Assistance Scores Research Articles

Impact of HIV infection on cervical intraepithelial neoplasia detection in pregnant and non-pregnant women in Germany: a cross-sectional study.

Women living with HIV (WLWH) are frequently affected by cervical dysplasia caused by Human Papillomavirus (HPV) and invasive cervical cancer (CxCa). CxCa screening programs can include colposcopy, cytology, and HPV testing. These methods, however, have limitations in effectively stratifying cervical dysplasia. This study aimed to evaluate the applicability of an innovative mRNA-based multiplexed expression-quantifying assay in the detection and assessment of cervical dysplasia in WLWH. The QuantiGene-Molecular-Profiling-Histology Assay (QG-MPH) was used to detect and quantify HPV oncogene and cellular biomarker mRNA expression. These results were included in the Risk Score (QG-MPH RS) calculations that inform about the presence and severity of dysplasia. QG-MPH RS results were compared to the highly sensitive Multiplexed Papillomavirus Genotyping (MPG) Assay and clinical results obtained by cytology, colposcopy and histology. For a standardized nomenclature of clinical results, the clinical ASSIST Score was used. Of 241 WLWH, including 96 pregnant women, a concordance between the QG-MPH RS and the ASSIST Score was found to 36.3% (49/135) in non-pregnant WLWH and 67.1% (57/85) in pregnant WLWH. The QG-MPH method demonstrated high specificity for detecting high-risk HPV (HR-HPV) genotypes and high-grade cervical dysplasia, achieving 89.6% and 82.4%, respectively, including pregnant and non-pregnant WLWH. The QG-MPH assay shows potential for improving the detection and management of HPV-related cervical dysplasia in WLWH, including pregnant women. Its high specificity, however, is tempered by its tendency to overestimate dysplasia severity in certain cases, indicating that further research is needed to refine its use as a reliable diagnostic tool for this high-risk population.

Characteristics of women on opioid substitution therapy in primary healthcare in Tshwane (South Africa): a retrospective observational study.

Women who use drugs face specific challenges compared to men, such as higher rates of HIV infection, unsafe injecting practices and intimate partner violence. However, this population's access to drug dependence treatment and gender-sensitive interventions remains limited, leading to unmet needs and increased vulnerability. To investigate the characteristics of and associations with retention in care among women on opioid substitution therapy (OST) in a community based primary care setting. A descriptive observational study within the Community Orientated Substance Use Programme in Tshwane, South Africa. Data from 199 women (>18 years) on OST was extracted from an electronic database and paper-based files. Data was analysed descriptively, and inferential analysis looked for association of variables with retention on OST for≥6 months. Majority of participants were unemployed, with 44.3% falling within the 20-29 years age range. During the initiation and course of OST, 39.2% of women experienced intimate partner violence, and 19.0% were pregnant. Retention on OST was significantly associated with increasing age at initiation (p=0.047), knowledge of HIV status (p=0.029), an increase in the ASSIST score (p=0.023), and methadone dose (p<0.001). Factors such as race, employment status, health system level, pregnancy, intimate partner using substances, intimate partner violence, route of administering opioids, and having tuberculosis and/or hepatitis C exposure did not show a significant relationship with retention on OST (p>0.05). This study reveals specific vulnerabilities in women receiving OST, emphasising the need for the integration of interventions to address reproductive health, violence mitigation, infectious disease and polydrug use into care.

Genetic analysis of a maternal assistance score in sheep

Maternal behaviour is important for lamb survival, as ewes perform many behaviours that affect the chances of a lamb surviving. Collecting maternal behaviour data directly at lambing is time−consuming and not considered suitable for acquiring the large volumes of data that would be required for using as selection criteria within commercial breeding flocks. The aim of this study was to investigate if a simple scoring system is heritable and assesses the expression of behaviours that reduce the probability of lamb mortality. Ewe behaviour was scored on a 3-point Maternal Assistance Score (MAS): (1) the ewe shows a high level of maternal interest (assumed if no intervention required); (2) the ewe shows limited interest in her lamb; and (3) the ewe shows no interest in her lamb. A total of 19 453 MAS were collected over 12 years, across 24 farms (including both indoor and outdoor lambing systems) and 12 different breed lines that make up the Innovis breeding programme. Ewe parity, breed, number of lambs carried, flock, lambing batch, lambing day within flock and pre-mating weight all had a significant effect on MAS (P < 0.05). The maternal assistance score was shown to be heritable (h2 = 0.05) and repeatable (0.10), positively genetically correlated to lambing difficulty (rg = 0.29) and amount of assistance the lamb required to suckle from the ewe (rg = 0.88), and negatively genetically correlated with the number of lambs successfully reared (rg = 0.49). This study shows that an easy−to−measure score can be used by shepherds with large breeding flocks, based on whether the ewe requires further assistance to support her lamb rearing. The score could be used in breeding programmes to select for lamb rearing ability in the future and potentially lead to an improvement in lamb welfare through a reduction in mortality.

