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1دورية أكاديمية
المؤلفون: Garrett, Nigel, Tapley, Asa, Andriesen, Jessica, Seocharan, Ishen, Fisher, Leigh H, Bunts, Lisa, Espy, Nicole, Wallis, Carole L, Randhawa, April Kaur, Miner, Maurine D, Ketter, Nzeera, Yacovone, Margaret, Goga, Ameena, Huang, Yunda, Hural, John, Kotze, Philip, Bekker, Linda Gail, Gray, Glenda E, Corey, Lawrence, Ahmed, Khatija, Badal-Faesen, Sharlaa, Barnabas, Shaun, Brumskine, William, Comline, Kim, Diacon, Andreas, Dubula, Thozama, Gill, Katherine, Grobbelaar, Coert, Innes, Craig, Kassim, Sheetal, Kotze, Sheena, Lazarus, Erica, Lombaard, Johannes, Luabeya, Angelique, Maboa, Rebone Molobane, Mahoney, Scott, Mahkaza, Disebo, Malahleha, Moelo, Malan, Daniel, Mngadi, Kathryn, Naicker, Nivashnee, Naicker, Vimla, Naidoo, Logashvari, Nchabeleng, Maphoshane, Rassool, Mohammed, Spooner, Elizabeth, Tempelman, Hugo, Mgodi, Nyaradzo, Dadabhai, Sufia, Makhema, Joe, Nuwagaba-Biribonwoha, Harriet, Samandari, Taraz, Elyanu, Peter James, Chilengi, Roma, Chirenje, Zvavahera, McElrath, Julie, Cohen, Myron, Kublin, James, Gilbert, Peter, Peda, Melissa, Andersen-Nissen, Erica, Ferrari, Guido, Villaran, Manuel, Takalani, Azwidhwi, Gildea, Marianne, Nebergall, Michelle, Sopher, Carrie, Proulx-Burns, Lori, Govender, Dhevium, Sanders, Lisa, Hanke, Jen, Baepanye, Kagisho, Le Roux, Bert, Wilvich, Haven, Sripathy, Smitha, Margineantu, Daciana, Brown, Valerie, Linton, Kim, Howell, Haley, Noronha, Bianca, Nikles, Sarah, Toledano, Alicia, May, Jeanine, El-Khorazaty, Jill, Naidoo, Keshani, Khuto, Kentse, Mayat, Fatima, Fairall, Lara, Sanne, Ian
المصدر: Clinical Infectious Diseases. 75(1)
مصطلحات موضوعية: Medical Microbiology, Biomedical and Clinical Sciences, Pneumonia & Influenza, Infectious Diseases, Vaccine Related, Lung, Prevention, Emerging Infectious Diseases, Clinical Research, Pneumonia, Biodefense, Clinical Trials and Supportive Activities, Infection, Good Health and Well Being, COVID-19, Humans, Polymerase Chain Reaction, SARS-CoV-2, South Africa, Omicron variant, asymptomatic carriage, PWH, Ubuntu Study Team, Biological Sciences, Medical and Health Sciences, Microbiology, Clinical sciences
الوصف: We report a 23% asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) Omicron carriage rate in participants being enrolled into a clinical trial in South Africa, 15-fold higher than in trials before Omicron. We also found lower CD4 + T-cell counts in persons with human immunodeficiency virus (HIV) strongly correlated with increased odds of being SARS-CoV-2 polymerase chain reaction (PCR) positive.
