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Hughes GD, Sommers E, Steel A. The Changing Global Public Health Landscape of Traditional, Complementary, and Integrative Medicine in Primary Care: Responding to the Vision of the Declaration of Astana. J Integr Complement Med 2023. [PMID: 37092968 DOI: 10.1089/jicm.2023.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Affiliation(s)
- Gail D Hughes
- Medical Biosciences Department, Faculty of Natural Sciences, University of Western Cape, Bellville, South Africa
- School of Health Professions, University of Missouri-Columbia, Columbia, MO, USA
- Integrative, Complementary and Traditional Health Practices Section, Public Health Association of South Africa
| | - Elizabeth Sommers
- Department of Family Medicine, School of Medicine, Boston University, Boston, MA, USA
- Integrative Medicine and Health Disparities, Boston Medical Center, Boston, MA, USA
- Integrative, Complementary and Traditional Health Practices Section, American Public Health Association, Washington, DC, USA
| | - Amie Steel
- Australian Research Consortium in Complementary and Integrative Medicine, Faculty of Health, School of Public Health, University of Technology Sydney, Ultimo, Australia
- Complementary Medicine Evidence, Research and Policy Special Interest Group, Public Health Association of Australia, Deakin, Australia
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Okonji EF, van Wyk B, Hughes GD, Mukumbang FC. Psychosocial Support Programme Improves Adherence and Health Systems Experiences for Adolescents on Antiretroviral Therapy in Mpumalanga Province, South Africa. Int J Environ Res Public Health 2022; 19:15468. [PMID: 36497544 PMCID: PMC9739873 DOI: 10.3390/ijerph192315468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/09/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Psychosocial support (PSS) plays a significant role in persistent adherence to and retention in antiretroviral therapy (ART) for adolescents living with the human immunodeficiency virus (ALHIV). This paper qualitatively explores the experiences of ALHIV on ART, who participated in a PSS programme in five public primary healthcare facilities in Mpumalanga Province in South Africa during the COVID-19 pandemic. (2) Methods: Data were collected through 24 focus group discussions with 173 ALHIV on ART and subjected to inductive thematic analysis. Informed consent was obtained before all data collection. (3) Results: The PSS programme facilitated the process of full HIV disclosure to these adolescents with the support of parents/guardians while motivating adherence through peer support groups and health education for improved treatment literacy. Participants reported positive health systems experiences, improved healthcare provider-client relations, and prompt access to health services. (4) Conclusions: The PSS programme successfully kept ALHIV engaged in ART care despite the health service disruptions encountered during the COVID-19 pandemic. We recommend rigorous evaluation of the effects of the PSS intervention on adherence to and retention in ART among ALHIV in HIV-endemic settings.
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Affiliation(s)
- Emeka Francis Okonji
- School of Public Health, University of the Western Cape, Cape Town 7535, South Africa
| | - Brian van Wyk
- School of Public Health, University of the Western Cape, Cape Town 7535, South Africa
| | - Gail D. Hughes
- Medical Biosciences Department, University of the Western Cape, Cape Town 7535, South Africa
| | - Ferdinand C. Mukumbang
- School of Public Health, University of the Western Cape, Cape Town 7535, South Africa
- Department of Global Health, University of Washington, Seattle, WA 98195, USA
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Hughes GD, Sommers E, Steel A. Call for Special Issue Papers: Global Public Health - Contributions of Traditional, Complementary, and Integrative Medicine in Primary Care. J Integr Complement Med 2022; 28:105-107. [PMID: 35133874 DOI: 10.1089/jicm.2022.29103.cfp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Gail D. Hughes
- Gail D. Hughes, DrPH, MPH; Professor, Medical Biosciences Department, Faculty of Natural Sciences, University of Western Cape; Adjunct Professor, University of Missouri-Columbia School of Health Professions; Founder and Chair, Integrative, Complementary Alternative and Traditional Health Practices Special Interest Group for Public Health Association South Africa; Contributor, American Public Health Association, Integrative, Complementary and Traditional Health Practices Section
| | - Elizabeth Sommers
- Elizabeth Sommers PhD, MPH, LicAc; Assistant Professor, Boston University School of Medicine, Dept. of Family Medicine; Senior Acupuncturist and Researcher, Boston Medical Center, Integrative Medicine and Health Disparities; Governing Councilor, American Public Health Association, Integrative, Complementary and Traditional Health Practices Section
| | - Amie Steel
