Barriers and facilitators of adherence to TB treatment in patients on concomitant TB and HIV treatment: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Tuberculosis is a major public health problem in Ethiopia, and a high number of TB patients are co-infected with HIV. There is a need for more knowledge about factors influencing treatment adherence in co-infected patients on concomitant treatment. The aim of the present study is to explore patients' and health care professionals' views about barriers and facilitators to TB treatment adherence in TB/HIV co-infected patients on concomitant treatment for TB and HIV.</p> <p>Methods</p> <p>Qualitative study using in-depth interviews with 15 TB/HIV co-infected patients and 9 health professionals and focus group discussions with 14 co-infected patients.</p> <p>Results</p> <p>We found that interplay of factors is involved in the decision making about medication intake. Factors that influenced adherence to TB treatment positively were beliefs in the curability of TB, beliefs in the severity of TB in the presence of HIV infection and support from families and health professionals. Barriers to treatment adherence were experiencing side effects, pill burden, economic constraints, lack of food, stigma with lack of disclosure, and lack of adequate communication with health professionals.</p> <p>Conclusion</p> <p>Health professionals and policy makers should be aware of factors influencing TB treatment in TB/HIV co-infected patients on concomitant treatment for TB and HIV. Our results suggest that provision of food and minimal financial support might facilitate adherence. Counseling might also facilitate adherence, in particular for those who start ART in the early phases of TB treatment, and beliefs related to side-effects and pill burden should be addressed. Information to the public may reduce TB and HIV related stigma.</p

Cognitive control of intentions for voluntary actions in individuals with a high level of autistic traits

Contains fulltext : 102383.pdf (publisher's version ) (Open Access)Impairments in cognitive control generating deviant adaptive cognition have been proposed to account for the strong preference for repetitive behavior in autism. We examined if this preference reflects intentional deficits rather than problems in task execution in the broader autism phenotype using the Autism-Spectrum Quotient (AQ). Participants chose between two tasks differing in their relative strength by indicating first their voluntary task choice and then responding to the subsequently presented stimulus. We observed a stronger repetition bias for the harder task in high AQ participants, with no other differences between the two groups. These findings indicate that the interference between competing tasks significantly contributes to repetitive behavior in autism by modulating the formation of task intentions when choosing tasks voluntarily.11 p

Managing Workplace Bullying Complaints: Conceptual Influences and the Effects of Contextual Factors

Workplace bullying complaints are commonly utilized as the primary intervention approach for organizations where employees seek to stop inappropriate behaviour or gain redress. No single agreed-upon approach has been forwarded as a best practice for organizations to adopt. Instead, complaints can be viewed as disciplinary matters, health and safety concerns or public disclosures that can be raised through whistleblowing. These different conceptualizations adopt differing terminology and assumptions, which in turn has implications for how bullying is tackled. A critical concern in this area is the high prevalence of bullying reported in academic literature and staff surveys. In contrast, the number of complaints is often much lower indicating significant under-reporting. A range of organizational and individual factors are discussed that may enable and inhibit the efficacy of a complaint process. The means by which the complaint process may act as a negative influence as a form of undermining through raising vexatious complaints, with the intent of undermining the accused perpetrator, are also discussed. A review of these factors will ultimately contribute towards a consideration of what constitutes a successful complaint process and what practices and strategies organizations can adopt to ensure the effective handling of workplace bullying complaints. Finally, future directions for research are also proposed