Mediating antiretroviral treatment for HIV during COVID-19: lessons from implementation in Gomba District, Uganda

Initial and subsequent waves of COVID-19 in Uganda disrupted the delivery of HIV care. In rural areas, village health teams and organisations on the ground had to develop strategies to ensure that people living with HIV could continue their treatment. It was necessary to take evolving circumstances into account, including dealing with movement restrictions, constrained access to food and stigma due to anonymity being lost as a result of a shift from health facility-based services to community-level support. Uganda has a long history of community-driven response to HIV, although health systems and response programming have become more centralised through government and donors to address political commitments to HIV treatment and other targets. The delivery system for antiretroviral therapy was vulnerable to the impacts of COVID-19 restrictions and related circumstances. To understand the continuum of challenges, and to inform ongoing and future support of treatment for people living with HIV, interviews were conducted with HIV organisation implementers, health workers, village health team members and people living with HIV. It was found that stigma was a central challenge, which led to nuanced adaptations for delivering antiretroviral treatment. There is a need to strengthen support to households of people living with HIV through improving community capacity to manage crises through improving household food gardens and savings, as well as capacity to organise and interact with support systems such as the village health teams. In communities, there is a need to evoke dialogue on stigma and to support community leadership on pressing issues that affect communities as a whole and their vulnerable groups. There are opportunities to reawaken the grassroots civic response systems that were evident in Uganda's early response to HIV yet were lacking in the COVID-19 context.

Effect Of Motor Control Retraining Of Scapular Stabilizers Versus Mulligan Mobilisation With Movement In Shoulder Impingement Syndrome

Background: Shoulder Impingement is one of the most common causes of shoulder pain in adults. Scapular muscle imbalances results in impaired scapular orientation with altered scapular kinematics and altered glenohumeral rhythm. Purpose of study: To study the effect of motor control retraining of scapular stabilizers versus mulligan mobilisation with movement in shoulder impingement patients. Methodology: 60 patients with positive Hawkins, kinetic medial rotation and/or Neer impingement test were taken for the study as subjects. They were then divided into two groups of 30 each- Group A and Group B. Both the groups were assessed and reassessed for(i) pain status using VAS (Visual Analogue Scale) both at rest and on internal rotation, (ii)Shoulder Flexion, Extension, Shoulder Abduction, Adduction, Internal and External Rotation Range Of Motion (ROM), (iii)Functional Scale SPADI( Shoulder Pain and Disability Index) pre and post the intervention. Group A received motor control retraining of scapular stabilizers whereas group B received Mulligan’s mobilization with movement for 6 weeks (3 times in a week). Both the groups received conventional physiotherapy. Data analysis was done using Wilcoxon sign ranked test for intragroup comparison and Manwhitney test for intergroup comparison. Results: The results showed statistically significant improvement in shoulder pain, ROM and shoulder function in motor control retraining as compared to mulligan mobilisation with movement. Conclusion: Motor control retraining of scapular stabilizers is more effective treatment technique as compared to mulligan mobilisation with movement in shoulder impingement.

Health librarians making a difference in a health care setting: the Chitambo emergency care communications project

Health librarians in the role of a knowledge broker can encourage health care workers to use evidence based health information. The knowledge broker role is an intervention dedicated to translating knowledge into action originating from the evidence-based medicine campaign. The Chitambo Emergency Care Communications Project through its knowledge component work strand has visualisations of converting knowledge into action to improve emergency care response by health workers, through the implementation of the knowledge broker role for health care workers in Chitambo district, Central Zambia. Implementation of the knowledge broker activity for Chitambo adopted a framework purposefully designed to build capacity for health librarians by the National Health Service Education for Scotland. The knowledge to action model can be useful in providing the relevant information to improve patient outcomes for healthcare workers. These knowledge gaps can be alleviated by knowledge brokering as it straddles through any knowledge gaps between the health workers' knowledge and their service delivery practice.

Effect Of Bilateral Ankle Joint Mobilisation On Functional Balance In Community Dwelling Elderly

