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Biomedical subjects

E Secord

Publications and source records attributed to E Secord.

6 recordsLinked to original sources
PubMed2006

Psychosocial factors and treatment adherence in paediatric HIV/AIDS.

A social ecological model provides a promising framework for understanding the individual, family, and societal factors contributing to non-adherence to treatment of paediatric HIV. This study explored which factors relevant to this model are associated with caregivers' adherence and child health outcomes. A cross-sectional design was utilized to assess relationships among current individual, familial, extra-familial factors, caregiver adherence, and viral load. Data were collected from 43 caregivers, and viral load data were obtained from the medical records of their HIV+ children. Caregiver drug and alcohol use and HIV+ status were associated with non-adherence and elevated viral load. Negative outcome expectancy was associated with lower adherence but was not significant in the multivariate analyses. Family factors were not significant, but these measures had low reliability in this sample. Extra-familial factors such as dissatisfaction with medical specialty care and more stressful life events were not directly associated with adherence but were related to increased caregiver substance use. Results of this first study to explore multiple predictors of adherence and health outcomes in paediatric HIV require replication with larger samples, but findings suggest caregiver characteristics that place children at risk for disease progression due to poor adherence to treatment.

Adolescent↗
PubMed2000

Factor VIII inhibitors. Potential for prevention of inhibitor formation by immune tolerance.

Factor VIII inhibitory antibodies occur following treatment in more than 30% of subjects with severe factor VIII deficiency. Almost all inhibitor formation occurs in subjects with little if any circulating factor VIII. In the absence of in utero exposure to endogenous or maternal factor VIII, these subjects probably recognize factor VIII as a non-self antigen; in other words, their immune systems fail to become tolerant to factor VIII. This opens up the possibility of preventing inhibitor formation by neonatal induction of tolerance to factor VIII. The various possible approaches include prenatal or neonatal tolerance by the parenteral or oral administration of purified factor VIII protein or factor VIII-encoding DNA. The results of preliminary experiments in mice indicate that feeding newborns a series of low doses of factor VIII does not suppress induction of anti-factor VIII antibody. Whether tolerance can be achieved by feeding mice high doses of factor VIII or by intrauterine or neonatal administration of factor protein or DNA remains to be determined.

Animals↗