Improvements in Virologic Control Among PWH Over Time: Narrowing the Gap Between Those With and Without STIs.

Using the incidence of bacterial sexually transmitted infection (STI) as a surrogate for condomless sexual behavior, we assessed the association between STI and uncontrolled HIV replication among in-care persons with HIV (PWH) enrolled in a longitudinal HIV cohort study in the District of Columbia (the DC Cohort). Although STI occurrence initially correlated with higher HIV viral load (VL), this difference became more attenuated over time (2012-2016). This was true overall and among those with the greatest number of STIs [age 18-34, men who have sex with men (MSM)]. This likely reflects gains in population-wide virologic control through improved antiretroviral therapy and access to care, which helps mitigate the risk of HIV transmission.

Identifying Geographic Areas of Washington, DC, With Increased Potential for Sexual HIV Transmission Among People With HIV With STIs and Concurrent Elevated HIV RNA: Data From the DC Cohort.

Background: The Undetectable = Untransmittable (U = U) campaign advances the goal of ending the HIV epidemic by promoting durable viral suppression and therefore reducing sexual transmission. We used geospatial analysis to assess the potential for sexual HIV transmission by ZIP code of residence in the District of Columbia (DC) using data from the DC Cohort Longitudinal HIV Study (DC Cohort), a city-wide cohort of persons with HIV (PWH). Methods: DC Cohort participants aged ≥13 years were included in the study period between April 1, 2016, and March 31, 2018. Potential for sexual HIV transmission was defined as the proportion of participants with incident sexually transmitted infection (STI; gonorrhea, chlamydia, syphilis) and with HIV RNA ≥200 copies/mL from 9 months before to 3 months after STI diagnosis. We performed geographic information system (GIS) analysis to determine the ZIP codes with the highest potential for sexual HIV transmission. Results: Of 3467 participants, 367 (10.6%) had at least 1 incident STI, with 89.4% residing in 11 of the 20 residential ZIP codes in DC. Of the 367 participants with an incident STI, at least 1 HIV RNA was available for 348 (94.8%). Ninety-seven (27.9%) individuals with an incident STI had HIV RNA ≥200 copies/mL in the defined time window. Of these 97, 66 (68.0%) resided in 5 of the 20 DC ZIP codes. Conclusions: In DC, 5 ZIP codes of residence accounted for the majority of the estimated potential for HIV transmission among participants in the DC Cohort. These results support focused neighborhood-level interventions to help end the HIV epidemic.

Use of BioFire FilmArray gastrointestinal PCR panel associated with reductions in antibiotic use, time to optimal antibiotics, and length of stay.

BACKGROUND: Rapid and accurate diagnostic tools are needed for appropriate management of infectious diarrhea. METHODS: We evaluated the impact of the introduction of rapid multiplex PCR testing using the FilmArray gastrointestinal (GI) panel (BioFire Diagnostics, LLC, Salt Lake City, UT) at our institution, and compared the results to those of standard stool cultures. RESULTS: The most common pathogens detected by the FilmArray GI panel were Clostridium difficile (55.0%), Campylobacter species (20.9%), Salmonella species (12.4%), and Shigella/EIEC species (12.4%). Rates of reproducibility in stool culture for these pathogens ranged from 56.3 to 77.8%. Co-detection of two or more organisms was common (24.2%), most commonly involving EPEC, EAEC, ETEC, and STEC. The time from arrival in the Emergency Department to discharge or admission to the hospital was unchanged after the introduction of FilmArray GI panel, but length of hospital stay was shorter (3 vs. 7.5 days, p = 0.0002) for the FilmArray group. The time to empiric antibiotics did not differ significantly, but optimal antibiotics were started earlier after introduction of the FilmArray GI panel (hospital day 1 vs. 2, p < 0.0001). More patients were discharged without antibiotics after introduction of the FilmArray GI panel (14.0% vs. 4.5%; p < 0.001). CONCLUSION: Our results demonstrate that the FilmArray GI panel is an important tool for improving both patient care and antibiotic stewardship, despite the tendency for positive results with multiple pathogens.

Sexually transmitted infections in persons living with HIV infection and estimated HIV transmission risk: trends over time from the DC Cohort.

OBJECTIVE: A rise in incidence of STIs has been noted in the USA and in the District of Columbia (DC). We aim to describe changes in incident STIs among persons in care for HIV in Washington, DC as well as trends in HIV viral load among those with incident STIs. METHODS: We conducted a retrospective DC Cohort analysis (n=7810) measuring STI incidence (syphilis, gonorrhoea and chlamydia) as well as incare viral load (ICVL) and percentage with all viral loads less than the limit of detection (%

Influence of post-migration living difficulties on post-traumatic symptoms in Chinese asylum seekers resettled in Italy.

