Body image and antiretroviral therapy adherence among people living with HIV: a protocol for a systematic review and meta-analysis.

INTRODUCTION: Adherence to antiretroviral therapy (ART) remains a key challenge to achieving the fast-track goal of ending the HIV epidemic by 2030. To provide a more comprehensive indication of whether interventions designed to promote ART adherence might benefit from targeting body image perceptions, we aim to conduct a systematic review to synthesise existing evidence on the association between body image and ART adherence. METHODS AND ANALYSIS: A systematic review of peer-reviewed observational studies and randomised controlled trials that have investigated the association between body image and adherence to ART will be performed. JSTOR, PsycARTICLES, PsycINFO, PubMed, ScienceDirect and Web of Science databases will be searched from 1 January 2000 to 31 March 2021. Eligible records will consider body image as either an independent variable or a mediator, whereas ART adherence will be assessed as an outcome variable. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and study quality will be assessed using relevant tools developed by the National Institute of Health. If sufficient data are available, a meta-analysis will be conducted. Effect size estimates will be aggregated using a random effects meta-analysis approach. Publication bias and its impact will be evaluated through the use of a funnel plot and the trim-and-fill method. The Grading of Recommendations Assessment, Development and Evaluation approach will be used to report on the overall quality of evidence. ETHICS AND DISSEMINATION: Ethical approval is not required for a systematic review protocol. Findings of the proposed systematic review will be disseminated through conference presentations and publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020212597.

A person-centered approach to achievement goal orientations in competitive tennis players: Associations with motivation and mental toughness.

BACKGROUND: Research on achievement goal orientations in sport has typically relied on the use of variable-centered approaches that tend to overlook population heterogeneity. In this study, we used a person-centered approach to identify subgroups of competitive tennis players according to unique combinations of achievement goal orientations and tested for subgroup differences in motivation and mental toughness. METHODS: A sample of 323 competitive tennis athletes (69.35% male) between 15 and 25 years of age (17.60 ± 2.40 years, mean ± SD) completed the 3 × 2 Achievement Goal Questionnaire for Sport, Sport Motivation Scale II, and Mental Toughness Index. Latent profile analysis was used to identify unique combinations of achievement goal orientations. Comparisons between latent subgroups on autonomous motivation, controlled motivation, and mental toughness were performed using analysis of variance. RESULTS: Latent profile analysis supported 3 distinct patterns of achievement goal profiles that were primarily distinguishable based on valence of competence (i.e., approach vs. avoidance). Analyses of variance indicated that athletes who were classified into subgroups that endorsed approach types of goals (regardless of the types of avoidance goals they endorsed) reported higher levels of autonomous motivation and mental toughness. CONCLUSION: Results indicated that athletes tend to pursue a number of achievement goals collectively rather than in isolation. Although approach goals are more commonly linked to adaptive psychological functioning and positive outcomes, avoidance goals may also be associated with desirable psychological characteristics if they are pursued in conjunction with approach types of achievement goals.

Additive, Curvilinear, and Interactive Relations of Anxiety and Depression With Indicators of Psychosocial Functioning.

This study examines additive, curvilinear, and interactive relations of anxiety and depression with several subjective indicators of intrapersonal (i.e., hope, self-compassion, shame) and interpersonal (i.e., social connectedness, quality of social relationships) functioning in a sample of adults (N = 547, Mage = 43.37 ± 12.02, female = 56.88%) seeking treatment for psychological difficulties. Results of complementary analyses were largely consistent with the hypothesis that increasing levels of anxiety and depression would correspond with worse psychosocial functioning, although nonlinear relations indicated that the effect of depression progressively attenuated at higher levels of symptom severity. Whereas the findings generally supported additive effects of anxiety and depression, the hypothesis that there would be synergistic effects of anxiety and depression was not supported. Supplementary group comparisons revealed that the functional implications of subsyndromal combinations of anxiety and depression may be comparable to those associated with symptoms that meet more traditional standards (i.e., syndromal or dimensional definitions) of comorbid anxiety-depression. The findings offer further insight into the complex relations of anxiety and depression with psychosocial functioning and emphasize the importance of detecting and offering appropriate treatments for anxiety and depression symptoms that coexist at subsyndromal levels.

Beyond the Disease: Contextualized Implications of the COVID-19 Pandemic for Children and Young People Living in Eastern and Southern Africa.

The coronavirus disease 2019 (COVID-19) pandemic has created extraordinary challenges and prompted remarkable social changes around the world. The effects of COVID-19 and the public health control measures that have been implemented to mitigate its impact are likely to be accompanied by a unique set of consequences for specific subpopulations living in low-income countries that have fragile health systems and pervasive social-structural vulnerabilities. This paper discusses the implications of COVID-19 and related public health interventions for children and young people living in Eastern and Southern Africa. Actionable prevention, care, and health promotion initiatives are proposed to attenuate the negative effects of the pandemic and government-enforced movement restrictions on children and young people.

Predictors of in-hospital mortality in patients with left ventricular assist device.

BACKGROUND: A left ventricular assist device (LVAD) is used to support patients with end-stage heart failure. AIMS: To examine the role of comorbidities and complications in predicting in-hospital mortality since the introduction of continuous flow (CF)-LVAD. METHODS: The Nationwide Inpatient Sample was queried from 2010 to 2014 using International Classification of Disease-9 code for LVAD among patients 18 years or older. The sample consisted of 2,359 patients (mean age = 55 ± 13.7 years, 76.8% men, 59.3% Caucasian). RESULTS: Comparative analysis revealed mortality did not differ from 2010 to 2014 (p = 0.653). Increases in comorbidities of atrial fibrillation, acute kidney injury, mechanical ventilation, body mass index ≥ 25, cerebrovascular disease, and mild liver disease were evidenced over the 5-year period (p values ≤ 0.049). Multivariate analysis showed that significant predictors of mortality were comorbid hemodialysis (AOR = 7.62, 95% CI [4.78, 12.27]), cerebrovascular disease (AOR = 5.38, 95% CI [3.49, 8.26]), mechanical ventilation (AOR = 3.83, 95% CI [2.84, 5.18]), mild liver disease (AOR = 1.96, 95% CI [1.38, 2.76]), and acute kidney injury (AOR = 1.62, 95% CI [1.16, 2.28]). Predictive complications included disseminated intravascular coagulation (AOR = 6.41, 95% CI [2.79, 6.84]), sepsis (AOR = 4.37, 95% CI [2.79, 6.84]), septic shock (AOR = 3.9, 95% CI [2.11, 7.59]), and gastrointestinal bleed (AOR = 1.81, 95% CI [1.11, 2.93]). CONCLUSIONS: CF-LVADs have not reduced mortality, possibly due to utilization in patients with comorbid conditions. Future trials are necessary for improved patient selection and reduced post-procedural complications.