2024
Cost-effectiveness of screening and treating alcohol use and depression among people living with HIV in Zimbabwe: a mathematical modeling study
Su J, Yeo Y, Jeetoo M, Morojele N, Francis J, Shenoi S, Braithwaite R. Cost-effectiveness of screening and treating alcohol use and depression among people living with HIV in Zimbabwe: a mathematical modeling study. BMC Medicine 2024, 22: 481. PMID: 39428460, PMCID: PMC11492560, DOI: 10.1186/s12916-024-03674-8.Peer-Reviewed Original ResearchConceptsCognitive-behavioral therapyBackgroundAlcohol use disorderTreating alcohol useCompared to baselineLong-acting PrEPDepressive disorderTreat AUDUse disorderMDDMDD screeningAlcohol usePHQ-9Quality-adjusted life yearsAUDCost-effectiveness of screeningSub-Saharan African settingDisordersImpact of screeningIntervention costsHIV infectionHIV transmissionHIV reductionInterventionHIV outcomesHIV epidemicPrior tuberculosis, radiographic lung abnormalities and prevalent diabetes in rural South Africa
Castle A, Moosa Y, Claassen H, Shenoi S, Magodoro I, Manne-Goehler J, Hanekom W, Bassett I, Wong E, Siedner M. Prior tuberculosis, radiographic lung abnormalities and prevalent diabetes in rural South Africa. BMC Infectious Diseases 2024, 24: 690. PMID: 38992607, PMCID: PMC11238449, DOI: 10.1186/s12879-024-09583-8.Peer-Reviewed Original ResearchConceptsPrevalent diabetesChest X-rayChest X-ray abnormalitiesX-ray abnormalitiesOdds of prevalent diabetesHemoglobin A1c testingPost-TB lung diseaseHistory of TB diseaseAssociated with prevalent diabetesPulmonary abnormalitiesExposure of interestRural South AfricaPrevalence of diabetesTB diseaseCohort of peopleCAD4TBMethodsWe analyzed dataCross-sectional studyCompare groupsLogistic regression modelsIncidence of diabetesDiabetes prevalenceA1c testingConclusionsAmong peopleDigital chest X-ray
2023
Perceived stigma related to TB preventive therapy
Palacios C, Hough M, Shrestha R, Moll A, Kompala T, Andrews L, Shenoi S. Perceived stigma related to TB preventive therapy. The International Journal Of Tuberculosis And Lung Disease 2023, 27: 209-214. PMID: 36855038, DOI: 10.5588/ijtld.22.0570.Peer-Reviewed Original ResearchConceptsTB preventative therapyTB preventive therapyAnonymous cross-sectional surveyBurden of TBCommunity-dwelling adultsRural South African communityCross-sectional surveyPreventive therapyMean agePreventative therapyEndemic settingsPatient's familyKruskal-Wallis testStigma scoresRural South AfricaPoisson regressionNovel interventionsSouth African communityTherapyLess stigmaDescriptive statisticsFamily membersStigmaTBTwo-factor solution
2022
Efficacy and Safety of COVID-19 Convalescent Plasma in Hospitalized Patients
Ortigoza MB, Yoon H, Goldfeld KS, Troxel AB, Daily JP, Wu Y, Li Y, Wu D, Cobb GF, Baptiste G, O’Keeffe M, Corpuz MO, Ostrosky-Zeichner L, Amin A, Zacharioudakis IM, Jayaweera DT, Wu Y, Philley JV, Devine MS, Desruisseaux MS, Santin AD, Anjan S, Mathew R, Patel B, Nigo M, Upadhyay R, Kupferman T, Dentino AN, Nanchal R, Merlo CA, Hager DN, Chandran K, Lai JR, Rivera J, Bikash CR, Lasso G, Hilbert TP, Paroder M, Asencio AA, Liu M, Petkova E, Bragat A, Shaker R, McPherson DD, Sacco RL, Keller MJ, Grudzen CR, Hochman JS, Pirofski LA, Rahman F, Ajayi A, Rodriguez S, Ledesma A, Keeling D, Rappoport N, Ebel S, Kim J, Chang M, Chan K, Patel P, Martocci A, Dave S, Darwish Y, Taveras M, Shoyelu V, Xin P, Iturrate E, Moldolsky L, Raimondo B, Mendez S, Hughes P, Sterling S, Lord A, Yaghi S, Veloso K, Sheikh M, Visconti-Ferrara E, Fleming A, Youn H, Jane Fran B, Medina R, McKell R, Khan S, Hamilton T, Sanchez C, Patel N, Cleare L, Vergnolle