BackgroundNot much is known about the risk factors of major depressive disorder (MDD) in HIV/AIDS in the African socio-cultural context. Therefore a study was undertaken to examine the prevalence and risk factors of MDD in HIV/AIDS in semi-urban Uganda.MethodsA cross-sectional study was undertaken among 618 respondents attending two HIV clinics in Uganda.ResultsPrevalence of MDD was 8.1%. Factors associated with MDD at univariate analysis only were female gender, family history of mental illness, negative coping style, alcohol dependency disorder, food insecurity and stress; not associated with MDD were social support, neurocognitive impairment, CD4 counts and BMI. Factors independently associated with MDD were psychosocial impairment, adverse life events, post traumatic stress disorder, generalised anxiety disorder and life-time attempted suicide.ConclusionPsychological and social factors were the main risk factors of MDD among ambulatory HIV positive persons with no evidence for the role of the neurotoxic effects of HIV. Treatment approaches for MDD in this patient group should be modeled on those used among non-HIV groups.
BackgroundSuicidality in HIV/AIDS is not only a predictor of future attempted suicide and completed suicide, it is also associated with poor quality of life and poor adherence with antiretroviral therapy. This paper examines the prevalence and correlates of suicidality in HIV/AIDS in the African nation of Uganda.MethodsA cross-sectional study was undertaken among 618 respondents attending two HIV clinics in semi-urban Uganda. A structured questionnaire was used to collect data on demographic, social, psychological and clinical factors. Correlates of suicidality were assessed using mulitvariable logistic regression.ResultsPrevalence of ‘moderate to high risk for suicidality’ (MHS) was 7.8 % and that of life-time attempted suicide was 3.9 %. Factors associated with MHS at univariate analysis were: female gender, food insecurity, increasing negative life events, high stress score, negative coping style, past psychiatric history, psychosocial impairment, diagnoses of post-traumatic stress disorder, generalised anxiety disorder and major depressive disorder. Factors independently associated with MHS in multivariate models were female gender, increasing negative life events, a previous psychiatric history, and major depressive disorder.ConclusionsThese results are in agreement with the stress-vulnerability model where social and psychological stressors acting on an underlying diathesis (including previous and current psychiatric morbidities) leads to suicidality. These results identify potential targets to mitigate risk through treatment of psychiatric disorders and promoting greater adaptation to living with HIV/AIDS.
Ultra-High Molecular Weight Polyethylene (UHMWPE) is used in biomedical applications due to its high wear-resistance, ductility, and biocompatibility. A great deal of research in recent decades has focused on further improving its mechanical and tribological performances in order to provide durable implants in patients. Several methods, including irradiation, surface modifications, and reinforcements have been employed to improve the tribological and mechanical performance of UHMWPE. The effect of these modifications on tribological and mechanical performance was discussed in this review.
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