BACKGROUND: Little is known about mental health and resettlement difficulties of Chinese asylum seekers fleeing China due to religious persecutions. AIM: This study explores main post-migration living difficulties (PMLD) in this population, with a focus on their role in post-traumatic stress disorder (PTSD). METHODS: A total of 67 patients (95.52% women, mean age 34.75 ± 7.63) were included in the study. The Harvard Trauma Questionnaire (HTQ) was used to assess PTSD, the List of Migration Experiences (LiMEs) was used for pre-migration and post-migration experiences (potentially traumatic events as well as living difficulties). The t-test was used to examine the differences in pre-migration and post-migration mean scores. Logistic regression was used to test the effect of pre-migration traumatic experiences (PMTE) and most frequent PMLD on having a PTSD. RESULTS: A total of 49 patients scored above the HTQ cut-off score for PTSD. As expected, traumatic experiences were concentrated in the pre-migration phase, while living difficulties were present in both phases but more frequently in the post-migration period. PMTE were significantly related to PTSD (OR 1.29, p = .01). However, three PMLD ('Feeling that you do not know where you will lend up tomorrow', 'Loneliness and boredom' and 'Not being able to find work') showed a significant interaction with PMTE, suggesting that their presence in the post-migration phase has a modulation effect by increasing the likelihood of PTSD. CONCLUSION: This study extends to Chinese asylum seekers the previous evidence that PMLD have a significant role in the likelihood to have a PTSD after landing in the host country.

Improved Bowel Preparation with Multimedia Education in a Predominantly African-American Population: A Randomized Study.

Background and Aim. Inadequate bowel preparation is a major impediment in colonoscopy quality outcomes. Aim of this study was to evaluate the role of multimedia education (MME) in improving bowel preparation quality and adenoma detection rate. Methods. This was an IRB-approved prospective randomized study that enrolled 111 adult patients undergoing outpatient screening or surveillance colonoscopy. After receiving standard colonoscopy instructions, the patients were randomized into MME group (n = 48) and control group (n = 46). The MME group received comprehensive multimedia education including an audio-visual program, a visual aid, and a brochure. Demographics, quality of bowel preparation, and colonoscopy findings were recorded. Results. MME group had a significantly better bowel preparation in the entire colon (OR 2.65, 95% CI 1.16-6.09) and on the right side of the colon (OR 2.74, 95% CI 1.12-6.71) as compared to control group (p < 0.05). Large polyps (>1 cm) were found more frequently in the MME group (11/31, 35.5% versus 0/13; p < 0.05). More polyps and adenomas were detected in MME group (57 versus 39 and 31 versus 13, resp.) but the difference failed to reach statistical significance. Conclusion. MME can lead to significant improvement in the quality of bowel preparation and large adenoma detection in a predominantly African-American population.

The rise of a science in the early twentieth century: the forgotten voice of Gualtiero Sarfatti and the first "social psychology" volumes in Italy.

Establishing social psychology as a distinct field of study has been the object of heated debate over the first decades of the 20th century. Entrenched in different theoretical traditions, such as philosophy, sociology, psychology, and criminology, the development of the conceptual boundaries of social psychology as an autonomous science was the result of a historic effort. Resulting from a negotiation process between competing stances, some voices relevant to the identity construction of social psychology have been lost over time. Within the framework of a "polycentric" historical perspective valorizing local histories, the present study aims to scrutinize those early voices, which were later marginalized. To this scope, we conducted a narrative analysis on the first volumes explicitly naming social psychology in their titles and identified the main themes, conceptual frameworks, and scientific advancements. The analysis illustrates the work of Gualtiero Sarfatti and articulates his forgotten contribution to drawing social psychology as a distinct discipline, built on the scientific method and positioned within the psychological sociocentric tradition. Our analysis reveals the leading role of Sarfatti in the disciplinary foundation of social psychology as a psychological science based on the concept of social psyche. Yet despite the fact his contribution was influential in the scholarly community of his time, our work highlights how his voice vanished from the subsequent disciplinary developments to date, and suggests some explanations behind this neglect.

Building the boundaries of a science: First representations of Italian social psychology between 1875 and 1954.

The present study embraces the critical traditions of "New History" and of social representations theory articulated with the mainstream historiographical tradition of a bibliometric approach. The historical analysis deals with the early representations of Italian social psychology articulated and disseminated by some of the main Italian scientific-cultural and philosophical journals. We examined seven journals published between 1875 and 1954, and gathered 2,030 texts dealing with the various forms of social and collective psychology. We have applied a grid of content analysis whose data have been transcribed to a numerical file. At the same time, we have created a textual file containing the titles of the contributions as well as the names of the authors and scholars reviewed. The two files have been processed by SPAD-T for a correspondence analysis in which both lexical data and category variables have been considered as active variables. Through the scree-test, two factors that explain 18.90% of the variance have been singled out. Their combination has produced a factorial plan able to highlight three distinct areas differently characterized from journals and years. The results are also discussed with regard to the contextual historical frame.