Functioning and activity outcomes of the Akwenda Intervention Program for children and young adults with cerebral palsy in Uganda: A cluster-randomized trial.

To evaluate the efficacy of the Akwenda Intervention Program on motor, self-care, and social function of children and young people with cerebral palsy (CP). This was a cluster-randomized, controlled, single-blinded, intervention study of 100 participants with CP (2-23 years; 52 males) in rural eastern Uganda. Half were allocated to the intervention program, the remainder served as waitlist controls. Gross Motor Function Measure-66 (GMFM-66) and the Ugandan version of Pediatric Evaluation of Disability Inventory (PEDI-UG) were collected before group allocation and after intervention. General linear models and t-tests were used to compare changes within and between groups. Cohen's d estimated the effect size of group differences. Change scores were evaluated by age and mobility subgroups. Significant group by time interactions were found for GMFM-66 (p =0.003) and PEDI-UG outcomes (p <0.001), except mobility, with the intervention group demonstrating greater changes. Both groups increased their scores on the GMFM-66 and child PEDI-UG, while only the intervention group had significant increases in caregiver assistance scores and across all age and mobility subgroups. Cohen's d showed large effect sizes (d >0.8) of differences for PEDI-UG outcomes except mobility. The Akwenda Intervention Program had a large positive impact on functioning and activity across age and mobility levels.

Correlation Analysis of Non-Suicidal Self-Injury Behavior with Childhood Abuse, Peer Victimization, and Psychological Resilience in Adolescents with Depression.

In recent years, the number of adolescents with depression has been increasing annually, with individuals often exhibiting non-suicidal self-injury (NSSI) behavior. The purpose of this study is to investigate the family (childhood abuse), school (peer victimization), and individual (psychological resilience) factors of adolescents with depression with or without NSSI (the Chinese version of the Functional Assessment of Self-Mutilation [C-FASM] scale), and to analyze the correlation between the above psychological and social factors and the frequency of NSSI, to provide a basis for NSSI prevention and intervention in adolescents with depression. We recruited 355 adolescents with depressive symptoms to participate in this study and divided them into Group NSSI (N = 227) and Group no-NSSI (n-NSSI) (N = 128) based on the C-FASM scale. The Short-Form Childhood Trauma Questionnaire (CTQ-SF), Multidimensional Peer Visualization Scale (MPVS), and Resilience Scale for Chinese Adolescents (RISC) scores were compared between two groups of adolescents. Pearson correlation coefficient was used to analyze the correlation between NSSI frequency and the above scores. Emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, and total CTQ-SF score in Group NSSI were significantly higher than those in Group n-NSSI (all p < 0.001). Physical victimization, verbal victimization, social manipulation, attacks on property, and total MPVS score in Group NSSI were significantly higher than those in Group n-NSSI (p < 0.001, p < 0.001, p = 0.009, p < 0.001, p < 0.001). Goal concentration, emotion regulation, positive perception, family support, interpersonal assistance, and total RISC score in Group NSSI were significantly lower than those in Group n-NSSI (all p < 0.001). The frequency of NSSI was significantly positively correlated with emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, and total CTQ-SF score (r = 0.366, p < 0.001; r = 0.411, p < 0.001; r = 0.554, p < 0.001; r = 0.220, p = 0.001; r = 0.255, p < 0.001; r = 0.673, p < 0.001). The frequency of NSSI was significantly positively correlated with physical victimization, verbal victimization, social manipulation, attacks on property, and total MPVS score (r = 0.418, p < 0.001; r = 0.455, p < 0.001; r = 0.447, p < 0.001; r = 0.555, p = 0.001; r = 0.704, p < 0.001). The frequency of NSSI was significantly negatively correlated with goal concentration, emotion regulation, positive perception, family support, interpersonal assistance, and total RISC score (r = -0.393, p < 0.001; r = -0.341, p < 0.001; r = -0.465, p < 0.001; r = -0.272, p = 0.001; r = -0.160, p = 0.016; r = -0.540, p < 0.001). Our findings highlight the importance of family (childhood abuse), school (peer victimization), and individual (psychological resilience) factors for NSSI in depressed adolescents, and these factors are closely related to NSSI frequency. Maintaining a good family environment, solving the problem of peer victimization at school, and developing corresponding measures to improve psychological resilience are of great significance for improving the mental health of depressed adolescents and reducing the risk of NSSI.