Background: Falls are most frequent cause of accident related injury and are frequently associated with accident related death in the elderly. While an individual’s risk for falling is associated with a variety of sensory, motor, cognitive and environmental variables, it ultimately depends on their frequency of loss of balance episodes and their ability to recover balance by stepping, grasping or swaying (via the ankle strategy or hip strategy). Although visual, vestibular and somatosensory functions are known to be contributing factors in maintaining balance, they are not as easily altered as muscle strength and joint range of motion and stiffness. The study aimed To assess the effects of bilateral ankle joint mobilisation on functional balance in community dwelling elderly Materials and methods: In the present study a convenience sample of 60 community dwelling elderly between the age 65 to 75 years wererandomly and evenly divided into 2 groups :The Experimental Group &Control Group.For the purpose of selecting the subject in the study they were evaluated with the Time Up And Go Test.Maitland joint mobilization three times a week for four weeks was performed for bilateral ankle joint for the experimental group.The Control group were not given any exercises during the study protocol. At the end of 4 weeks, the outcome measures Functional Reach Test (FRT) andOne leg Stance Test (OLST) were assessed pre & post intervention in both the groups and the data was statistically analysed. Results: Intragroup analysis of both groups pre and post intervention showed statistically significant values for both the outcome measures FRT and OLST ( p value< 0.05). Intergroup analysis also showed statistically significant values for outcome measures inferring that experimental group was better than the control group (p value < 0.05). Conclusion:The study concludes that Ankle joint mobilisation helps in improving the dynamic balance in elderly individuals.

(Im)possibilidade de mobilização subjetiva na clínica das patologias do trabalho: o caso das professoras readaptadas / (Im)possibility of subjective mobilization in the clinic of work pathologies: the case of readapted teachers / (Im)posibilidad de movilización subjetiva en la clínica de las patologías del trabajo: el caso de profesoras readaptadas / (Im)possibilité de Mobilisation Subjective en Clinique de Pathologies de Travail: Le Cas des Enseignants Réadaptés

A partir da constatação de que os estudos em clínica psicodinâmica do trabalho enfocam trabalhadores em situação de normalidade e não expressam, claramente, como a mobilização subjetiva ocorre a partir da escuta clínica, pretendeu-se, com este artigo, problematizar o conceito dejouriano de mobilização subjetiva em contexto de trabalhadores adoecidos. A pesquisa foi realizada com base no referencial teórico e metodológico da psicodinâmica do trabalho. Foram realizadas 22 sessões de clínica do trabalho com professoras readaptadas do Distrito Federal e os dados foram analisados conforme a técnica de análise clínica do trabalho. A mobilização subjetiva, como um processo de resgate do sentido e do prazer no trabalho, não foi possível de ser alcançada na clínica. Esse resultado se deve ao fato de o trabalho na readaptação se constituir em um trabalho morto, inclusive no sentido de contribuir para o isolamento e a exclusão dessas profissionais, levando ao desmoronamento dos laços sociais e à impossibilidade de uma mobilização coletiva potente o suficiente para mudar as questões estruturais desse não trabalho a que estão submetidas. Apesar de defender a impossibilidade de mobilização subjetiva em um trabalho morto, a grande contribuição da clínica do trabalho realizada foi no sentido de demonstrar a potência política da clínica do trabalho a partir de novos destinos que as professoras adoecidas puderam dar ao sofrimento.

This article aimed to problematize the Dejourian concept of subjective mobilization in the context of sick workers based on the fact that studies in clinical psychodynamic work focus on workers in a normal situation and do not clearly express how subjective mobilization occurs from clinical listening. The research was based on the theoretical and methodological framework of psychodynamic work. Twenty-two occupational clinic sessions were held with readapted teachers from the Federal District and the data were analyzed according to the clinical work analysis technique. Subjective mobilization, as a process of rescuing meaning and pleasure at work, could not be achieved in the clinic. This result is due to the fact that the work on re-adaptation constitutes a dead work, including in the sense of contributing to the isolation and exclusion of these professionals, leading to the collapse of social ties and the impossibility of a collective mobilization powerful enough to change the structural issues of this non-work to which they are subjected. Despite defending the impossibility of subjective mobilization in a dead work, the great contribution of the clinic work performed was to demonstrate the political power of the work clinic from new destinations that the sick teachers could give to suffering.

A partir de la constatación de que los estudios en clínica psico-dinámica del trabajo enfocan trabajadores en situación de normalidad y no exprimen, claramente, cómo la movilización subjetiva ocurre a partir de la escucha clínica, se pretendió, con este trabajo, problematizar el concepto dejouriano de movilización subjetiva en contexto de trabajadores enfermos. La investigación fue realizada con base en el referencial teórico y metodológico de la psico-dinámica del trabajo. Fueron realizadas 22 sesiones de clínica del trabajo con profesoras readaptadas del Distrito Federal y los datos fueron analizados según la técnica de análisis clínica del trabajo. La movilización subjetiva, como un proceso de rescate del sentido y del placer en el trabajo, no fue posible de ser alcanzada en la clínica. Este resultado es debido al hecho de que el trabajo en la readaptación se constituye en un trabajo muerto, incluso en el sentido de contribuir para el aislamiento y la exclusión de estas profesionales, llevando al derrumbe de los lazos sociales y a la imposibilidad de una movilización colectiva suficientemente fuerte para cambiar cuestiones estructurales de este no-trabajo a lo cual están sometidas. Aunque se defienda la imposibilidad de movilización subjetiva en un trabajo muerto, la gran contribución de la clínica del trabajo realizada fue en el sentido de demostrar la potencia política de la clínica del trabajo a partir de nuevos destinos que las profesoras enfermas pudieron dar al sufrimiento.

