Impact of ART Use on Labour Force Participation among PLWHA Using ART in Southern Highlands HIV/AIDS Program in Tanzania

This is the retrospective cohort study which was conducted to analyse the impact of ART on labour force participation by 2829 PLWHA using ART at in Tanzania from 2005 to 2011. Quantitative method of research was applied and review of patients’ record was used to collect data. The results revealed that 92.4% of PLWHA registered on ART belong to working age group i.e. 15 – 65 years old (t-statistical value = 4.9 and p - value = 0.0002). There were 92.0% PLWHA who were able to work before ART, but labour force increased to 99.5% after PLWHA initiated on ART (correlation coefficient, r = 0.999, p-value < 0.001). The researcher concluded that majority of PLWHA using ART belongs to the working age group, and ART increases PLWHA labour force participation .The researcher therefore recommended that ART is worth continuing on with the universal population coverage. The study has some limitations as it assessed only one benefits of ART that is labour force participation of PLWHA. Key words: PLWHA, Antiretroviral therapy, labour force participation, resource limited settin

Identification of subgroups of early breast cancer patients at high risk of nonadherence to adjuvant hormone therapy: results of an italian survey.

The aim of this study was the identification of subgroups of patients at higher risk of nonadherence to adjuvant hormone therapy for breast cancer. Using recursive partitioning and amalgamation (RECPAM) analysis, the highest risk was observed in the group of unmarried, employed women, or housewives. This result might be functional in designing tailored intervention studies aimed at improvement of adherence. Background: Adherence to adjuvant endocrine therapy (HT) is suboptimal among breast cancer patients. A high rate of nonadherence might explain differences in survival between clinical trial and clinical practice. Tailored interventions aimed at improving adherence can only be implemented if subgroups of patients at higher risk of poor adherence are identified. Because no data are available for Italy, we undertook a large survey on adherence among women taking adjuvant HT for breast cancer. Patients and Methods: Patients were recruited from 10 cancer clinics in central Italy. All patients taking HT for at least 1 year were invited, during one of their follow-up visit, to fill a confidential questionnaire. The association of sociodemographic and clinical characteristics of participants with adherence was assessed using logistic regression. The RECPAM method was used to evaluate interactions among variables and to identify subgroups of patients at different risk of nonadherence. Results: A total of 939 patients joined the study and 18.6% of them were classified as nonadherers. Among possible predictors, only age, working status, and switching from tamoxifen to an aromatase inhibitor were predictive of nonadherence in multivariate analysis. RECPAM analysis led to the identification of 4 classes of patients with a different likelihood of nonadherence to therapy, the lowest being observed in retired women with a low level of education, the highest in the group of unmarried, employed women, or housewives. Conclusion: The identification of these subgroups of “real life” patients with a high prevalence of nonadherers might be functional in designing intervention studies aimed at improving adherenc

Flash flood mitigation as a positive consequence of anthropogenic forcing on the groundwater resource in a karst catchment

The Mediterranean coastal region is prone to high-intensity rainfall events that are frequently associated with devastating flash floods. This paper discusses the role of a karst aquifer system in the flash floods of a Mediterranean river, the Lez river. Most of the Lez river watershed is located on karst terrains where interactions between surface water and groundwater take place. During extreme rainfall events, the presence of fractures and well-developed karst features in carbonate terrains enhances the infiltration processes and involves the concentration of the recharge into highly organized and permeable flow paths. The groundwater, therefore, quickly moves towards the natural outlets of the karst system. The influence of the Lez karst aquifer system on the associated river floods dynamics is analysed while considering the spatially distributed rainfall, as well as the time series of the groundwater level within the aquifer and of the Lez river discharge measured at various gauging stations. Special attention is given to the relative importance of the surface and underground processes involved in flash flood genesis. It is shown that the karst groundwater contributes to flash floods under certain conditions, while high-rate pumping within the karst aquifer, which generates significant drawdown, may mitigate flash floods under other conditions

Improved understanding of dynamic water and mass budgets of high‐alpine karst systems obtained from studying a well‐defined catchment area

