Efficacy of an Educational and Counseling Intervention on Adherence to Highly Active Antiretroviral Therapy: French Prospective Controlled Study

Abstract

Purpose: The objective was to evaluate the impact of an intervention for improving adherence to antiretroviral therapies (HAART) in HIV-infected patients. Method: We designed a prospective, controlled, randomized trial to assess the impact of an educational and counseling intervention in addition to standard of care. At M0, the study enrolled 244 HAART-treated patients who attended a medical consultation between September and December 1999 who were not included in another protocol. Patients in the intervention group (IG) were offered three individual sessions by trained nurses. The proportions of adherent patients at 6 months followup (M6) and the change in HIV RNA between M0 and M6 were measured. Results: Between M0 and M6, HIV RNA significantly decreased in the 123 patients of the IG (mean difference = –0.22 log [±0.86], p = .013), while it increased (+0.12 log [±0.90], p = .14) in the 121 patients of the control group. However, the proportion of patients with HIV RNA <40 copies/mL remained similar in both groups. In an intent-to-treat analysis, the only significant predictor of 100% adherence at M6 was the intervention group (p = .05) after adjustment for baseline adherence (p = .001). Among the 202 patients with available data on adherence, the proportion of adherent patients was similar in both groups at M0 (58% vs. 63%, p = .59) but became higher in the IG at M6 (75% vs. 61%, p = .04). Conclusion: The educational and counseling intervention was efficient for increasing adherence to HAART and could be implemented in most clinical settings.     

结核病患者的营养筛查及个体化营养干预的效果分析

〔摘 要〕 目的：观察营养风险筛查、个体化营养干预对肺结核患者临床疗效的影响。方法：选择 2021 年 3 月至 2022 年 3 月就诊于巩义市人民医院感染科的 64 例肺结核患者，运用营养风险筛查评估表（NRS 2002）对患者进行营 养风险筛查，并检验个体化营养干预前后淋巴细胞计数（TLC）、血清白蛋白（ALB）、血红蛋白（HGB）、前白蛋 白（PA）、体质量指数（BMI）的变化及肌酐水平。结果：营养干预 12 周的 NRS 2002 评分≥ 3 分的肺结核患者占比 低于入组时，＜ 3 分的肺结核患者占比高于入组时，差异均具有统计学意义（P ＜ 0.05）；营养干预 4 周后，患者的 HGB、PA、BMI 水平较入组时均有改善，干预 12 周后，患者的 ALB、HGB、PA、BMI 水平较入组时均有改善，差异 具有统计学意义（P ＜ 0.05）。结论：肺结核患者大多存在营养风险，个体化营养干预可改善肺结核患者的营养状态。     

Theories of behaviour and behaviour change across the social and behavioural sciences: a scoping review

Interventions to change health-related behaviours typically have modest effects and may be more effective if grounded in appropriate theory. Most theories applied to public health interventions tend to emphasise individual capabilities and motivation, with limited reference to context and social factors. Intervention effectiveness may be increased by drawing on a wider range of theories incorporating social, cultural and economic factors that influence behaviour. The primary aim of this paper is to identify theories of behaviour and behaviour change of potential relevance to public health interventions across four scientific disciplines: psychology, sociology, anthropology and economics. We report in detail the methodology of our scoping review used to identify these theories including which involved a systematic search of electronic databases, consultation with a multidisciplinary advisory group, web searching, searching of reference lists and hand searching of key behavioural science journals. Of secondary interest we developed a list of agreed criteria for judging the quality of the theories. We identified 82 theories and 9 criteria for assessing theory quality. The potential relevance of this wide-ranging number of theories to public health interventions and the ease and usefulness of evaluating the theories in terms of the quality criteria are however yet to be determined.     

Training police trainees about ways to manage trauma and loss

For the second year we were invited to be trainers at a training seminar for senior police educators, held in the German Federal Police University and sponsored by the European Police College, hence, having the opportunity to build on their previous applications. We applied exercises (psychoeducation, mindfulness/awareness, journaling, processing in dyads) that introduced in this training and designed to teach officers how to handle exposure to adversities and minimize potential negative consequences. Police officers expect exposure to potentially traumatic incidents, yet, often suffer deeply because of unresolved trauma related to handling horrific events. Our work aimed to open discussion in order to formulate a standard component in training curricula related to teaching police trainees ways to effectively handle and process trauma.     

Task Force Report on Methodology and Empirically Supported Treatments: Introduction

ABSTRACT

Recent criticism of biofeedback has increased the importance of rating the efficacy of each biofeedback and neurofeedback therapy. A joint task force of the Association for Applied Psychophysiology and Biofeedback (AAPB) and the Society for Neuronal Regulation (SNR) has developed standards for efficacy research methodology and template for rating the level of efficacy of each application. The Task Force Report has been approved as a policy guideline by both the AAPB and SNR Boards.     

The Effect of Reading Interventions among Poor Readers at a Forensic Psychiatric Clinic

The aim of the present study was to investigate the effect of a short period, 15 sessions, of reading interventions in a sample of adult forensic psychiatric patients: 61 patients with decoding difficulties – 44 in the experimental group and 17 in the comparison group – with an average age of 31.6 participated. Of these, 36% were female, and 29% had an immigrant background. The participants carried out a battery of reading tests. The results in the experimental group showed a medium effect size (d = .36 to .76) on all reading tests between pre- and post-test. The comparison group, however, showed no gain at all between the test occasions. The results indicate that a proportionally low reading intervention effort produces improvement in reading. This study discusses the importance of including reading assessment and offering remediation in order to reach optimal future social adjustment for patients in forensic clinics.     

Alcohol misuse,policy and treatment responses in Sub-Saharan Africa: The case of Uganda

Abstract

Alcohol has become an important feature in the lives of many inhabitants of Sub-Saharan Africa and is increasingly associated with excessive consumption and negative personal and social consequences. Uganda is one of the Sub-Saharan countries with the highest rate of alcohol-related burden in the world, but supply and demand reduction strategies such as regulatory measures, prevention and treatment programs are hardly available. Consequently, the aim of this article is to critically review the situation in Uganda as part of a regional trend. First, the origins of alcohol misuse and emerging policy initiatives in Sub-Saharan Africa are discussed. Then, the consequences of alcohol misuse in Uganda are highlighted, as well as policy and treatment responses. Recommendations are formulated for developing more effective and culturally adapted treatment programs and policies.