Preventing human immunodeficiency virus infection among sexual assault survivors in Cape Town, South Africa: an observational study.

We describe 131 South African sexual assault survivors offered HIV post-exposure prophylaxis (PEP). While the median days completed was 27 (IQR 27, 28), 34% stopped PEP or missed doses. Controlling for baseline symptoms, PEP was not associated with symptoms (OR = 1.30, 95% CI = 0.66, 2.64). Factors associated with unprotected sex included prior unprotected sex (OR = 6.46, 95% CI = 3.04, 13.74), time since the assault (OR = 1.33, 95% CI = 1.12, 1.57) and age (OR = 1.30, 95% CI = 1.08, 1.57). Trauma counseling was protective (OR = 0.18, 95% CI = 0.05, 0.58). Four instances of seroconversion were observed by 6 months (risk = 3.7%, 95% CI = 1.0, 9.1). Proactive follow-up is necessary to increase the likelihood of PEP completion and address the mental health and HIV risk needs of survivors. Adherence interventions and targeted risk reduction counseling should be provided to minimize HIV acquisition

Feasibility of Cell Phone Surveys in People with Mental Illness Experiencing Homelessness During COVID-19

People experiencing homelessness (PEH) may be at increased risk for negative physical and mental health outcomes in the context of community spread of COVID-19. Research into the impacts of COVID-19 on this vulnerable population can be affected by inaccessibility and poor engagement resulting in minimal representation in population-based survey data. The increased use of mobile phone technology (mHealth) to provide medical and psychiatric care during the COVID-19 pandemic could provide an effective platform for gathering data from this hard-to-reach group. This paper examines feasibility, via review of the barriers and facilitators, of using a mobile phone intervention to administer a series of surveys. Data collected via mHealth includes health behaviors and health awareness, access to services, and mental health symptoms in the context of the COVID-19 pandemic among a sample of 30 PEH. At the end of the six month study, 11 (36.7%) participants completed the full study protocol while 19 (63.3%) partially completed the study. There was a significant difference in completion rates based on whether participants were unsheltered-homeless or sheltered-homeless. The study was rated highly by fully compliant participants in measures of acceptability and usability. Applying principles learned in this pilot study to develop feasible, usable and acceptable means of data gathering through the use of mHealth, can have wider ramifications outside of COVID-19

Greece Takes Its Bailout, but Doubts for the Region Persist

https://www.nytimes.com/2010/05/03/business/global/03drachma.htm

A Submaximal Field Test of Aerobic Capacity does not Accurately Reflect VO2max in Career Firefighters

International Journal of Exercise Science 15(4): 221-230, 2022. Adequate aerobic capacity is crucial to maintaining firefighter safety. The purpose of this study was to compare predicted VO2max scores from a submaximal and maximal step test. Eighteen career male firefighters from a medium sized urban municipality completed both a submaximal Forestry step test and a maximal laboratory WFI step test. A lack of association (p = .017) and low level of agreement (p = .015) was determined between step test protocols producing a mean bias of ± 5.61 mL.kg-1/min-1 with most scores being overestimated. Use of the Forestry step test to predict true VO2max in firefighters should be used with caution when classifying firefighter fitness

Neuropsychological outcomes in adults commencing highly active anti-retroviral treatment in South Africa: a prospective study.

BACKGROUND: Infection with HIV may result in significant neuropsychological impairment, especially in late stage disease. To date, there have been no cohort studies of the impact of highly active anti-retroviral treatment (HAART) in South Africa where clade C HIV is predominant. METHODS: Participants in the current study were recruited from a larger study of HIV-associated neurocognitive disorders (HAND) and included a group of individuals commencing HAART (n = 82). Baseline and one-year neuropsychological function was assessed using a detailed battery, and summary global deficit scores (GDS) obtained. Associations with change in GDS were calculated. RESULTS: Participants had a median CD4 cell count of 166 at baseline and 350 at follow-up. There were significant difference across groups of GDS severity at baseline with respect to level of education and GDS change at one year (p = 0.00 and 0.00 respectively). Participants with severe impairment at baseline improved significantly more than those with lesser degrees of impairment. Significant improvements were observed in the domains of attention, verbal fluency, motor function, and executive functions. There were unadjusted associations between GDS change and male gender, lower levels of education, baseline CD4 count and baseline GDS severity. In an adjusted model, only baseline GDS severity (p = 0.00) remained significant, with a lower level of education nearing significance (p = 0.05). The overall model was highly significant (p = 00; r-squared = 0.58). DISCUSSION: In individuals in late stage HIV commencing HAART in South Africa, those with severe baseline neuropsychological impairment improved significantly more than those less impaired. While improvement across a number of neuropsychological domains was observed, high rates of impairment persisted. CONCLUSIONS: The effects of HAART and participant variables, such as test experience, require clarification. Studies with larger comparison groups, and where HIV disease characteristics are needed to establish whether the trends we identified are clinically meaningful

Measures of Anxiety and Mindfulness in Student Pharmacists after Conducting a Relaxation Activity

