Project Passport: An Integrated Group-Centered Approach Targeting Pregnant Teens and Their Partners

Objective: To describes the development of Project Passport, a perinatal intervention designed to reduce negative outcomes among pregnant teens. Methods: A logic model guided the planning, development and evaluation plan for the intervention. It included the selection of health goals, behaviors to be targeted, determinants of the selected behaviors, and activities to impact each selected determinant. Results: The process resulted in the formulation of an intervention that incorporates CenteringPregnancy, a group model of prenatal care, Positive Youth Development components, and male involvement. The evaluation examines the effectiveness of the intervention in enhancing health, educational and psychosocial outcomes among pregnant adolescents. Conclusions: The present program was designed to address an important gap in evidence-based interventions targeting pregnant adolescents and their partners

High Prevalence of Hepatitis B Virus Markers in Romanian Adolescents With Human Immunodeficiency Virus Infection

<p>Abstract</p> <p>Background</p> <p>We evaluated the frequency of hepatitis coinfection in Romanian adolescents who were diagnosed with human immunodeficiency virus (HIV) infection prior to 1995.</p> <p>Methods</p> <p>One hundred sixty-one adolescents (13–18 years of age) with symptomatic HIV infection, but without signs of hepatic dysfunction, and 356 age-matched, HIV-uninfected controls underwent laboratory testing for markers of parenterally acquired hepatitis virus infection.</p> <p>Results</p> <p>Seventy-eight percent of HIV-infected adolescents had markers of past or present hepatitis B virus (HBV) infection, as compared with 32% of controls (<it>P </it>= .0001). The prevalence of HBV replicative markers was more than 5-fold higher in HIV-infected adolescents as compared with controls: 43.4% vs 7.9% (<it>P </it>= .0001), respectively, for hepatitis B surface antigen (HBsAg); and 11.2% vs 2.2% (<it>P </it>= .0001), respectively, for hepatitis B e antigen (HBeAg). The prevalence of HBsAg chronic carriers and the presence of HBV replicative markers was significantly higher in patients with immunologically defined AIDS (CD4+ cell counts < 200 cells/mcL): 59.6% vs 34.6% (<it>P </it>= .02) for HBsAg and 22.8% vs 5.7%, (<it>P </it>= .002) for HBV DNA. After 1 year of follow-up, the proportion of those who cleared the HBeAg was considerably lower in severely immunosuppressed coinfected patients: 4.7% vs 37.1% (<it>P </it>= .003). Four additional HIV-infected adolescents became HBsAg-positive over the term of follow-up (incidence rate, 24.9/1000 person-years), despite a record of immunization against hepatitis B.</p> <p>Conclusion</p> <p>A substantial percentage of HIV-infected and HIV-uninfected Romanian adolescents have evidence of past or present HBV infection. In HIV-infected adolescents, the degree of immunosuppression is correlated with persistence of HBV replicative markers, even in the absence of clinical or biochemical signs of liver disease.</p

High Prevalence of Hepatitis B Virus Markers in Romanian Adolescents With Human Immunodeficiency Virus Infection

<p>Abstract</p> <p>Background</p> <p>We evaluated the frequency of hepatitis coinfection in Romanian adolescents who were diagnosed with human immunodeficiency virus (HIV) infection prior to 1995.</p> <p>Methods</p> <p>One hundred sixty-one adolescents (13–18 years of age) with symptomatic HIV infection, but without signs of hepatic dysfunction, and 356 age-matched, HIV-uninfected controls underwent laboratory testing for markers of parenterally acquired hepatitis virus infection.</p> <p>Results</p> <p>Seventy-eight percent of HIV-infected adolescents had markers of past or present hepatitis B virus (HBV) infection, as compared with 32% of controls (<it>P </it>= .0001). The prevalence of HBV replicative markers was more than 5-fold higher in HIV-infected adolescents as compared with controls: 43.4% vs 7.9% (<it>P </it>= .0001), respectively, for hepatitis B surface antigen (HBsAg); and 11.2% vs 2.2% (<it>P </it>= .0001), respectively, for hepatitis B e antigen (HBeAg). The prevalence of HBsAg chronic carriers and the presence of HBV replicative markers was significantly higher in patients with immunologically defined AIDS (CD4+ cell counts < 200 cells/mcL): 59.6% vs 34.6% (<it>P </it>= .02) for HBsAg and 22.8% vs 5.7%, (<it>P </it>= .002) for HBV DNA. After 1 year of follow-up, the proportion of those who cleared the HBeAg was considerably lower in severely immunosuppressed coinfected patients: 4.7% vs 37.1% (<it>P </it>= .003). Four additional HIV-infected adolescents became HBsAg-positive over the term of follow-up (incidence rate, 24.9/1000 person-years), despite a record of immunization against hepatitis B.</p> <p>Conclusion</p> <p>A substantial percentage of HIV-infected and HIV-uninfected Romanian adolescents have evidence of past or present HBV infection. In HIV-infected adolescents, the degree of immunosuppression is correlated with persistence of HBV replicative markers, even in the absence of clinical or biochemical signs of liver disease.</p

Human adipose tissue as a reservoir for memory CD4\u3csup\u3e+\u3c/sup\u3e T cells and HIV