O, Nakouzi A, Quevedo G, Bortz R, Wirchnianski A, Florez C, Babb R, Ayala J, Tsagaris K, James A, Eke I, Obeidallah A, Sandu O, Sohval S, Serrano-Rahman L, Uehlinger J, Bartash R, Al-Abduladheem A, Gendlina I, Sheridan C, Bortnick A, Eichler J, Kaufman R, Yukelis S, Pennock M, Goggin M, Shen C, Annam J, Khokhar A, Barboto D, Lally B, Lee A, Lee M, Yang X, Allen S, Malaviya A, Moussa O, Park R, Sample R, Bae A, Benoni G, Boerger L, Baker L, Luther M, Ameti L, Briggs N, Golden M, Gormally M, Huang G, Johnson R, Morrison A, Montagna-Hill M, Rivera B, Cortezzo G, Debski K, Nicoletti, DeBenedictis K, Davis R, Marshall C, Duque Cuartas M, Beauchamps L, Bertran-Lopez J, Gonzales Zamora J, Delgado-Lelievre M, Dominguez S, Lee C, Kusack H, Karakeshishyan V, Hajaz A, Deniz D, Garcia G, Dae K, Blenet P, Jaffe D, Olson L, Sabogal D, Blust O, Del Prete Perez V, Bornia C, Rodriguez-Perez V, Calderon V, Ramdev R, Jolly A, Guzman I, Guerra R, Brito S, Hobbs R, Denham R, Dick J, Hernandez M, Nielsen L, Anjum S, Mader S, Stutz T, Mammadova M, Nichols P, Khan T, Boktour M, Castaneda B, Benitez B, Hinojosa E, Guerra B, Ortiz A, Hebbeler-Clark R, McShane P, Hibbard R, Hawkins B, Dohanich E, Wadle C, Greenlee K, Brooks J, Herrick C, Gode A, Bergl P, Hu K, Patel J, Srinivasan S, Graf J, Klis C, Reimer K, Carpenter E, Naczek C, Petersen R, Dex R, Drossart J, Zelten J, Brummitt C, Liang M, Yanny L, Dennison G, Runningen P, Brzezinski B, Fiebig S, Naczek C, Kasdorf M, Parameswaran L, Corcoran A, Rohatgi A, Wronska M, Wu X, Srinivasan R, Deng F, Filardo T, Pendse J, Blaser S, Whyte O, Gallagher J, Thomas O, Ramos D, Sturm-Reganato C, Fong C, Daus I, Payoen A, Chiofolo J, Friedman M, Wu D, Jacobson J, Schneider J, Sarwar U, Wang H, Huebinger R, Dronavalli G, Bai Y, Grimes C, Eldin K, Umana V, Martin J, Heath T, Bello F, Ransford D, Laurent-Rolle M, Shenoi S, Akide-Ndunge O, Thapa B, Peterson J, Knauf K, Patel S, Cheney L, Tormey C, Hendrickson J. Efficacy and Safety of COVID-19 Convalescent Plasma in Hospitalized Patients. JAMA Internal Medicine 2022, 182: 115-126. PMID: 34901997, PMCID: PMC8669605, DOI: 10.1001/jamainternmed.2021.6850.Peer-Reviewed Original ResearchConceptsCCP recipientsPlacebo recipientsSecondary outcomesSymptom durationHospitalized patientsPrimary outcomeDay 28COVID-19SARS-CoV-2 serostatusSARS-CoV-2 titersWorld Health Organization (WHO) ordinal scaleCOVID-19 convalescent plasmaConvalescent plasma usePlacebo-controlled trialLess daysExploratory subgroup analysisNon-Hispanic blacksSARS-CoV-2CCP efficacyConcomitant medicationsAdverse eventsClinical improvementSymptom onsetConvalescent plasmaMedian age
2021
Cumulative burden of non-communicable diseases predicts COVID hospitalization among people with HIV: A one-year retrospective cohort study
Virata MD, Shenoi SV, Ladines-Lim J, Villanueva MS, Barakat LA. Cumulative burden of non-communicable diseases predicts COVID hospitalization among people with HIV: A one-year retrospective cohort study. PLOS ONE 2021, 16: e0260251. PMID: 34851963, PMCID: PMC8635326, DOI: 10.1371/journal.pone.0260251.Peer-Reviewed Original ResearchConceptsOne-year retrospective cohort studyCohort of PWHNon-communicable comorbiditiesPredictors of hospitalizationRetrospective cohort studyChronic lung diseaseLikelihood of hospitalizationSingle-site experienceCOVID-19 infectionNon-communicable diseasesOutcomes of peopleCohort studyHIV diseaseOverall mortalityClinical outcomesLung diseaseCardiovascular diseaseHospitalizationCumulative burdenHIVLater timeframeDiseaseEarly epidemicPWHOutcomesFeasibility of a community‐based delivery model for HIV pre‐exposure prophylaxis among bar patrons in rural South Africa