- Amie Steel BHSc(Nat), MPH, PhD; Senior Research Fellow, Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney; Founding Member, Complementary Medicine, Evidence, Research & Policy Special Interest Group, Public Health Association of Australia
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Okonji EF, Wyk BV, Hughes GD, Mukumbang FC. Implementation of a Psychosocial Support Intervention for Adolescents on Antiretroviral Treatment: Challenges and Experiences from Ehlanzeni District, South Africa. J Int Assoc Provid AIDS Care 2022; 21:23259582221121094. [PMID: 35993156 PMCID: PMC9403444 DOI: 10.1177/23259582221121094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Adolescents living with HIV (ALHIV) need support from family, peers and health workers to remain on antiretroviral therapy and achieve and sustain viral suppression. This paper qualitatively explores the implementation of a psychosocial support intervention (PSS) in five primary health care facilities in the Ehlanzeni district, South Africa. Data were collected through key informant interviews and focus group discussions with ALHIV on ART. Data analysis employed inductive thematic analysis. Informed consent was obtained prior to all data collection. The PSS intervention facilitated full disclosure of HIV status to adolescents, supported treatment adherence through health education, peer support, health care provider- and client relations, and quick access to health service delivery. However, COVID-19 restrictions and regulations challenged the implementation of the intervention. The PSS intervention showed promise to support adolescent's adherence and retention in care. We recommend innovative approaches to account for systemic disruptions, as evidenced by the COVID-19 pandemic.
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Affiliation(s)
- Emeka F Okonji
- School of Public Health, 56390University of the Western Cape, Cape Town, South Africa
| | - Brian Van Wyk
- School of Public Health, 56390University of the Western Cape, Cape Town, South Africa
| | - Gail D Hughes
- Medical Biosciences Department, 56390University of the Western Cape, Cape Town, South Africa
| | - Ferdinand C Mukumbang
- School of Public Health, 56390University of the Western Cape, Cape Town, South Africa.,Department of Global Health, University of Washington, Seattle, WA, United States of America
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Okonji EF, van Wyk B, Mukumbang FC, Hughes GD. Determinants of viral suppression among adolescents on antiretroviral treatment in Ehlanzeni district, South Africa: a cross-sectional analysis. AIDS Res Ther 2021; 18:66. [PMID: 34627300 PMCID: PMC8501534 DOI: 10.1186/s12981-021-00391-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/20/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Achieving undetectable viral load is crucial for the reduction of HIV transmissions, AIDS-related illnesses and death. Adolescents (10 to19 years) living with HIV (ALHIV) on antiretroviral treatment (ART) have worse treatment adherence and lower viral suppression rates compared to adults. We report on the clinical factors associated with viral suppression among ALHIV in the Ehlanzeni district, Mpumalanga in South Africa. METHODS A cross-sectional analysis was conducted with 9386 ALHIV, aged 10 to 19 years, who were enrolled in 136 ART clinics in the Ehlanzeni district. Clinical and immunological data were obtained from electronic medical records (Tier.net). ALHIV were categorised as having achieved viral suppression if their latest viral load count was < 1000 ribonucleic acid (RNA) copies/mL. Using a backward stepwise approach, a multivariate logistic regression analysis was performed to identify factors independently associated with viral suppression. RESULTS The mean age of the participants was 14.75 years (SD = 2.9), and 55.43% were female. Mean duration on ART was 72.26 (SD = 42.3) months. Of the 9386 adolescents with viral load results recorded, 74% had achieved viral suppression. After adjusting for other covariates, the likelihood of achieving viral suppression remained significantly higher among ALHIV who were: female (AOR = 1.21, 95% CI 1.05-1.39), and had most recent CD4 count > 200 (AOR = 2.53, 95% CI 2.06-3.11). Furthermore, the likelihood of having viral suppression was lower among adolescents with CD4 count > 200 at baseline (AOR = 0.73, 95% CI 0.61-0.87), and who were switched to second line regimen (AOR = 0.41, 95% CI 0.34-0.49). CONCLUSIONS Viral suppression amongst ALHIV at 74% is considerably lower than the WHO target of 95%. Of particular concern for intervention is the lower rates of viral suppression amongst male ALHIV. Greater emphasis should be placed to early enrolment of ALHIV on ART and keeping them engaged in care (beyond 6 months). Furthermore, improved and regular viral load monitoring will help to adequately identify and manage ALHIV with unsuppressed viral load and subsequently switching to second line treatment.
