Integrating research into dental student training: a global necessity. The integration of research into dental education is necessary to ensure that evidence-based practice reaches the clinical setting and that dentistry remains a scientifically driven health profession. Consequently, dental accreditation standards in the United States and Canada require dental schools to integrate research components into curricula. Organizations (e.g., NIDCR, ADEA, AADR, IADR, and NSRG) provide some opportunities for dental students to experience research. Assessment of the integration of research into dental curricula suggests that US students are interested in learning and utilizing evidence-based practice, but lack adequate time for research participation. Records show limited student involvement in research organizations internationally (i.e., AADR and IADR). Vague accreditation standards and limited research opportunities outside of dental schools may be barriers. We lack an understanding of the status of integration of research into dental curricula internationally, but predict that similar issues exist. We propose that dental institutions consider implementing the following: (1) curriculum components to assess the use of evidence-based practice, (2) faculty and student seminars for discussing evidence-based practice, (3) subsidization of student membership in dental research organizations (e.g., AADR and IADR), and (4) sponsorship of students as institutional representatives at annual research meetings (e.g., IADR, AADR, ADA, and ADEA meetings), with subsequent school-wide dissemination of knowledge attained from attendance.
Socioeconomic determinants of mortality in HIV: evidence from a clinical cohort in Uganda. To delineate the association between baseline socioeconomic status (SES) indicators and mortality and lost to follow-up (LTFU) in a cohort of HIV-infected individuals enrolled in antiretroviral treatment (ART) in urban Uganda. SES indicators including education, employment status, and a standardized wealth index, and other demographic and clinical variables were assessed at baseline among ART-treated patients in a clinic-based cohort in Kampala, Uganda. Confirmed mortality (primary outcome) and LTFU (secondary outcome) were actively ascertained over a 4-year follow-up period from 2005-2009.
Perception of Neighborhood Crime and Drugs Increases Cardiometabolic Risk in Chilean Adolescents. Studies report an association between neighborhood risk and both obesity and cardiometabolic risk factors (CMR) among adolescents. Here we describe the effect of perceived neighborhood risk on adiposity and CMR among Chilean adolescents. Participants were 523 low- to middle-income Chilean adolescents. We assessed neighborhood risk in early adolescence, adiposity in childhood and in early and later adolescence, and blood pressure and fasting glucose in later adolescence. Neighborhood risk profiles were estimated using latent profile analysis (LPA) and based on reported perceptions of crime and drug sales/use. Using linear and logistic regression, we examined the effect of neighborhood risk on adiposity and CMR.
Epidemiology and awareness of hypertension in a rural Ugandan community: a cross-sectional study. Hypertension is one of the largest causes of preventable morbidity and mortality worldwide. There are few population-based studies on hypertension epidemiology to guide public health strategies in sub-Saharan Africa. Using a community-based strategy that integrated screening for HIV and non-communicable diseases, we determined the prevalence, awareness, treatment rates, and sociodemographic factors associated with hypertension in rural Uganda. A household census was performed to enumerate the population in Kakyerere parish in Mbarara district, Uganda. A multi-disease community-based screening campaign for hypertension, diabetes, and HIV was then conducted. During the campaign, all adults received a blood pressure (BP) measurement and completed a survey examining sociodemographic factors. Hypertension was defined as elevated BP (≥140/≥90 mmHg) on the lowest of three BP measurements or current use of antihypertensives. Prevalence was calculated and standardized to age distribution. Sociodemographic factors associated with hypertension were evaluated using a log-link Poisson regression model with robust standard errors.
Toll-like receptor 7 mediates early innate immune responses to malaria. Innate immune recognition of malaria parasites is the critical first step in the development of the host response. At present, Toll-like receptor 9 (TLR9) is thought to play a central role in sensing malaria infection. However, we and others have observed that Tlr9(-/-) mice, in contrast to mice deficient in the downstream adaptor, Myeloid differentiation primary response gene 88 (MYD88), exhibit few deficiencies in immune function during early infection with the malaria parasite Plasmodium chabaudi, implying that another MYD88-dependent receptor also contributes to the antimalarial response. Here we use candidate-based screening to identify TLR7 as a key sensor of early P. chabaudi infection.
