In 2017, the government of Ukraine initiated its ART Optimization Initiative, revising its national antiretroviral therapy (ART) guidelines and embracing Dolutegravir (DTG) as a backbone of first-line ART regimens. A cross-sectional survey of 464 ART patients from 22 large ART clinics was carried out in mid-2019. The survey assessed patient-reported outcomes (PROS) including treatment satisfaction, physical health, mental health, depression, side effects of ART, and adherence. The associations between ART regimen and PROs were assessed using bivariable and multivariable generalized estimating equations (GEE) models. More than half (55.6%) of the patients were satisfied with their current ART regimen. Less than a half (45.3%) considered their physical health as good while only 36.9% rated their mental health as good, 21.3% reported moderate or severe depression, 82.3% reported no side effect in the past 4 weeks, and 44.4% reported not missing ART medication in the past month. In adjusted analysis, patients starting ART with DTG had higher treatment satisfaction compared to people continuing LPV-based regimens (aOR = 0.49, 95% confidence interval: 0.22-0.90). Also in adjusted analyses, unemployment, low income, and history of injection drug use were associated with unfavorable PROs. While the results indicate modestly favorable effects of ART Optimization, there is clearly a need for complementary interventions to improve PROs among disadvantaged ART patients in Ukraine.
Background Understanding the differences in timing and composition of physical distancing policies is important to evaluate the early global response to COVID-19. A physical distancing intensity monitoring framework comprising 16 domains was recently published to compare physical distancing approaches across 12 U.S. States. We applied this framework to a diverse set of low and middle-income countries (LMICs) (Botswana, India, Jamaica, Mozambique, Namibia, and Ukraine) to test the appropriateness of this framework in the global context and to compare the policy responses in these LMICs with a sample of U.S. States during the first 100-days of the pandemic. Results The LMICs in our sample adopted wide ranging physical distancing policies. The highest peak daily physical distancing intensity during this period was: Botswana (4.60); India (4.40); Ukraine (4.40); Namibia (4.20); Mozambique (3.87), and Jamaica (3.80). The number of days each country stayed at peak policy intensity ranged from 12-days (Jamaica) to more than 67-days (Mozambique). We found some key similarities and differences, including substantial differences in whether and how countries expressly required certain groups to stay at home. Despite the much higher number of cases in the US, the physical distancing responses in our LMIC sample were generally more intense than in the U.S. States, but results vary depending on the U.S. State. The peak policy intensity for the U.S. 12-state average was 3.84, which would place it lower than every LMIC in this sample except Jamaica. The LMIC sample countries also reached peak physical distancing intensity earlier in outbreak progression compared to the U.S. states sample. The easing of physical distancing policies in the LMIC sample did not discernably correlate with change in COVID-19 incidence. Conclusions This physical distancing intensity framework was appropriate for the LMIC context with only minor adaptations. This framework may be useful for ongoing monitoring of physical distancing policy approaches and for use in effectiveness analyses. This analysis helps to highlight the differing paths taken by the countries in this sample and may provide lessons to other countries regarding options for structuring physical distancing policies in response to COVID-19 and future outbreaks.
Background Approximately one-third of people living with HIV in Ukraine are unaware of their HIV status. Index testing (IT) is an evidence-based HIV testing strategy that supports voluntary notification of partners with HIV risk, so they can receive HIV testing, prevention, and treatment services. Methods Ukraine scaled up IT services in 2019. This observational study of Ukraine’s IT program covered 39 health facilities located in 11 regions with high HIV burden. The study used routine program data from January—December 2020 to describe the profile of named partners and explore index client (IC) and partner factors associated with two outcomes: 1) completing testing; and 2) HIV case finding. Analysis used descriptive statistics and multilevel linear mixed regression models. Results The study included 8,448 named partners, of whom 6,959 had unknown HIV status. Among them,72.2% completed HIV testing and 19.4% of those tested were newly diagnosed with HIV. Two-thirds of all new cases were among partners of ICs who were recently diagnosed and enrolled in care (< 6 months), while one third were among partners of established ICs. In adjusted analysis, partners of ICs with unsuppressed HIV viral load (VL) were less likely to complete HIV testing (adjusted odds ratio [aOR] = 0.11, p < 0.001), but more likely to receive a new HIV diagnosis (aOR = 1.92, p < 0.001). Partners of ICs who cited injection drug use or having a known HIV + partner as their own reason for testing were more likely to receive a new HIV diagnosis (aOR = 1.32, p = 0.04 and aOR = 1.71, p < 0.001 respectively). Involving providers in the partner notification process was associated with completed testing (aOR = 1.76, p = 0.001) and HIV case finding (aOR = 1.64, p < 0.01), compared with notification by ICs. Conclusion HIV case detection was highest among partners of recently diagnosed ICs, but IT participation among established ICs still yielded an important share of all newly-identified HIV cases. Areas for improvement in Ukraine’s IT program include completing testing for partners of ICs with unsuppressed HIV VL, with history of injection drug use or discordant partnerships. Using intensified follow-up for the sub-groups at risk of incomplete testing may be practical. Greater use of provider-assisted notification could also accelerate HIV case finding.