Large areas of Europe, especially in the Alps, are covered by carbonate rocks and in many alpine regions, karst springs are important sources for drinking water supply. Because of their high variability and heterogeneity, the understanding of the hydrogeological functioning of karst aquifers is of particular importance for their protection and utilisation. Climate change and heavy rainfall events are major challenges in managing alpine karst aquifers which possess an enormous potential for future drinking water supply. In this study, we present research from a high‐alpine karst system in the UNESCO Biosphere Reserve Großes Walsertal in Austria, which has a clearly defined catchment and is drained by only one spring system. Results show that (a) the investigated system is a highly dynamic karst aquifer with distinct reactions to rainfall events in discharge and electrical conductivity; (b) the estimated transient atmospheric CO2 sink is about 270 t/a; (c) the calculated carbonate rock denudation rate is between 23 and 47 mm/1000a and (d) the rainfall‐discharge behaviour and the internal flow dynamics can be successfully simulated using the modelling package KarstMod. The modelling results indicate the relevance of matrix storage in determining the discharge behaviour of the spring, particularly during low‐flow periods. This research and the consequent results can contribute and initiate a better understanding and management of alpine karst aquifers considering climate change with more heavy rainfall events and also longer dry periods.The investigated karst system contributes to the transient atmospheric CO2 sink with about 270 t/a. Carbonate denudation rates vary between 23 and 47 mm/1000a. Rainfall‐discharge modelling results indicate the importance of matrix storage particularly during low‐flow periods. imageBundesministerium für Bildung und Forschung http://dx.doi.org/10.13039/501100002347FP7 People: Marie‐Curie Actions http://dx.doi.org/10.13039/10001126

Hospital admission and mortality rates for non-Covid diseases among residents of the long-term care facilities before and during the pandemic: a cohort study in two Italian regions

Aim: Long-term-care facility residents are a vulnerable population who experienced reduced healthcare access during the pandemic. This study aimed to assess the indirect impact of the COVID-19 pandemic, in terms of hospitalisation and mortality rates, among this population in two Italian Regions, Tuscany and Apulia, during 2020 in comparison with the pre-pandemic period. Subject and methods: We conducted a retrospective cohort study on people residing in long-term-care facilities from 1 January 2018 to 31 December 2020 (baseline period: 1 January 2018-8 March 2020; pandemic period: and 9 March-31 December 2020). Hospitalisation rates were stratified by sex and major disease groups. Standardised weekly rates were estimated with a Poisson regression model. Only for Tuscany, mortality risk at 30 days after hospitalisation was calculated with the Kaplan-Meier estimator. Mortality risk ratios were calculated using Cox proportional regression models. Results: Nineteen thousand two hundred and fifty individuals spent at least 7 days in a long-term-care facility during the study period. The overall mean non-Covid hospital admission rate per 100 000 residents/week was 144.1 and 116.2 during the baseline and pandemic periods, with a decrease to 99.7 and 77.3 during the first (March-May) and second lockdown (November-December). Hospitalisation rates decreased for all major disease groups. Thirty-day mortality risk ratios for non-Covid conditions increased during the pandemic period (1.2, 1.1 to 1.4) compared with baseline. Conclusion: The pandemic resulted in worse non-COVID-related health outcomes for long-term-care facilities' residents. There is a need to prioritise these facilities in national pandemic preparedness plans and to ensure their full integration in national surveillance systems. Supplementary information: The online version contains supplementary material available at 10.1007/s10389-023-01925-1

Habitual diet and cardiovascular disease risk factors

INTRODUCTION: A survey by sampling in a county of the State of S. Paulo in 1990 sought, by means of home interviews, to analyse the habitual diet and risk factors for cardiovascular disease of people over 20 years of age. METHODOLOGY: Of the sub-specimen of a comprehensive study population, 557 individuals, aged between 20 and 88, were interviewed. The habitual diet, characterized by the dietary history, was compared with the recommendations on energy and nutrients of the WHO and the risk factors (obesity, lipemic disorders and diabetes mellitus) diagnosed by the Body Mass Index and biochemical measurements. RESULTS AND CONCLUSION: It was observed that 60% of the population consume a diet with total energy below the estimated need and that the caloric contribution of carbohydrates was of 56%, of the lipids 29% and of the proteins 15%. However, by percentil analysis, the caloric contribuition of lipids and of proteins was far above the recommended levels to the detriment of the carbohydrates. Energy, caloric distribution and quantity of cholesterol were satisfactory in only 5% of diets. Among the risk factors for the cardiovascular disease studied, obesity was found to be present in 38% of individuals, lipemic disorders in 26% and diabetes mellitus in 5%. Preponderantly light physical activity together with unsatisfactory diet, both in qualitative as in quantitative terms, aggravated this scenario still further.INTRODUÇÃO: Estudo descritivo por amostragem em munícípio do Estado de São Paulo, Brasil, em 1990, com objetivo de analisar, mediante entrevistas domiciliares, a dieta habitual e fatores de risco para doenças cardiovasculares em indivíduos maiores de 20 anos. METODOLOGIA: Foram entrevistados 557 indivíduos, de idade entre 20 e 88 anos, que fazem parte de subamostra de um estudo global na região. A dieta habitual, identificada pelo histórico alimentar foi comparada às recomendações da OMS e os fatores de risco estudados (obesidade, dislipidemias, diabetes melito) diagnosticados pelo Índice de Massa Corpórea e dosagens bioquímicas. RESULTADOS E CONCLUSÕES: Observou-se que 60% da população consome dieta com energia total abaixo da estimativa das necessidades e que a contribuição calórica dos carboidratos foi de 56%, dos lipídios de 29% e das proteínas de 15%. Entretanto, na análise por percentil, a contribuição calórica dos lipídios e das proteínas encontra-se muito acima dos padrões recomendados em detrimento dos carboidratos. A energia, distribuição calórica e quantidade de colesterol foi adequada em apenas 5% das dietas. Dentre os fatores de risco para doenças cardiovasculares estudados observou-se a prevalência de obesidade em 38% dos indivíduos, de dislipidemias em 26% e de diabetes melito em 5%. A atividade física leve preponderante com dieta inadequada, tanto em termos de qualitativos quanto quantitativos, agravam ainda mais esse quadro

