scholarly journals Identifying Factors Associated with Changes in CD4+Count in HIV-Infected Adults in Saskatoon, Saskatchewan

2015 ◽  
Vol 26 (4) ◽  
pp. 207-211 ◽  
Author(s):  
Kelsey Hunt ◽  
Prosanta Mondal ◽  
Stephanie Konrad ◽  
Stuart Skinner ◽  
Kali Gartner ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
First Nations ◽  
Social Assistance ◽  
High Risk Population ◽  
Multivariate Models ◽  
Factors Associated ◽  
History Of ◽  
Hcv Coinfection ◽  
The Impact ◽  
Count Change

OBJECTIVE: To assess the impact of clinical and social factors unique to HIV-infected adults in Saskatoon, Saskatchewan, regarding the rate of CD4+count change, and to identify factors associated with a risk of CD4+count decline.METHODS: A retrospective longitudinal cohort study from medical chart reviews at two clinics was conducted in Saskatoon. Univariate and multivariate linear mixed effects models were used to assess the impact of selected factors on CD4+count change.RESULTS: Four hundred eleven HIV-infected patients were identified from January 1, 2003 to November 30, 2011. Two hundred eighteen (53%) were male, mean (± SD) age was 35.6 ±10.1 years, 257 (70.8%) were First Nations or Métis, 312 (80.2%) were hepatitis C virus (HCV) coinfected and 300 (73.3%) had a history of injection drug use (IDU). In univariate models, age, ethnicity, HCV, IDU, antiretroviral therapy and social assistance were significant. Using ethnicity, HCV and IDU, three multivariate models (models 1, 2, 3) were built due to high correlation. First Nations or Métis ethnicity, HCV coinfection and a history of IDU were associated with significantly lower CD4+counts in multivariate models. Older age and social assistance were associated with significantly lower CD4+counts in models 1 and 3. Age was marginally significant in model 2 (P=0.055). Not prescribed antiretroviral therapy was associated with a significantly negative CD4+count slope in all multivariate models.CONCLUSION: The unique epidemiology of this HIV-infected population may be contributing to CD4+count change. Increased attention and resources focused on this high-risk population are needed to prevent disease progression and to improve overall health and quality of life.

Investigating the Relationship Between Self-Esteem and Stigma Among Young Adults With History of Suicide Attempts

Crisis ◽  
2016 ◽  
Vol 37 (4) ◽  
pp. 265-270 ◽  
Author(s):  
Meshan Lehmann ◽  
Matthew R. Hilimire ◽  
Lawrence H. Yang ◽  
Bruce G. Link ◽  
Jordan E. DeVylder
Keyword(s):  
Young Adults ◽  
Suicide Attempts ◽  
Self Esteem ◽  
High Risk Population ◽  
High Functioning ◽  
People With Mental Illness ◽  
History Of ◽  
The Individual ◽  
The Impact ◽  
The Relationship

Abstract. Background: Self-esteem is a major contributor to risk for repeated suicide attempts. Prior research has shown that awareness of stigma is associated with reduced self-esteem among people with mental illness. No prior studies have examined the association between self-esteem and stereotype awareness among individuals with past suicide attempts. Aims: To understand the relationship between stereotype awareness and self-esteem among young adults who have and have not attempted suicide. Method: Computerized surveys were administered to college students (N = 637). Linear regression analyses were used to test associations between self-esteem and stereotype awareness, attempt history, and their interaction. Results: There was a significant stereotype awareness by attempt interaction (β = –.74, p = .006) in the regression analysis. The interaction was explained by a stronger negative association between stereotype awareness and self-esteem among individuals with past suicide attempts (β = –.50, p = .013) compared with those without attempts (β = –.09, p = .037). Conclusion: Stigma is associated with lower self-esteem within this high-functioning sample of young adults with histories of suicide attempts. Alleviating the impact of stigma at the individual (clinical) or community (public health) levels may improve self-esteem among this high-risk population, which could potentially influence subsequent suicide risk.

scholarly journals Racial Disparities in Virologic Failure and Tolerability During Firstline HIV Antiretroviral Therapy

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Priya Bhagwat ◽  
Shashi N Kapadia ◽  
Heather J Ribaudo ◽  
Roy M Gulick ◽  
Judith S Currier
Keyword(s):  
Antiretroviral Therapy ◽  
Adverse Events ◽  
Socioeconomic Factors ◽  
Ethnic Groups ◽  
Virologic Failure ◽  
Virologic Suppression ◽  
Factors Associated ◽  
Race Ethnicity ◽  
The Impact ◽  
Racial Ethnic