Background: Achievement of the UNAIDS 95-95-95 targets requires ARV regimens that are easy to use, well-tolerated, and cost-effective. Dolutegravir (DTG)-based regimens are efficacious and less costly than other common first-line regimens. This study assessed real-world effectiveness of DTG regimens in treatmentnaive people living with HIV in Ukraine. Methods:We extracted data from the national Medical Information System on all adult patients who initiated antiretroviral therapy (ART) with DTG, lopinavir/ritonavir, or efavirenz (EFV) between October 2017 and June 2018, at 23 large clinics in 12 regions of Ukraine. Viral suppression at 12 6 3 months and retention at 12 months after treatment initiation were the outcomes of interest.Results: Of total 1057 patients, 721 had a viral load test within the window of interest, and 652 (90%) had viral load of # 200 copies/mL. The proportion with suppression was lower in the EFV group [aOR = 0.4 (95% confidence interval: 0.2 to 0.8)] and not different in the LPV group [aOR = 1.6 (0.5 to 4.9)] compared with the DTG group. A 24-month or longer gap between diagnosis and treatment was associated with lower odds of suppression [aOR = 0.4 (0.2 to 0.8)]. Treatment retention was 90% (957/1057), with no significant difference by regimen group. History of injecting drug use was associated with decreased retention [aOR = 0.5 (0.3 to 0.8)].Conclusions: DTG-based regimens were comparable with LPV and more effective than EFV in achieving viral suppression among ARTnaive patients in a multisite cohort in Ukraine. Treatment retention was equally high in all 3 groups. This evidence from Ukraine supports the ART Optimization Initiative as a strategy to improve efficiency of the ART program without negatively affecting patient clinical outcomes.
Analysis of linguocultural aspect of temporal nominations is impossible without involving the problems of hrononymic lexics. Chrononyms is an important information resource of a certain linguaculture, some distinctive peculiarities of conceptual picture of the world. The aim of the experimental analysis is a complex examination of the linguacultural aspect of temporal nominations that function in Chinese and Turkish languages reflecting the concepts of the world. The research was based on the material of the novels “Imperial woman” by Pearl Buck and “Roxolana” by Pavlo Zagrebelniy. The analysis of recent scientific publications allowed us to come to the conclusion that the investigation of hrononymic lexics can involve different theoretical and practical principles. Being guided by the existing classifications of chrononyms (N. Podolskaya, M. Torchinsky, S. Remmer) the linguocultural features of the following types of temporal chrononymic lexical units were identified and studied in the research: georthonyms, dynastic chrononyms, tumultonyms, parsonyms and mensonyms. The results of the research demonstrate that not all lexical units of temporal denotation chosen from the above mentioned novels refer to the class of chrononyms. The group under investigation includes the following lexemes: nominations of the lunar calendar, nominations of the solar calendar, nominations of mixed calendar and temporal slots denoting day and night. The basic system of chronology in the linguiacultures under analysis is the dominance of the lunar calendar nominations (Chinese picture of the world — 51,0 %, Turkish — 40,4 %). In the analyzed works the nominations of the solar calendar are used less often in the Chinese picture of the world; the usage of this unit reaches 20 %, and this phenomenon is historically conditioned. Mixed calendar nominations (21 % of temporal units) are rather common, solar calendar nominations are refined by the monthly calendar; it can be explained by the fact that the Chinese mind is conservative towards the new temporal system. In the Turkish picture of the world 45 % of temporal vocabulary belongs to the solar calendar since in the sixteenth century only a lunar calendar operated in the Ottoman Empire. It should be mentioned that significant place in the temporal vocabulary of “Roxolana” is conditioned by the influence of the linguistic personality of the author, who was a Ukrainian.
