Global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017

Background Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980–2017 and forecast these estimates to 2030 for 195 countries and territories. Methods We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package—a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce age-sex-specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections. Findings Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87–2·04) and has since decreased to 0·95 million deaths (0·91–1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79–3·67) and since then have gradually decreased to 1·94 million (1·63–2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8–39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets. Interpretation Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact

Evaluation of well-being at work among nursing professionals at a University Hospital Evaluación del bienestar en el trabajo entre los profesionales de enfermería de un hospital universitario Avaliação do bem-estar no trabalho entre profissionais de enfermagem de um hospital universitário

Well-being at work is based on Positive Psychology, and is defined as a psychological state with positive affective links towards work and also towards the organisation. The purpose of this study was to look at the degree of well-being at work among nursing professionals who work at a University hospital and also identify differences between occupational categories and types of work contracts. The sample was made up of 340 professionals who answered valid scales of the following constructs: Work Satisfaction, Involvement with Work and Affective Organisational Commitment. For the analysis of the data we used SPSS, version 12, for descriptive statistics, and also for testing differences between means. The results showed an average level of well-being in the workplace and also differences between professional categories and work regime, when it comes to satisfaction with salaries and promotions, which can have a reflection in the quality of service provided to the patients of this University hospital.<br>Bienestar en el trabajo se apoya en la Psicología Positiva, siendo definido como un estado psicológico compuesto por vínculos afectivos positivos con el trabajo y con la organización. Este estudio tuvo por objetivo conocer el nivel de bienestar en el trabajo de profesionales de enfermería que actúan en un hospital universitario e identificar diferencias entre categorías ocupacionales y tipos de contrato de trabajo. La muestra fue compuesta por 340 profesionales que contestaron escalas válidas de los constructos: Satisfacción en el Trabajo, Envolvimiento con el Trabajo y Comprometimiento Organizacional Afectivo. Para análisis de los datos se utilizó el programa SPSS, versión 12, para efectuar estadísticas descriptivas y testes de diferencia entre medias. Los resultados indicaron nivel medio de bienestar en el trabajo y diferencias entre las categorías profesionales y régimen de contratación en cuanto a la satisfacción con salario y promociones, lo que puede reflejar en la calidad del servicio prestado a los pacientes del hospital universitario.<br>Bem-estar no trabalho apoia-se na Psicologia Positiva, sendo definido como um estado psicológico composto por vínculos afetivos positivos com o trabalho e com a organização. Este estudo teve por objetivo conhecer o nível de bem-estar no trabalho de profissionais de Enfermagem que atuam em um hospital universitário e identificar diferenças entre categorias ocupacionais e tipos de contrato de trabalho. A amostra foi composta por 340 profissionais que responderam a escalas válidas dos construtos: Satisfação no Trabalho, Envolvimento com o Trabalho e Comprometimento Organizacional Afetivo. Para análise dos dados utilizou-se o programa SPSS, versão 12, a fim de efetuar estatísticas descritivas e testes de diferença entre médias. Os resultados indicaram nível médio de bem-estar no trabalho e diferenças entre as categorias profissionais e regime de contratação quanto à satisfação com salário e promoções, o que pode refletir na qualidade do atendimento prestado aos pacientes do hospital universitário

Productivity of determinate growth tomato lines tolerant to heat under the organic system Produtividade de linhagens de tomate rasteiro tolerantes ao calor sob o sistema orgânico

The objective of the present work was to evaluate the productive response of heat tolerant lines of determinate growth tomato under the organic production system. The experiment was carried out in the Instituto de Ciências Agrárias of UFMG, Montes Claros, Minas Gerais state, Brazil. The experimental design was of randomized complete blocks with eight treatments and four replications. The treatments consisted of eight heat tolerant processing type tomato lines obtained from the Asian Vegetable Research and Development Center (AVRDC), China: CLN1621L, CLN1621F, CLN1621E, CLN1466P, CLN2026E, CLN2026D, CLN2026C and CLN2001C. There was an inverse relationship between the average weight of the fruits and the number of fruits per plant. The highest average fruit weight of some lines was compensated by the lowest quantity of fruits, in such a way that there were no significant differences among the lines. Symptoms of nutritional deficiency and incidences of pests and diseases were not verified in any of the studied lines. All lines presented potential for genetic improvement research and cultivation using organic production systems under higher temperature conditions.<br>O objetivo do presente trabalho foi avaliar o desempenho produtivo de linhagens de tomate rasteiro tolerantes ao calor sob o sistema orgânico de produção. O experimento foi realizado no Núcleo de Ciências Agrárias da UFMG, Montes Claros-MG. Foi utilizado o delineamento em blocos casualizados com oito tratamentos e quatro repetições. Os tratamentos consistiram de oito linhagens de tomate do tipo rasteiro tolerantes ao calor obtidos na Asian Vegetable Research and Development Center (AVRDC), China: CLN1621L, CLN1621F, CLN1621E, CLN1466P, CLN2026E, CLN2026D, CLN2026C e CLN2001C. Houve uma relação inversa entre o peso médio dos frutos e o número de frutos produzidos por planta. O maior peso médio de frutos de algumas linhagens foi compensado pelo menor número de frutos, de tal forma que não houve diferenças significativas entre as linhagens. Não foram constatados sintomas de deficiência nutricional e incidências de pragas e doenças nas linhagens estudadas. Todas as linhagens apresentam potencial para pesquisas de melhoramento genético e cultivo em sistemas orgânicos de produção em condições de temperatura mais elevada