À partir de la constatation que les études sur le travail chez des cliniques psychodynamiques n'observent que des travailleurs en situation normale et n'expriment pas clairement comment la mobilisation subjective peut arriver chez l'écoute clinique, cet article a l'objectif à problématiser le concept de mobilisation subjective de Dejourian dans le contexte des travailleurs malades. La recherche a été menée sur la base du cadre théorique et méthodologique de la psychodynamique du travail. Vingt-deux séances de clinique du travail ont été organisées avec des enseignantes réadaptées du District Fédéral, au Brésil. Les données ont été analysées selon la technique d'analyse du travail clinique. La mobilisation subjective, en tant que processus de récupération du sens et du plaisir au travail, n'a pas pu être réalisée dans la clinique. Ce résultat est dû au fait que le travail de réadaptation constitue un travail mort, spécialement au sens de contribuer à l'isolement et à l'exclusion de ces professionnelles. Cela conduit à la rupture des liens sociaux et à l'impossibilité d'une mobilisation collective assez puissante pour changer les problèmes structurels de ce non-travail auquel elles sont soumises. Malgré la défense de l'impossibilité de mobilisation subjective dans un travail mort, la contribution importante de la clinique de travail réalisée a été de démontrer le pouvoir politique de la clinique de travail à partir de nouvelles destinations que les enseignantes malades ont pu donner à la souffrance.

Tipos de participación política: análisis factorial confirmatorio con estudiantes universitarios de Buenos Aires, Argentina / Political participation types: confirmatory factorial analyzes with college students of Buenos Aires, Argentina / Tipos de participação política: análise fatorial confirmatória com estudantes universitários de Buenos Aires, Argentina / Types de participación politique: analyses factorielles confirmatoire avec étudiants des collèges en Buenos Aires, Argentine

Distintos estudios han intentado definir y clasificar los tipos de participación política. El presente trabajo analiza la estructura factorial de la participación política en el contexto argentino. La muestra estuvo compuesta por 496 estudiantes universitarios de la Ciudad Autónoma de Buenos Aires. La escala utilizada es una adaptación de Sabucedo e col. (1992). Los resultados ponen de manifiesto un modelo según el cual la participación política incluiría dos grandes formas: la participación proselitista o institucional y la participación de movilización o directa (dividida a su vez en pacífica y agresiva). El modelo presenta buenos índices de ajuste. Asimismo, se hallaron diferencias estadísticamente significativas en función de datos sociodemográficos, el interés por la política y la orientación política.

Several studies have attempted to define and classify different types of political participation. Present study analyzes political participation factorial structure of in Argentina context. The sample is composed by 496 college students from Buenos Aires. A scale constructed ad hoc from Sabucedo e col. (1992) was used. Results reveal a pattern of political participation with two major dimensions: proselytizing or institutional involvement and direct participation or mobilization (divided into peaceful and aggressive). Model shows good fit indices. Furthermore, statistically significant differences were found in terms of sociodemographic data, interest in politics and political orientation.

Vários estudos têm tentado definir e classificar os tipos de participação política. Este artigo analisa a estrutura de fatores de participação política no contexto argentino. A amostra foi composta por 496 estudantes universitários da Cidade Autônoma de Buenos Aires e foi utilizada uma escala ad hoc construída a partir de Sabucedo e col. (1992). Os resultados revelam um padrão em que a participação política inclui duas formas principais: envolvimento proselitismo ou institucional e participação direta ou mobilização (divididos por sua vez em paz e agressivo). O modelo mostra bons índices de ajuste. Além disso, as diferenças estatisticamente significativas em termos de dados sociodemográficos, de juros na política e de orientação política.

Plusieurs études ont tenté de définir et de catégoriser les types de participation politique. Cet article analyse la structure des facteurs de la participation politique dans le contexte argentin. L'échantillon était composé de 496 étudiants des collèges de la ville autonome de Buenos Aires. L'échelle utilisée est une adaptation de Sabucedo e col. (1992). Les résultats révèlent un modèle dans lequel la participation politique comprend deux grandes façons : le prosélytisme ou de participation institutionnelle et de mobilisation ou de participation directe (divisée à son tour en paisible et agressif). Le modèle montre de bons indices d'ajustement. En outre, des différences statistiquement significatives en termes de données sociodémographiques, l'intérêt pour la politique et l'orientation politique ont été trouvés.