وصف الملف: application/pdf
الوصول الحر: https://escholarship.org/uc/item/3v17n75bTest
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2
المؤلفون: Narayanan, Priyadharshini, MD, Ramos, Gladys, MD, Hill, Linda, MD, Spooner, Elizabeth, RN, Strohl, Harmonie
مصطلحات موضوعية: Gestational Diabetes, CDC, Diabetes prevention program
الوصف: Gestational diabetes mellitus (GDM) that affects 2-10% of pregnancies in the United States is a harbinger of future GDM, type 2 Diabetes Mellitus, Hypertension, and cardiovascular disease. This risk can be significantly reduced with weight loss. Lifestyle changes are often intensive processes that require involvement in a program with skilled and certified educators such as Center for disease control and prevention’s (CDC) National Diabetes Prevention Program (DPP), however due to insufficient provider knowledge and the time lapse between GDM and development of type 2 DM, the risk is often forgotten or lost in the transition of healthcare from a women’s obstetric care to primary care. This QI project sought to address this issue with a multifaceted approach to the issue and incorporates community involvement, multispecialty collaboration, and health communication.A community needs assessment was conducted through focus group interviews of women with history of GDM. 8 demographically diverse women were interviewed. Key findings of the study were unawareness about DPP among women and interest and motivation to commit to these programs if provided the opportunity. A major aspect of the project is collaborations of Obstetrics, primary care, and population health departments at UCSD with CDC certified DPPs. Local and nationwide DPPs were contacted to gain information on program resources, referral requirements and cost. An external referral system to the various DPPs was proposed to representatives from Obstetrics and population health and is under consideration.Certified Diabetes Educators (CDE) at UCSD were educated in DPP. Educational handouts and PowerPoint slides were developed and provided to the health educators to pass on to their GDM patients. A webpage with DPP resources was developed and captured in a QR code that is printed on a magnet to be handed out during delivery. Behavioral changes require readiness in an individual, which sometimes takes time. The magnet will provide a steady, reiterating reminder for the women after delivery to enroll in a National Diabetes prevention program when they are ready. Evaluation of this QI project will be through data gathered from collaborating DPPs. Quality measures will include 1. Referral rates from UCSD, 2. Enrolment rates, 3. rates of completion of at least 9 months in the program and, 4. rate of accomplishment of weight loss goals. The evaluations will be performed at 6 and 12 months.
الوصول الحر: https://escholarship.org/uc/item/9cg0q6vsTest
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3رسالة جامعية
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4دورية أكاديمية
المصدر: American Journal of Obstetrics and Gynecology ; volume 230, issue 1, page S179 ; ISSN 0002-9378
مصطلحات موضوعية: Obstetrics and Gynecology
الإتاحة: https://doi.org/10.1016/j.ajog.2023.11.336Test
https://api.elsevier.com/content/article/PII:S0002937823011389?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0002937823011389?httpAccept=text/plainTest -
5دورية أكاديمية
المؤلفون: Daniels, Brodie, Kuhn, Louise, Spooner, Elizabeth, Mulol, Helen, Goga, Ameena Ebrahim, Feucht, Ute Dagmar, Essack, Sabiha Y., Coutsoudis, Anna
مصطلحات موضوعية: Cotrimoxazole, Infants, HIV-exposed but uninfected (HEU), Human immunodeficiency virus (HIV), Prophylaxis, SDG-03: Good health and well-being
الوصف: WHO first recommended cotrimoxazole prophylaxis for all infants who are HIV-exposed but uninfected (HEU) in 2000, given the ability of this treatment to prevent mortality from pneumocystis pneumonia in adults living with HIV. Over the last 21 years, evidence has been generated from the use of cotrimoxazole prophylaxis in infants who are HEU, including two randomised controlled trials, which have shown no clinical benefit and an increase in antibiotic resistance and microbiome dysbiosis. Additionally, improvements in health care over the last two decades in terms of antiretroviral treatment and prophylaxis for mothers and infants, and notably improved vaccination programmes, have substantially reduced the risk of HIV transmission and the overall morbidity and mortality of infants who are HEU from pneumonia and diarrhoeal diseases. Here, we highlight these changes in health care alongside the unchanged cotrimoxazole prophylaxis guidelines and call for a change in these guidelines on the basis of a public health and ethics approach. ; www.thelancet.com/lancetgh ; am2023 ; Obstetrics and Gynaecology ; Paediatrics and Child Health
