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Avoidance of healthcare service use and correlates among HIV-positive patients in Vietnam: a cross-sectional study.
No full textObjectiveThe prevention of HIV/AIDS is not making sufficient progress. The slow reduction of HIV/AIDS infections needs to prioritise hesitancy towards service utilisation, including treatment duration, social support and social stigma. This study investigates HIV-positive patients' avoidance of healthcare services and its correlates.DesignA cross-sectional study.SettingThe secondary data analysis used cross-sectional data from a randomised controlled intervention, examining the effectiveness of HIV-assisted smartphone applications in the treatment of HIV/AIDS patients in the Bach Mai and Ha Dong clinics in Hanoi.MethodsSimple random sampling was used to identify 495 eligible patients. Two-tailed χ2, Mann-Whitney, multivariate logistic and ordered logistic regression models were performed.Primary and secondary outcome measuresThe main study outcome was the patients' healthcare avoidance and frequency of healthcare avoidance. The association of individual characteristics, social and behavioural determinants of HIV patients' usage of health services was also determined based on the collected data using structured questionnaires.ResultsNearly half of the participants avoid health service use (47.3%), while 30.7% rarely avoid health service use. Duration of antiretroviral therapy and initial CD4 cell count were negatively associated with avoidance of health services and frequency of health service avoidance. Similarly, those with the middle and highest income were more likely to avoid health services compared with those with the lowest income. People having health problems avoided health service use more frequently (OR 1.47, 95% CI 1.35 to 1.61).ConclusionsOur study's findings identify characteristics of significance in relation to health service avoidance and utilisation among HIV-positive patients. The results highlighted the need to improve satisfaction, adherence and utilisation of treatment. Moreover, identifying ways to address or incorporate those social determinants in new policy may also help the treatment of HIV/AIDS and strategically allocate funding in the changing financial and political climate of Vietnam.Trial registration numberThai Clinical Trials Registry TCTR20220928003
South as a Method: From the “Southern Question” to the “Southern Thoughts”
No full text“South as Method: From the ‘Southern Question’ to the ‘Southern Thoughts’” examines the emergence of narrative and rhetoric patterns within the context of the unclear and unstable meaning of race and nation-building discourses in Italy, Spain, Peru, and Argentina. My methodology combines a close reading of late nineteenth-century novels and short stories published in these countries with an analysis of the ways that the global editorial market and local sociological essays influenced the creation of local ‘social types’ in these texts. Bridging intersectional literary analysis with post- and decolonial theories, this study analyzes writers’ definitions of their novels rather than what critics or theorists have called ‘naturalist’ or ‘realist’ novels. It is an invitation to look inside the writers’ peculiar ways of producing novels in this style while prioritizing national concerns. The literary corpus analyzed spans from essays—Luigi Capuana’s L’isola del sole, Antonio Gramsci’s Quaderni del carcere, Cesare Lombroso’s L’uomo delinquente, José Carlos Mariátegui’s Siete ensayos de interpretación de la realidad peruana, Ezequiel Martinez Estrada’s Radiografia de la pampa, Domingo Faustino Sarmiento’s Civilización y barbarie—to novels and short stories—Emilia Pardo Bazán’s La tribuna, Mercedes Cabello’s Blanca Sol, Eugenio Cambaceres’s En la sangre, Clorinda Matto’s Herencia, Luigi Pirandello’s “L’altro figlio,” Benito Pérez Galdós’s Lo prohibido and Tormento, Giovanni Verga’s “Rosso Malpelo” and “L’amante di Gramigna.” In my analysis of these nineteenth-century texts, the concept of ‘social type’ is highlighted as a key framework and a descriptive tool that responds to the growing need for orientation within the unsteady national borders. In this sense, I analyze the osmotic relationship between social science and literature, which culminates in the responses articulated by Marxist theorists such as Antonio Gramsci, Ezequiel Martinez Estrada, and José Carlos Mariátegui, in the 1930s, through their original articulation of the south as a method rather than an object of study. </p
Floquet Majorana fermions for topological qubits in superconducting devices and cold-atom systems.