Abstract Background Racial/ethnic disparities in HIV outcomes have persisted despite effective antiretroviral therapy. In a study of initial regimens, we found viral suppression varied by race/ethnicity. In this exploratory analysis, we use clinical and socioeconomic data to assess factors associated with virologic failure and adverse events within racial/ethnic groups. Methods Data were from AIDS Clinical Trial Group A5257, a randomized trial of initial regimens with either atazanavir/ritonavir, darunavir/ritonavir, or raltegravir (each combined with tenofovir DF and emtricitabine). We grouped participants by race/ethnicity and then used Cox-proportional hazards regression to examine the impact of demographic, clinical, and socioeconomic factors on the time to virologic suppression and time to adverse event reporting within each racial/ethnic group. Results We analyzed data from 1762 participants: 757 self-reported as non-Hispanic black (NHB), 615 as non-Hispanic white (NHW), and 390 as Hispanic. The proportion with virologic failure was higher for NHB (22%) and Hispanic (17%) participants compared with NHWs (9%). Factors associated with virologic failure were poor adherence and higher baseline HIV RNA level. Prior clinical AIDS diagnosis was associated with virologic failure for NHBs only, and unstable housing and illicit drug use for NHWs only. Factors associated with adverse events were female sex in all groups and concurrent use of medications for comorbidities in NHB and Hispanic participants only. Conclusions Clinical and socioeconomic factors that are associated with virologic failure and tolerability of antiretroviral therapy vary between and within racial and ethnic groups. Further research may shed light into mechanisms leading to disparities and targeted strategies to eliminate those disparities.

scholarly journals Association of family risk and lifestyle/comorbidities in ovarian cancer patients

2015 ◽  
Vol 61 (3) ◽  
pp. 234-239 ◽  
Author(s):  
Natália Teixeira ◽  
Maria Aparecida Azevedo Koike Folgueira ◽  
Simone Maistro ◽  
Giselly Encinas ◽  
Geertruida Hendrika de Bock ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Mutation Detection ◽  
Regression Analyses ◽  
Family Risk ◽  
Familial Predisposition ◽  
Factors Associated ◽  
System A ◽  
History Of ◽  
Psychiatric Conditions ◽  
The Impact

Summary Objectives: to analyze factors that might indicate familial predisposition for ovarian cancer in patients diagnosed with this disease. Methods: in a prospective single center cohort study at the Institute of Cancer of the State of São Paulo (ICESP), 51 women diagnosed with ovarian cancer were included. Familial predisposition for ovarian cancer was defined as having a higher than 10% chance of having a BRCA1/2 mutation according to the Manchester scoring system, a validated method to assess the likelihood of mutation detection. Each patient was interviewed with a standardized questionnaire on established risk factors for ovarian cancer and other factors that might influence the risk to develop ovarian cancer. Logistic regression analyses were performed to estimate the impact of the evaluated factors on the likelihood of mutation detection, by calculating odds ratios and 95% confidence intervals. Results: seventeen out of 51 patients had a family history of breast and/or ovarian cancer, four patients had a history of breast or endometrial cancer, 11 were diagnosed before the age of 50, and 12 presented a risk of familial predisposition to ovarian cancer higher than 10%. Patients with comorbidities, such as hypertension, diabetes, hormonal disorders, dyslipidemia and psychiatric conditions, presented a lower chance of having a familial predisposition for ovarian cancer (OR: 0.22; 95% CI: 0.06-0.88; p=0.03). Conclusion: in this study, having comorbidities was associated with a lower risk of having a familial predisposition for ovarian cancer. Other factors associated with the risk of ovarian cancer did not have an impact on this predisposition.

Indigena: Teaching case of IT Impact Sourcing

2019 ◽  
Vol 9 (2) ◽  
pp. 64-71
Author(s):  
Ron Babin ◽  
Brian Nicholson ◽  
Megan Young
Keyword(s):  
First Nations ◽  
Rockefeller Foundation ◽  
It Outsourcing ◽  
Business Success ◽  
Management Technique ◽  
Teaching Case ◽  
Global Outsourcing ◽  
History Of ◽  
Outsourcing Contracts ◽  
The Impact

This teaching case introduces the concept of Impact Sourcing, in the context of global IT outsourcing. While IT outsourcing is a well-established management technique, with a history of at least 30 years, Impact Sourcing is a relatively new concept, conceptualized by the Rockefeller Foundation in 2011 and recently defined by the Global Impact Sourcing Coalition. To summarize this case, a First Nations band collaborated with a successful global outsourcing firm, Accenture, to establish Indigena, a Canadian-based impact-sourcing enterprise. Indigena found it difficult to attract, hire and retain qualified Aboriginal employees. The suburban office location in the high-cost Vancouver market may have been a key challenge in building a robust Aboriginal workforce. However, the challenge of winning outsourcing contracts in a competitive market may have been hindered by the Aboriginal workforce, despite the outward positive response of clients to the Impact Sourcing model. Indigena was not able to meet its social goals and at the same time it struggled to attract and retain clients. It was unable to demonstrate profitable business success, resulting in a strategic challenge from its investors.

