7 results
56 Cognitive Intra-Individual Variability Profiles of a Spanish Speaking Population Living with HIV and Injection Drug Use
- Jeremy A Feiger, Rachael L. Snyder, Alec J Miller, Carmen A Davila, Kim G Carrasco, Kirk Dombrowski, Roberto Abadie, Anibal Valentin, Samodha Fernando, John T West, Charles Wood, Sydney J Bennett, Kathy S Chiou
-
- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 52-53
-
- Article
-
- You have access Access
- Export citation
-
Objective:
Individuals living with HIV may experience cognitive difficulties or marked declines known as HIV-Associated Neurocognitive Disorder (HAND). Cognitive difficulties have been associated with worse outcomes for people living with HIV, therefore, accurate cognitive screening and identification is critical. One potentially sensitive marker of cognitive impairment which has been underutilized, is intra-individual variability (IIV). Cognitive IIV is the dispersion of scores across tasks in neuropsychological assessment. In individuals living with HIV, greater cognitive IIV has been associated with cortical atrophy, poorer cognitive functioning, with more rapid declines, and greater difficulties in daily functioning. Studies examining the use of IIV in clinical neuropsychological testing are limited, and few have examined IIV in the context of a single neuropsychological battery designed for culturally diverse or at-risk populations. To address these gaps, this study aimed to examine IIV profiles of individuals living with HIV and who inject drugs, utilizing the Neuropsi, a standardized neuropsychological instrument for Spanish speaking populations.
Participants and Methods:Spanish speaking adults residing in Puerto Rico (n=90) who are HIV positive and who inject drugs (HIV+I), HIV negative and who inject drugs (HIV-I), HIV positive who do not inject drugs (HIV+), or healthy controls (HC) completed the Neuropsi battery as part of a larger research protocol. The Neuropsi produces 3 index scores representing cognitive domains of memory, attention/memory, and attention/executive functioning. Total battery and within index IIV were calculated by dividing the standard deviation of T-scores by mean performance, resulting in a coefficient of variance (CoV). Group differences on overall test battery mean CoV (OTBMCoV) were investigated. To examine unique profiles of index specific IIV, a cluster analysis was performed for each group.
Results:Results of a one-way ANOVA indicated significant between group differences on OTBMCoV (F[3,86]=6.54, p<.001). Post-hoc analyses revealed that HIV+I (M=.55, SE=.07, p=.003), HIV-I (M=.50, SE=.03, p=.001), and HIV+ (M=.48, SE=.02, p=.002) had greater OTBMCoV than the HC group (M=.30, SE=.02). To better understand sources of IIV within each group, cluster analysis of index specific IIV was conducted. For the HIV+ group, 3 distinct clusters were extracted: 1. High IIV in attention/memory and attention/executive functioning (n=3, 8%); 2. Elevated memory IIV (n=21, 52%); 3. Low IIV across all indices (n=16, 40%). For the HIV-I group, 2 distinct clusters were extracted: 1. High IIV across all 3 indices (n=7, 24%) and 2. Low IIV across all 3 indices (n=22, 76%). For the HC group, 3 distinct clusters were extracted: 1. Very low IIV across all 3 indices (n=5, 36%); 2. Elevated memory IIV (n=6, 43%); 3. Elevated attention/executive functioning IIV with very low attention/memory and memory IIV (n=3, 21%). Sample size of the HIV+I group was insufficient to extract clusters.
Conclusions:Current findings support IIV in the Neuropsi test battery as clinically sensitive marker for cognitive impairment in Spanish speaking individuals living with HIV or who inject drugs. Furthermore, the distinct IIV cluster types identified between groups can help to better understand specific sources of variability. Implications for clinical assessment in prognosis and etiological considerations are discussed.
29 Human Immunodeficiency Virus (HIV) Status, Injection Drug Use, and Cognitive Effects in a Spanish-Speaking Population
- Rachael L. Snyder, Alec J. Miller, Jeremy A. Feiger, Carmen A. Davila, Kim G. Carrasco, Kirk Dombrowski, Roberto Abadie, Anibal Valentin, Samodha Fernando, John T. West, Charles Wood, Sydney J. Bennett, Kathy S. Chiou
-
- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 442-443
-
- Article
-
- You have access Access
- Export citation
-
Objective:
Injection drug use is a significant public health crisis with adverse health outcomes, including increased risk of human immunodeficiency virus (HIV) infection. Comorbidity of HIV and injection drug use is highly prevalent in the United States and disproportionately elevated in surrounding territories such as Puerto Rico. While both HIV status and injection drug use are independently known to be associated with cognitive deficits, the interaction of these effects remains largely unknown. The aim of this study was to determine how HIV status and injection drug use are related to cognitive functioning in a group of Puerto Rican participants. Additionally, we investigated the degree to which type and frequency of substance use predict cognitive abilities.
