Mackinnontorres5528

Results Among 226 HIV-negative Black MSM, the majority (60%) were 25+ years of age. Most of the substance use behaviors, were not significantly associated with PrEP initiation or adherence. However, stimulant use before/during CAI was significantly associated with lower odds of PrEP adherence (Adjusted odds ratio=0.21, 95% confidence interval=0.07, 0.61; p= less then 0.01). Conclusions These findings suggest that PrEP adherence is feasible among Black MSM who use substances. However, Black MSM who engage in stimulant use before/during CAI may present a unique group for additional study and support with enhanced behavioral health and support services.Background The Dapivirine Vaginal Ring, reduces the risk of HIV infection by approximately 30-50% depending on adherence to ring use. To ensure higher levels of protection against HIV and sexually transmitted infections (STIs) women should be counselled to use condoms when using the vaginal ring. This paper evaluates the compatibility of male condoms with a placebo vaginal ring. Methods This was a two-period crossover, randomized non-inferiority trial. Couples in two sites in the United States of America were randomized to male condom use, with and without a placebo silicone vaginal ring, and asked to use four male condoms in each period. The primary non-inferiority endpoints were total clinical failure and their component failure events (clinical breakage or slippage). Frequencies and percentages were calculated for each failure mode and differences in performance of the two periods using the male condom without the ring as reference. Non-inferiority was defined using a 3% margin at the 5% significance level. Safety and acceptability were also assessed. Results Seventy couples were enrolled, and 68 completed the trial with a total of 275 male condoms used in each period. Total condom clinical failure rates were 2.2% and 4.0% in the presence and absence of the vaginal ring, respectively, with a difference of -1.9% (95% CI -5.3%; 1.5%), thereby demonstrating non-inferiority when used with the ring. There was no difference in safety between the two periods. Discussion Concurrent use of the placebo silicone vaginal ring had no significant effect on male condom functionality or safety outcomes.Background Greater knowledge regarding stool frequency and infrequency during pelvic and abdominal irradiation is needed to accurately identify patients at risk of either. Objective To describe occurrence of frequent and infrequent stools during pelvic-abdominal radiotherapy, and to compare quality of life (QoL) and activities of daily living (ADLs) of those patients experiencing frequent stools with those of patients experiencing infrequent stools. Methods Longitudinally during radiotherapy, 193 patients (64% had gynecological tumors) documented stool frequency, medications, and QoL using the Functional Assessment of Cancer Therapy-General. Results Fifty (26%) experienced frequent stools (≥28 stools a week), and 17 (9%) experienced infrequent stools ( less then 3 stools a week). The frequency of stools and the consumption of medication for diarrhea were highest the last week of the radiotherapy period (50% had ≥49 stools a week, and 50% could not even define the number of stools). Thirty-seven of the patients experiencing frequent stools used antidiarrhea medications. Patients with frequent stools experienced lower QoL (P = .035) and capacity in ADLs (P = .023) compared with patients not experiencing frequent stools. Conclusions A fourth of patients irradiated over pelvic or abdominal fields experienced frequent stools, defined as moderate to severe diarrhea, and those patients experienced lower QoL and capacity in ADLs compared with patients who did not experience frequent stools. Infrequent stools were rarely experienced. Implications for practice Cancer nursing professionals should deliver evidence-based strategies to prevent frequent stools and treat frequent stools as an approach to lower the risk of impaired capacity in daily living and worsened QoL.Background Rapid changes in the healthcare marketplace are driving healthcare systems to modify operations by which advanced practice registered nurses (APRNs) and physician assistants (PAs) serve patients. By identifying more effective and efficient utilization workflows, organizations can meet these demands, resulting in high-functioning clinical teams. Local problem With the growing number of APRNs and PAs in a large academic medical center, there was a recognized need to establish effective and efficient utilization practices for these healthcare providers. Methods Directors of the APP Best Practice Center developed an internal NP/certified nurse midwife (CNM)/clinical nurse specialist (CNS)/PA assessment service which conducted evaluations to optimize APRN and PA practice at the clinical/department level. This assessment excluded certified registered nurse anesthetists. Interventions Thirty-two clinical areas were evaluated between September 2016 and May 2019. This included an NP/CNM/CNS/PA survey and more than 200 individual NP/CNM/CNS/PA interviews. Assessments addressed utilization, billing practices, professional development, and communication among team members. Results Qualitative and quantitative reports were compiled. Many common themes were identified. These were broken down into three major categories productivity, clinical operations, and professional development/support. Conclusions Several recommendations were presented to department leaders about NP/CNM/CNS/PA practice. Departments that implemented several of the recommendations showed positive outcomes. This was evidenced by increased financial gain (increased relative value units, increase in revenue generated), increased patient access (increased clinic densities), and overall NP/CNM/CNS/PA satisfaction.Many patients with severe asthma continue to have high symptom burden despite maximization of conventional therapy. As the understanding of asthma pathophysiology has evolved, however, more personalized therapy options have become available. Asthma biologics are a new class of medications that target the specific pathways that underlie a patient's disease and can reduce the frequency of asthma exacerbations and improve patient quality of life. Prednisolone F supplier Clinicians should refer potential candidates to a specialist for further evaluation.