Grammatico MA, Moll AP, Choi K, Springer SA, Shenoi SV. Feasibility of a community‐based delivery model for HIV pre‐exposure prophylaxis among bar patrons in rural South Africa. Journal Of The International AIDS Society 2021, 24: e25848. PMID: 34826363, PMCID: PMC8625837, DOI: 10.1002/jia2.25848.Peer-Reviewed Original ResearchConceptsPre-exposure prophylaxisAlcohol Use Disorders Identification TestLargest HIV epidemicCommunity-based delivery modelPrEP uptakeHIV testingOdds ratioOral tenofovir disoproxil fumarate/emtricitabineTenofovir disoproxil fumarate/emtricitabineRural South AfricaHazardous drinkingDisoproxil fumarate/emtricitabineHIV pre-exposure prophylaxisUptake of PrEPHIV care cascadeRapid HIV testingAdjusted odds ratioYoung menRural KwaZulu-Natal ProvinceAlcohol use disorderSexual risk behaviorsDisorders Identification TestBar patronsPrEP deliveryPrEP initiatorsAn expanding HIV epidemic among older adults in Ukraine: Implications for patient-centered care
Rozanova J, Zeziulin O, Rich KM, Altice FL, Kiriazova T, Zaviryukha I, Sosidko T, Gulati K, Carroll C, Shenoi SV. An expanding HIV epidemic among older adults in Ukraine: Implications for patient-centered care. PLOS ONE 2021, 16: e0256627. PMID: 34591848, PMCID: PMC8483339, DOI: 10.1371/journal.pone.0256627.Peer-Reviewed Original ResearchConceptsStandardized mortality ratioMortality rateCause standardized mortality ratioTime of diagnosisGeneral population ratesLate-stage HIVAge-matched groupHigh mortality ratePatient-centered careIncident HIVHIV diagnosisHIV testingHIV incidenceHIV treatmentHIV epidemicMortality ratioTreatment strategiesGeneral populationHIVMortality trendsAge groupsEECA countriesTreatment programSame calendar yearOlder people“We’ve Got Our Own Beliefs, Attitudes, Myths”: A Mixed Methods Assessment of Rural South African Health Care Workers' Knowledge of and Attitudes Towards PrEP Implementation
Asabor EN, Lett E, Moll A, Shenoi SV. “We’ve Got Our Own Beliefs, Attitudes, Myths”: A Mixed Methods Assessment of Rural South African Health Care Workers' Knowledge of and Attitudes Towards PrEP Implementation. AIDS And Behavior 2021, 25: 2517-2532. PMID: 33763802, PMCID: PMC8450017, DOI: 10.1007/s10461-021-03213-z.Peer-Reviewed Original ResearchConceptsLocal healthcare workersHealthcare workersPrEP implementationHealth care workers' knowledgeHIV pre-exposure prophylaxisSkilled clinical staffPre-exposure prophylaxisImpact of HIVPrEP interventionsHIV prevalenceHCW roleClinical staffTravel burdenMixed-methods assessmentDisproportionate burdenHIVWorkers' knowledgeAdditional concernsSexual behaviorBlack South AfricansBarriers researchersPrEPRisk compensationBurdenImplementation scientists
2020
Mobile Device Usage by Gender Among High-Risk HIV Individuals in a Rural, Resource-Limited Setting
Campbell BR, Choi K, Neils MG, Canan C, Moll A, Dillingham R, Shenoi SV. Mobile Device Usage by Gender Among High-Risk HIV Individuals in a Rural, Resource-Limited Setting. Telemedicine Journal And E-Health 2020, 27: 615-624. PMID: 32835638, PMCID: PMC8215405, DOI: 10.1089/tmj.2020.0218.Peer-Reviewed Original ResearchConceptsMHealth interventionsRural KwaZulu-NatalCare of HIVLack of circumcisionMultivariable logistic regressionMedical male circumcisionResource limited settingsHealthcare messagesCircumcision statusHIV counselingHIV individualsMiddle-income countriesCondomless sexMale circumcisionCondom useCommunity settingsLogistic regressionHIVYoung womenHealthcare interventionsUnderserved populationsKwaZulu-NatalHealth information seekingHealth informationInterventionSocial Support is Key to Retention in Care during Covid-19 Pandemic among Older People with HIV and Substance Use Disorders in Ukraine