Screening for problematic opioid use in the emergency department: Comparison of two screening measures.

Earlier intervention for opioid use disorder (OUD) may reduce long-term health implications. Emergency departments (EDs) in the United States treat millions with OUD annually who may not seek care elsewhere. Our objectives were (1) to compare two screening measures for OUD characterization in the ED and (2) to determine the proportion of ED patients screening positive for OUD and those who endorse other substance use to guide future screening programs. A cross-sectional study of randomly selected adult patients presenting to three Midwestern US EDs were enrolled, with duplicate patients excluded. Surveys were administered via research assistant and documented on tablet devices. Demographics were self-reported, and OUD positivity was assessed by the DSM 5 checklist and the WHO ASSIST 3.1. The primary outcome was the concordance between two screening measures for OUD. Our secondary outcome was the proportion of ED patients meeting OUD criteria and endorsed co-occurring substance use disorder (SUD) criteria. We enrolled 1305 participants; median age of participants was 46 years (range 18-84), with 639 (49.0%) Non-Hispanic, White, and 693 (53.1%) female. Current OUD positivity was identified in 17% (222 out of 1305) of the participants via either DSM-5 (two or more criteria) or ASSIST (score of 4 or greater). We found moderate agreement between the measures (kappa=0.56; Phi coefficient=0.57). Of individuals screening positive for OUD, 182 (82%) endorsed criteria for co-occurring SUD. OUD is remarkably prevalent in ED populations, with one in six ED patients screening positive. We found a high prevalence of persons identified with OUD and co-occurring SUD, with moderate agreement between measures. Developing and implementing clinically feasible OUD screening in the ED is essential to enable intervention.

The effectiveness of electronic screening and brief intervention for alcohol-related maxillofacial trauma: a randomized controlled trial

ObjectivesThis study aims to deliver a novel web-app-based electronic Screening and Brief Intervention to patients with alcohol-related facial trauma and assess changes in at-risk drinking behaviors and attitudes towards their drinking and alcohol-related trauma. Study design, setting, and sampleThis was a two-arm parallel randomized controlled trial. Participants who had sustained alcohol-related facial injuries were recruited from three Australian hospitals. Results56 participants were enrolled and randomized initially with 45 participants completing the questionnaire at baseline and 3-month follow-up. Most of the participants were male (71.1%), aged between 18 and 29 (40%), and presented to the ED for the first time (68.9%). The study revealed that the intervention group participants found the information provided via the e-SBI helpful in changing their drinking habits and seek help. The e-SBI intervention had a moderate effect on ASSIST Scores (d=-.59; 95% CI, -.03, 1.18). The effect sizes of the e-SBI on the secondary outcomes also ranged between small and moderate. ConclusionsThe novel app-based e-SBI can effectively deliver information on harmful drinking and provide brief intervention and other venues for help and subsequently improve awareness and willingness to seek help and reduce the risk of injury recurrence. Statement of Clinical RelevanceElectronic Screening and Brief Intervention may provide a means of bypassing clinician based limitations of training and time constraints for tertiary prevention for patients who have sustained alcohol related facial trauma, this project encourages further larger studies in the future to assess the effectiveness of this modality of prevention.