Student pharmacists experience stress, work overload, and burnout throughout the intensive Doctor of Pharmacy curriculum. In Spring 2016, ninety-five student pharmacists were recruited from Southwestern Oklahoma State University College of Pharmacy to be a part of a study to investigate the potential usefulness of relaxation in improving personal well-being. Study participants were assigned to conduct one of the following activities: body scan, mindful meditation, 4x4 breathing meditation, power posing, or mental stimulation by using the Word Streak mobile app. After conducting the activity and providing saliva samples for evaluation of physiological biomarkers, participants completed validated surveys to assess anxiety (Generalized Anxiety Disorder, GAD-7, and Four System Anxiety Questionnaire, FSAQ) and mindfulness (Kentucky Inventory of Mindfulness Skills, KIMS). In preparation for an upcoming mindfulness study, it was determined that the 2016 survey data was never analyzed. Therefore, our objectives were to examine past levels of anxiety and mindfulness in these student pharmacists, and to evaluate factors such as assigned activity, gender, and year in pharmacy school which could have impacted survey scores. Data were analyzed by Chi-Square tests for categorical data (GAD-7) and non-parametric tests for scores (FSAQ and KIMS) using JASP (Version 0.12.2) [JASP Team (2020), Amsterdam, the Netherlands]. No significant differences (p \u3e 0.05) were found when evaluating the effects of assigned activity on survey results. Anxiety, as measured by GAD-7 illustrated most student pharmacists had mild and minimal anxiety levels (p \u3c 0.001). The FSAQ results suggest student pharmacists overall had highest anxiety levels in the “somatic” category and lowest in the “feeling” category (p \u3c 0.001). As measured by KIMS, the “observe” component of mindfulness was found to be highest in student pharmacists, while their perceived ability to “describe” thoughts, feelings, and sensations was lowest (p \u3c 0.001). Neither gender nor year in pharmacy school significantly impacted KIMS (p \u3e 0.337) or GAD-7 scores (p \u3e 0.323). Within the somatic category of the FSAQ, female student pharmacists experienced higher anxiety as compared to their male counterparts (p = 0.047), and students in their second year of pharmacy school had higher anxiety scores as compared to first-year students (p \u3c 0.015). Findings from Spring 2016 suggest that, while overall anxiety levels were low in student pharmacists, specific components of anxiety and mindfulness could be targeted for improvement. These findings will be compared to the results of current studies as being performed by these researchers, who are investigating the anxiety, mindfulness, and application of relaxation techniques in student pharmacists dealing with the challenges and uncertainty of COVID-19

Healthcare provider knowledge and attitudes about pre-exposure prophylaxis (PrEP) in pregnancy in Cape Town, South Africa.

Pre-exposure prophylaxis (PrEP) in pregnancy can reduce HIV incidence and vertical transmission. Healthcare providers (HCPs) play a critical role in delivering PrEP in antenatal care but little is known about HCP knowledge and attitudes about PrEP in pregnancy. We conducted a qualitative study in two healthcare facilities to assess HCPs PrEP knowledge and perspectives relating to HIV prevention in pregnant women. Between January-March19, we administered in-depth interviews among antenatal HCPs. We utilized a constant comparison approach to identify major qualitative findings. We enrolled 35 female HCPs (median age=43yrs. Fewer than half of HCPs had heard of PrEP before. Of those who had heard of PrEP, most felt that it was safe to take during pregnancy. Most HCPs described inaccurate PrEP knowledge regarding effectiveness, and most who knew about PrEP lacked clinical detail. HCPs highlighted important potential barriers to maternal PrEP use including: fear that PrEP may be unsafe, or belief that women must talk to partners/parents before initiating PrEP. Facilitators include good knowledge about serodiscordancy and vulnerability to seroconversion in pregnancy and desire to help women gain control overHIV prevention. We recommend integrating PrEP training into HIV testing and PMTCT nurse training to improve counseling and maternal PrEP delivery

Effect of volcanic aerosol on stratospheric NO₂ and N₂O₅ from 2002-2014 as measured by Odin-OSIRIS and Envisat-MIPAS

Following the large volcanic eruptions of Pinatubo in 1991 and El Chichón in 1982, decreases in stratospheric NO₂ associated with enhanced aerosol were observed. The Optical Spectrograph and Infrared Imaging Spectrometer (OSIRIS) measured the widespread enhancements of stratospheric aerosol following seven volcanic eruptions between 2002 and 2014, although the magnitudes of these eruptions were all much smaller than the Pinatubo and El Chichón eruptions. In order to isolate and quantify the relationship between volcanic aerosol and NO₂, NO₂ anomalies were calculated using measurements from OSIRIS and the Michelson Interferometer for Passive Atmospheric Sounding (MIPAS). In the tropics, variability due to the quasi-biennial oscillation was subtracted from the time series. OSIRIS profile measurements indicate that the strongest anticorrelations between NO₂ and volcanic aerosol extinction were for the 5 km layer starting  ∼  3 km above the climatological mean tropopause at the given latitude. OSIRIS stratospheric NO₂ partial columns in this layer were found to be smaller than background NO₂ levels during these aerosol enhancements by up to  ∼  60 % with typical Pearson correlation coefficients of R ∼ −0. 7. MIPAS also observed decreases in NO₂ partial columns during periods affected by volcanic aerosol, with percent differences of up to  ∼  25 % relative to background levels. An even stronger anticorrelation was observed between OSIRIS aerosol optical depth and MIPAS N₂O₅ partial columns, with R ∼ −0. 9, although no link with MIPAS HNO3 was observed. The variation in OSIRIS NO₂ with increasing aerosol was found to be consistent with simulations from a photochemical box model within the estimated model uncertainty