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Affiliation(s)
- Emeka F Okonji
- School of Public Health, University of the Western Cape, P Bag X17, Bellville, 7535, South Africa.
| | - Brian van Wyk
- School of Public Health, University of the Western Cape, P Bag X17, Bellville, 7535, South Africa
| | - Ferdinand C Mukumbang
- School of Public Health, University of the Western Cape, P Bag X17, Bellville, 7535, South Africa
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Gail D Hughes
- Medical Biosciences Department, University of the Western Cape, Bellville, South Africa
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Rahiman F, Chikte U, Hughes GD. Nursing students' knowledge, attitude and practices of infection prevention and control guidelines at a tertiary institution in the Western Cape: A cross sectional study. Nurse Educ Today 2018; 69:20-25. [PMID: 30007142 DOI: 10.1016/j.nedt.2018.06.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 05/24/2018] [Accepted: 06/22/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Nurses in sub-Saharan Africa are particularly at a higher risk of acquiring nosocomial infections, considering the increased prevalence of infectious diseases. It is therefore imperative that these nurses have a sound knowledge and understanding of infection prevention procedures. OBJECTIVE The main objective of this study was to describe the knowledge, attitudes and practices concerning infection prevention and control precautions among nursing students in a resource limited setting. METHOD A cross sectional study design was employed. A self-administered questionnaire concerning infection prevention and control guidelines were made available to students enrolled in a mainstream programme for completion of an undergraduate nursing degree. SETTING AND PARTICIPANTS A total of 301 students at second, third and final years of study from a tertiary institution in the Western Cape were invited to participate. RESULTS The final cohort comprised of 301 students with the majority between the ages of 17-26 (88.2%), with a mean age of 23 ± 4.7 (SD) years and the dominant gender being female (83.4%). According to the classification system used in this study, the majority of the students were overall evaluated as having good level of knowledge (47.4%) and poor attitude (41.7%) scores, with little difference in practice scores observed between different years of study. There was a positive correlation found between students' total attitude and total practice scores (r = 0.48 p < 0.01). Results showed that significant associations between gender and knowledge (p < 0.05), attitudes (p < 0.05) and practice (p < 0.05) exists. There was also a significant association between province and those who repeated a year with total knowledge scores (p < 0.05). CONCLUSION Based on the results of this study, it is recommended that interactive infection control courses that promote critical thinking are implemented at undergraduate level along with more stringent forms of assessments focusing on infection prevention and control, during clinical training.
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Affiliation(s)
- Farzana Rahiman
- Department of Medical Bioscience, University of the Western Cape, South Africa.
| | - Usuf Chikte
- Department of Global Health, Faculty of Medicine and Health Sciences, University of Stellenbosch, South Africa
| | - Gail D Hughes
- Department of Medical Bioscience, University of the Western Cape, South Africa
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Hughes GD, Aboyade OM, Beauclair R, Mbamalu ON, Puoane TR. Characterizing Herbal Medicine Use for Noncommunicable Diseases in Urban South Africa. Evid Based Complement Alternat Med 2015; 2015:736074. [PMID: 26557865 PMCID: PMC4629029 DOI: 10.1155/2015/736074] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/16/2015] [Indexed: 01/10/2023]
Abstract
Economic challenges associated with noncommunicable diseases (NCDs) and the sociocultural outlook of many patients especially in Africa have increased dependence on traditional herbal medicines (THMs) for these diseases. A cross-sectional descriptive study designed to determine the prevalence of and reasons for THM use in the management of NCDs among South African adults was conducted in an urban, economically disadvantaged area of Cape Town, South Africa. In a cohort of 1030 participants recruited as part of the existing Prospective Urban and Rural Epidemiological (PURE) study, 456 individuals were identified. The overall prevalence of THM use was 27%, of which 61% was for NCDs. Participants used THM because of a family history (49%) and sociocultural beliefs (33%). Hypertensive medication was most commonly used concurrently with THM. Healthcare professionals need to be aware of the potential dualistic use of THM and conventional drugs by patients, as this could significantly influence health outcomes. Efforts should be made to educate patients on the potential for drug/herb interactions.