scholarly journals Admission to psychiatric hospital for mental illnesses 2 years prechildbirth and postchildbirth in Scotland: a health informatics approach to assessing mother and child outcomes

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016908 ◽  
Author(s):  
Julie Langan Martin ◽  
Gary McLean ◽  
Daniel Martin ◽  
Roch Cantwell ◽  
Daniel J Smith
Keyword(s):  
Mental Illness ◽  
Psychiatric Hospital ◽  
Potential Risk ◽  
Health Informatics ◽  
Psychiatric Admission ◽  
Affective Psychosis ◽  
Factors Associated ◽  
History Of ◽  
Depressive Episodes ◽  
The Impact

ObjectiveTo identify factors associated with: admission to a specialist mother and baby unit (MBU) and the impact of perinatal mental illness on early childhood development using a data linkage approach in the 2 years prechildbirth and postchildbirth.MethodsScottish maternity records (SMR02) were linked to psychiatric hospital admissions (SMR04). 3290 pregnancy-related psychiatric admissions for 1730 women were assessed. To investigate factors associated with MBU admission, the group of mothers admitted to an MBU were compared with those admitted to general psychiatric wards. To assess the impact of perinatal mental illness on early child development, a pragmatic indicator for ‘at potential risk of adversity’, defined as a child who was recorded as requiring intensive treatment at any time under the health plan indicators (HPI) and/or who had no record of completing three doses of the 5-in-1 vaccine by 12 months was generated. Logistic regression models were used to describe the association between each variable and the risk of admission between those with a history of prior psychiatric admission and those without.ResultsWomen admitted to an MBU were significantly more likely to be admitted with non-affective psychosis (OR=1.97, 95% CI 1.22 to 3.18), affective psychosis (OR=2.44, 95% CI 1.37 to 4.33) and non-psychotic depressive episodes (OR=1.93, 95% CI 1.42 to 2.63). They were less likely to come from deprived areas (OR=0.68 95% CI 0.49 to 0.93). Women with a previous history of psychiatric admission were significantly more likely to be located in the two most deprived quintiles. Almost one-third (29%) of children born to mothers with a pregnancy-related psychiatric admission were assessed as ‘at potential risk of adversity.’ConclusionsA health informatics approach has potential for improving understanding of social and clinical factors, which contribute to the outcomes of perinatal mental illness, as well as potential adverse developmental outcomes for offspring.

scholarly journals “It’s Our Country”: First Nations’ Participation in the Indian Pavilion at Expo 67

2007 ◽  
Vol 17 (2) ◽  
pp. 148-173 ◽  
Author(s):  
Myra Rutherdale ◽  
Jim Miller
Keyword(s):  
First Nations ◽  
Federal Government ◽  
Economic Conditions ◽  
Aboriginal Peoples ◽  
Political Leaders ◽  
Native Canadians ◽  
The Social ◽  
History Of ◽  
Expo 67 ◽  
The Impact

Abstract This paper traces the history of Aboriginal people’s participation in national spectacle and argues that the Indian Pavilion at Expo 67 was unique in its assertion of the portrayal of Native/Newcomer relations. Historians have interpreted the impact of the Indian Pavilion as an event that awakened non-Native Canadians to both the plight of Aboriginal peoples and their increasing unwillingness to suffer in silence. The controversy over the contents and general argument of the Indian Pavilion followed soon after the release of the two-volume Hawthorn Report on the social and economic conditions First Nations faced, and operated just as the federal government was initiating a series of talks with First Nations leaders to forge a new policy towards First Nations. At the same time, there is little evidence that the Indian Pavilion, whatever succès de scandale it enjoyed, had a lasting impact on public opinion or policymakers. Where the experience of mounting, operating, and defending the Indian Pavilion did matter, however, was with First Nations themselves. Whether causation or coincidence, the newfound confidence and pride that underlay the creation of the Indian Pavilion was completely consistent with the positive demeanour of Aboriginal political leaders from the late 1960s on.