Rozanova J, Shenoi S, Zaviryukha I, Zeziulin O, Kiriazova T, Rich K, Mamedova E, Yariy V. Social Support is Key to Retention in Care during Covid-19 Pandemic among Older People with HIV and Substance Use Disorders in Ukraine. Substance Use & Misuse 2020, 55: 1902-1904. PMID: 32666857, PMCID: PMC7523433, DOI: 10.1080/10826084.2020.1791183.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnti-Retroviral AgentsBetacoronavirusComorbidityCoronavirus InfectionsCOVID-19FemaleHealth PersonnelHIV InfectionsHumansMaleMiddle AgedPandemicsPneumonia, ViralRetention in CareSARS-CoV-2Social IsolationSocial SupportSubstance-Related DisordersSurveys and QuestionnairesUkraineConceptsSubstance use disordersUse disordersHuman immunodeficiency virus HIVCOVID-19 pandemicOlder peopleLay health workersSocial supportTreatment interruptionConclusions/Health workersSUD treatmentPharmacological approachesYears old accountTelehealth supportVirus HIVHIVOlder adultsDisordersSuch interventionsPhone surveyTherapyProvision of supportCOVID-19 lockdownPandemicOld accountAttenuated Novel SARS Coronavirus 2 Infection in an Allogeneic Hematopoietic Stem Cell Transplant Patient on Ruxolitinib
Foss FM, Rubinowitz A, Landry ML, Isufi I, Gowda L, Seropian S, Perreault S, Shenoi SV. Attenuated Novel SARS Coronavirus 2 Infection in an Allogeneic Hematopoietic Stem Cell Transplant Patient on Ruxolitinib. Clinical Lymphoma Myeloma & Leukemia 2020, 20: 720-723. PMID: 32727701, PMCID: PMC7316063, DOI: 10.1016/j.clml.2020.06.014.Peer-Reviewed Original ResearchMeSH KeywordsBetacoronavirusCoronavirus InfectionsCOVID-19COVID-19 Drug TreatmentGraft vs Host DiseaseHematopoietic Stem Cell TransplantationHumansImmunocompromised HostLymphoma, T-CellMaleMiddle AgedNitrilesPandemicsPneumonia, ViralPyrazolesPyrimidinesSARS-CoV-2Severity of Illness IndexTransplantation, HomologousTreatment OutcomeConceptsAllogeneic hematopoietic stem cell transplant patientsHematopoietic stem cell transplant patientsSevere acute respiratory syndrome coronavirus 2SARS coronavirus 2 (SARS-CoV-2) infectionSARS-CoV-2 pneumoniaAcute respiratory syndrome coronavirus 2Stem cell transplant patientsSARS-CoV-2 infectionRespiratory syndrome coronavirus 2Coronavirus 2 infectionCell transplant patientsCoV-2 infectionStem cell transplantationSyndrome coronavirus 2High death rateImmunocompromised stateJAK/STAT inhibitor ruxolitinibTransplant patientsCell transplantationCoronavirus 2Novel therapiesInhibitor ruxolitinibPatientsDeath rateRuxolitinib‘PrEP should be for men only’: Young heterosexual men’s views on PrEP in rural South Africa
Hannaford A, Lim J, Moll AP, Khoza B, Shenoi SV. ‘PrEP should be for men only’: Young heterosexual men’s views on PrEP in rural South Africa. Global Public Health 2020, 15: 1337-1348. PMID: 32207661, DOI: 10.1080/17441692.2020.1744680.Peer-Reviewed Original ResearchConceptsRural South AfricaSouth AfricaYoung men's perspectivesHeterosexual menCommunity-based servicesYoung heterosexual menMen's perspectivesPrevention servicesService delivery modelsMen's viewsHIV prevention servicesStructural barriersFemale partnersKey themesHIV prevention knowledgeGender-specific interventionsCasual sexual partnersDifferentiated service delivery modelsGaps persistHigh HIV risk behaviorHIV-negative heterosexual menHigh-risk sexual behaviorPre-exposure prophylaxisHigh attributable mortalityHIV risk behaviors
2019
Increasing male engagement in the prevention of vertical transmission of HIV: what works in sub-Saharan Africa?