No full textWe develop an approach to realizing a topological phase transition and non-Abelian braiding statistics with dynamically induced Floquet Majorana fermions (FMFs). When the periodic driving potential does not break fermion parity conservation, FMFs can encode quantum information. Quasienergy analysis shows that a stable FMF zero mode and two other satellite modes exist in a wide parameter space with large quasienergy gaps, which prevents transitions to other Floquet states under adiabatic driving. We also show that in the asymptotic limit FMFs preserve non-Abelian braiding statistics and, thus, behave like their equilibrium counterparts
Embracing Culture and Connection: Asset-Based Approaches and Multilingual Learner Parent-Teacher Relationships
No full textAlthough strong parent-teacher relationships are pertinent to students’ achievement and well-being, there are many common barriers to effective parent-teacher relationships, such as miscommunication and misalignment of beliefs or expectations. This study investigates one possible way to overcome these challenges: increasing teachers’ understanding of families’ cultural wealth and the application of that knowledge utilizing asset-based approaches. Through a secondary analysis of survey data collected from 23 classroom teachers and 44 parents, this study examined how teachers’ incorporation of families’ cultural wealth into the classroom and their interactions with families impacts parent perspectives on the parent-teacher relationship (as measured by communication, cultural wealth, parental engagement). The results of multi-level modeling showed no significant effects of teachers’ inclusion of cultural wealth (specifically familial or linguistic capital) into the classroom or relationships on parent sentiments regarding communication, cultural wealth, or parental engagement. The findings showed meaningful medium-sized effects of teachers speaking a little bit of Spanish on all three measured aspects of the parent-teacher relationship. These findings suggest measuring specific components of cultural wealth requires complex and nuanced measures with multiple sources of information (e.g., qualitative interviews, observational data) to capture the relationships between multilingual families and teachers
Self-Reported versus observed audit: Measuring CHG bathing compliance.
No full textMeasuring compliance with the appropriate chlorhexidine gluconate (CHG) bathing process through direct observation audits can be helpful in sustaining this important practice; however, capturing this data may be difficult. This study reports the differences between observed and self-reported CHG bathing process compliance audits. The difference between mean observed and self-reported compliance was not significant (p = .06), indicating that self-reported compliance may be an accurate, easy to obtain proxy measure for CHG bathing process compliance
Mild diabetes is not a contraindication for surgical decompression in cervical spondylotic myelopathy: results of the AOSpine North America multicenter prospective study (CSM).
No full textBackground contextCervical spondylotic myelopathy (CSM) is a chronic spinal cord disease and can lead to progressive or stepwise neurologic decline. Several factors may influence this process, including extent of spinal cord compression, duration of symptoms, and medical comorbidities. Diabetes is a systemic disease that can impact multiple organ systems, including the central and peripheral nervous systems. There has been little information regarding the effect of diabetes on patients with coexistent CSM.PurposeTo provide empirical data regarding the effect of diabetes on treatment outcomes in patients who underwent surgical decompression for coexistent CSM.Study design/settingLarge prospective multicenter cohort study of patients with and without diabetes who underwent decompressive surgery for CSM.Patient sampleTwo hundred thirty-six patients without and 42 patients with diabetes were enrolled. Of these, 37 were mild cases and five were moderate cases. Four required insulin. There were no severe cases associated with end-organ damage.Outcome measuresSelf-report measures include Neck Disability Index and version 2 of 36-Item Short Form Health Survey (SF-36v2), and functional measures include modified Japanese Orthopedic Association (mJOA) score and Nurick grade.MethodsWe compared presurgery symptoms and treatment outcomes between patients with and without diabetes using univariate and multivariate models, adjusting for demographics and comorbidities.ResultsDiabetic patients were older, less likely to smoke, and more likely to be on social security disability insurance. Patients with diabetes presented with a worse Nurick grade, but there were no differences in mJOA and SF-36v2 at presentation. Overall, there was a significant improvement in all outcome parameters at 12 and 24 months. There was no difference in the level of improvement between the patients with and without diabetes, except in the SF-36v2 Physical Functioning, in which diabetic patients experienced significantly less improvement. There were no differences in surgical complication rates between diabetic patients and nondiabetic patients.ConclusionsExcept for a worse Nurick grade, diabetes does not seem to affect severity of symptoms at presentation for surgery. More importantly, with the exception of the SF-36v2 Physical Functioning scores, outcomes of surgical treatment are similar in patients with diabetes and without diabetes. Surgical decompression is effective and should be offered to patients with diabetes who have symptomatic CSM and are appropriate surgical candidates
