Joseph Perazzo

Physical activity is associated with reduced fatigue in adults living with HIV/AIDS.

AIMS The aim of this study was to describe the relationships among home-based physical activity, fatigue, sleep, gender and quality of life in people living with HIV/AIDS BACKGROUND: Fatigue is a common and distressing symptom among people living with HIV/AIDS. Few interventions exist that effectively reduce fatigue in this population. Physical activity has shown promise to reduce fatigue in other populations, but its impact on fatigue in HIV/AIDS has not yet been explored. DESIGN This study was conducted using a prospective, descriptive cohort design. METHODS Overall, 90 adults living with HIV/AIDS completed cross-sectional measures. Home-based physical activity was measured using a 7-day self-report diary. Fatigue was measured using the self-reported HIV-Related Fatigue Scale. Sleep was assessed using wrist actigraphy and quality of life was assessed using the HIV-Associated Quality of Life Scale. Data were collected from December 2012-April 2013 and analysed using correlations and multiple linear regression. RESULTS The number of minutes of home-based physical activity was significantly associated with reduced fatigue among people living with HIV/AIDS. In addition, increased fatigue was associated with decreased quality of life. No associations were found among fatigue, sleep or gender. CONCLUSIONS Our study demonstrates that physical activity in the home setting is an effective strategy to reduce fatigue among people living with HIV/AIDS. Future work developing and testing interventions to improve home-based physical activity in this population is needed.

Alcohol Use and HIV Self-management

Joseph Perazzo, PhD, RN, is a Postdoctoral Fellow, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. (*Correspondence to: jdp118@case.edu). Allison Webel, PhD, RN, is an Assistant Professor, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA.

Evaluation of a Summer Bridge: Critical Component of the Leadership 2.0 Program

BACKGROUND Summer bridges facilitate the transition from high school to college. Although many schools employ summer bridges, few have published outcomes. This articles purpose is to share preconceptions of college by underrepresented and disadvantaged nursing students and describe important elements and long-term impact of a summer bridge, a component of the Leadership 2.0 program. METHOD A longitudinal study design was used to collect baseline, short-term, and long-term post-summer bridge data. Methods included pre- and postsurveys, interviews, and focus groups. RESULTS After bridge completion, students felt more prepared for the nursing program. Students ranked socialization components as most important. The summer bridge had lasting impact through the first year, where grade point average and retention of underrepresented and disadvantaged bridge students was comparable to the majority first-year students. CONCLUSION The summer bridge was effective in preparing nursing students for the first year of college. Through holistic evaluation, unique aspects of socialization critical to student success were uncovered.

The Influence of Exercise on Cardiovascular Health in Sedentary Adults with Human Immunodeficiency Virus

Background: Lifestyle physical activity (ie, moderate physical activity during routine daily activities most days of the week) may benefit human immunodeficiency virus (HIV)–positive adults who are at high risk for cardiovascular disease. Objective: The aims of this study were to describe lifestyle physical activity patterns in HIV-positive adults and to examine the influence of lifestyle physical activity on markers of cardiovascular health. Our secondary objective was to compare these relationships between HIV-positive adults and well-matched HIV-uninfected adults. Methods: A total of 109 HIV-positive adults and 20 control participants wore an ActiGraph accelerometer, completed a maximal graded cardiopulmonary exercise test, completed a coronary computed tomography, completed anthropomorphic measures, and had lipids and measures of insulin resistance measured from peripheral blood. Results: Participants (N = 129) had a mean age of 52 ± 7.3 years, 64% were male (n = 82), and 88% were African American (n = 112). On average, HIV-positive participants engaged in 33 minutes of moderate-to-vigorous physical activity per day (interquartile range, 17–55 minutes) compared with 48 minutes in controls (interquartile range, 30–62 minutes, P = .05). Human immunodeficiency virus–positive adults had poor fitness (peak oxygen uptake [VO2], 16.8 ± 5.2 mL/min per kg; and a ventilatory efficiency, 33.1 [4.6]). A marker of HIV disease (current CD4+ T cell) was associated with reduced peak VO2 (r = −0.20, P < .05) and increased insulin resistance (r = 0.25, P < .01) but not with physical activity or other markers of cardiovascular health (P ≥ 0.05). After controlling for age, gender, body mass index, and HIV status, physical activity was not significantly associated with peak VO2 or ventilatory efficiency. Conclusion: Human immunodeficiency virus–positive adults have poor physical activity patterns and diminished cardiovascular health. Future longitudinal studies should examine whether HIV infection blunts the beneficial effects of physical activity on cardiovascular health.

Association Between the 6-Minute Walk Test Distance and Peak Cardiorespiratory Fitness Among People Living with HIV Varies by Fitness Level

Vitor H. F. Oliveira, MS, is a PhD Student, Department of Physical Education, Londrina State University, Londrina, Parana, Brazil. Joseph D. Perazzo, PhD, RN, is an Assistant Professor, University of Cincinnati, Cincinnati, Ohio, USA. Richard A. Josephson, MS, MD, is a Cardiologist, Harrington Heart & Vascular Institute, University Hospitals, Cleveland, Ohio, USA. Rafael Deminice, PhD, is an Assistant Professor, Department of Physical Education, Londrina State University, Londrina, Parana, Brazil. Allison R. Webel, PhD, RN, is an Assistant Professor, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA. (*Correspondence to: allison.webel@case.edu).

