Incidence of hypertension in people with HIV who are treated with integrase inhibitors versus other antiretroviral regimens in the RESPOND cohort consortium.

OBJECTIVE To compare the incidence of hypertension in people living with HIV receiving integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART) versus non-nucleoside reverse transcriptase inhibitors (NNRTIs) or boosted protease inhibitors (PIs) in the RESPOND consortium of HIV cohorts. METHODS Eligible people with HIV were aged ≥18 years who initiated a new three-drug ART regimen for the first time (baseline), did not have hypertension, and had at least two follow-up blood pressure (BP) measurements. Hypertension was defined as two consecutive systolic BP measurements ≥140 mmHg and/or diastolic BP ≥90 mmHg or initiation of antihypertensives. Multivariable Poisson regression was used to determine adjusted incidence rate ratios (aIRRs) of hypertension, overall and in those who were ART naïve or experienced at baseline. RESULTS Overall, 4606 people living with HIV were eligible (INSTIs 3164, NNRTIs 807, PIs 635). The median baseline systolic BP, diastolic BP, and age were 120 (interquartile range [IQR] 113-130) mmHg, 78 (70-82) mmHg, and 43 (34-50) years, respectively. Over 8380.4 person-years (median follow-up 1.5 [IQR 1.0-2.7] years), 1058 (23.0%) participants developed hypertension (incidence rate 126.2/1000 person-years, 95% confidence interval [CI] 118.9-134.1). Participants receiving INSTIs had a higher incidence of hypertension than those receiving NNRTIs (aIRR 1.76; 95% CI 1.47-2.11), whereas the incidence was no different in those receiving PIs (aIRR 1.07; 95% CI 0.89-1.29). The results were similar when the analysis was stratified by ART status at baseline. CONCLUSION Although unmeasured confounding and channelling bias cannot be excluded, INSTIs were associated with a higher incidence of hypertension than were NNRTIs, but rates were similar to those of PIs overall, in ART-naïve and ART-experienced participants within RESPOND

Seasonal influenza vaccination of healthcare workers : Systematic review of qualitative evidence

Background Most countries recommend that healthcare workers (HCWs) are vaccinated seasonally against influenza in order to protect themselves and patients. However, in many cases coverage remains low. A range of strategies have been implemented to increase uptake. Qualitative evidence can help in understanding the context of interventions, including why interventions may fail to achieve the desired effect. This study aimed to synthesise evidence on HCWs’ perceptions and experiences of vaccination for seasonal influenza. Methods Systematic review of qualitative evidence. We searched MEDLINE, EMBASE and CINAHL and included English-language studies which reported substantive qualitative data on the vaccination of HCWs for seasonal influenza. Findings were synthesised thematically. Results Twenty-five studies were included in the review. HCWs may be motivated to accept vaccination to protect themselves and their patients against infection. However, a range of beliefs may act as barriers to vaccine uptake, including concerns about side-effects, scepticism about vaccine effectiveness, and the belief that influenza is not a serious illness. HCWs value their autonomy and professional responsibility in making decisions about vaccination. The implementation of interventions to promote vaccination uptake may face barriers both from HCWs’ personal beliefs and from the relationships between management and employees within the targeted organisations. Conclusions HCWs’ vaccination behaviour needs to be understood in the context of HCWs’ relationships with each other, with management and with patients. Interventions to promote vaccination should take into account both the individual beliefs of targeted HCWs and the organisational context within which they are implemented

New [3+3] Schiff-base macrocycles and their complexes

A series of conjugated [3+3] Schiff-base macrocycles containing both a central crown ether-like pocket and three tetradentate N[sub 2]O[sub 2] binding sites were prepared and investigated. The formation mechanism was investigated through the synthesis and study of macrocycle fragments. Further understanding of the macrocycle conformations and dynamics was obtained through computational studies. A monoreduced macrocycle where one of the six imines has been reduced was obtained as a by-product of macrocycle formation. Reactivity studies and deuterium labeling investigations revealed that the selective reducing agent is likely a benzimidazoline. This intermediate is generated in situ during the formation of the nonreduced macrocycle and with macrocycle reduction is converted to a stable benzimidazole unit. Upon addition of small cations, the conjugated Schiff-base macrocycles assemble into tubular structures. Spectroscopic and mass spectrometric studies have shown that the cations bind to the crown ether-like centre of the macrocycle and induce aggregation to form structures composed of alternating cations and macrocycles. With the addition of seven equivalents of Zn[sup 2+] or Cd[sup 2+] to these fully conjugated macrocycles surprising heptametallic complexes were obtained. Here, the trimetallated macrocycle is first formed (with metal ions bound to the three N[sub 2]O[sub 2] pockets) and then this templates the formation of a [M[sub 4]O][sub 6+] cluster that caps the cone-shaped macrocycle. NMR studies indicated that these zinc complexes dimerize under certain solvent conditions forming capsule-like structures resembling cavitands used in host-guest chemistry. Variations of these [3+3] Schiff-base macrocycles were prepared by modifying the substituents of the diformyl diol unit. In this way naphthalene-based macrocycles were prepared. Studies on a series of related model compounds revealed that the ketoenamine isomer is stabilized in these macrocycles rather than the enolimine isomer as observed in the analogous phenyl-based macrocycles.Science, Faculty ofChemistry, Department ofGraduat

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Procedure in video forma

Ethics Approval

Ethics, consent, and debriefin

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Questionnaires and surveys administere

Descriptive study of carers\u27 support, encouragement and modelling of healthy lifestyle behaviours in residential out-of-home care

OBJECTIVE: Given the high prevalence of overweight/obesity among young people in residential out-of-home care (OOHC), and as their carers are in loco parentis, this research aimed: 1) to examine the healthy lifestyle cognitions and behaviours of residential carers; and 2) to describe resources needed to improve diet and/or physical activity outcomes for residents. METHODS: Cross-sectional data were collected from 243 residential carers. Measures included: demographics; knowledge of dietary/physical activity recommendations; self-reported encouragement/importance of health behaviours; physical activity/screen time (at work); unit \u27healthiness\u27; and necessary resources for creating a healthy environment. RESULTS: Staff placed importance on the residents eating well and being physically active. However, examination of carer knowledge found significant gaps in staff education. Three key priority areas were identified to help build a healthy food and activity environment in residential OOHC: funding, professional development and policy. CONCLUSION: Carer knowledge of healthy lifestyles can be improved and they need to be well resourced to ensure children in public care settings live in a healthy environment. IMPLICATIONS: These findings may inform the development of ongoing professional development to improve carers\u27 health literacy, as well as policy to support dietary/activity guidelines for the OOHC sector