Managing (Unconventional) Water: Essays on Expert Knowledge, Media Framings, and Stakeholder Debates
No full textEnsuring access to adequate quantities of water for basic needs remains a fundamental goal and challenge in many world regions amid the ongoing climate crisis. Yet the uncertainties with existing water supplies coupled with management challenges and rising water demand have shifted attention towards unconventional water sources. Unconventional waters are alternative water sources obtained by using technologies, such as desalination, to transform previously untapped water into drinking water. While desalination is touted as a technical ‘solution’ to alleviate freshwater scarcity by policymakers, businesses, and the public alike, its high financial costs, intensive energy needs, local community impact, and harm to marine life, as well as other yet unseen effects, make it socially, economically, environmentally, and politically contentious. Before the shift towards unconventional waters, and desalination in particular, extends further, it is imperative for informed policymaking to understand how these water options emerge and what constitutes the knowledge base on them.This dissertation examines how water management is shaped at the level of international organizations and what information on desalination is shared and debated across two other policy-relevant settings: the global media and a local community. It focuses on these three different settings to capture wide information streams that individually and collectively generate some of the corpus of knowledge on water management and desalination. The first chapter examines UN-Water, the coordinating body on international water policy for the UN system, and how it uses expert knowledge to shape the global water agenda, including the foundations upon which unconventional waters become part of this agenda. The second chapter applies automated content analysis to global news media coverage to examine which framings related to desalination’s adaptive and maladaptive features are most prevalent and in what combinations. The third chapter presents a discourse analysis of stakeholder statements and official deliberations tied to the Huntington Beach desalination facility in southern California, which was ultimately denied, to reveal the key storylines that arise both in favor of and in opposition to desalination during permitting debates. This dissertation’s key findings highlight the significance of expert knowledge in shaping global water policy, biases in the current information landscape of desalination as a climate adaptation strategy, and the opportunities for engaging with diverse stakeholders for collaborative decision-making on water management options like desalination.</p
The True Cost of Solar Tariffs in East Africa
No full textOver a billion people around the world continue to lack access to basic electricity, many of them unlikely to be connected to the grid for years or decades. Pay-as-you-go solar home systems (SHS)—kits that consumers can frequently purchase on credit that include a small solar panel, battery, light bulbs and wires, phone charging equipment, and sometimes televisions and other appliances—have quickly become a viable, private sector-driven solution that empowers consumers to take control of their energy future.
Many low- and middle-income governments look to import duties and value-added taxes (VAT) to fund critical government services and the bulk of SHS equipment is produced in China. As sales of systems have grown, the question of how these systems should be treated under border taxation regimes has become a prominent issue.
To better understand the trade-offs at stake, actual sales data for 700,000 units of solar home systems was collected from Uganda and Kenya, countries with vibrant SHS markets and where the border tariff debate looms large. The data was analyzed to measure the price sensitivity of consumers of two different SHS product lines in order to better understand the impact of tariffs on system sales as well as broader ramifications for households, electrification goals, and government revenue.
More about this project can be found on the Energy Access Project site
One Small Step for a Patient, One Giant Leap for Orthostatic Hypotension.
No full textA 52-year-old man with ischemic cardiomyopathy presented with progressive, severe orthostatic hypotension refractory to medical therapy. Standard abdominal and leg compression devices were used without success. A novel, inflatable abdominal compression device was created that alleviated the patient's symptoms and maintained his blood pressure