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. Objective: The objective of this study is to determine whether adipose tissue functions as a reservoir for HIV-1. Design: We examined memory CD4+ T cells and HIV DNA in adipose tissue-stromal vascular fraction (AT-SVF) of five patients [four antiretroviral therapy (ART)-treated and one untreated]. To determine whether adipocytes stimulate CD4+ T cells and regulate HIV production, primary human adipose cells were cocultured with HIV-infected CD4+ T cells. Methods: AT-SVF T cells were studied by flow cytometry, and AT-SVF HIV DNA (Gag and Env) was examined by nested PCR and sequence analyses. CD4+ T-cell activation and HIV production were measured by flow cytometry and ELISA. Results: AT-SVF CD3+ T cells were activated (\u3e60% CD69+) memory CD4+ and CD8+ T cells in uninfected andHIV-infected persons, but the AT-SVF CD4+/CD8+ ratiowas lower in HIV patients. HIVDNA(Gag and Env)was detected in AT-SVF of all five patients examined by nested PCR, comparably to other tissues [peripheral blood mononuclear cell (PBMC), lymph node or thymus]. In coculture experiments, adipocytes increased CD4+ T-cell activation and HIV production approximately two to three-fold in synergy with gammachain cytokines interleukin (IL)-2, IL7 or IL15. These effects were mitigated by neutralizing antibodies against IL6 and integrin-a1b1. Adipocytes also enhanced T-cell viability. Conclusion: Adipose tissues of ART-treated patients harbour activated memory CD4+ T cells and HIV DNA. Adipocytes promote CD4+ T-cell activation and HIV production in concert with intrinsic adipose factors. Adipose tissue may be an important reservoir for HIV

Lymphotropism of Merkel Cell Polyomavirus Infection, Nova Scotia, Canada

Lymphoid cells may be a site for virus persistence

Self-Assessed Female Maturation Stages: A Research Tool

Wide variations in growth and maturation exist; thus, chronological age does not provide instructive descriptive information. A selfassessment method for rating pubertal stage was incorporated in a field study to assess its use for population research of children and adolescents. Anthropometric and sociodemographic data from 142 black and 361 white girls, ages seven through 18, were collected. Similar proportions of subjects in this study were classified by self-assessment, at the five stages of breast development and pubic hair growth, as subjects classified by direct physician assessment in previous studies. This simple and quick method for pubertal rating should be considered for inclusion in all studies of children and adolescents

The Mitigating Effect of Low Firearm Background Check Requirements on Firearm Homicides in Border States

BACKGROUND: Firearm-related violence is a significant public health issue in the US. Research has found an increase in guns used in crimes sourced from low gun law states into high gun law states. The purpose of this study is to evaluate the effect of distance from states without universal background checks (UBC), background checks at shows (BCS), or permit to purchase (PTP) laws on firearm homicide rates in states with them. METHODS: States were identified based on their enactment of laws that are designed to prevent the private sale of firearms to criminals. Demographic data for each county were obtained for the years 2014 through 2017. The border distance from a county in a state with the evaluated gun laws to the nearest border state without the gun laws was obtained using Google Maps. Multiple regression analyses were performed to test the relationship between border distance and firearm homicide rates. RESULTS: The regression model evaluating all formats found the border distance was negatively associated with firearm homicides (p=.009). The parameter estimate indicated as border distance increased, the firearm homicide rate decreased. When counties with UBC or PTP on all guns were evaluated separately from all formats model, the statistical significance was lost (p=.62). In counties where all handgun sales either require a background check or a PTP is required, the distance was also not statistically significant (p=.11). CONCLUSIONS: This study provides evidence that there may be a mitigating effect on the reduction of firearm homicides in states that require background checks or PTP on private sales when there is a state in close proximity that did not have these laws. Limited counties at certain distances may have contributed to the insignificant findings in other models

Geographic Differences and Trends in Birth Outcomes 2009-2014: Northeast Tennessee vs Tennessee

Literature provides evidence for disparities and inequities in health and birth outcomes based on geographical location, which highlight differential mother characteristics. These differences influence behaviors associated with adverse birth outcomes such as premature birth and low birth weight (LBW), the leading causes of infant morbidity and mortality. Consistent with the Healthy People 2020 and Millennium Development goal, to reduce infant morbidity and mortality rates, we sought to compare maternal characteristics and behaviors and the occurrence of adverse birth outcomes in Northeast (NETN) region, as defined by the Tennessee Department of Health, compared to the rest of Tennessee (TN). TN vital statistics birth record data for the years 2009 - 2014 were used in this analysis; n = 20,786 and 482,681 live births for NETN and TN respectively. Bivariate analyses were performed to deduce the demographic and birth characteristics and their proportions across the years. Logistic regression was used to calculate crude odds ratios for pre-pregnancy smokers, with the dependent variables of preterm birth and LBW. We followed with adjusted odds ratios, which controlled for mother’s demographic variables; age, education years and reported household income and mother’s behavioral characteristics; pre-pregnancy cigarette smoking, prenatal care by first trimester and previous preterm birth. From 2009 through 2014, the percentage of teenage mothers decreased for both TN groups, with a larger proportion in NETN (%:13.8,12.2,12.5, 11.9,9.6,9.4) compared to TN (%:12.8,11.8,10.8,10.0,9.0,8.4). A larger percentage of TN mothers did not have a high school degree or completed GED compared to NETN. A larger proportion of NETN mothers were married at the time of birth of the infant (%:60.3,60.5,59.3,58.6,57.6,57.8) compared to TN mothers (%:55.5,55.9,55.9,55.8,56.0,56.0). Over the period, 34% of NETN women smoked during the 3 months prior to pregnancy versus 21% for TN mothers. Through the third trimester 24% of NETN mothers reported cigarette smoking compared to 13% of TN mothers. Throughout, more adverse birth outcomes were observed in NETN. Compared to non-smokers, for six consecutive years and overall, the odds of a LBW among pre-pregnancy smoking mothers were higher in NETN (odds ratio (OR):2.16,1.73,2.56,2.03, 2.02,1.83,2.05) than in TN (OR:1.51,1.53,1.56,1.56,1.56,1.52,1.54), p-value