NLOAD : an interactive, web-based modeling tool for nitrogen management in estuaries

Author Posting. © Ecological Society of America, 2007. This article is posted here by permission of Ecological Society of America for personal use, not for redistribution. The definitive version was published in Ecological Applications 17, Supple. (2007): S17–S30, doi:10.1890/05-1460.1.Eutrophication of estuaries is an increasing global concern that requires development of new tools to identify causes, quantify conditions, and propose management options that address this environmental problem. Since eutrophication is often associated with increased inputs of land-derived nitrogen to estuaries, we developed NLOAD, a user-friendly, web-based tool that brings together six different published models that predict nitrogen loading to estuaries and two models that estimate nitrogen concentrations in coastal waters. Here we describe each of the models, demonstrate how NLOAD is designed to function, and then use the models in NLOAD to predict nitrogen loads to Barnegat Bay, New Jersey (USA). The four models that we used to estimate nitrogen loads to Barnegat Bay, when adjusted, all had similar results that matched well with measured values and indicated that Barnegat Bay receives roughly 26 kg N·ha−1·yr−1. Atmospheric deposition was the dominant source of nitrogen to Barnegat Bay, followed by fertilizer nitrogen. Wastewater in Barnegat Bay is diverted to an offshore outfall and contributes no nitrogen to the system. The NLOAD tool has an additional feature that allows managers to assess the effectiveness of a variety of management options to reduce nitrogen loads. We demonstrate this feature of NLOAD through simulations in which fertilizer inputs to the Barnegat Bay watershed are reduced. Even modest cutbacks in the use of fertilizers on agricultural fields and lawns can be shown to reduce the amount of N entering Barnegat Bay.Support for the NLOAD tool came from the Cooperative Institute for Coastal and Estuarine Environmental Technologies (CICEET, CICEET-UNH grants #02-610 and #04-833). Additional funding was received from Environmental Defense

MiRNA dysregulation underlying common pathways in type 2 diabetes and cancer development. an Italian Association of Medical Oncology (AIOM)/Italian Association of Medical Diabetologists (AMD)/Italian Society of Diabetology (SID)/Italian Society of Endocrinology (SIE)/Italian Society of Pharmacology (SIF) multidisciplinary critical view

Increasing evidence suggests that patients with diabetes, particularly type 2 diabetes (T2D), are characterized by an increased risk of developing different types of cancer, so cancer could be proposed as a new T2D-related complication. On the other hand, cancer may also increase the risk of developing new-onset diabetes, mainly caused by anticancer therapies. Hyperinsulinemia, hyperglycemia, and chronic inflammation typical of T2D could represent possible mechanisms involved in cancer development in diabetic patients. MicroRNAs (miRNAs) are a subset of non-coding RNAs, ⁓22 nucleotides in length, which control the post-transcriptional regulation of gene expression through both translational repression and messenger RNA degradation. Of note, miRNAs have multiple target genes and alteration of their expression has been reported in multiple diseases, including T2D and cancer. Accordingly, specific miRNA-regulated pathways are involved in the pathogenesis of both conditions. In this review, a panel of experts from the Italian Association of Medical Oncology (AIOM), Italian Association of Medical Diabetologists (AMD), Italian Society of Diabetology (SID), Italian Society of Endocrinology (SIE), and Italian Society of Pharmacology (SIF) provide a critical view of the evidence about the involvement of miRNAs in the pathophysiology of both T2D and cancer, trying to identify the shared miRNA signature and pathways able to explain the strong correlation between the two conditions, as well as to envision new common pharmacological approaches