Aliyu MH, Sam-Agudu NA, Shenoi S, Goga AE, Ramraj T, Vermund SH, Audet CM. Increasing male engagement in the prevention of vertical transmission of HIV: what works in sub-Saharan Africa? The BMJ 2019, 365: l1965. PMID: 31171558, PMCID: PMC6598674, DOI: 10.1136/bmj.l1965.Peer-Reviewed Original ResearchPerceptions of HIV Preexposure Prophylaxis Among Young Pregnant Women from Rural KwaZulu-Natal, South Africa
Vazquez L, Moll AP, Kacin A, Ndlovu NE, Shenoi SV. Perceptions of HIV Preexposure Prophylaxis Among Young Pregnant Women from Rural KwaZulu-Natal, South Africa. AIDS Patient Care And STDs 2019, 33: 214-219. PMID: 31067125, PMCID: PMC6531897, DOI: 10.1089/apc.2018.0242.Peer-Reviewed Original ResearchConceptsYoung pregnant womenPreexposure prophylaxisPregnant womenHIV riskCondom useSexual partnersHIV preexposure prophylaxisLast monthPregnant women 18Rural South African womenSub-Saharan womenRural KwaZulu-NatalSouth African womenHIV acquisitionNonpregnant womenPrEP effectivenessPrEP knowledgeMean agePrEP rolloutPostpartum periodHIV preventionWomen 18HIV stigmaHigh riskMost women
2018
Synergism between diabetes and human immunodeficiency virus in increasing the risk of tuberculosis
Sinha P, Moll AP, Brooks RP, Deng YH, Shenoi SV. Synergism between diabetes and human immunodeficiency virus in increasing the risk of tuberculosis. The International Journal Of Tuberculosis And Lung Disease 2018, 22: 793-799. PMID: 29914606, PMCID: PMC6050202, DOI: 10.5588/ijtld.17.0936.Peer-Reviewed Original ResearchConceptsRisk of tuberculosisDiabetes mellitusTB symptomsOdds ratioHuman immunodeficiency virus (HIV) infectionImmunodeficiency virus infectionHuman immunodeficiency virusCommunity health screeningCross-sectional studyCommunity health projectsActive tuberculosisHIV infectionHIV positivityPrimary outcomeImmunodeficiency virusScreening servicesHealth screeningCongregate settingsVirus infectionResource-limited regionsMultiplicative scaleHIVMultivariate analysisRetrospective dataTuberculosis
2017
Predictors of loss to follow-up among patients on ART at a rural hospital in KwaZulu-Natal, South Africa
Arnesen R, Moll AP, Shenoi SV. Predictors of loss to follow-up among patients on ART at a rural hospital in KwaZulu-Natal, South Africa. PLOS ONE 2017, 12: e0177168. PMID: 28542309, PMCID: PMC5443492, DOI: 10.1371/journal.pone.0177168.Peer-Reviewed Original ResearchConceptsPrimary health clinicsPredictors of lossART clinicsSouth African HIV clinicAntiretroviral therapy accessInadequate medical recordsCells/μLART initiationLow CD4LTFU ratesCD4 countHIV careHIV clinicHIV outcomesRetrospective reviewMedical recordsHealth clinicsTherapy accessHigh riskLTFUPatientsRural hospitalsRural South AfricaNovel interventionsClinic“It’s about my life”: facilitators of and barriers to isoniazid preventive therapy completion among people living with HIV in rural South Africa