Relationship between physical activity and who assist scores in substance addiction clients at the addiction Polyclinic of Prof Ngoerah General Hospital Denpasar

Drug abuse which includes narcotic, psychotropic, and addictive substances can affect the central nervous system function. Substances are often abused because of the pleasurable and calming effects of their use. Physical activity is said to have the potential as an adjunct therapy for substance addiction disorders. The purpose of the study was to determine the relationship between physical activity and WHO ASSIST scores in substance addiction clients. This study used a cross-sectional design on substance addiction clients undergoing treatment at the Addiction Polyclinic of Prof Ngoerah General Hospital Denpasar. Physical activity score checks were conducted using GPAQ questionnaires and WHO ASSIST scores. Data collection to patients as research subjects was carried out after obtaining informed consent. After data collected, the next stages was data analysis using SPSS, with descriptive statistical analysis, normality test and spearman correlation test. From 30 samples, an average GPAQ score of 2099.33 ± 2225.32 was obtained. The average WHO ASSIST score for each substance was highest in tobacco 15.57 ± 8.98 and lowest in hallucinogen 0.70 ± 1.664.

Reliability and validity testing of the ASSIST functional performance index

ABSTRACT Reliability and validity testing of the ASSIST Functional Performance Index (AFPI) was conducted, focusing on persons with physical disabilities (PwPD). The AFPI was iteratively developed to assess persons’ needs for Mainstream Smart Home Technologies (MSHT) as Assistive Technology (AT) and to measure the impact of a service delivery model for MSHT. The AFPI consists of 46 items organized by functional domains. A total of N = 22 PwPD completed the AFPI twice. The median response time between these two time points was four days. Test-retest reliability of overall scores was assessed using the Intraclass Correlation Coefficient model (ICC, 3.1). The weighted kappa coefficient was applied to conduct an item analysis, demonstrating moderate to substantial agreement in all but one of the items. During the second administration, validity was established by correlating the number of hours of assistance and total AFPI scores with the SCI-FI Self-Care and Basic Mobility Short Form Questionnaires. Results indicate that the AFPI demonstrates good to very good validity as an assessment tool and outcome measure in recommending and evaluating the impact of MSHT for PwPD. Future studies, including more participants and persons with cognitive and sensory disabilities, may further establish the clinical utility of the AFPI.

Pencak Silat Match Score Assist Application

In 1973 for the first time, pencak silat competed precisely at PON VIII in Jakarta. Until now, matches have always been held at the district level and even ASEAN in the annual activity agenda. In a match, of course, there is an assessment to find the final result of a match, the match assessment tool in each match event is still manual, which uses paper and pen media to determine the value of the match, but such a scoring model has problems in the time of accumulation of total assessments, the loss of assessment data paper after the match and the high costs incurred to buy match assessment tools. It is hoped that the Pencak Silat Match Assist Score Application can help assess pencak silat matches and enjoy its usefulness in all pencak silat martial arts games at the regional, district, and even national levels.

Alcohol and drug use severity are independently associated with antiretroviral adherence in the current treatment era

ABSTRACT Substance use in people with HIV (PWH) negatively impacts antiretroviral therapy (ART) adherence. However, less is known about this in the current treatment era and the impact of specific substances or severity of substance use. We examined the associations of alcohol, marijuana, and illicit drug use (methamphetamine/crystal, cocaine/crack, illicit opioids/heroin) and their severity of use with adherence using multivariable linear regression in adult PWH in care between 2016 and 2020 at 8 sites across the US. PWH completed assessments of alcohol use severity (AUDIT-C), drug use severity (modified ASSIST), and ART adherence (visual analogue scale). Among 9400 PWH, 16% reported current hazardous alcohol use, 31% current marijuana use, and 15% current use of ≥1 illicit drugs. In multivariable analysis, current methamphetamine/crystal use, particularly common among men who had sex with men, was associated with 10.1% lower mean ART adherence (p < 0.001) and 2.6% lower adherence per 5-point higher severity of use (ASSIST score) (p < 0.001). Current and more severe use of alcohol, marijuana, and other illicit drugs were also associated with lower adherence in a dose-dependent manner. In the current HIV treatment era, individualized substance use treatment, especially for methamphetamine/crystal, and ART adherence should be prioritized.

