19683 research outputs found
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Cohort Profile: International Collaboration on Hepatitis C Elimination in HIV Cohorts (InCHEHC)
No full textKey Features:
- The International Collaboration on Hepatitis C Elimination in HIV Cohorts (InCHEHC) is a multinational consortium of longitudinal cohorts of people with HIV who are at risk of hepatitis C virus (HCV) infection or infected with HCV. InCHEHC has been specifically designed to assess progress towards HCV elimination as a public health threat among people with HIV.
- The first data merge includes 104 740 participants from 11 cohorts in Australia (n = 22 033), Canada (n = 2070), France (n = 18 387), The Netherlands (n = 24 785), Spain (n = 16 725) and Switzerland (n = 20 740), with data collected between 1987 and 2021. Participants include 86 132 males (81.4%), 19 514 females (18.4%) and 191 with unknown sex at birth (0.2%); 725 (1.0%) were known to be transgender across eight cohorts collecting data on this variable. At enrolment, the median age was 38 years (interquartile range: 30–46). Of the total 104 740 participants, 12 784 (12%) had an HCV antibody or RNA positive test at or up to 1 year prior to individual cohort enrolment; 32 360 (31%) did not have an HCV RNA or antibody test recorded at that time.
- Clinical data are collected on all participants and behavioural and mortality data on a subset of them. Clinical data include HIV-related markers, HCV testing and treatment, liver health-related markers and sexually transmitted and blood-borne virus co-infections. Behavioural data include sexual and injecting risk behaviours and alcohol and drug use. Mortality data are collected using the International Classification of Diseases 9th or 10th revision (ICD-9/10) or Coding Causes of Death in HIV (CoDE) classification.
- Data are available by request from the InCHEHC steering committee. Initial requests should be directed to Rachel Sacks-Davis ([email protected]).</p
Efficacy of online communication partner training package for student healthcare professionals
No full textBackground: People with aphasia are vulnerable recipients of healthcare. The nature of the communicative environment and the communication disability can adversely impact access to timely and quality healthcare. Student healthcare professionals are often underprepared to interact successfully with people with aphasia and may benefit from communication partner training (CPT). Aims: To investigate the potential effectiveness and acceptability of a brief, two-part introductory Supported Conversation for Adults with Aphasia (SCA™)-based CPT package, delivered to a sample of students across a diverse range of healthcare disciplines. Methods & Procedures: A pre–post-within group experimental design was used to investigate the potential effectiveness and acceptability of an online CPT package (50 minute module + 1 hour workshop) for healthcare students. The Aphasia Attitudes, Strategies and Knowledge (AASK) survey measured participants’ knowledge of aphasia, facilitative communication strategies and attitudes towards people with aphasia. Data were collected pre-training, following the training module and following the workshop, and 6 weeks post-training. Statistical analysis was conducted on the AASK data. In addition, participant feedback (ratings and open text responses) was collected after the workshop. Ratings were analysed descriptively, and thematic content analysis was used for open text responses. Outcomes & Results: 236 participants completed the pre-training AASK and 106 completed the AASK at subsequent time points. Statistically significant gains were demonstrated from pre- to post-module completion. Between the end of the module and the end of the workshop, some gains were maintained and others showed further statistically significantly improvements. While all gains were not maintained at the 6-week follow-up, statistically significantly improvements from pre-training scores remained evident. Student feedback was predominantly positive, with suggested improvements for training content and length. Conclusions & Implications: The results provide preliminary evidence that a brief, online CPT package can support student healthcare professionals’ knowledge and attitudes towards aphasia and communicating with people with aphasia. Online training was acceptable to students and feasible as an embedded or optional component of curriculum. Ongoing training (e.g., in the form of refresher sessions) and inclusion of a skills-based component are recommended to maximize communication skill development. </p
Promoting positive physical activity behaviours in children undergoing acute cancer treatment: feasibility of the CanMOVE intervention
No full textBackground: Supporting children and adolescents with cancer to be physically active can improve medium- and long-term health outcomes. Objective: To assess the feasibility of CanMOVE, a 10-week complex, theoretically-informed, behaviour change intervention to promote physical activity for children and adolescents undergoing acute cancer treatment. Methods: A feasibility study using a single-group, repeated measures, mixed methods design. Participants completed CanMOVE, which included provision of a Fitbit (child/adolescent and carer) and structured support from a physical therapist. Feasibility domains of demand, acceptability, implementation, practicality, limited efficacy, and integration were evaluated. Data sources included service level data, objective assessment of physical activity, physical function, and health-related quality of life; and qualitative data collected via semi-structured interviews with participants and focus groups with staff. Results: Twenty children/adolescents (median age 13yrs, interquartile-range 9–14) with a mix of cancer diagnoses, 20 parents, and 16 clinicians participated. There was high demand with 95% enrolment rate. CanMOVE was acceptable for participants. All feasibility thresholds set for implementation were met. Under practicality, there were no serious adverse events related to the intervention. Limited efficacy data indicated CanMOVE showed positive estimates of effect in influencing child/adolescent physical activity behaviour, physical function, and health-related quality of life. Positive impacts were also seen in parent and staff attitudes towards physical activity promotion. To improve integration into the clinical setting, it was suggested the duration and scope of CanMOVE could be expanded. Conclusion: CanMOVE was feasible to implement in a paediatric cancer setting. CanMOVE is appropriate to be tested in a large-scale trial
