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  • atm kinase inhibitor Findings Three factors were significant

    2019-05-21

    Findings Three factors were significant predictors of treatment failure: the presence of at least 1 month of fair or poor adherence (OR 15·7, 95% CI 1·8–136·7; p=0·01); previous treatment at another clinic before the WWO/AHF Family Health Clinic (1·4, 1·2–13·7; p=0·02); and tuberculosis symptoms at baseline (3·6, 1·1–12·3; p=0·04). In adult patients (n=58), two separate factors were significant predictors of treatment failure: non-use of soft drugs, such as marijuana and khat (0·02, 0·001–0·445; p=0·02), and low baseline CD4 count (0·985, 0·972–0·999; p=0·03) Interpretation Predictors of ART failure can be used for early identification of patients at high risk of first-line treatment failure. Subsequent rapid transition to second-line therapy could result in better outcomes and care for these patients at the WWO/AHF Family Health Clinic in Addis Ababa, Ethiopia. The association between non-use of soft drugs and failure of first-line ART should be explored further. Funding Arnold Institute for Global Health, Icahn School of Medicine at Mount Sinai. Declaration of interests
    Abstract Background Social atm kinase inhibitor is a complex environmental construct used for development and health promotion. Many governments, along with global and regional agencies, have begun to use social cohesion strategies to promote development and health equity. However, there is little understanding of how the concept of social cohesion is applied practically—that is, operationalised—in interventions. Our aim was to examine stakeholder perspectives on how social cohesion interventions are operationalised in Latin America and Europe to inform development of social cohesion strategies in the USA. Methods We interviewed 17 key informants from various constituencies, including coordinators of social cohesion programmes, government officials, researchers, funders, policy makers, planners, and representatives of non-governmental organisations. The interviewees were from institutions in Mexico, France, Belgium, Spain, and Germany. Findings Respondents expressed how social cohesion is an important tool to promote health through the leveraging of the resilience of communities. Another theme highlighted how social cohesion programmes address societal gaps, such as social inclusion, equity, social mobility, and social capital. Specific issues addressed under these dimensions were corruption, human rights, and participation of stakeholders. Although projects were able to bring together various, and sometimes conflicting, stakeholders to address major social issues, we found little consensus on what social cohesion means in the context of health interventions and how to apply social cohesion within these interventions. Interpretation Social cohesion can be considered both a driver and an outcome for addressing inequities and could be implemented at either the micro or macro level. Civil society plays an important role in the development of public policy to create social cohesion. However, more rigorous evaluation is needed to assess the effect of social cohesion programmes on global health. Funding Robert Wood Johnson Foundation. Declaration of interests
    Abstract Background Researchers have found dietary differences between people who smoke tobacco and those who do not, with lower intakes of fish, fruits, and vegetables in smokers. However, most of these studies are from developed countries, and less is known about the effects of tobacco on diet in developing countries where malnutrition is an important public-health challenge. Furthermore, the effect of smokeless tobacco on diet are not known. In this study, we aim to evaluate the effect of tobacco use on diet in a developing country. Methods We used data from the nationally representative Household Income Expenditure Survey (HIES-2010) from Bangladesh. The HIES 2010 included data from 12 240 households (7840 rural and 4400 urban). The consumption module of the HIES survey recorded household food consumption quantities and money spent on those for 14 days. The data for 14 days\' food expenditure was collected in 7 visits with 2 days\' recall, and included both ethnic and region-specific foods. Data on tobacco and tobacco products, including cigarettes, tobacco leaf, bidies, gul, and betel leaf were recorded in the consumption section of the questionnaire.