RESUMEN
Depression is prevalent among people living with HIV in South Africa and interferes with adherence to antiretroviral therapy. This study evaluated a nurse-delivered, cognitive behavioral therapy intervention for adherence and depression among antiretroviral therapy users with depression in South Africa ( n = 14). Primary outcomes were depression, antiretroviral therapy adherence, feasibility, and acceptability. Findings support robust improvements in mood through a 3-month follow up. Antiretroviral therapy adherence was maintained during the intervention period. Participant retention supports acceptability; however, modest provider fidelity despite intensive supervision warrants additional attention to feasibility. Future effectiveness research is needed to evaluate this nurse-delivered cognitive behavioral therapy intervention for adherence and depression in this context.
Asunto(s)
Fármacos Anti-VIH/administración & dosificación , Terapia Cognitivo-Conductual/métodos , Trastorno Depresivo/enfermería , Infecciones por VIH/enfermería , Cumplimiento de la Medicación/psicología , Enfermeras Practicantes , Adulto , Asistencia Sanitaria Culturalmente Competente , Trastorno Depresivo/psicología , Estudios de Factibilidad , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/psicología , Humanos , Masculino , Persona de Mediana Edad , Aceptación de la Atención de Salud , Proyectos Piloto , SudáfricaRESUMEN
Melt processing of poly(L-lactide) (PLLA) and poly(methyl methacrylate) (PMMA) was conducted over a targeted range of compositions with PLLAs of 118 and 316 kDa in molecular mass to identify morphologies and the phase relationships in these blends. These blends are of interest for use in biomaterials and the morphologies are critical for tissue-engineering studies where biodegradability, pore connectivity and surface texture control tissue viability and adhesion. Simple extrusion of the two polymers produced multiphase blends with an average domain size near 25 microm. Scanning electron microscopy and dynamic mechanical analysis demonstrated that these blends are immiscible, at least in a metastable sense, and regions of co-continuous structures were identified. Such co-continuous, which occurred generally in accordance with rheology prediction models, exhibit a fine interconnected structure that appears effective for fabricating certain biomaterials. A broad and unexpected transition appears in these blends, as measured by modulated differential scanning calorimetry between 70 and 100 degrees C, which may be the glass transition temperature of an alloy phase. The magnitude of this transition is greatest in the fine-structured co-continuous composition region of blends, suggesting the presence of a complex or other derivative of the two primary phases.