Unauthorized reproduction of this article is prohibited. Background:Mental health conditions are common among persons with HIV (PWH). An understanding of factors associated with prescription medication use for these conditions and clinical impact of the prescription medications may improve care of mental health disorders in PWH.Methods:Psychotropic medication use was examined among PWH within the AIDS Clinical Trials Group A5322 (HAILO) study. Multivariable logistic models and Cox regression models estimated the association between psychotropic medications (any/none) with baseline and incident slow gait (>1 s/m) and neurocognitive impairment (NCI) for more than 4 years.Results:Of 1035 participants, the median age was 51 years.81% were men, 30% black, non-Hispanic, and 20% Hispanic. Psychotropic medication use was similar between men (34%) and women (38%; P = 0.19). PWH using psychotropic medications had greater odds of baseline slow gait {odds ratio 1.61, [95% confidence interval (CI): 1.23 to 2.10]; P < 0.001}. Men but not women using psychotropic medications had an increased risk of developing slow gait [hazard ratio 1.85; (1.29 to 2.65) vs 0.77; (CI: 0.35 to 1.68), P interaction = 0.045]. The sex-specific odds ratios for medication use and NCI were qualitatively but not statistically different [men: 1.79; (1.14-2.80); women: 1.27; (0.56-2.90); P interaction = 0.47]. Psychotropic medication use was associated with an increased risk of incident NCI [hazard ratio 2.18; (95% CI: 1.23 to 3.84), P = 0.007] in both men and women.Conclusions:Psychotropic medications are associated with impairment in functional outcomes of aging, with a greater risk of baseline NCI and incident slow gait among men. Further investigation is needed to optimize outcomes in PWH and prescription of psychotropic medications among both men and women.

Dissertation submitted in fulfilment of the requirements for the degree of Master of Education in the Department of Foundations of Education at the University of Zululand, 2003. / Outcomes-based education, like all other systems, need love, interest, background knowledge to learners as well as educators and proper resources for backing up the learning process. Educators' success in OBE depends on conditions of the country and circumstances like geographical locations that lead to imbalance of changes accompanied by problems such as overcrowded classrooms and inadequate of educational resources in rural and urban area.

Aims: The Pulmonary Embolism in Syncope Italian Trial reported 17.3% prevalence of pulmonary embolism (PE) in patients admitted with syncope. We investigated the prevalence of venous thromboembolism [VTE, including PE and deep vein thrombosis (DVT)] in syncope vs. non-syncope admissions and readmissions, and if syncope is an independent predictor of VTE. Methods and results: We conducted an observational study of index admissions of the 2013-14 Nationwide Readmission Database. / National Institutes of Health / Revisión por pares

Minimum resource requirements support population persistence; however, ecologists and conservationists often want to identify factors that improve biological outcomes of animals. The population-level approach common in wildlife-resource studies limits our ability to draw inferences about the importance of resources and other factors by failing to link them with individual fitness. Measuring individual-based biological outcomes and resource use helps determine variation in mechanistic relationships between animal fitness and behavior. I suggest using direct metrics of resource use such as food consumption and distance traveled, to avoid errors with estimating resource availability. I summarize these concepts in an analytical framework for modeling relationships between resource use and fitness to guide readers toward effective study designs. I also describe constraints on an animal’s ability to use resources freely, which must be considered when modeling these relationships to account for additional sources of variation in biological outcomes. I investigated effects of resource use on body condition, survival, and reproduction using field data from four species of vertebrates. I found that using multiple predictor metrics to model biological outcomes allows comparison between factors affecting fitness. In general, factors more closely relating to energetics (e.g., movement pattern or distance traveled) were more useful predictors of animal outcome than metrics of habitat use or selection. Management and conservation efficiency can be improved by focusing efforts on preventing detrimental risks and threats, and supporting less stressful access to beneficial resources rather than supporting average population habitat use without consideration of biological outcomes. Improving the study of ecology depends in part on our efforts to seek finer-scaled mechanistic observations of relationships among individual organism behavior, resource use, and biological outcomes that improve our understanding of population-level resource ecology. Melding current techniques to obtain detailed evidence of how habitat is used at an individual level will allow us to relate resources to fitness for more efficiently understanding an animal’s ecology and improving conservation and control of populations. While we will continue to manage for populations, we must not lose sight of the individual variation that drives natural selection if we want to fully understand variation in resource-outcome relationships.

The purpose of the present study was to determine whether patients with common foot disorders have different medical outcomes depending on whether podiatrists, orthopedic surgeons, or other physicians provided their medical care in rural or urban areas. A validated medical effectiveness score was formulated using indirect standardization of risk-adjusted morbidity, based on patient reports from a national random household interview survey of 3,270 subjects. Patients in rural and urban areas did not differ significantly in medical outcomes across provider types, but there was a trend for patients in rural areas to have poorer outcomes. The medical effectiveness score of podiatrists was 3.9 times higher (indicating more beneficial outcomes) than that of orthopedic surgeons or other physicians (p < 0.01). Patients that visited podiatrists for common foot problems reported significantly more beneficial outcomes than those who visited other types of health care providers.

Client outcomes in psychology training clinics have been shown to be generally worse than other outpatient settings. Although this finding has been repeatedly demonstrated, no consensus of cause has emerged in the literature. One possible explanation of such findings may relate to psychotherapist effects, a historically neglected variable that has received increased attention in more recent literature. Among psychotherapist effects researched, competency has emerged as a compelling factor worthy of more research. Given that most growth in competence occurs during graduate training, investigating the relationship between competency and client outcome offers great potential benefit for informing optimal training, nature of client symptom improvement, and a more accurate depiction of differences in psychotherapist effects across training and non-training settings. The purpose of this study was to explore the trajectory of competence development during doctoral training in health services psychology and to investigate the association of trainee competency to the psychotherapy outcomes evidenced by their clients. Practicum evaluations of 36 trainees and outcome data (using the Outcome Questionnaire-45.2) from 244 adult clients were included in analyses. Results of the study suggest there is a positive relationship between cumulative semesters of training and competency scores (rs[118]= .34, p < .001). Notably, there was no significant difference in psychotherapy outcome between low and high trainee competence. The results of the current study, relevant literature and limitations are discussed. Suggestions for future research are proposed.

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