Combination antiretroviral therapy can have a salutary effect on preserving or improving neurological function. Superior systemic treatments may likewise better preserve neurological function. The significant association of poor neurological performance with mortality, independent of CD4 counts and HIV-1 RNA levels indicates that neurological dysfunction is an important cause or a strong marker of poor prognosis in late HIV-1 infection. This study demonstrates the value of adjunctive neurological measures in large therapeutic trials of late HIV-1 infection.

In this article, the results of a mixed-methods study integrating the use of simulations in a nursing theory course in order to assess students' perceptions of self-efficacy for nursing practice are presented. Nursing students in an intervention group were exposed to a combination of lecture and simulation, and then asked to rate their perceptions of self-efficacy, satisfaction and effectiveness of this combined teaching and learning strategy. Based on Bandura's (1977, 1986) theory of self-efficacy, this study provides data to suggest that students' self-confidence for nursing practice may be increased through the use of simulation as a method of teaching and learning. Students also reported higher levels of satisfaction, effectiveness and consistency with their learning style when exposed to the combination of lecture and simulation than the control group, who were exposed to lecture as the only method of teaching and learning.

We evaluated neurocognitive function in 149 HIV-seropositive and 82 seronegative women enrolled in the Women's Interagency HIV Study (WIHS), a large multi-center study of disease progression in women living with HIV/AIDS. We evaluated the prevalence of abnormal neuropsychological (NP) test findings in HIV-seropositive and seronegative women and factors associated with increased risk of abnormal NP test performance. Risk of NP impairment was no higher for HIV positive women receiving antiretroviral therapy at testing than for HIV-negative women (OR = 1.00). However, the risk of abnormal NP performance increased significantly for seropositive women not receiving antiretroviral therapy (OR = 2.43). Further, treatment status was a significant predictor of NP impairment in a multivariate analysis that included viral load (OR = 1.48) and CD4 count (OR = 1.08) which were not significant. The multivariate analyses controlled for substance use, age, education, head injury, ethnicity, estimated IQ, and psychological distress. This study emphasizes the critical association of antiretroviral therapy with the risk of neurocognitive impairment in women living with HIV/AIDS. (JINS, 2002, 8, 781–793.)

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