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Affiliation(s)
- Gail D. Hughes
- South African Herbal Science and Medicine Institute (SAHSMI), Faculty of Natural Sciences, University of the Western Cape, Private Bag X17, Bellville 7535, South Africa
| | - Oluwaseyi M. Aboyade
- South African Herbal Science and Medicine Institute, University of the Western Cape, Bellville 7535, South Africa
| | - Roxanne Beauclair
- The South African Centre for Epidemiological Modelling and Analysis, Stellenbosch University, Stellenbosch 7602, South Africa
- International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 UZP114, 9000 Gent, Belgium
| | - Oluchi N. Mbamalu
- School of Pharmacy, University of the Western Cape, Bellville 7535, South Africa
| | - Thandi R. Puoane
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa
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Hughes GD, Aboyade OM, Clark BL, Puoane TR. The prevalence of traditional herbal medicine use among hypertensives living in South African communities. BMC Complement Altern Med 2013; 13:38. [PMID: 23414344 PMCID: PMC3598715 DOI: 10.1186/1472-6882-13-38] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 02/05/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND In South Africa, over 6 million people are hypertensive and the burden of disease shows that cardiovascular diseases (CVDs) are the leading cause of death among adults. Although treatments exist, few people comply or adhere to recommended treatment due to side effects or costs of the drugs, hence the reliance on alternative forms of treatment. Traditional herbal medicines (THM) are used for the management of hypertension but the prevalence of its use among hypertensive patients living in South African communities is not sufficiently known. METHODS This was a cross-sectional descriptive study to determine the prevalence of THM use for hypertension, among 135 purposefully selected South African participants of the Prospective Urban and Rural Epidemiological (PURE) study, who are THM users. Data on THM use were collected by way of face to face interviews using structured questionnaires administered by trained field workers. Standard descriptive measures were used to characterize the study sample and responses to the questionnaire. Chi-square test was used when making comparisons between groups. RESULTS There were 135 THM users, 21% of whom used THM to treat hypertension. Majority (82.1%) of the hypertensive THM users were females, only 29% were married or co-habitating, virtually all (96%) were unemployed and 86% were Christians. More than half (56%) of the respondents were aged between 55 and 64 years. THM was occasionally used (51.9%) as a combination of tea and other mixtures (63%) and prescribed by family/ friends/self-administered. There was a significant difference in the age, marital and employment status, as well as the form and frequency of THM use of hypertensive THM users compared to other THM users. CONCLUSIONS The study gives an insight into the prevalence of THM use by hypertensive patients in selected South African communities. The practice of self-medication was also observed which raises concern regarding the safety of medications taken by the participants. Health care providers should however be more aware of THM use and counsel patients regarding the combination of prescribed treatment regimen and herbal medicines and the potential of herb-drug interactions.
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Affiliation(s)
- Gail D Hughes
- South African Herbal Science and Medicine Institute, University of the Western Cape, Bellville 7535, South Africa
| | - Oluwaseyi M Aboyade
- South African Herbal Science and Medicine Institute, University of the Western Cape, Bellville 7535, South Africa
| | - Bobby L Clark
- Clark & Associates Statistical Consulting, Nolensville, TN, USA
| | - Thandi R Puoane
- School of Public Health, University of the Western Cape, Bellville, 7535, South Africa
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Hughes GD, Puoane TR, Clark BL, Wondwossen TL, Johnson Q, Folk W. Prevalence and predictors of traditional medicine utilization among persons living with AIDS (PLWA) on antiretroviral (ARV) and prophylaxis treatment in both rural and urban areas in South Africa. Afr J Tradit Complement Altern Med 2012; 9:470-84. [PMID: 23983383 DOI: 10.4314/ajtcam.v9i4.4] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Previous studies have reported that majority of antiretroviral (ARV) treatment-naïve patients use traditional medicine (TM). Given that TM use is ubiquitous in South Africa especially for chronic conditions, there is a potential for ARV non-adherence and serious drug interactions among patients with HIV/AIDs who use TM. The motivating factors for TM use in HIV/AIDS patients on ARV and prophylaxis treatment have not been well defined in South Africa. This study aimed to investigate the prevalence, facilitators, predictors, and types of TM used among persons living with HIV/AIDS on antiretroviral treatment. The study was a cross-sectional survey which involved 100 participants enrolled at ARV clinics in two South African provinces. Univariate and bivariate analyses were performed to assess the relationships between variables and potential predictors of TM. Sixteen percent of participants on ARV reported TM use. Seventy-nine percent used TM prior to a diagnosis of HIV. Participants were more likely to use TM if they were from a rural province, female, older, unmarried, employed, had limited education, or were HIV-positive for less than five years. TM users reported utilizing herbal or medicinal mixtures that were claimed to heal all conditions. This study provides insights into the treatment modalities selected by patients with HIV/AIDS in South Africa who are receiving ARV. This study revealed that less than 20% of participants co-used TM and ARV. However, close to 80% of participants utilize TM before contracting HIV, which is in keeping with approximate estimates by the WHO.