How did COVID-19 restrictions impact alcohol consumption in Australia? A longitudinal study
No full textIntroduction: The state of Victoria experienced more stringent public health measures than other Australian states during the COVID-19 pandemic. This study investigated how these public health measures impacted: (i) total alcohol consumption; (ii) location-specific consumption; and (iii) consumption among different pre-pandemic drinking groups, in Victoria compared to the rest of Australia during the first year of the pandemic. Method: A longitudinal study with six survey waves was conducted between April and December 2020. A total of 775 adults completed data on alcohol use, including detailed consumption location information. Based on their 2019 consumption, participants were classified into low, moderate or high-risk groups. Data were analysed descriptively. Results: There was no difference in total alcohol consumption from 2019 levels among Victorians and those from the other Australian states when Victoria was the only state in lockdown. Location-specific consumption was relatively similar for Victoria and the rest of Australia, with an increase in home drinking, and a decrease in consumption in someone else's home, licensed premises and public spaces during lockdown compared with 2019. Participants in the high-risk group reported a reduction of two standard drinks per day in November 2020 compared with 2019. In contrast, consumption remained relatively stable for participants in the low and moderate-risk groups once accounting for regression to the mean. Discussion and Conclusion: Contrary to expectations, restrictions on licensed premises appeared to impact high-risk drinkers more than low and moderate-risk drinkers. Reducing availability of on-premise alcohol may be an effective way to reduce consumption in heavier drinkers
The Effects of a Simulated Duathlon on Trunk Motion: A Sensor Based Approach
No full textDuathlon consists of two durations of running separated by cycling in a format similar to triathlon. The addition of cycling and the associated loadings on the neuromuscular system can modify spatiotemporal variables in running including trunk motion, which can impact running economy. Changes to trunk motion can be inferred by measuring accelerations of the centre of mass (CoM). However, there is scarce research into trunk dynamics in duathlon. Therefore, the aim of this study was to use an inertial sensor (an accelerometer) to compare acceleration magnitudes of the trunk in the vertical, mediolateral, and anteroposterior directions during a simulated field-based duathlon. Specifically, running performance and magnitudes of trunk acceleration were compared pre and post a cycling load. Ten well-trained duathletes (seven males, three females (mean ± SD; age: 31.1 ± 3.4 years; body mass: 70.9 ± 6.9 kg; body height: 177 ± 5.82 cm; 9.45 ± 1.7 weekly training hours per week; 9.15 ± 5.2 years training experience)) completed a 5 km run performed at a self-selected pace (described as moderate intensity) prior to 20 km of continuous cycling at four varied cadence conditions. This was immediately followed by a 2.5 km run. Mean completion times for the final 2.5 km in running pre-cycling (4.03:05 ± 0.018) compared to the 2.5 km in running post-cycling (4.08:16 ± 0.024) were significantly different. Regarding trunk acceleration, the largest difference was seen in the vertical direction (y axis) as greater magnitudes of acceleration occurred during the initial 1 km of running post-cycling combined with overall significant alterations in acceleration between running pre- and post-cycling (p = 0.0093). The influence of prior cycling on trunk acceleration activity in running likely indicates that greater vertical and mediolateral trunk motion contributes to decremental running performance. In future, further advanced simulation and analysis could be performed in ecologically valid contexts whereby multiple accelerometers might be used to model a more complete set of dynamics
Does Gesture Improve the Communication Success of People with Aphasia?: A Systematic Review
No full textBackground: Speakers with aphasia gesture, but the extent to which these gestures improve their communication success is unclear. Aim: The primary aim is to assess if gesture improves the communication success of people with aphasia using a systematic review. Methods & Procedures: Following the PRISMA protocol, we systematically reviewed the literature assessing the contribution of gesture to the communication success of people with aphasia. Multiple electronic databases were searched using specified keywords and MeSH explode. This identified 2177 articles, seven of which met our inclusion criteria. Outcomes & Results: The included articles were reviewed in the context of three research questions, which concluded that: (1) the communication success of gesture is compromised in people with aphasia when compared to healthy language users, (2) gesture improves the communication success of people with aphasia beyond spoken language alone, and 3) apraxia severity impedes the communication success of gesture, whereas aphasia severity and semantic processing deficits do not. Conclusions: This systematic review clarifies inconsistencies in the literature and confirms that gesture can improve the communication success of people with aphasia. This supports the continued use of gesture as a therapeutic intervention for people with aphasia
Does it pay to treat employees well?: The case of informal finance
No full textWe examine the role of employee treatment in firms’ access to informal finance in the form of trade credit. We find that better employee treatment improves the amount of informal finance a firm can obtain. This effect is stronger in environments with (1) more intensive product market competition, (2) highly customized inputs, (3) lower social capital and (4) high demand for skilled labor. Furthermore, the role of employee treatment varies according to a firm's financial health and liquidity. Employee treatment becomes less important for firms having a low level of liquidity but is more pronounced for firms experiencing financial distress