Comparison of proposed National Institute of Child Health and Human Development panel recommendations with newborn sepsis risk calculator in term neonates exposed to maternal chorioamnionitis

Maternal chorioamnionitis (MC) is one of the major risk factors for early-onset neonatal sepsis. Kaiser sepsis risk calculator (SRC) is a validated risk assessment tool for such newborns. The National Institute of Child Health and Human Development (NICHD) workshop on MC has proposed a risk assessment algorithm. The objective of the study was to compare the reduction in antibiotic use in newborns treated with SRC and NICHD algorithm and determine the antibiotic use correlation between them. A retrospective chart review was performed on newborns born at ≥ 37 weeks to mothers with MC during the years 2018-2020. The same cohort of newborns was evaluated using SRC and NICHD algorithm to determine whether treatment with antibiotics could have been avoided in some patients. The data were analyzed using a t-test, Chi-square test, and ANOVA. During the study period, 101 newborns were born to mothers with chorioamnionitis and received antibiotics. When the newborns were assessed using the SRC, only 16/101 (15.84%) would have received treatment. When NICHD algorithm was applied to the same cohort 71/101 (70.30%) newborns would have received treatment. The two approaches agreed in their assessment for treatment or observation only in 44/101 (43.56%) of the cases. The NICHD treatment group had a higher incidence of chorioamnionitis as seen in placental pathology (94.37% vs. 75.00% for Kaiser, p-0.015). The SRC treatment group however had newborns with significantly lower Apgar score at 1min (8.21 vs 6.63, p-0.006) and 5-minute (8.69 vs 8.00, p-0.019) and had significantly higher supplemental oxygen requirements at admission (62.50% vs. 21.13%, p<0.001). Both SRC and NICHD algorithms expose fewer newborns to antibiotics; however, they differ in the number of newborns that would require antibiotics. Ventilation assistance and lower Apgar scores were associated with higher probability of antibiotic administration.

The accuracy of artificial intelligence-based virtual assistants in responding to routinely asked questions about orthodontics.

To evaluate the utility and efficiency of four voice-activated, artificial intelligence-based virtual assistants (Alexa, Google Assistant, Siri, and Cortana) in addressing commonly asked patient questions in orthodontic offices. Two orthodontists, an orthodontic resident, an oral and maxillofacial radiologist, and a dental student used a standardized list of 12 questions to query and evaluate the four most common commercial virtual assistant devices. A modified Likert scale was used to evaluate their performance. Google Assistant had the lowest (best) mean score, followed by Siri, Alexa, and Cortana. The score of Google Assistant was significantly lower than Alexa and Cortana. There was significant variablity in virtual assistant response scores among the evaluators, with the exception of Amazon Alexa. Lower scores indicated superior efficiency and utility. The common commercially available virtual assistants tested in this study showed significant differences in how they responded to users. There were also significant differences in their performance when responding to common orthodontic queries. An intelligent virtual assistant with evidence-based responses specifically curated for orthodontics may be a good solution to address this issue. The investigators in this study agreed that such a device would provide value to patients and clinicians.

Impact of Postoperative Pain on Early Initiation of Breastfeeding and Ambulation After Cesarean Section: A Randomized Trial

Aim: To compare the effect of different analgesic regimens on the time to initiate breastfeeding (BF) and ambulation after cesarean section (CS). Methods: This prospective, double-blinded, placebo-controlled randomized study included 300 women (20-40 years of age) of the American Society of Anesthesiologists status 1 or 2 with singleton term pregnancies scheduled for CS under spinal anesthesia. Women were allocated to three groups of 100 each by computer-generated randomization. As an adjunct to 1,000 mg intravenous acetaminophen, Group 1 received 100 mg rectal diclofenac, Group 2 received 100 mg rectal tramadol, and Group 3 received rectal glycerin suppository. The time to initiate BF and ambulation was compared between different analgesic regimens and corelated with pain score. Results: BF (both with and without support) was initiated significantly earlier in Groups 1 and 2 as compared with control Group 3 (p < 0.001). A significantly shorter time was taken to initiate BF without support in Group 1 as compared with Group 2 (p = 0.028). The time to start ambulation (both with and without assistance) was significantly lower in Groups 1 and 2 as compared with Group 3 and in Group 1 versus Group 2 (p < 0.001). A significant positive correlation was found between the time to initiate BF with support and ambulation without assistance and postoperative pain score at 0, 1, and 6 hours. Conclusion: Effective post-CS analgesia affects early initiation of BF and ambulation in the immediate postnatal period. The inclusion of rectal diclofenac suppository in post-CS analgesic regimens is a promising approach to postoperative delivery care.