Participants and Methods:96 Puerto Rican adults completed the Neuropsi Attention and Memory-3rd Edition battery for Spanish-speaking participants. Injection substance use over the previous 12 months was also obtained via clinical interview. Participants were categorized into four groups based on HIV status and injection substance use in the last 30 days (HIV+/injector, HIV+/non-injector, HIV/injector, HIV-/non-injector). One-way analysis of variance (ANOVA) was conducted to determine differences between groups on each index of the Neuropsi battery (Attention and Executive Function; Memory; Attention and Memory). Multiple linear regression was used to determine whether type and frequency of substance use predicted performance on these indices while considering HIV status.
Results:The one-way ANOVAs revealed significant differences (p’s < 0.01) between the healthy control group and all other groups across all indices. No significant differences were observed between the other groups. Injection drug use, regardless of the substance, was associated with lower combined attention and memory performance compared to those who inject less than monthly (Monthly: p = 0.04; 2-3x daily: p < 0.01; 4-7x daily: p = 0.02; 8+ times daily: p < 0.01). Both minimal and heavy daily use predicted poorer memory performance (p = 0.02 and p = 0.01, respectively). Heavy heroin use predicted poorer attention and executive functioning (p = 0.04). Heroin use also predicted lower performance on tests of memory when used monthly (p = 0.049), and daily or almost daily (2-6x weekly: p = 0.04; 4-7x daily: p = 0.04). Finally, moderate injection of heroin predicted lower scores on attention and memory (Weekly: p = 0.04; 2-6x weekly: p = 0.048). Heavy combined heroin and cocaine use predicted worse memory performance (p = 0.03) and combined attention and memory (p = 0.046). HIV status was not a moderating factor in any circumstance.
Conclusions:As predicted, residents of Puerto Rico who do not inject substances and are HIVnegative performed better in domains of memory, attention, and executive function than those living with HIV and/or inject substances. There was no significant difference among the affected groups in cognitive ability. As expected, daily injection of substances predicted worse performance on tasks of memory. Heavy heroin use predicted worse performance on executive function and memory tasks, while heroin-only and combined heroin and cocaine use predicted worse memory performance. Overall, the type and frequency of substance is more predictive of cognitive functioning than HIV status.
Contributors
-
- By Jay M. Baltz, Diana Patricia Bernal, William R. Boone, Ching-Chien Chang, Ri-Cheng Chian, Takeo Cho, Natalie A. Clark, Joe Conaghan, Shan-Jun Dai, Anna P. Ferraretti, Luca Gianaroli, H. Lee Higdon, Theresa Jeary, Eduardo Kelly, Michelle Lane, Henry J. Leese, M. Cristina Magli, Marius Meintjes, Kathleen A. Miller, Markus H. M. Montag, André Monteiro da Rocha, David Mortimer, Sharon T. Mortimer, Zsolt Peter Nagy, Kamilla S. Pedersen, Thomas B. Pool, Patrick Quinn, Niels B. Ramsing, Sarah A. Robertson, Gary Daniel Smith, Jason E. Swain, Jeremy G. Thompson, Yao Wang, Sarah-Louise Whitear, Deirdre Zander-Fox
- Edited by Patrick Quinn
-
- Book:
- Culture Media, Solutions, and Systems in Human ART
- Published online:
- 05 April 2014
- Print publication:
- 27 March 2014, pp ix-x
-
- Chapter
- Export citation
Contributors
-
