800 university students from non-health (mainly sciences) courses Gitam University in India. The students were 541 (67.6%) males and 259 (32.4%) females in the age range of 17-20 years. 37.5% were overweight or obese, 26.8% overweight and 10.7% obese, 11.7% underweight and 16.4% central obesity. In multivariate analysis among men lack of non-organised religious activity, lower dietary risk knowledge, tobacco use, and suffering from depression were associated with overweight/obesity, and younger age, lives away from parents or guardians, healthy dietary practices and 9 or more hours sleep duration were associated with central obesity.