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ion, for which the risk was predominantly low. Finally, 2.0-2.3 μg m-3 should be considered as PM2.5 concentrations that are irreducible when setting voluntary targets for ambient levels in the area.Although integration of HIV and maternal health services is recommended by the World Health Organization, evidence to guide implementation is limited. We describe facility-level implementation of policies for integrating HIV care within maternal health services and explore experiences of service users and providers in rural Tanzania (Ifakara), South Africa (uMkhanyakude) and Malawi (Karonga). Policy in all countries included HIV testing during antenatal care (ANC), same-day antiretroviral therapy (ART) initiation for HIV-positive pregnant women, and postpartum referral to ART clinics, between six weeks (Malawi, South Africa) and two years after delivery (Tanzania). All facilities offered HIV testing within ANC, most commonly during the first visit. Although most women were comfortable with HIV testing, some felt that opting out would lead to sub-standard services. Some facilities conducted group post-test counselling for HIV-negative women, raising concerns of unintended HIV status disclosure. ART initiation was offered on the same day, the same room as an HIV diagnosis in >90% of facilities. Women's worries around postpartum referral included having unknown providers, insufficient privacy and queues. Adoption and implementation of policies on integrated HIV and maternal health services varied across settings. Patients' experiences of these policies may influence uptake and retention in care.Visual search is facilitated when the target is repeatedly encountered at a fixed position within an invariant (vs. randomly variable) distractor layout-that is, when the layout is learned and guides attention to the target, a phenomenon known as contextual cuing. Subsequently changing the target location within a learned layout abolishes contextual cuing, which is difficult to relearn. Here, we used lateralized event-related electroencephalogram (EEG) potentials to explore memory-based attentional guidance (N = 16). The results revealed reliable contextual cuing during initial learning and an associated EEG-amplitude increase for repeated layouts in attention-related components, starting with an early posterior negativity (N1pc, 80-180 ms). When the target was relocated to the opposite hemifield following learning, contextual cuing was effectively abolished, and the N1pc was reversed in polarity (indicative of persistent misguidance of attention to the original target location). Thus, once learned, repeated layouts trigger attentional-priority signals from memory that proactively interfere with contextual relearning after target relocation.The use of recorded video in medical education is increasing. Video material may be assigned before scheduled sessions to create a flipped classroom. Here, the instructor may lead a session that is organized for discussion, interpretation, and reflection of the previewed content. We established conditions that lead to increased student participation and engagement with prerecorded content for a medical genetics section in a first-year medical school basic sciences integrated course. Preliminary analysis of an asynchronous video-based pre-professional program directed the design of video material to support a first semester medical genetics course. We compared student participation in, and opinion of, a flipped-classroom session based on written vs. video presentation of material. Student opinion was surveyed with audience response devices (clickers). Shorter videos that were created specifically for the course were preferred by students compared to recordings of previously delivered lectures. Students preferred videos to assigned reading material and consistent scheduling throughout the teaching semester increased student participation. Presentation of medical school content with previously recorded video material can be a useful teaching tool if properly implemented.A growing population of older adults resides in sub-Saharan Africa's urban slums. Although environmental conditions in slums are adversarial, there is limited knowledge on the wellbeing of older adults residing in these settings. This review sought to understand the scope, extent, and nature of current research on the health and wellbeing of older slum dwellers in sub-Saharan Africa. We searched 8 bibliographic databases for studies examining the health and wellbeing of older slum dwellers in the region. We also completed a grey literature search. The literature search together yielded 3,388 records, of which we selected 25 for review following a rigorous screening process. The included studies covered a variety of health issues of concern to older slum dwellers (1) disease and injury prevalence; (2) self-assessed health and quality of life status; (3) physical/mental health impairment and disability; (4) healthcare access and utilisation; and (5) sociodemographic disparities in health and wellbeing. The gaps in this literature include a regional bias in research efforts, near absence of non-slum control samples, and limited research on the health impacts of the built environment of slums. Suggestions for future research are presented.Cognitive deficits are barriers to job acquisition or return to school, and can be reduced through Cognitive remediation therapy (CRT). The main goal of this multiple case study was to investigate the effect of personalized CRT on occupational status in three participants with a recent-onset psychosis. Two cases improved their occupational status at post-treatment, and showed improvements in cognitive, psychological, and/or clinical variables. This study suggests that personalized CRT may facilitate job acquisition or return to school. However, the different pathways showed by our cases indicate that personalized CRT may influence occupational status through multiple mechanisms, underlining the relevance of treatment personalization.
Several studies have reported on liver injury during COVID-19. However, the definition and timing of liver injury is different among the published articles. The aim of the present study is to evaluate whether COVID-19 related liver injury at the time of first presentation is associated with the course of the disease.
We conducted a single center retrospective study at Amphia Hospital in Breda, The Netherlands, from February 1 through April 30, 2020. Patients with reverse transcription polymerase chain reaction confirmed COVID-19 were included. We excluded patients with known chronic liver disease, harmful alcohol consumption or patients on certain antibiotics prior to admission. The clinical characteristics and outcomes of patients with and without COVID-19 related liver injury were compared. Metabolism inhibitor Liver injury was defined as elevated alanine aminotransferase and/or alkaline phosphatase at the time when the first positive COVID-19 sample was obtained.
We included 382 patients with COVID-19 infection. The incidence of liver injury was 41.
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