Анотація. Статтю присвячено дослідженню фітонімів, що є специфічними для китайської і турецької картин світу. Під час аналізу було встановлено, що кожен фітонім має свою символічну семантику. Опираючись на дослідження символіки фітонімів, виявлено лінгвокультурологічні концепти властиві китайській і турецькій картинам світу. Ключові слова: мовна картина світу, фітоніми, концепт, символ.
Learning the character's linguistic personality is impossible without exploring its individual vocabulary. The study was based on the novels Pearl Buck "Imperial woman" and Pavlo Zagrebelniy "Roxolana". The main theoretical aspects of the concept of "character’s individual lexicon" are considered in the article. The terms "individual lexicon", "mental lexicon" and "internal lexicon" are specified. The comparative analysis of the individual lexicon of the real linguistic personality and character’s linguistic personality is carried out. The independent value of the character’s individual lexicon is determined. Analysis of the individual lexicon is performed at the morphological and syntactic level. For both heroines, concepts such as knowledge, hope, children, freedom, greatness (triumph), painting (singing) are most essential. In other cases, Roxolana's priorities are faith, native land, happiness, salvation. For Tzu Hsi - peace, triumph, debt, people. The individual lexicon of the character is characterized by the distinctive characteristics of the linguistic personality (the closeness of the list of lexical units, statical state of the system). The individual lexicons of the characters share common morphological indicators (nouns and verbs predominate). From the point of view of syntax the prevailing use of direct imperative forms in the communicative acts of the characters has been revealed (order, requirement Tzu Hsi - 48%, Roxolana -35%). In the speech of both characters in the analysis of the affirmative form of imperative is dominated by verbs of movement and auditory perception. Direct imperative forms testify to the highest situational and status position of both ladies. Threat sentences are more typical of Tzu Hsi. Indirect imperative forms (request, offer, advice, persuasion, praise, support and consolation) are dominant in Roxolana’s individual lexicon.
Background. Understanding the differences in timing and composition of physical distancing policies is important to evaluate the early global response to COVID-19. A physical distancing intensity framework comprising 16 domains was recently published to compare physical distancing approaches between U.S. States. We applied this framework to a diverse set of low and middle-income countries (LMICs) (Botswana, India, Jamaica, Mozambique, Namibia, and Ukraine) to test the appropriateness of this framework in the global context and to compare the policy responses in this set of LMICs and with a sample of U.S. States during the first 100-days of the epidemic. Results. All six of the LMICs in our sample adopted wide ranging physical distancing policies. The highest peak daily physical distancing intensity in each country was: Botswana (4.60); India (4.40); Ukraine (4.40); Namibia (4.20); and Jamaica (3.80). The number of days each country stayed at peak intensity ranged from 12-days (Jamaica) to more than 67-days (Mozambique). We found some key similarities and differences, including substantial differences in whether and how countries expressly required certain groups to stay at home. We also found that the LMICs generally implemented physical distancing policies when there were few confirmed cases and the easing of physical distancing policies did not discernably correlate with change in COVID-19 incidence. The physical distancing responses in the LMIC sample were generally more intense than in a sample of U.S. States, but results vary depending on the U.S. State. For example, California had a peak intensity of 4.29, which would place California below the peak intensity for Botswana, India, and Ukraine but above Mozambique, Namibia and Jamaica. The U.S. State of Georgia had a peak intensity of 3.07, which would place it lower than all of the LMICs in this sample. The peak intensity for the U.S. 12-state average was 3.84, which would place it lower than every LMIC in this sample except Jamaica. Conclusion. This analysis helps to highlight the differing paths taken by the countries in this sample and may provide lessons to other countries regarding options for structuring physical distancing policies in response to COVID-19 and future outbreaks.
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