Current treatment and outcome for childhood acute leukemia in Tanzania. In order to understand the disparity in childhood leukemia survival in low-income countries (LICs) compared to high-income countries (HICs), we evaluated the resources available at Tanzania's national pediatric oncology ward, and clinical characteristics, disease course and outcomes of children diagnosed with acute leukemia from 2008 through 2010. A chart review and assessment of services was performed to assess childhood leukemia diagnoses, treatment, and outcomes in Tanzania at the Ocean Road Cancer Institute (ORCI) from January 1, 2008 to December 31, 2010. Results were compared to those from a 2005 evaluation that showed only one of 20 children with leukemia surviving at 1 year.
Incidence of WHO Stage 3 and 4 Events, Tuberculosis, and Mortality in Untreated, HIV-Infected Children Enrolling in Care Before 1 Year of Age: An Iedea (International Epidemiologic Databases To Evaluate AIDS) East Africa Regional Analysis. Few studies have reported CD4%- and age-stratified rates of WHO Stage 3 (WHO3) events, WHO Stage 4 (WHO4) events, tuberculosis (TB), and mortality in HIV-infected infants before initiation of antiretroviral therapy (ART). HIV-infected children enrolled before 1 year of age in the International Epidemiologic Databases to Evaluate AIDS (IeDEA) East Africa region (10/01/2002-11/30/2008) were included. We estimated incidence rates of earliest clinical event (WHO3, WHO4, and TB), prior to ART initiation per local guidelines, stratified by current age (< or ≥6 months) and current CD4% (<15%, 15-24%, ≥25%). CD4%-stratified mortality rates were estimated separately for children who did not experience a clinical event ("background" mortality) and for children who experienced an event, including 'acute' mortality (≤30 days post-event) and "later" mortality (>30 days post-event).
Recognizing and treating anal cancer: training medical students and physicians in Puerto Rico. This training activity aimed at increasing the knowledge of anal cancer screening, diagnostic and treatment options in medical students and physicians, to determine the interest of these individuals in receiving training in the diagnosis and treatment of anal cancer, and to explore any previous training and/or experience with both anal cancer and clinical trials that these individuals might have. An educational activity (1.5 contact hours) was attended by a group of medical students, residents and several faculty members, all from the Medical Sciences Campus of the University of Puerto Rico (n = 50). A demographic survey and a 6-item pre- and post-test on anal cancer were given to assess knowledge change.
Higher CD27(+)CD8(+) T Cells Percentages during Suppressive Antiretroviral Therapy Predict Greater Subsequent CD4(+) T Cell Recovery in Treated HIV Infection. HIV-mediated immune dysfunction may influence CD4(+) T cell recovery during suppressive antiretroviral therapy (ART). We analyzed cellular biomarkers of immunological inflammation, maturation, and senescence in HIV-infected subjects on early suppressive ART. We performed longitudinal analyses of peripheral immunological biomarkers of subjects on suppressive ART (n = 24) from early treatment (median 6.4 months, interquartile range [IQR] 4.8-13.9 months) to 1-2 years of follow-up (median 19.8 months, IQR 18.3-24.6 months). We performed multivariate regression to determine which biomarkers were associated with and/or predictive of CD4(+) T cell recovery.
"Computerized Counseling Reduces HIV-1 Viral Load and Sexual Transmission Risk: Findings from a Randomized Controlled Trial" Evaluate a computerized intervention supporting antiretroviral therapy (ART) adherence and HIV transmission prevention. HIV-1 viral suppression, and self-reported ART adherence, and transmission risks, compared using generalized estimating equations.
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