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Affiliation(s)
- G D Hughes
- South African Herbal Science and Medicine Institute (SAHSMI), University of the Western Cape, Belleville, South Africa.
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Puoane TR, Hughes GD, Uwimana J, Johnson Q, Folk WR. Why HIV positive patients on antiretroviral treatment and/or cotrimoxazole prophylaxis use traditional medicine: perceptions of health workers, traditional healers and patients: a study in two provinces of South Africa. Afr J Tradit Complement Altern Med 2012; 9:495-502. [PMID: 23983385 PMCID: PMC3746650 DOI: 10.4314/ajtcam.v9i4.6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The study explored the perceptions, knowledge and attitudes of patients, health workers and traditional healers about the use of traditional medicine and Anti Retroviral Therapy (ART). The study explored the perceptions, knowledge and attitudes of patients, health workers and traditional healers about the use of traditional medicine and Anti Retroviral Therapy (ART), using an exploratory qualitative design in two provinces of South Africa: an urban township health facility in the Western Cape, and a rural district hospital in KwaZulu-Natal (KZN) with antennal HIV rate of 32% and 28%'respectively. In-depth interviews were conducted with 14 participants: six HIV patients on ART and using Traditional Medicine(TM), two doctors, two nurses and four traditional healers. Two focus group discussions -one at each site - were held with community health workers who work with HIV-positive patients (Western Cape [5] and in KZN [4]). Patient said to have used Traditional Healing Practices (THP) before they were diagnosed with HIV, and some who have been diagnosed with HIV continue using TM in conjunction with ART and/or Cotrimoxazole prophylaxis. Patients preferred not to disclose THP to health professionals because of lack of support and understanding. Patients utilize THP because of family expectations, privacy and confidentiality, especially when they have not disclosed their HIV status. Healthcare professionals had strong negative opinions about THP, especially for HIV-positive patients. Traditional healers supported the patient's rationale for THP use. This study revealed a need to better understand factors involved in patients' choosing to use THP concurrently with ART.
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Affiliation(s)
- T R Puoane
- School of Public Health, University of the Western Cape, Private Bag X17 Bellville, 7945, South Africa.
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Pratt GM, Learn CA, Hughes GD, Clark BL, Warthen M, Pories W. Demographics and outcomes at American Society for Metabolic and Bariatric Surgery Centers of Excellence. Surg Endosc 2009; 23:795-9. [PMID: 19184200 DOI: 10.1007/s00464-008-0077-8] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2008] [Revised: 06/15/2008] [Accepted: 06/23/2008] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Surgery is currently an effective long-term therapy for morbid obesity and its complications. A variety of surgical procedures can now offer durable and safe weight control as well as previously unrealized full remission of costly comorbidities. This is a preliminary investigation of patient characteristics and outcomes at Bariatric Surgery Centers of Excellence) (BSCOE) hospitals. METHODS AND PROCEDURES Data were analyzed from 235 American Society for Metabolic and Bariatric Surgery (ASMBS) BSCOE hospitals receiving Full Approval status from August 2005 to May 2007. Metrics for the 66,339 bariatric surgeries performed at these hospitals included type, volume and distribution of various bariatric surgical procedures performed at each hospital, patient demographics, payer information, and adverse outcomes. RESULTS Data from these analyses demonstrate significant differences in terms of surgical procedure selection (laparoscopic gastric bypass 61%), patient demographics (females 83%, White 60%, mean age 43 years) and type of payer (private insurance 78%), and adverse outcomes (readmission 5%, re-operation 2%, mortality 0.36%). CONCLUSIONS The collective performance of ASMBS BSCOE hospitals in bariatric outcomes of readmissions, re-operations, and mortality are equivalent to, or more favorable, than currently reported outcomes. However, risk assessment and risk adjustment of the patients and each of the bariatric procedures will be necessary to appropriately evaluate these rates.