Relationships Between Physical Activity and Bone Density in People Living with HIV: Results from the SATURN-HIV Study

&NA; We conducted a cross‐sectional secondary analysis of baseline data from the SATURN‐HIV study (N = 147; 78% male, 68% Black, median body mass index [BMI] 26.72 kg/m2, 13% with osteopenia, HIV‐1 RNA < 1,000 copies/mL, stable antiretroviral therapy [ART]) to explore the relationship between physical activity (PA) and bone mineral density (BMD). We measured self‐reported minutes of PA and BMD in the overall sample and subgroups based on national recommendations (≥150 minutes/week). Forty‐one (28%) participants met recommended PA levels. Higher intensity PA was associated with higher BMD at the total hip (r = 0.27, p = .09; n = 41; 28%) and lumbar spine (r = 0.32, p < .05), and predicted higher BMD at the hip (p < .01; controlling for age, BMI, ART). Lumbar spine BMD did not retain significance in the regression model. Moderate‐to‐high intensity PA could prevent or mitigate excessive bone loss in people living with HIV.

Creation of Data Repositories to Advance Nursing Science

Data repositories are a strategy in line with precision medicine and big data initiatives, and are an efficient way to maximize data utility and form collaborative research relationships. Nurse researchers are uniquely positioned to make a valuable contribution using this strategy. The purpose of this article is to present a review of the benefits and challenges associated with developing data repositories, and to describe the process we used to develop and maintain a data repository in HIV research. Systematic planning, data collection, synthesis, and data sharing have enabled us to conduct robust cross-sectional and longitudinal analyses with more than 200 people living with HIV. Our repository building has also led to collaboration and training, both in and out of our organization. We present a pragmatic and affordable way that nurse scientists can build and maintain a data repository, helping us continue to make to our understanding of health phenomena.

Bone health in people living with HIV: The role of exercise and directions for future research

Joseph D. Perazzo, PhD, RN, is an Assistant Professor of Nursing, University of Cincinnati College of Nursing, Cincinnati, Ohio, USA. (*Correspondence to: joseph. perazzo@uc.edu). Allison R. Webel, PhD, RN, is an Assistant Professor of Nursing, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA. Carl J. Fichtenbaum, MD, is an Associate Chairman of Medicine for Translational Research and Professor of Clinical Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. Grace A. McComsey, MD, is an Associate Professor of Medicine and Pediatrics, Case Western Reserve School of Medicine, Cleveland, Ohio, USA. People living with HIV (PLWH) are at a threefold risk for bone loss compared to individuals who are not living with HIV (Yin & Brown, 2016). Low bone mineral density (BMD) in this population is the result of a combination of risk factors, including higher rates of traditional risk factors for bone loss (e.g., aging, steroid use, low body mass index, smoking), as well as disease and treatment-specific risk factors (Hileman, Eckard, & McComsey, 2015; See Figure 1). The increased risk of bone loss in PLWH results in a higher incidence of fractures (Gonciulea et al., 2017; Sharma et al., 2015), prompting the need for clinician assessment and intervention to improve bone density. To date, the majority of studies and clinical interventions have included pharmacologic agents to treat bone loss and promote absorption and retention of minerals (e.g., bisphosphonates, vitamin D supplementation). Pharmacologic treatments, while effective, carry an increased risk for side effects (particularly after long-term use), and do not address the behavioral and psychosocial contributors to low BMD. Furthermore, failure to address behavioral and psychosocial problems may limit the overall effectiveness of drug therapy, as these problems may affect adherence to medications and further accelerate bone loss. A comprehensive approach to treat and prevent bone loss that includes

Fatigue Symptom Management in People Living With Human Immunodeficiency Virus

Fatigue is a subjective, unpleasant, potentially disabling symptom rooted in physiological, psychological, and behavioral causes. People living with HIV are a population highly affected by fatigue due to risk factors associated with HIV-infection, treatment, and psychosocial disease burden. People with HIV are living longer, and are facing the challenge of a longer disease trajectory. Palliative nurses with expertise in symptom management can play a crucial role in helping people with HIV to engage in health behaviors that prevent or mitigate fatigue. In this paper we present a definition and overview of fatigue, describe the problem of fatigue in people living with HIV, and present a case study that illustrates the role of the palliative nurse in helping a person with HIV to cope with fatigue.

Transitioning newly diagnosed patients with HIV into care

Abstract: Fewer than half of the individuals in the United States with HIV are receiving the full benefit of treatment. Primary care providers play a pivotal role in creating a pipeline into HIV care following diagnosis. Using interview data and current literature, this article provides recommendations for promoting care initiation for individuals newly diagnosed with HIV.