وصف الملف: application/pdf
العلاقة: Daniels, B., Kuhn, L., Spooner, E. et al. 2022, 'Cotrimoxazole guidelines for infants who are HIV-exposed but uninfected: a call for a public health and ethics approach to the evidence', Lancet Global Health, vol. 401, pp. e1198-1203. DOI : 10.1016/S2214-109X(22)00120-6.; http://hdl.handle.net/2263/92126Test
الإتاحة: https://doi.org/10.1016/S2214-109XTest(22)00120-6
http://hdl.handle.net/2263/92126Test -
6دورية أكاديمية
المؤلفون: Daniels, Brodie, Spooner, Elizabeth, Coutsoudis, Anna
المساهمون: Family Larsson Rosenquist Foundation, HIV Prevention Research Unit of the South African Medical Research Council
المصدر: BMJ Global Health ; volume 7, issue 9, page e009927 ; ISSN 2059-7908
الوصف: We report here on the transmission of HIV in a cohort of breastfeeding infants enrolled in a prevention of mother to child HIV transmission (PMTCT) programme at the epicentre of the HIV pandemic. South Africa implemented option B+ for PMTCT in 2015. Between 2013 and 2018, we enrolled 1219 infants born to HIV positive women into a non-inferiority trial assessing the current cotrimoxazole prophylaxis guidelines for HIV-exposed uninfected infants. Breastfeeding mothers and infants were enrolled and followed up at one of two clinics in eThekwini, KwaZulu-Natal, until 12 months of age. During the study period, 8 infants seroconverted (<1% transmission); these were likely four birth transmissions and four breastfeeding transmissions. It is critical in the post option B era to assess the reasons for vertical transmission of HIV to enable healthcare workers and policy makers to provide strategies to mitigate future infections. This report details the possible contributors to vertical transmission in this cohort and highlights the continued strategies that should be employed to further our goal towards reaching the elimination of mother to child HIV transmission
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7دورية أكاديمية
المؤلفون: Bekker, Linda-Gail, Garrett, Nigel, Goga, Ameena, Fairall, Lara, Reddy, Tarylee, Yende-Zuma, Nonhlanhla, Kassanjee, Reshma, Collie, Shirley, Sanne, Ian, Boulle, Andrew, Seocharan, Ishen, Engelbrecht, Imke, Davies, Mary-Ann, Champion, Jared, Chen, Tommy, Bennett, Sarah, Mametja, Selaelo, Semenya, Mabatlo, Moultrie, Harry, de Oliveira, Tulio, Lessells, Richard John, Cohen, Cheryl, Jassat, Waasila, Groome, Michelle, Von Gottberg, Anne, Le Roux, Engelbert, Khuto, Kentse, Barouch, Dan, Mahomed, Hassan, Wolmarans, Milani, Rousseau, Petro, Bradshaw, Debbie, Mulder, Michelle, Opie, Jessica, Louw, Vernon, Jacobson, Barry, Rowji, Pradeep, Peter, Jonny G, Takalani, Azwi, Odhiambo, Jackline, Mayat, Fatima, Takuva, Simbarashe, Corey, Lawrence, Gray, Glenda E, Brumskine, William, Naicker, Nivashnee, Makhaza, Disebo, Naicker, Vimla, Naidoo, Logashvari, Spooner, Elizabeth
المصدر: The Lancet ; volume 399, issue 10330, page 1141-1153 ; ISSN 0140-6736
مصطلحات موضوعية: General Medicine
الإتاحة: https://doi.org/10.1016/s0140-6736Test(22)00007-1
https://api.elsevier.com/content/article/PII:S0140673622000071?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0140673622000071?httpAccept=text/plainTest -
8دورية أكاديمية
المؤلفون: Delany-Moretlwe, Sinead, Hughes, James P, Bock, Peter, Ouma, Samuel Gurrion, Hunidzarira, Portia, Kalonji, Dishiki, Kayange, Noel, Makhema, Joseph, Mandima, Patricia, Mathew, Carrie, Spooner, Elizabeth, Mpendo, Juliet, Mukwekwerere, Pamela, Mgodi, Nyaradzo, Ntege, Patricia Nahirya, Nair, Gonasagrie, Nakabiito, Clemensia, Nuwagaba-Biribonwoha, Harriet, Panchia, Ravindre, Singh, Nishanta, Siziba, Bekezela, Farrior, Jennifer, Rose, Scott, Anderson, Peter L, Eshleman, Susan H, Marzinke, Mark A, Hendrix, Craig W, Beigel-Orme, Stephanie, Hosek, Sybil, Tolley, Elizabeth, Sista, Nirupama, Adeyeye, Adeola, Rooney, James F, Rinehart, Alex, Spreen, William R, Smith, Kimberly, Hanscom, Brett, Cohen, Myron S, Hosseinipour, Mina C, Asmelash, Aida, Sehurutshi, Alice, Baguma, Allan, Marais, Anita, Kawoozo, Barbarah, Malinga, Bongiwe Prudence, Mirembe, Brenda Gati, Okech, Brenda, Esterhuizen, Bryan, Murombedzi, Caroline, Gadama, Daphne