- By Naif Al-Hathal, Kenneth I. Aston, Marc A. Beal, Lars Björndahl, Jens Peter Bonde, William O. Brant, Douglas T. Carrell, Chiara Chianese, Donald F. Conrad, Simon L. Conti, Jessie Dorais, Michael L. Eisenberg, Harry Fisch, John R. Gannon, Aleksander Giwercman, Ahmad O. Hammoud, David Iles, Csilla Krausz, Oumar Kuzbari, Cristina Joana Marques, David Miller, Jeremy B. Myers, Queenie V. Neri, Gianpiero D. Palermo, Zev Rosenwaks, Denny Sakkas, Heide Schatten, Christopher M. Somers, Mário Sousa, Qing-Yuan Sun, Armand Zini
- Edited by Douglas T. Carrell
-
- Book:
- Paternal Influences on Human Reproductive Success
- Published online:
- 05 April 2013
- Print publication:
- 11 April 2013, pp ix-x
-
- Chapter
- Export citation
Contributors
-
- By Gregory A. Aarons, Nick Axford, Frances Wallace Bailey, Judith Bennett, Karen A. Blase, James Boyle, Tracey Bywater, Linda L. Caldwell, Jeanne Century, Anne Michelle Daniels, Thomas J. Dishion, Celene E. Domitrovich, Morgaen Donaldson, Glen Dunlap, Carl J. Dunst, Melissa Van Dyke, Dean L. Fixsen, Tamsin Ford, Lise Fox, Cassie Freeman, Robyn M. Gillies, Amy E. Green, Mark T. Greenberg, Violet H. Harada, Tim Hobbs, Cindy Huang, Robert J. Illback, Barbara Kelly, Kathryn Margolis, Elizabeth Miller, Dana T. Mitra, Jeremy J. Monsen, Julia E. Moore, Louise Morpeth, Barbara Neufeld, Colleen K. Reutebuch, Mollie Rudnick, Robert Savage, Robert E. Slavin, Elizabeth A. Stormshack, Phillip Strain, Keith J. Topping, Carol M. Trivette, Sharon Vaughn, Janet A. Welsh, Lisa Marks Woolfson, Joyce Yukawa
- Edited by Barbara Kelly, University of Strathclyde, Daniel F. Perkins, Pennsylvania State University
-
- Book:
- Handbook of Implementation Science for Psychology in Education
- Published online:
- 05 November 2012
- Print publication:
- 20 August 2012, pp xi-xiv
-
- Chapter
- Export citation
Contributors
-
- By Shamsuddin Akhtar, Greg Albert, Sidney Allison, Muhammad Anwar, Haruo Arita, Amanda Barker, Mary Hanna Bekhit, Jeanna Blitz, Tyson Bolinske, David Burbulys, Asokumar Buvanendran, Gregory Cain, Keith A. Candiotti, Daniel B. Carr, Derek Chalmers, John Charney, Rex Cheng, Roger Chou, Keun Sam Chung, Anna Clebone, Frederick Conlin, Susan Dabu-Bondoc, Tiffany Denepitiya-Balicki, Jeanette Derdemezi, Anahat Kaur Dhillon, Ho Dzung, Juan Jose Egas, Stephen M. Eskaros, Zhuang T. Fang, Claudia R. Fernandez Robles, Victor A. Filadora, Ellen Flanagan, Dan Froicu, Allison Gandey, Nehal Gatha, Boris Gelman, Christopher Gharibo, Muhammad K. Ghori, Brian Ginsberg, Michael E. Goldberg, Jeff Gudin, Thomas Halaszynski, Martin Hale, Dorothea Hall, Craig T. Hartrick, Justin Hata, Lars E. Helgeson, Joe C. Hong, Richard W. Hong, Balazs Horvath, Eric S. Hsu, Gabriel Jacobs, Jonathan S. Jahr, Rongjie Jaing, Inderjeet Singh Julka, Zeev N. Kain, Clinton Kakazu, Kianusch Kiai, Mary Keyes, Michael M. Kim, Peter G. Lacouture, Ryan Lanier, Vivian K. Lee, Mark J. Lema, Oscar A. de Leon-Casasola, Imanuel Lerman, Philip Levin, Steven Levin, JinLei Li, Eric C. Lin, Sharon Lin, David A. Lindley, Ana M. Lobo, Marisa Lomanto, Mirjana Lovrincevic, Brenda C. McClain, Tariq Malik, Jure Marijic, Joseph Marino, Laura Mechtler, Alan Miller, Carly Miller, Amit Mirchandani, Sukanya Mitra, Fleurise Montecillo, James M. Moore, Debra E. Morrison, Philip F. Morway, Carsten Nadjat-Haiem, Hamid Nourmand, Dana Oprea, Sunil J. Panchal, Edward J. Park, Kathleen Ji Park, Kellie Park, Parisa Partownavid, Akta Patel, Bijal Patel, Komal D. Patel, Neesa Patel, Swati Patel, Paul M. Peloso, Danielle Perret, Anthony DePlato, Marjorie Podraza Stiegler, Despina Psillides, Mamatha Punjala, Johan Raeder, Siamak Rahman, Aziz M. Razzuk, Maggy G. Riad, Kristin L. Richards, R. Todd Rinnier, Ian W. Rodger, Joseph Rosa, Abraham Rosenbaum, Alireza Sadoughi, Veena Salgar, Leslie Schechter, Michael Seneca, Yasser F. Shaheen, James H. Shull, Elizabeth Sinatra, Raymond S. Sinatra, Neil Singla, Neil Sinha, Denis V. Snegovskikh, Dmitri Souzdalnitski, Julie Sramcik, Zoreh Steffens, Alexander Timchenko, Vadim Tokhner, Marc C. Torjman, Co T. Truong, Nalini Vadivelu, Ashley Vaughn, Anjali Vira, Eugene R. Viscusi, Dajie Wang, Shu-ming Wang, J. Michael Watkins-Pitchford, Steven J. Weisman, Ira Whitten, Bryan S. Williams, Jeremy M. Wong, Thomas Wong, Christopher Wray, Yaw Wu, Anthony T. Yarussi, Laurie Yonemoto, Bita H. Zadeh, Jill Zafar, Martha Zegarra, Keren Ziv