Study Protocol for a Stepped-Wedge Cluster (Nested) Randomized Controlled Trial of Antenatal Colostrum Expression (ACE) Instruction in First-Time Mothers: The ACE Study
No full textBackground: Although many mothers initiate breastfeeding, supplementation with human-milk substitutes (formula) during the birth hospitalization is common and has been associated with early breastfeeding cessation. Colostrum hand expressed in the last few weeks before birth, known as antenatal colostrum expression (ACE), can be used instead of human-milk substitutes. However, evidence is lacking on the efficacy of ACE on breastfeeding outcomes and in non-diabetic mothers. Methods and Planned Analysis: This multicenter stepped-wedge cluster (nested) randomized controlled trial aims to recruit 945 nulliparous pregnant individuals. The trial is conducted in two phases. During Phase 1, control group participants are under standard care. During Phase 2, participants are randomized to ACE instruction via a pre-recorded online video or a one-on-one session with a midwife. Adjusted logistic regression analysis will be used to examine the relationship between ACE instruction and breastfeeding outcomes. Research Aims and Questions: Primary aim: (1) Does advising pregnant individuals to practice ACE and providing instruction improve exclusive breastfeeding rates at 4 months postpartum? Secondary research questions: (2) Do individuals who practice ACE have higher rates of exclusive breastfeeding during the initial hospital stay after birth? (3) Is teaching ACE via an online video non-inferior to one-on-one instruction from a midwife? (4) Does expressing colostrum in pregnancy influence time to secretory activation, or (5) result in any differences in the composition of postnatal colostrum? Discussion: Trial findings have important implications for maternity practice, with the online video providing an easily accessible opportunity for ACE education as part of standard antenatal care
Cognitive-communication difficulties due to traumatic brain injury sustained in adults 55 years and older: A survey of speech-language pathology professional practice in Australia
No full textPurpose: Limited research informs management of cognitive-communication difficulties following traumatic brain injury (TBI) in older adulthood. The purpose of this study was to understand the characteristics and practice of speech-language pathologists (SLPs) working with people who sustained TBI at ≥55 years and more specifically their management of cognitive-communication difficulties with this population. This included assessment and treatment practices, resource needs, barriers to practice, and impact to service delivery from COVID-19 restrictions. Method: A cross-sectional survey-based design with non-probability sampling of SLPs working in Australia with adults with TBI was utilised. Descriptive statistics and content analysis were used for analysis of survey data. Result: Fifty responses were eligible for inclusion. Participants predominantly worked in inpatient rehabilitation (48%), acute (40%), and community settings (36%). Service delivery to adults who sustained TBI at ≥55 years commonly included cognitive-communication management. Assessment and treatment trends are described. Most SLPs (74%) perceived barriers to cognitive-communication management, often relating to time and funding, that existed prior to the COVID-19 pandemic. Pandemic restrictions presented additional challenges. Conclusion: Research relating to cognitive-communication difficulties following TBI in older adulthood is required to support evidence-based practice and inform services for older adults who sustain TBI.</p
Cytotaxonomic characterization and estimation of migration patterns of onchocerciasis vectors (Simulium damnosum sensu lato) in northwestern Ethiopia based on RADSeq data
No full textBACKGROUND: While much progress has been made in the control and elimination of onchocerciasis across Africa, the extent to which vector migration might confound progress towards elimination or result in re-establishment of endemism in areas where transmission has been eliminated remains unclear. In Northern Ethiopia, Metema and Metekel-two foci located near the Sudan border-exhibit continuing transmission. While progress towards elimination has been faster in Metema, there remains a problematic hotspot of transmission. Whether migration from Metekel contributes to this is currently unknown. METHODOLOGY/PRINCIPLE FINDINGS: To assess the role of vector migration from Metekel into Metema, we present a population genomics study of 151 adult female vectors using 47,638 RADseq markers and mtDNA CoI sequencing. From additional cytotaxonomy data we identified a new cytoform in Metema, closely related to S. damnosum s.str, here called the Gondar form. RADseq data strongly indicate the existence of two distinctly differentiated clusters within S. damnosum s.l.: one genotypic cluster found only in Metema, and the second found predominantly in Metekel. Because blackflies from both clusters were found in sympatry (in all four collection sites in Metema), but hybrid genotypes were not detected, there may be reproductive barriers preventing interbreeding. The dominant genotype in Metema was not found in Metekel while the dominant genotype in Metekel was found in Metema, indicating that (at the time of sampling) migration is primarily unidirectional, with flies moving from Metekel to Metema. There was strong differentiation between clusters but little genetic differentiation within clusters, suggesting migration and gene flow of flies within the same genetic cluster are sufficient to prevent genetic divergence between sites. CONCLUSIONS/SIGNIFICANCE: Our results confirm that Metekel and Metema represent different transmission foci, but also indicate a northward movement of vectors between foci that may have epidemiological importance, although its significance requires further study.</p