المساهمون: National Institutes of Health, Gilead Sciences, National Institute of Mental Health, ViiV Healthcare, National Institute on Drug Abuse, National Institute of Allergy and Infectious Diseases, Bill and Melinda Gates Foundation, Office of the Director
المصدر: The Lancet ; volume 399, issue 10337, page 1779-1789 ; ISSN 0140-6736
مصطلحات موضوعية: General Medicine
الإتاحة: https://doi.org/10.1016/s0140-6736Test(22)00538-4
https://api.elsevier.com/content/article/PII:S0140673622005384?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0140673622005384?httpAccept=text/plainTest -
9دورية أكاديمية
المؤلفون: Loveday, Marian, Goga, Ameena, Dhai, Ames, Labuschaigne, Melodie, Roussouw, Theresa, Burgess, Theresa, Strode, Ann, Wallace, Melissa, Blockman, Marc, Daniels, Brodie, Spooner, Elizabeth, Bekker, Linda-Gail
المصدر: Southern African Journal of HIV Medicine; Vol. 23 No. 1 (2022) ; 2078-6751 ; 1608-9693
الوصف: Background: Adolescents are a unique population with significant unmet health needs. They are often excluded from research that may benefit them as they are perceived as vulnerable and needing protection from research participation. For Research Ethics Committees, conflicting positions in statutes, regulations and ethical guidelines about who provides informed consent for adolescent involvement in health research can be a significant barrier to approving adolescent research. For researchers, the requirement for parental/guardian proxy consent or prolonged approval processes may potentially result in the exclusion of those adolescents most vulnerable and at risk, particularly if issues such as gender-based violence, gender identity, sexuality and sexual practices are in question. Objectives: To describe the challenges to adolescent research and suggest strategies to address these. Method: We consider the legal and ethical framework in South Africa regarding the consenting age for adolescents in research, outline the challenges and, using examples of best practices, suggest strategies to address the current conundrum. Results: We suggest three principles to guide Research Ethics Committees on their approach to reviewing health research involving adolescents. Strategies to develop ethically acceptable approaches to adolescent research and consent processes are described, which include community involvement. We elaborate on examples of nuanced approaches to adolescent research. Conclusion: The inclusion of adolescents in research is critical in informing appropriate and effective health services for this vulnerable population, whilst providing an opportunity to link them into care and services where relevant.
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10دورية أكاديمية
المؤلفون: Biggs, Chara, Spooner, Elizabeth
المصدر: South African Journal of Clinical Nutrition; Vol. 31 No. 4 (2018); 78-86 ; 2078-6204 ; 2078-6190
مصطلحات موضوعية: HIV, ART-naïve, obesity, albumin, C-reactive protein
الوصف: Objectives: A cross-sectional study was undertaken at Lancers Road Clinic, Durban, South Africa to determine body composition, haemoglobin, serum albumin and serum high sensitivity C-reactive protein (hs-CRP) levels in asymptomatic ART-naive HIV positive adults. Methods: All eligible adults attending the clinic were sampled. Body composition was assessed using deuterium dilution. Descriptive statistics, Wilcoxon rank-sum test, chi-square test, Fisher’s exact test and Spearman’s rank correlation coefficient were used for data analysis. Results: A total of 84 participants (CD4 count: 542.5 ± 145 cell/mm3) enrolled. The mean body mass index (BMI) was 29.5 (± 6.4) kg/m2 and the mean fat mass percentage was 44.9 (± 18.7). The prevalence of overweight (26.2%, 22/84) and obesity (46.4%, 39/84) was high. Mean haemoglobin (Hb) levels were 12.0 ± 1.6 g/dl. Mild, moderate and severe anaemia was present in 21.4% (18/84), 20.2% (17/84) and 1.2% (1/84) of patients, respectively. Mean albumin levels (36.2 ± 3.8 g/l) were on the borderline low range of normal with mildly depleted albumin levels being present in a third (32.1%, 27/84) of patients. The mean hs-CRP levels (5.5 ± 7.2 mg/l) were high. Conclusion: In this cohort of patients, wasting was not associated with HIV as the prevalence of overweight/obesity was high and followed the population trend in SA. This seemingly well, asymptomatic population of people living with HIV was at an increased risk of morbidity, progression and death due to the compounding factors of overweight/obesity, hypoalbuminemia, raised hs-CRP levels and anaemia.
وصف الملف: application/pdf
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