- Edited by Raymond S. Sinatra, Jonathan S. Jahr, University of California, Los Angeles, School of Medicine, J. Michael Watkins-Pitchford
-
- Book:
- The Essence of Analgesia and Analgesics
- Published online:
- 06 December 2010
- Print publication:
- 14 October 2010, pp xi-xviii
-
- Chapter
- Export citation
Hepatitis B Vaccination Coverage Levels Among Healthcare Workers in the United States, 2002-2003
- Edgar P. Simard, Jeremy T. Miller, Prethibha A. George, Annemarie Wasley, Miriam J. Alter, Beth P. Bell, Lyn Finelli
-
- Journal:
- Infection Control & Hospital Epidemiology / Volume 28 / Issue 7 / July 2007
- Published online by Cambridge University Press:
- 02 January 2015, pp. 783-790
- Print publication:
- July 2007
-
- Article
- Export citation
-
Background.
Hepatitis B virus (HBV) infection is a well recognized risk for healthcare workers (HCWs), and routine vaccination of HCWs has been recommended since 1982. By 1995, the level of vaccination coverage among HCWs was only 67%.
Objective.To obtain an accurate estimate of hepatitis B vaccination coverage levels among HCWs and to describe the hospital characteristics and hepatitis B vaccination policies associated with various coverage levels.
Design.Cross-sectional survey.
Methods.A representative sample of 425 of 6,116 American Hospital Association member hospitals was selected to participate, using probability-proportional-to-size methods during 2002-2003. The data collected included information regarding each hospital's hepatitis B vaccination policies. Vaccination coverage levels were estimated from a systematic sample of 25 HCWs from each hospital whose medical records were reviewed for demographic and vaccination data. The main outcome measure was hepatitis B vaccination coverage levels.
Results.Among at-risk HCWs, 75% had received 3 or more doses of the hepatitis B vaccine, corresponding to an estimated 2.5 million vaccinated hospital-based HCWs. The coverage level was 81% among staff physicians and nurses. Compared with nurses, coverage was significantly lower among phlebotomists (71.1%) and nurses' aides and/or other patient care staff (70.9%; P < .05). Hepatitis B vaccination coverage was highest among white HCWs (79.5%) and lowest among black HCWs (67.6%; P < .05). Compared with HCWs who worked in hospitals that required vaccination only of HCWs with identified risk for exposure to blood or other potentially infectious material, hepatitis B vaccination coverage was significantly lower among HCWs who worked in hospitals that required vaccination of HCWs without identified risk for exposure to blood or other potentially infectious material (76.6% vs 62.4%; P < .05).
Conclusions.In the United States, an estimated 75% of HCWs have been vaccinated against hepatitis B. Important differences in coverage levels exist among various demographic groups. Hospitals need to identify methods to improve hepatitis B vaccination coverage levels and should consider developing targeted vaccination programs directed at unvaccinated, at-risk HCWs who have frequent or potential exposure to blood or other potentially infectious material.