Indicator “Risk of harm from alcohol use” (ASSIST score ) in patients with schizophrenia and related disorders

Objective. To establish the relationship between the ASSIST score (Humeniuk R. et al. 2008) «risk of harm from alcohol use» (RHAU), impaired social functioning and manifestation of aggression in patients with schizophrenia and related disorders.Materials and methods. From 2014 to 2020 a comparative, one-stage, observational study was conducted on the basis of the Gomel Regional Clinical Psychiatric Hospital with a sampling formation using directional selection method. Patients who met diagnostic criteria of schizophrenia (F20) or acute psychotic disorder (F23) according to ICD-10 were included in the study. The following assessment methods were used: 1) screening for alcohol use – ASSIST scale (Humeniuk R. et al. 2008), 2) determination of the level of aggression OASCL (Yudofsky S. C. 1986).Results. The entire sample of 123 people examined by us was divided into 3 groups depending on the level of RHAU. The first group «ASSIST 0» (n=37) was accepted as a control group, since RHAU was equal to 0. The second group is «ASSIST up to 10» (n=42), with minimal RVUA (1-10 points on the ASSIST scale). The third group «ASSIST over 11» (n=44) combines moderate and high RHAU. The group study did not show any differences between men and women in alcohol consumption and aggression within the groups. Comparison of 3 groups, and their subsequent pairwise comparison, made it possible to establish statistically significant differences in social dysfunction groups (decrease in the working status of «ASSIST 0» – 81%, «ASSIST over 11» – 73%, «ASSIST up to 10» – 45%) and of aggression (OASCL total score H 62.4=p≤0.001: physical aggression vs. others H=45.2 p≤0.001).Conclusion. In patients with schizophrenia and disorders close to it, the «risk of harm from alcohol use» indicator (ASSIST scale) indirectly indicates the formation of psychosocial dysfunction and indicates a differentiated effect of alcohol in the display of aggression in this group of patients.

1258. B/F/TAF in HIV-Infected Adults with Substance Use Disorders: BASE Week 48 Results

Abstract Background People with HIV (PWH) and substance use disorders (SUD) are at higher risk of non-adherence. Bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) exhibits high rates of efficacy with a favorable adverse event profile. The BASE study (NCT03998176) is a Phase 4, single-arm study evaluating the effectiveness and safety of B/F/TAF among PWH and SUD. Methods Viremic (HIV RNA &amp;gt;1000 copies [c]/mL) treatment-naïve or -experienced PWH and ongoing SUD initiated B/F/TAF once daily for 48 weeks (W). The primary endpoint was HIV RNA &amp;lt; 50 c/mL (FDA Snapshot Algorithm) at W48. Secondary endpoints were safety, adherence (dried blood spot [DBS] levels of emtricitabine-triphosphate [FTC-TP] and tenofovir-diphosphate [TVF-DP]), substance use (NIDA ASSIST) and quality of life (SF-12). Results Forty-three participants enrolled; 95% reported methamphetamine use. Median age was 38 years (range: 21-62); 19% female, 81% White, 14% Black, 16% Latinx. At W48, 21 participants (49%) had HIV RNA &amp;lt; 50 c/mL (ITT, Figure 1). Four participants (9%) experienced confirmed virologic failure; none developed treatment-emergent resistance. Seventeen participants (40%) experienced grade ≥3 adverse events; none attributed to B/F/TAF. Five participants reported suicidal ideation; none resulted in discontinuation. Observed mean FTC-TP and TVF-DP concentrations in DBS corresponded to 5-6 doses/week (FTC-TP: &amp;gt;3.6 pmol/7mm punches; TVF-DP: &amp;gt;1733 fmol/7 mm punches; Figure 2). NIDA ASSIST scores declined from baseline, with methamphetamine use decreasing most (-7.9 points; -29%). SF-12 physical/mental scores increased 1.2 and 7.6 points, respectively, but remained below mean US scores. Longitudinal virologic outcomes, intent-to-treat analysis Mean observed intracellular emtricitabine triphosphate (FTC-TP) and tenofovir diphosphate (TFV-DP) in dried blood spots at weeks 6, 24, and 48 Thresholds for 2-3 doses/week (Solid Line) and 4-5 doses/week (Dashed Line) are noted for both FTC-TP and TFV-DP based on TAF-DBS data [Yager J, et al. JAIDS, 2020]. Notes: Y-axis represents femtomoles/punches Conclusion B/F/TAF among a high-risk population of PWH and ongoing SUD resulted in a 49% viral suppression rate at W48. No emergent resistance was noted supporting the high barrier to resistance provided by B/F/TAF. Disclosures Sara H. Bares, MD, Gilead Sciences: Expert Testimony|GSK ViiV Healthcare: Grant/Research Support|Janssen: Grant/Research Support Kimberly Scarsi, PharmD, Organon: Grant/Research Support.