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Affiliation(s)
- Gary M Pratt
- Surgical Review Corporation, 4800 Falls of Neuse Road, Raleigh, NC 27609, USA.
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Hughes GD, Sellers DB, Fraser L, Teague R, Knight B. Prostate cancer community collaboration and partnership: education, awareness, recruitment, and outreach to southern African-American males. J Cult Divers 2007; 14:68-73. [PMID: 19175246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Prostate cancer is a significant health problem for African-American men intensified by low participation in screenings, clinical trials, and prospective cohort studies. Ten focus groups were conducted with African-American males and their female partners/spouses. Perceptions and knowledge about prostate cancer, as well as willingness to participate in screening and research studies were measured. Participants had a basic level of knowledge about prostate cancer, and the importance of education was a unified theme. Dialogue with targeted African-American men and their partners/spouses may increase awareness and retention in medical research, while influencing health promotion, education and behavior.
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Affiliation(s)
- Gail D Hughes
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
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Hughes GD, Hoyo C, Puoane TR. Fear of sexually transmitted infections among women with male migrant partners -- relationship to oscillatory migration pattern and risk-avoidance behaviour. S Afr Med J 2006; 96:434-8. [PMID: 16751920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND In South Africa, former apartheid laws encouraged rural males seeking employment to migrate to urban areas, moving weekly, monthly or annually between their rural families and urban workplaces. The combination of the migrant labour system and long family separations caused an explosion of serious health consequences, among others sexually transmitted infections (STIs) in the migrant population. OBJECTIVE To describe some correlates of male migration patterns for the rural women left behind, especially the fear of STIs that this engendered in them and their risk-avoidance behaviour. Setting and subjects. In KwaZulu-Natal, 208 prenatal patients who were partners of oscillating male migrant workers were interviewed to determine their demographic and behavioural characteristics, and their fear of STIs. RESULTS Thirty-six per cent of the rural women said that they were afraid of contracting STIs from their returning migrant partners. Women who saw their partners infrequently were more fearful of STI transmission, and were less able to have sexual communication. However, almost none of the women protected themselves, while only 8% used condoms, primarily for contraceptive purposes. CONCLUSIONS These results reflect the gender-based power relationships of South African male migrants and their rural partners, the social and economic dependency of the women on their migrant partners, and the women's social responsibility to bear children. The results point to the need to go beyond interventions that simply seek to modify behaviour without altering the forces that promote risk taking and discourage risk reduction, and the need to develop appropriate interventions to curb STIs and decrease HIV.
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Affiliation(s)
- G D Hughes
- Department of Preventive Medicine, University of Mississipi Medical Center, Jackson, Mississipi, USA
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Hughes GD, Puoane T, Bradley H. Ability to manage diabetes—community health workers' knowledge, attitudes and beliefs. Journal of Endocrinology, Metabolism and Diabetes of South Africa 2006. [DOI: 10.1080/22201009.2006.10872134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Puoane T, Hughes GD. Impact of the HIV/AIDS pandemic on non-communicable disease prevention. S Afr Med J 2005; 95:228, 230. [PMID: 15889843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Affiliation(s)
- Thandi Puoane
- School of Public Health, University of the Western Cape
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Abstract
Background Today Iraq suffers from severe shortages of food, medicine, clean water and adequate sanitation. Malnutrition and communicable diseases are major factors in the rising morbidity and mortality rates. However, supplies and equipment are insufficient or outmoded, and public health training is outdated. The Universities have been unable to help because under-funding and isolation from their professional colleagues has limited their effectiveness. Methods To revitalize public health education, we describe a partnership between a US education consortium and the University of Mosul that will be carried out in the next several years. The plan is based on "three R's": Recovery from the past damage due to war and neglect; Retooling of key public health faculty to remedy the years of isolation and restriction of activity; and Reestablishment of the University as a resource for the its constituents, for the community and for other educational institutions. In all these activities, Iraqi minorities, especially women, will participate and contribute. Conclusion The work to repair the public health educational infrastructure has just begun. When completed, it will represent a small but necessary step in restoring normalcy to the people of Mosul, and of Iraq.
