SM Journal of Family Medicine

Archive Articles

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Perceived Barriers to Medication Adherence among African American Patients on Antiretroviral Therapy in Alabama’s Black Belt

In Alabama’s Black Belt, African Americans are disproportionately affected by Acquired Immunodeficiency Syndrome (AIDS). New treatments that slow the progression of human immunodeficiency virus (HIV) infection offer hope for individuals living with HIVIAIDS, but lack of adherence to medications remain significant obstacles to HIV treatment in rural Alabama.

Lack of adherence limits the potential benefit of antiretroviral therapy to improve the health of those living with HIV/ AIDS. As an extension previous research on HIV/AIDS the purpose of the current research is to explore perceived reasons for lack of adherence to medication experienced by HIV-infected African Americans living in Alabama’s Black Belt region of the United States. Qualitative research results showed that Perceived Barriers to Medications Adherence are: lack of health insurance, Financial constraints and Poverty, Lack of Trust in White Medical Health Professionals, Household Food Insecurity and HIV medicine side effects, poor Mental Health, Social Stigma and Alcohol Use, Lack of transportation, Trouble swallowing pills and Substance use, Not Enough Black Medical practitioners in the Black Belt, and Poor Public Goods and Services. Endorsing HIV/AIDS Conspiracy beliefs such as “AIDS is a form of genocide against Blacks” is an important barrier to medication adherence in the sample. It is important that all members of the healthcare team address potential barriers to medication adherence in order to achieve viral suppression and optimize outcomes in patients with HIV.

Andrew Zekeri1* and Cordelia C. Nnedu2


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A Quadripartite Cu2O-Cds-Bivo4-WO3 VisibleLight Driven Photocatalyst Contained Three Cascade Z-Scheme Systems: Focus on Conditions’ Optimization, Scavenging Agents and the Mechanism Pathway Towards Sulfasalazine

The explosive pollution of water suppliers via the discharged various industrial and pharmaceuticals effluents prompted researchers to construct novel adsorbents and photocatalysts, especially their visible-light driven photocatalysts. A novel coupled Cu2 O-CdS-BiVO4 -WO3 quadripartite nanoscale catalyst was prepared and characterized by XRD, SEM-DX, x-ray mapping, and DRS techniques. Its pHpzc was also determined to be about 9. The Eg-values obtained were 1.95, 1.96, 2.16, 2.38, and 2.19 for Cu2 O, BiVO4 , CdS, WO3 , and quadripartite catalysts, respectively. The photodegradation experiments were designed via RSM. The significance of the suggested model was confirmed by greater model F-value of 26.19 than F0.05,14,15=2.55. The optimal run in the photodegradation of sulfasalazine (SFSZ) included the CSFSZ: 7 mg/L, pH 6.25, 30 min irradiation time, 0.45 g/L of the catalyst dose, by a catalyst with a Cu2 O-CdS-BiVO4 -WO3 mole ratio 3:1:1:1 under visible light illumination. The effects of the scavenging agents were also studied, and the results confirmed the critical role of superoxide in SFSZ photodegradation and the hydroxyl radicals. The photodegradation pathway obeyed the direct Z-scheme mechanism, which involved three successive binary Z-scheme components involving WO3 -BiVO4 , BiVO4 -CdS, and CdS-Cu2 O, which accumulates the photoinduced electrons in the CB-Cu2 O and the holes in the VB-WO3 , the more powerful reducing and oxidizing centers, respectively.

Narges Omrani and Alireza Nezamzadeh-Ejhieh*


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“Out of the Woods”: Perspectives of Caregivers of Adult Children with CHARGE Syndrome

CHARGE syndrome is complex genetic condition that affects approximately 1 in 8,500 to 10,000 newborns worldwide. Individuals living with CHARGE syndrome frequently face significant physical challenges from birth, requiring managed medical and developmental assistance. Many of these individuals are cared for by family caregivers who often report elevated levels of stress. However, as children with CHARGE Syndrome get older, their medical complications often subside. With the resolution of many of their medical complications, it is possible the experiences of these caregivers may be different than the experiences of caregivers for younger children with this condition. The purpose of this study was to determine the quality of life of caregivers of older (18 years and older) individuals with CHARGE Syndrome. A total of seven family caregivers of adult children living with CHARGE syndrome participated in this study. Transcripts from these semi-structured interviews were analyzed using qualitative description methodology. The following four themes emerged from the qualitative interviews: (1) Reshaping Identity and Autonomy, focusing on how caregiving transforms parents’ sense of self and freedom; 2: Emotional Resilience and Coping, highlighting the strategies parents use to manage stress and maintain wellbeing; 3: Systemic Barriers and Support, addressing the challenges with formal systems and reliance on informal networks, and 4: Child’s Health Profile and Responsibilities, detailing the specific medical complexities and daily caregiving demands. The coping strategies and unique approaches to managing difficult times that caregivers in this study described can be helpful to specialists and parent groups as they navigate CHARGE syndrome.

Afeez A. Hazzan1*, Pamela Beach2, Lauren Lieberman3, Samantha Leung2 and Nicole Ness2