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Introduction: Patient satisfaction with clinical services can have an effect on retention in HIV care and adherence to antiretroviral therapy. This study assessed patient satisfaction and its association with retention and viral suppression in Zambézia Province, Mozambique. Methods: Monthly exit interviews with persons living with HIV were completed from August 2017-January 2019 in 20 health facilities; clinical data were extracted from medical records. Regression analyses assessed the effect of satisfaction scores on retention and viral suppression, adjusting for age, sex, education, civil status, time on treatment, and site. Satisfaction scores were correlated with time spent at health facilities using generalized linear regression models. Results: Data from 4388 patients were analyzed. Overall median satisfaction score was 75% (IQR 53%-84%); median time spent at facilities (from arrival until completion of clinical services) was 2h54min (IQR 1h48min-4h). Overall satisfaction score was not associated with higher odds of retention or viral suppression, but association was seen between satisfaction regarding attention given to patient and respect and higher odds of viral suppression. Patient satisfaction was negatively associated with time spent in facility (Spearman's correlation -0.63). Increased time spent at facility (from 1 to 3 hours) was not associated with lower retention in care (OR 0.72 [95%CI:0.52–1.01] and 0.83 [95%CI: 0.63–1.09] at 6- and 12-months, respectively), nor with a lower odds of viral suppression (OR 0.96 [95%CI: 0.71–1.32]). Conclusions: Strategies to reduce patient wait times at the health facility warrant continued prioritization. Differentiated models of care have helped considerably, but novel approaches are still needed to further decongest crowded health facilities. In addition, a good client-provider communication and positive attitude can improve patient satisfaction with health services, with an overall improved retention. [ABSTRACT FROM AUTHOR]

This study was initiated to identify biomarkers with potential value for the early detection of poor-outcome breast cancer. Two sets of well-characterized tissues were utilized: one from breast cancer patients with favorable vs. poor outcome and the other from healthy women undergoing reduction mammaplasty. Over 46 differentially expressed genes were identified from a large list of potential targets by a) mining publicly available expression data (identifying 134 genes for quantitative PCR) and b) utilizing a commercial PCR array. Three genes show elevated expression in cancers with poor outcome and low expression in all other tissues, warranting further investigation as potential blood markers for early detection of cancers with poor outcome. Twelve genes showed lower expression in cancers with poor outcome than in cancers with favorable outcome but no differential expression between aggressive cancers and most healthy controls. These genes are more likely to be useful as prognostic tissue markers than as serum markers for early detection of aggressive disease. As a secondary finding was that, when histologically normal breast tissue was removed from a distant site in a breast with cancer, 7 of 38 specimens displayed a cancer-like expression profile, while the remaining 31 were genetically similar to the reduction mammaplasty control group. This finding suggests that some regions of ipsilateral histologically 'normal' breast tissue are predisposed to becoming malignant and that normal-appearing tissue with malignant signature might warrant treatment to prevent new primary tumors.

The aim of this study was to analyze the agreement between self and proxy reports of quality of life (QoL) in people with intellectual disabilities and to examine the factors which contribute to these differences. The study was conducted across six international centres in a sample of 614 adults with intellectual disabilities as well as two different samples of proxies (N = 874) including both professional carers and relatives. QoL was assessed with the disability version of the WHOQOL-BREF. In both proxy samples results show a significant moderate association between the persons' QoL-assessment and the assessment of their proxies in all of the five QoL domains. There were significant mean differences in most items which varied in their direction. In general, people with disabilities rated their QoL higher than their proxies except for two items from the physical domain. The factors which most significantly contributed to these differences were proxy knowledge of the person as well as the WHODAS-disability score. Cross-cultural differences in the magnitude of concordance were observed. As a conclusion, the study shows a good agreement between the person-proxy QoL-assessments, and that the factors associated with disagreement are limited in this study. Future studies should elaborate the stability of concordance over time. (Contains 6 tables.)

This article talks about the issues on gender and contingent labor in the field of composition. The authors contend that the composition programs are feminized, devalued, and heavily populated by contingent faculty. The feminization of the field of composition in particular makes the work--and the potential solidarity between those on and off the track--all the more invisible and vulnerable to the kinds of myths the authors describe in this article. If teachers seek more equitable and thus sustainable solutions to academic supply and demand, they must recognize that gender concerns and labor concerns often are one and the same.

By addressing race and class through the stories we tell about service-learning in the classroom and in our scholarship, I argue that we can more effectively negotiate the divide between the university and the community and work toward social change. (Contains 13 notes.)

Presents an analysis of both quantitative and qualitative data collected for a study of the impact of World Wide Web use in elementary French and German courses. (Author/VWL)

Describes discussions of race, particularly whiteness, in a service learning class. Argues that teaching the implications of white privilege is crucial in service learning courses, particularly when most of the students are white and most of those being served are of color. Considers the ethical implications of race in service learning. (EV)

Presents an anecdotal inspection of the theory, classroom environment, and application of an experiment with hypertext and developmental writers in a computer-mediated classroom. Notes that the classroom focused on the maternal practice of storytelling and conversation--two alternative modes of learning associated with feminist concerns. Suggests that this environment encourages students to participate dynamically as a community. (RS)