EFFECTIVENESS OF BRIEF INTERVENTION IN REDUCING THE RISK OF RELAPSE IN PATIENTS WITH ALCOHOL INDUCED LIVER DISEASE – A NATURALISTIC FOLLOW UP COMPARATIVE STUDY

BACKGROUND: Alcoholic liver disease (ALD) comprises of simple steatosis to frank cirrhosis. Early identication and treatment of alcohol problems with the use of screening and brief interventions (BI) has been advocated as the way forward and is seen as the focus of a great deal of research. The objective of this study is to evaluate effectiveness of brief intervention (BI) on the risk of relapse in patients with Alcohol induced Liver Disease (ALD) compared with simple advice (SA). METHODOLOGY:A12-week interventional naturalistic follow-up study in a tertiary care centre with baseline assessments using standardized study instruments including Rutgers Alcohol Problem Index, ASSIST, Readiness to change questionnaire, and Big Five Factor Personality Test. Intervention given at baseline, one and three weeks. Relapse rate along with the time to relapse, quantity and frequency of drinking at the end of three months were recorded as primary outcome measures. RESULTS: 120 participants were recruited in the study and were alternatively included into the two groups using purposive sampling. There was a signicant decrease in the post RAPI and ASSIST score in BI group from baseline compared with the SAgroup. The time taken to relapse in BI group was found to be longer. CONCLUSION: Patients who relapsed at the end of the three months study period were less in BI than SAgroup. Time taken to relapse proved the effectiveness of BI.

An investigation of the psychometric properties of the Turkish adaptation of the activity limitations in cerebral palsy questionnaire

Purpose To translate the ACTIVLIM-CP questionnaire, developed to assess global activity performance in children with Cerebral Palsy (CP), into Turkish and to investigate its psychometric properties. Methods Eighty-nine children with CP, aged between 2 and 18 years (mean age: 10.08 ± 4.94 years), were included in the study. Internal consistency was measured by Cronbach’s alpha and test-retest reliability was assessed using intraclass correlation coefficient (ICC). Convergent validity was evaluated through the pattern of correlations between the ACTIVLIM-CP with PEDI, ABILOCO-Kids, ABILHAND-Kids, and Wee-FIM scores. Known-group comparisons were made according to epilepsy existence and ambulation level measured by Gross Motor Function Classification System (GMFCS). Results Internal consistency was excellent (Cronbach's α = 0.990), and the ICC for the test-retest reliability was 0.990. There was a very strong correlation between ACTIVLIM-CP and ABILHAND-Kids (r = 0.946), WeeFIM (r = 0.900), PEDI Functional Skills and Caregiver Assistance scores (r = 0.954, r = 0.937, respectively), and ABILOCO-Kids (r = 0.817) (p < 0.001) score. ACTIVLIM-CP score was lower in children with epilepsy (p = 0.001) and in the high-level group according to GMFCS (p < 0.001). Conclusion The Turkish adaptation of ACTIVLIM-CP is a valid and reliable scale for measuring activity limitations in children with CP and is compatible with other scales evaluating activity limitations. Clinical Trial Number NCT05184244 IMPLICATIONS FOR REHABILITATION Activity limitation measurements are crucial and necessary to determine the global activity performance of children with CP. ACTIVLIM-CP was translated and culturally adapted to Turkish and showed good psychometric properties. ACTIVLIM-CP is a valid and reliable tool to evaluate activity performance in children with CP.

Individual and Institutional Factors Associated with PGY5 General Surgery Resident Self-Efficacy: A National Survey.

