Search

AbstractAs the COVID-19 pandemic spread across the world, immunocompromised individuals such as people with HIV (PWH) may have faced a disproportionate impact on their health and HIV outcomes, both from COVID-19 and from the strategies enacted to contain it. Based on the SPIRIT guidelines, we describe the protocol for an international multisite observational study being conducted by The International Nursing Network for HIV Research, with the Coordinating Center based at the University of California, San Francisco (UCSF) School of Nursing. Site Principal Investigators implement a standardized protocol to recruit PWH to complete the study online or in-person. Questions address demographics; HIV continuum of care indicators; mental and social health; COVID-19 and vaccination knowledge, attitudes, behaviors, and fears; and overall outcomes. Results of this study will contribute to knowledge that can inform responses to future public health crises to minimize their impacts on vulnerable populations such as PWH.

Little is known about how demographic, employment and meteorological factors impact physical activity. We conducted an analysis to explore these associations from participants (N = 447) from six cities in the United States and matched their activity data with abstracted local meteorological data from National Oceanic and Atmospheric Administration (NOAA) weather reports. Participants were purposively recruited in 3-month blocks, from December 2015 to October 2017, to reflect physical activity engagement across the seasons. We calculated total physical activity (minutes/week) based on 7-day physical activity recall. Mild correlations were observed between meteorological factors and correlated with lower physical activity. Participants were least active in autumn (Median = 220 min/week) and most active in spring (Median = 375 min/week). In addition to level of education and total hours of work, maximum temperature, relative humidity, heating degree day, precipitation and sunset time together explained 17.6% of variance in total physical activity. Programs assisting in employment for PLHIV and those that promote indoor physical activity during more strenuous seasons are needed. Additional research to better understand the selection, preferences, and impact of indoor environments on physical activity is warranted.

Background: The purpose of this study is to examine and evaluate the existing clinical practice guidelines and consensus statements regarding tracheostomy care for non‐mechanically ventilated patients. Methods: A systematic search of databases, and professional organisations was conducted from inception to 19 March 2023. Two appraisers evaluated each guideline using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Text and Opinion Papers. Results: No specific clinical guidelines exist on airway management in non‐mechanically ventilated patients. Of 6318 articles identified, we included 12 clinical practice guidelines, and 9 consensus statements, which were from China, the US, the UK, South Korea, Australia, France and Belgium. The AGREE II scores in six domains are (1) the scope and purpose, 70.30%; (2) stakeholder involvement, 37.61%; (3) rigor of development, 33.97%; (4) clarity of presentation, 68.16%; (5) applicability, 44.23% and (6) editorial independence, 40.06%. The overall quality of evidence was level B. The summarised recommendations for clinical practice encompass the following six areas: airway humidification, management of the trach cuff, management of inner cannula, tracheostoma care, tracheostomy suctioning and management and prevention of common post‐operative complications. Conclusions: The overall quality of the clinical guidelines on non‐ventilated tracheostomy care was moderate, and further improvements are needed in domains of stakeholder involvement, applicability, clarity of presentation and editorial independence. Recommendations on non‐ventilated tracheostomy care are often embedded in the guidelines on ventilated tracheostomy. Specific clinical guidelines are needed to provide a standardised approach to tracheostomy care for non‐ventilated patients. Relevance to clinical practice: Patients with non‐ventilated tracheostomy need specialised airway management. Improving patient outcomes requires standardised protocols, patient involvement, quality evaluation, and interdisciplinary approaches. No patient or public contribution: The study reviewed clinical practice guidelines and consensus statements, therefore patient or public input was not needed. [ABSTRACT FROM AUTHOR]

Recognizing the importance of incorporating different risk measures in the portfolio management model, this paper examines the dynamic mean-risk portfolio optimization problem using both variance and value at risk (VaR) as risk measures. By employing the martingale approach and integrating the quantile optimization technique, we provide a solution framework for this problem. We demonstrate that, under a general market setting, the optimal terminal wealth may exhibit different patterns. When the market parameters are deterministic, we derive the closed-form solution for this problem. Examples are provided to illustrate the solution procedure of our method and demonstrate the benefits of our dynamic portfolio model compared to its static counterpart. [ABSTRACT FROM AUTHOR]

Although enacted and internalized stigma is a continuing problem for people living with HIV (PLWH) in Southeast Asia, there is little understanding of how PLWH cope with discrimination, exclusion, and other negative outcomes caused by HIV-related stigmatization. This article aims to bridge this gap by analyzing the lived experiences of HIV-related stigmatization and coping strategies among 30 people with HIV in Myanmar, a country heavily influenced by religion, especially Buddhism. Among the 30 study participants, 20 were female and 10 were male, with ages ranging from 18 to 50 years. Through the lens of Bourdieu's concepts of habitus, field, and capital, this article first elucidates the various forms of stigmatization in family, work, social, and other settings as symbolic violence on people with HIV. The present article shows that spirituality serves as a perceptual and action framework for people with HIV to generate reflexivity toward their HIV infection and related stigmatization and to further engage in agentic responses. More importantly, this article demonstrates how people with HIV draw on spirituality to support peers in reclaiming control over their lives and how they are perceived by society. The findings indicate that the local context, especially cultural and religious resources, should be considered when developing interventions to mitigate HIV-related stigmatization in Southeast Asia. [ABSTRACT FROM AUTHOR]

Objective: To determine how the COVID-19 pandemic impacts patients with chronic disease medication adherence. Methods: Four electronic databases, PubMed, MEDLINE, Web of Science, and CINAHL Plus Full Text, were searched for literature between 2019 and 2021. Abstracts and later full texts were independently screened by the authors of this review using inclusion and exclusion criteria to determine relevance to our study. Joanna Briggs Institute (JBI) critical appraisal tools were used to assess the quality of included texts. Relevant information and data from the included texts were extracted into tables for data synthesis and analysis. Results: Ten studies met the study criteria, the most popular study design was cross-sectional design (n = 9, 90.0%), others were case series (n = 1, 10.0%). Barriers to medication adherence and facilitators of medication adherence were the major two themes that participants reported regarding the impact of COVID-19 on medication adherence. Moreover, these two main themes have been organized in sub-themes that are dealt with in-depth. Discussion: Our results could heighten healthcare providers, stakeholders, and policy leaders' awareness of providing appropriate support for chronic disease patients, especially regarding medication adherence. Future research incorporating programs that support patients' needs is recommended. [ABSTRACT FROM AUTHOR]