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Affiliation(s)
- Gail D Hughes
- Department of Preventive Medicine-Epidemiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA
| | - Ally Mack
- Mississippi Consortium for International Development (MCID), 1225 Robinson Street, Jackson, MS 39203, USA
| | - Kathie Stromile Golden
- Department of International Programs, Mississippi Valley State University, 14000 Highway 82 W., #5098 Itta Bena, MS 38941-1400, USA
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Abstract
Obesity is one of the most common conditions seen in medical practice, and is one of the most difficult to treat. This condition is often perceived as a cosmetic problem, but it is associated with a number of chronic medical conditions including, but not limited to, heart disease, hypertension, and dyslipidemia. Youth obesity has increased at an alarming rate in the United States and in other developed countries around the world. Given the high prevalence of obesity among adults in the United States, it is not surprising that pediatric obesity is also on the rise. The current trends in obesity among African-American adolescents in the state of Mississippi remain alarming and disheartening. Since obesity starts in early childhood and extends into the adolescent years and possibly into adulthood, behavior modification is the key to preventing the onset of obesity in all population groups.
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Affiliation(s)
- Gail D Hughes
- Department of Preventive Medicine and Division of General Internal Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
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Hughes GD, Sellers DB, Fraser LB, Knight B, Areghan GA. Barriers and strategies for sustained participation of African-American men in cohort studies. Ethn Dis 2003; 13:534-6. [PMID: 14632274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Affiliation(s)
- Gail D Hughes
- Department of Preventive Medicine-Epidemiology, University of Mississippi Medical Center, Jackson, Mississippi, USA
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Abstract
Many believe that the United States has entered a "Golden Age" of cardiovascular health and medicine. Pharmacological and technological advances have indeed produced an era of declining mortality rates from cardiovascular diseases for the nation as a whole. However, there remain areas of challenge. Cardiovascular disease (CVD) is still by far the leading cause of death and disability in the United States, and it is the leading killer of US women. Perhaps the single most notable feature of the CVD epidemic in the United States is the substantial difference in morbidity and mortality that exists between White women and women of color, with a disproportionate share of suffering borne by minority women. Unexplained regional variations also cloud the otherwise notable progress of the last 30 years, and many rural areas appear to be uniquely affected by cardiovascular disease. This commentary reviews the evidence that the CVD epidemic disproportionately burdens women of color who reside in rural areas, itemizes and provides a logical framework for explaining this burden, and suggests approaches to solving this vexing public health problem.
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Affiliation(s)
- Herman A Taylor
- Jackson Heart Study, 350 West Woodrow Wilson Drive, Suite 701, Jackson, MS 39213, USA.
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Brown JM, Derome AE, Hughes GD, Monaghan PK. Homogeneous Hydrogenation With Iridium Complexes. Evidence for Polyhydride Intermediates in the Reduction of α-Pinene. Aust J Chem 1992. [DOI: 10.1071/ch9920143] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The hydrogenation of α-pinene by Crabtree's catalyst [(cycloocta-1,5-diene)(pyridine)(tricyclo-hexylphosphine)iridium hexafluorophosphate] in dichloromethane, occurs from the endo -face with high stereospecificity. Reaction is accompanied by reversible equilibration with β-pinene, which forms 2% of the equilibrium mixture. The hydrogenation of β-pinene is slower than its isomerization under these conditions. Reductions were carried out with deuterium in order to probe the reaction mechanism. Using the novel technique of 2H-decoupled 13C n.m.r., it was found that a complete analysis of the isotope distribution in the product could be obtained by analysis of the C1 signal, since the possible β-and y-perturbations gave rise to distinct spectral shifts. All possible isotopomers corresponding to deuterium substitution at C2, C3 and C10 were observed, and no other site of deuteration was detected. Analysis of the product demonstrated that iridium polyhydrides are likely to be involved, since the results are inconsistent with simpler mechanistic pathways.
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Abstract
The career dimensions of the job--assignment to the service of one's choice and responsibility consistent with training--are clearly important to the nurse during the selection of a hospital.
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Hughes GD, Rothfield NF. Serum antinuclear antibodies in rheumatoid arthritis. Conn Med 1970; 34:171-6. [PMID: 4906729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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