Variability in post-graduate year 5 (PGY5) residents' operative self-efficacy exists; yet the causes of variability have not been explored. Our study aims to determine resident-related and program-dependent factors associated with residents' perceptions of self-efficacy. Following the 2020 American Board of Surgery In-Training Examination, a national survey of self-efficacy in 10 of the most commonly performed Accreditation Council for Graduate Medical Education case-log procedures was completed. A total of 1,145 PGY5 residents completed the survey (response rate 83.8%), representing 296 surgical residency programs. Female sex (odds ratio [OR] 0.46 to 0.67; 95% CI 0.30 to 0.95; p < 0.05) was associated with decreased self-efficacy for 6 procedures. Residents from institutions with emphasis on autonomy were more likely to report higher self-efficacy for 8 of 10 procedures (OR 1.39 to 3.03; 95% CI 1.03 to 4.51; p < 0.05). In addition, increased socialization among residents and faculty also correlated with increased self-efficacy in 3 of 10 procedures (OR 1.41 to 2.37; 95% CI 1.03 to 4.69; p < 0.05). Procedures performed with higher levels of resident responsibility, based on Graduated Levels of Resident Responsibility (GLRR) and Teaching Assistant (TA) scores, were correlated with higher self-efficacy (p < 0.001). Ensuring that residents receive ample opportunities for GLRR and TA experiences, while implementing programmatic support for resident-dependent factors, may be crucial for building self-efficacy in PGY5 residents. Institutional support of resident "autonomy" and increasing methods of socialization may provide a means of building trust and improving perceptions of self-efficacy. In addition, reevaluating institutional policies that limit opportunities for graduated levels of responsibility, while maintaining patient safety, may lead to increased self-efficacy.

Patient Outcomes and Lessons Learned From Treating Patients With Severe COVID-19 at a Long-term Acute Care Hospital: Single-Center Retrospective Study.

BackgroundWith the continuation of the COVID-19 pandemic, shifting active COVID-19 care from short-term acute care hospitals (STACHs) to long-term acute care hospitals (LTACHs) could decrease STACH census during critical stages of the pandemic and maximize limited resources.ObjectiveThis study aimed to describe the characteristics, clinical management, and patient outcomes during and after the acute COVID-19 phase in an LTACH in the Northeastern United States.MethodsThis was a single-center group comparative retrospective analysis of the electronic medical records of patients treated for COVID-19–related impairments from March 19, 2020, through August 14, 2020, and a reference population of medically complex patients discharged between December 1, 2019, and February 29, 2020. This study was conducted to evaluate patient outcomes in response to the holistic treatment approach of the facility.ResultsOf the 127 total COVID-19 admissions, 118 patients were discharged by the data cutoff. At admission, 29.9% (38/127) of patients tested positive for SARS-CoV-2 infection. The mean age of the COVID-19 cohort was lower than that of the reference cohort (63.3, 95% CI 61.1-65.4 vs 65.5, 95% CI 63.2-67.8 years; P=.04). There were similar proportions of males and females between cohorts (P=.38); however, the proportion of non-White/non-Caucasian patients was higher in the COVID-19 cohort than in the reference cohort (odds ratio 2.79, 95% CI 1.5-5.2; P=.001). The mean length of stay in the COVID-19 cohort was similar to that in the reference cohort (25.5, 95% CI 23.2-27.9 vs 29.9, 95% CI 24.7-35.2 days; P=.84). Interestingly, a positive correlation between patient age and length of stay was observed in the COVID-19 cohort (r2=0.05; P=.02), but not in the reference cohort. Ambulation assistance scores improved in both the reference and COVID-19 cohorts from admission to discharge (P<.001). However, the mean assistance score was greater in the COVID-19 cohort than in the reference cohort at discharge (4.9, 95% CI 4.6-5.3 vs 4.1, 95% CI 3.7-4.7; P=.001). Similarly, the mean change in gait distance was greater in the COVID-19 cohort than in the reference cohort (221.1, 95% CI 163.2-279.2 vs 146.4, 95% CI 85.6-207.3 feet; P<.001). Of the 16 patients mechanically ventilated at admission, 94% (15/16) were weaned before discharge (mean 11.3 days). Of the 75 patients admitted with a restricted diet, 75% (56/75) were discharged on a regular diet.ConclusionsThe majority of patients treated at the LTACH for severe COVID-19 and related complications benefited from coordinated care and rehabilitation. In comparison to the reference cohort, patients treated for COVID-19 were discharged with greater improvements in ambulation distance and assistance needs during a similar length of stay. These findings indicate that other patients with COVID-19 would benefit from care in an LTACH.