Jacobson KB, Niccolai L, Mtungwa N, Moll AP, Shenoi SV. “It’s about my life”: facilitators of and barriers to isoniazid preventive therapy completion among people living with HIV in rural South Africa. AIDS Care 2017, 29: 936-942. PMID: 28147705, PMCID: PMC5545149, DOI: 10.1080/09540121.2017.1283390.Peer-Reviewed Original ResearchMeSH KeywordsAdultAIDS-Related Opportunistic InfectionsAmbulatory Care FacilitiesAntitubercular AgentsCounselingFemaleHealth Knowledge, Attitudes, PracticeHealth Services AccessibilityHIV InfectionsHumansIncidenceInterviews as TopicIsoniazidMalePatient ComplianceQualitative ResearchRural PopulationSocial StigmaSouth AfricaTrustTuberculosisConceptsIsoniazid preventive therapyIPT completionPreventive roleAbsence of symptomsHealth care workersKnowledge of TBHealth service deliveryResource-limited settingsHealth care systemRural KwaZulu-NatalAntiretroviral therapyHIV patientsHIV diagnosisPreventive therapyTherapy completionTB incidenceAppropriate counselingHealthcare workersIndividual patientsCare workersRural South AfricaHIVPatientsUnrelated conditionsIndividual semi-structured interviews
2016
Cost-Effectiveness of Community-Based TB/HIV Screening and Linkage to Care in Rural South Africa
Gilbert JA, Shenoi SV, Moll AP, Friedland GH, Paltiel AD, Galvani AP. Cost-Effectiveness of Community-Based TB/HIV Screening and Linkage to Care in Rural South Africa. PLOS ONE 2016, 11: e0165614. PMID: 27906986, PMCID: PMC5131994, DOI: 10.1371/journal.pone.0165614.Peer-Reviewed Original ResearchConceptsTB/HIVTB/HIV controlHIV screeningHIV controlRural South AfricaLife yearsMonths of IPTMost life yearsHigh-incidence settingsWidespread prevalenceCost-effectiveness resultsProbabilistic sensitivity analysesHIV transmissionHigh burdenTreatment coverageUnknown patientsHIVHealthcare accessDrug resistanceActive casesMonthsLifetime usePatientsYearsScreeningCharacterizing Patients with Very-Low-Level HIV Viremia: A Community-Based Study
Helou E, Shenoi S, Kyriakides T, Landry ML, Kozal M, Barakat LA. Characterizing Patients with Very-Low-Level HIV Viremia: A Community-Based Study. Journal Of The International Association Of Providers Of AIDS Care (JIAPAC) 2016, 16: 261-266. PMID: 27903948, PMCID: PMC5423832, DOI: 10.1177/2325957416680028.Peer-Reviewed Original ResearchConceptsVirologic failureViral load levelsPill burdenAlcohol useHuman immunodeficiency virus (HIV) careLow-level HIV viremiaUndetectable viral load levelsAntiretroviral regimen changesAntiretroviral therapy changesExperienced virologic failureLow-level viremiaIntravenous drug useSubset of patientsFrequent clinic visitsPoor clinical outcomePossible risk factorsHepatitis C virusHIV viremiaMore comorbiditiesNonfailure groupVirologic suppressionVirological failureCD4 countConsecutive chartsClinic visitsImpact of nurse-delivered community-based CD4 services on facilitating pre-ART care in rural South Africa
Kompala T, Moll AP, Mtungwa N, Brooks RP, Friedland GH, Shenoi SV. Impact of nurse-delivered community-based CD4 services on facilitating pre-ART care in rural South Africa. BMC Health Services Research 2016, 16: 374. PMID: 27515233, PMCID: PMC4982129, DOI: 10.1186/s12913-016-1627-8.Peer-Reviewed Original ResearchConceptsPre-ART careAntiretroviral treatmentCD4 testingCBVCT servicesTreatment cascadeRural South AfricaLocal primary care clinicsCD4 count resultsCommunity-based voluntary counselingPrimary care clinicsHIV-positive clientsPhlebotomy servicesResource-limited settingsART initiationHIV careART eligibilityCare cascadeCare clinicsHIV-positiveVoluntary counselingTreatment eligibilityCD4 resultsResult notificationResultsBetween 2010Nurse presence