An assessment of factors associated with neurocognitive decline in people living with HIV

2021 ◽  
pp. 095646242110433
Author(s):  
Zaeema Naveed ◽  
Howard S Fox ◽  
Christopher S Wichman ◽  
Pamela May ◽  
Christine M Arcari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiretroviral Therapy ◽  
Cox Proportional Hazards ◽  
Health Concern ◽  
People Living With Hiv ◽  
Hepatitis C Infection ◽  
Factors Associated ◽  
History Of ◽  
Living With Hiv ◽  
Neurocognitive Decline

Despite the widespread use of combination antiretroviral therapy (cART), HIV-associated neurocognitive impairment (NCI) remains a health concern. However, limited research has been done to identify factors associated with neurocognitive decline. We assessed risk factors associated with neurocognitive decline in people living with HIV using a definition of decline that is statistically easy to adopt, is based on a commonly used neuropsychological cut-off and may be clinically relevant. Cox proportional hazards modeling was performed using the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study database. 581 participants were followed for up to 12 years. Neurocognitive decline was defined as the first observed drop in global T-scores of at least 2.67. Lifetime methamphetamine use had the strongest association with neurocognitive decline (adjusted Hazard Ratio; aHR = 1.48; 95% CI = 0.92–2.39) followed by no current antiretroviral medication use (aHR = 1.32; 95% CI = 0.91–1.92). Other risk factors included Hispanic ethnicity, lifetime history of major depressive disorder, lifetime cannabis use, hepatitis-C infection, and difficulty eating, dressing, bathing, or using the toilet. Results indicate that consistent use of ART may be of high significance to preserving neurocognition. Furthermore, Hispanic patients, those with a history of depression and substance use, and those having difficulty in essential activities of daily living may require vigilant follow-up.

scholarly journals Gender Differences in Factors Associated with Clinically Meaningful Weight Loss among Adults Who Were Overweight or Obese: A Population-Based Cohort Study

Obesity Facts ◽  
2020 ◽  
pp. 1-13
Author(s):  
Ji-Bin Li ◽  
Zhi-Yu Qiu ◽  
Zhen Liu ◽  
Qian Zhou ◽  
Li-Fen Feng ◽  
...  
Keyword(s):  
Physical Activity ◽  
Gender Differences ◽  
Weight Loss ◽  
Chronic Diseases ◽  
Study Entry ◽  
Factors Associated ◽  
History Of ◽  
Males And Females ◽  
The Impact

<b><i>Objectives:</i></b> The impact of heterogeneity on gender difference for achieving clinically meaningful weight loss (cmWL) remains unclear. Here, we explored the potential gender differences in factors associated with cmWL. <b><i>Methods:</i></b> A total of 60,668 participants with body mass index (BMI) ≥25 kg/m<sup>2</sup> at study entry and available BMI values at follow-up were included in this study. cmWL was defined as a weight loss of ≥5% from the study entry to follow-up. The associations of social-demographic factors, personal history of chronic diseases, lifestyle behaviors, and history of BMI with cmWL were evaluated using logistic regression models. <b><i>Results:</i></b> During a median follow-up of 9.13 years, 26.6% of the participants had a cmWL (30.8% for females vs. 23.1% in males; <i>p</i> &#x3c; 0.001). Participants with older age, obesity at study entry, being more physical activity compared to 10 years ago, being relapsed smokers or consistent current smokers, having a history of chronic diseases (i.e., diabetes, osteoporosis, and stroke), cancer diagnosis during the study period, and more than 10-year follow-up were more likely to achieve cmWL in both males and females (all <i>p</i> &#x3c; 0.05). The new smoking quitters and participants with less active in physical activity compared to 10 years ago were less likely to achieve cmWL in both males and females (all <i>p</i> &#x3c; 0.05). Specifically, males with a history of emphysema were more likely to reach cmWL, and for females, those being overweight at 20 years old and current drinkers were more likely to reach cmWL (<i>p</i> &#x3c; 0.05). Sensitivity analyses demonstrated similar results. <b><i>Conclusion:</i></b> Age, BMI status, physical activity, smoking status, family income, and health status were independent factors in males and females for weight management. However, further well-designed prospective studies are warranted to confirm our findings.

scholarly journals Nocardia FarcinicaLung Abscess Presenting in the Context of Advanced HIV Infection: Spontaneous Resolution in Response to Highly Active Antiretroviral Therapy Alone

2009 ◽  
Vol 20 (3) ◽  
pp. e103-e106 ◽  
Author(s):  
Arienne S King ◽  
Jose G Castro ◽  
Gordon CK Dow
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Pathogen ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
Metastatic Infection ◽  
History Of ◽  
Cd4 Cell ◽  
The Impact

A 43-year-old man, known to be HIV-positive, presented with a six-week history of symptoms including cough, hemoptysis, anterior chest pain, fever and wasting. His CD4 cell count was 46 cells/μL, and his chest x-ray showed a cavitating lesion in the left upper lobe. Sputum culture was positive forNocardia farcinica. His infection resolved following initiation of antiretroviral therapy.Nocardiais an uncommon opportunistic pathogen in patients with HIV infection and is usually associated with advanced CD4 depletion, cavitary pneumonia, metastatic infection and high mortality. The impact of antiretroviral therapy onNocardiainfection in the setting of HIV has not been clearly elucidated. The current report is the first to present a case in which a complete clinical cure ofNocardiapneumonia has been documented, primarily in response to highly active antiretroviral therapy alone.

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