Developing and assessing the feasibility of a home-based preexposure prophylaxis monitoring and support program

We piloted PrEP@Home, a preexposure prophylaxis system of remote laboratory and behavioral monitoring designed to replace routine quarterly follow-up visits with home care to reduce the patient and provider burden. The system was highly acceptable and in-demand for future use, and more than one-third of participants reported greater likelihood of persisting in care if available

Child witnesses productively respond to "How" questions about evaluations but struggle with other "How" questions

Child interviewers are often advised to avoid asking “How” questions, particularly with young children. However, children tend to answer “How” evaluative questions productively (e.g., “How did you feel?”). “How” evaluative questions are phrased as a “How” followed by an auxiliary verb (e.g., “did” or “was”), but so are “How” questions requesting information about method or manner (e.g., “How did he touch you?”), and “How” method/manner questions might be more difficult for children to answer. We examined 458 5- to 17-year-old children questioned about sexual abuse, identified 2485 "How” questions with an auxiliary verb, and classified them as “How” evaluative (n = 886) or “How” method/manner (n = 1599). Across age, children gave more productive answers to “How” evaluative questions than “How” method/manner questions. Although even young children responded appropriately to “How” method/manner questions over 80% of the time, specific types of “How” method/manner questions were particularly difficult, including questions regarding clothing, body positioning, and the nature of touch. Children’s difficulties lie in specific combinations of “How” questions and topics, rather than “How” questions in general

Psychometric Properties and Correlates of Precarious Manhood Beliefs in 62 Nations

Precarious manhood beliefs portray manhood, relative to womanhood, as a social status that is hard to earn, easy to lose, and proven via public action. Here, we present cross-cultural data on a brief measure of precarious manhood beliefs (the Precarious Manhood Beliefs scale [PMB]) that covaries meaningfully with other cross-culturally validated gender ideologies and with country-level indices of gender equality and human development. Using data from university samples in 62 countries across 13 world regions (N = 33,417), we demonstrate: (1) the psychometric isomorphism of the PMB (i.e., its comparability in meaning and statistical properties across the individual and country levels); (2) the PMB’s distinctness from, and associations with, ambivalent sexism and ambivalence toward men; and (3) associations of the PMB with nation-level gender equality and human development. Findings are discussed in terms of their statistical and theoretical implications for understanding widely-held beliefs about the precariousness of the male gender role

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Clinical trial readiness study of distal myopathy and dysphagia in nephropathic cystinosis

BackgroundNephropathic cystinosis is a lysosomal storage disorder with late‐onset systemic complications, such as myopathy and dysphagia. Currently employed outcome measures lack sensitivity and responsiveness for dysphagia and myopathy, a limitation to clinical trial readiness.MethodsWe evaluated 20 patients with nephropathic cystinosis in two visits over the course of a year to identify outcomes sensitive to detect changes over time. Patients also underwent an expiratory muscle strength training program to assess any effects on aspiration and dysphagia.ResultsThere were significant differences in the Timed Up and Go Test (TUG) and Timed 25‐Foot Walk (25‐FW) between baseline and 1‐y follow‐up (P < .05). Maximum expiratory pressure (MEP) and peak cough flow (PCF) significantly improved following respiratory training (P < .05).ConclusionsImproved respiratory outcomes may enhance patients ability to expel aspirated material from the airway, stave off pulmonary sequelae associated with chronic aspiration, and yield an overall improvement in physical health and well‐being.See Editorial on pages 652–652 in this issue.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163642/2/mus27039.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163642/1/mus27039_am.pd

Community-acquired cavitary pseudomonas pneumonia linked to use of a home humidifier

Pseudomonas aeruginosa is an opportunistic pathogen that rarely causes pneumonia in otherwise healthy patients. We describe a case of community-acquired P. aeruginosa pneumonia in a previously healthy individual who likely acquired the infection from a home humidifier