Bringing social context into global biomedical HIV cure-related research: An urgent call to action

Advances in science have ushered in a wave of new potential curative and control strategies for HIV that could eliminate the current requirement for life-long antiretroviral therapy (ART) for people living with HIV (PLWH). In this article, we argue that it is critical to consider social contexts in the development of HIV cure trial protocols. The biological and behavioral risk factors for HIV acquisition by study participants are inseparable from the social context in which these participants live. The article discusses an example of a cohort established to further HIV cure research that included social context, called the FRESH Acute HIV study, which combines a sociostructural intervention while conducting HIV prevention, treatment and cure-related research in Durban, South Africa. We make an urgent call to action to include sociobehavioral components as instrumental in future HIV cure trials in global context

If someone cares about you, you are more apt to come around: improving HIV care engagement by strengthening the patient–provider relationship

Troy J Wood,1 Kimberly A Koester,2 Katerina A Christopoulos,3 John A Sauceda,1 Torsten B Neilands,1 Mallory O Johnson1 1Department of Medicine, University of California, San Francisco, CA, USA; 2AIDS Policy Research Center, Department of Medicine, University of California, San Francisco, CA, USA; 3Zuckerberg San Francisco General Hospital, Division of HIV, ID and Global Medicine, University of California, San Francisco, CA, USA Purpose: The patient–provider relationship is a central factor that can promote or hinder long-term engagement in care among people living with chronic illnesses. In this paper, we explore characteristics of the patient–provider relationship that facilitated or hindered engagement in care among patients receiving care at HIV specialty clinics.Patients and methods: We conducted 6 focus group discussions with a total of 43 well-retained and less well-retained HIV+ patients in San Francisco, Seattle, and Birmingham, to elicit a wide range of perspectives on engagement in HIV care. Borrowing from the field of psychotherapy, we examined patient–provider relationship characteristics through the lens of the therapeutic alliance, and with regard to their therapeutic efficacy and impact on patient engagement.Results: The majority of participants emphasized how a strong patient–provider relationship defined by trust, intimacy, and collaboration promoted engagement, while a weak patient–provider relationship impeded engagement.Conclusion: We discuss practical strategies and therapeutic techniques that may be helpful to providers in building strong patient–provider relationship and contend that a strong patient–provider relationship is crucial for patients to feel cared for during clinical encounters, which can promote long-term and sustained engagement in HIV care. Keywords: focus groups, engagement in care, therapeutic alliance, psychotherapy, HIV, HIV care&nbsp

Maxillary sinus balloon lifting and deferred implantation of 50 osseointegrated implants: a prospective, observational, non-controlled study

The aim of this study was to assess the effectiveness of minimally invasive antral membrane balloon elevation (MIAMBE). Twenty-seven patients with severe resorption of the posterior maxilla were treated by balloon catheter-assisted sinus lift procedure with deferred implant placement. Panoramic radiographs and computed tomography scans were obtained prior to surgery and at 6 months after surgery, before implantation. Data collected following surgery included inflammation, pain, bleeding, infection, and haematoma. Pain and inflammation were recorded using a six-point verbal rating scale (VRS). The patients were followed up for an average of 15 months. The initial sinus floor height was measured for each planned implant and compared with the height at 6 months post-surgery. The average bone height gain was 8.10 ± 3.45 mm (range 0.5–13.95 mm). Inflammation on the VRS ranged from 0 to 3 (mean 0.97 ± 0.85), while pain ranged from 0 to 4 (mean 0.87 ± 1.19). There was a perforation of the Schneiderian membrane smaller than 2 mm in one case. In another case, the balloon lift procedure had to be aborted and changed to the conventional Tatum technique due to breakage of the balloon inside the sinus. The results of this study show the balloon sinus lift technique to be an easy procedure to perform, with apparently low rates of inflammation and pain, and to provide sufficient quantity and quality of bone for the placement of osseointegrated implants.Depto. de Especialidades Clínicas OdontológicasFac. de OdontologíaTRUEpu

Scaling, rotation, and channeling behavior of helical and skyrmion spin textures in thin films of Te-doped Cu<inf>2</inf>OSeO<inf>3</inf>

Topologically nontrivial spin textures such as vortices, skyrmions, and monopoles are promising candidates as information carriers for future quantum information science. Their controlled manipulation including creation and annihilation remains an important challenge toward practical applications and further exploration of their emergent phenomena. Here, we report controlled evolution of the helical and skyrmion phases in thin films of multiferroic Te-doped Cu2OSeO3 as a function of material thickness, dopant, temperature, and magnetic field using in situ Lorentz phase microscopy. We report two previously unknown phenomena in chiral spin textures in multiferroic Cu2OSeO3: anisotropic scaling and channeling with a fixed-Q state. The skyrmion channeling effectively suppresses the recently reported second skyrmion phase formation at low temperature. Our study provides a viable way toward controlled manipulation of skyrmion lattices, envisaging chirality-controlled skyrmion flow circuits and enabling precise measurement of emergent electromagnetic induction and topological Hall effects in skyrmion lattices

Understanding the challenges to the safe delivery of care in the Mexican healthcare system

Safety and quality challenges have been identified by national and global organizations highlighting the need for health sector improvements in Mexico. The current research investigates healthcare workers’ perspectives of factors affecting their job performance and wellbeing, ability to provide effective care and overall patient safety culture within a public hospital in Guadalajara. A total of 30 hospital staff took part in a card sorting task to elicit the perceived impact of eight pre-identified organizational factors. Results showed that healthcare workers identified the top contributory factors as ‘Finance/budget’ and ‘Resources’. ‘Staff numbers and competency’ was chosen for having more significant impact in delivering safe and effective healthcare, while ‘Communication’ was perceived to have more impact on the way their do their job. The findings from this study helped to identify areas for future applied research projects and provisional direction to the Hospital Quality Managers for targeted improvements projects