Effect of Food on the Steady-State Pharmacokinetics of Tenofovir and Emtricitabine plus Efavirenz in Ugandan Adults

We investigated the effect of food on the steady-state pharmacokinetics of a proprietary fixed-dose combination (FDC) tablet containing tenofovir disoproxil fumarate (TDF)/emtricitabine/efavirenz. Fifteen Ugandan HIV-1 patients at steady-state dosing with TDF/emtricitabine/efavirenz were admitted for 24-hour intensive pharmacokinetic sampling after dosing in the fasting state. Blood sampling was repeated seven days later with TDF/emtricitabine/efavirenz administered with food (19 g fat). Drug concentrations in plasma were determined by liquid chromatography and tandem mass spectrometry. Geometric mean ratios (GMRs) and confidence intervals (CIs) of parameters were calculated (reference, fasting). For efavirenz, GMRs (90% CIs) for Cmax, AUC0−24, and C24 were 1.47 (1.24–1.75), 1.13 (1.03–1.23), and 1.01 (0.91–1.11), respectively. Corresponding GMRs were 1.04 (0.84–1.27), 1.19 (1.10–1.29), and 0.99 (0.82–1.19) for tenofovir, 0.83 (0.76–0.92), 0.87 (0.78–0.97), and 0.91 (0.73–1.14) for emtricitabine. Stable patients may take the FDC without meal restrictions. The FDC should be taken without food by patients experiencing central nervous system toxicities

Endorsement of growth factors and its relation to stage of group development in experiential groups

This dissertation utilized critical incidents methodology to examine participants\u27 endorsement of twelve primary growth factors during a Master\u27s level group counseling class. Additionally, the study examined whether some factors are more salient than others at each stage of development (i.e., forming, storming, norming, performing) as defined by Tuckman (1965). Although the counseling field has placed considerable emphasis on the importance of personal growth and awareness in the training of mental health professionals (Council for the Accreditation of Counseling and Related Educational Programs [CACREP], 2009), the counselor education literature remains heavily reliant on theory and anecdotal evidence to explain issues that influence trainees\u27 personal growth and awareness. The experiential group training has received wide acceptance as one of the effective means of facilitating the personal growth and awareness of trainees (Kline et al., 1997; Lennie, 2007; Merta, Johnson, & McNeil, 1995; Osborn et al. 2003; Payne, 1999; Yalom & Leszcz, 2005). However, there is much little research identifying the specific factors that are helpful in promoting the personal growth and awareness of student participants. Further, few of the available empirical studies have used a group development perspective in their investigation of such factors. The participants in this study were 27 students enrolled in master\u27s-level group work courses and four group facilitators at three CACREP-accredited counseling programs in the northeastern United States. Each student participant completed a weekly journal entry, termed critical incident questionnaire, over the course of the semester; while group facilitators completed a group development checklist following each group session. Critical incidents were then analyzed and coded by growth factor. Identified growth factors were then examined for their relative salience during the four stages of group development outlined in Tuckman\u27s (1965) model. Results indicated that the twelve growth factors accounted for 86% of the total number of critical incidents that participants reported as influencing their personal growth and awareness during the group experience. Two other factors, Outside Dynamics (OD) and Regular Attendance and Active Participation (RA), emerged and formed a secondary factors category, accounting for 100% of all the critical incidents. Tuckman\u27s (1965) proposed stages of forming, storming, norming, and performing and the sequential nature of his model were partially supported. Results also showed that participants\u27 endorsement of growth factors varied across stages of group development. The relative salience of growth factors varied as a function of both stage of development and time in the group. Within the forming stage, both Universality and facilitator Interventions emerged as the most salient factors. Vicarious Modeling and Dealing with Conflict were the two most salient factors during the storming stage. Within the norming stage, Cohesiveness/Bonding and Genuineness/Authenticity were the most salient factors. Self-Disclosure and Validation/Acceptance were the most salient factors during the performing stage. Implications for training and future research on growth factors in experiential groups in relation to group development are discussed

Crisis and Trauma Intervention Strategies for Healthcare and Law Enforcement Professionals

Presented for the Makerere University School of Psychology in Kampala, Uganda, July 2018