***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Although immunocompromised persons may be at increased risk for gastrointestinal illnesses , no trials investigating drinking water treatment and gastrointestinal illness in such patients have been published . Earlier results from San Francisco suggested an association ( OR 6.76 ) between tap water and cryptosporidiosis among HIV + persons . The authors conducted a r and omized , triple-blinded intervention trial of home water treatment in San Francisco , California , from April 2000 to May 2001 . Fifty HIV-positive patients were r and omized to externally identical active ( N = 24 ) or sham ( N = 26 ) treatment devices . The active device contained a filter and UV light ; the sham provided no treatment .  Forty-five ( 90 % ) of the participants completed the study and were successfully blinded . Illness was measured using ' highly credible gastrointestinal illness ' ( HCGI ) , a previously published measure . There were 31 episodes of HCGI during 1,797 person-days in the sham group and 16 episodes during 1,478 person-days in the active group . The adjusted relative risk was 3.34 ( 95 % CI : 0.99 - 11.21 ) times greater in those with the sham device . The magnitude of the point estimate of the risk , its consistency with recently published observational data , and its relevance for drinking water choices by immunocompromised individuals support the need for larger trials BACKGROUND Childhood malnutrition is common in Malawi , and the st and ard treatment , which follows international guidelines , results in poor recovery rates . Higher recovery rates have been seen in pilot studies of home-based therapy with ready-to-use therapeutic food ( RUTF ) . OBJECTIVE The objective was to compare the recovery rates among children with moderate and severe wasting , kwashiorkor , or both receiving either home-based therapy with RUTF or st and ard inpatient therapy .  DESIGN A controlled , comparative , clinical effectiveness trial was conducted in southern Malawi with 1178 malnourished children . Children were systematic ally allocated to either st and ard therapy ( 186 children ) or home-based therapy with RUTF ( 992 children ) according to a stepped wedge design to control for bias introduced by the season of the year . Recovery , defined as reaching a weight-for-height z score > -2 , and relapse or death were the primary outcomes . The rate of weight gain and the prevalence of fever , cough , and diarrhea were the secondary outcomes . RESULTS Children who received home-based therapy with RUTF were more likely to achieve a weight-for-height z score > -2 than were those who received st and ard therapy ( 79 % compared with 46 % ; P < 0.001 ) and were less likely to relapse or die ( 8.7 % compared with 16.7 % ; P < 0.001 ) . Children who received home-based therapy with RUTF had greater rates of weight gain ( 3.5 compared with 2.0 g . kg(-1 ) . d(-1 ) ; difference : 1.5 ; 95 % CI : 1.0 , 2.0 g . kg(-1 ) . d(-1 ) ) and a lower prevalence of fever , cough , and diarrhea than did children who received st and ard therapy . CONCLUSION Home-based therapy with RUTF is associated with better outcomes for childhood malnutrition than is st and ard therapy Aim : To determine if home‐based nutritional therapy will benefit a significant fraction of malnourished , HIV‐infected Malawian children , and to determine if ready‐to‐use therapeutic food ( RUTF ) is more effective in home‐based nutritional therapy than traditional foods . Methods : 93 HIV‐positive children > 1 y old discharged from the nutrition unit in Blantyre , Malawi were systematic ally allocated to one of three dietary regimens : RUTF , RUTF supplement or blended maize/soy flour . RUTF and maize/soy flour provided 730 kJ·kg−1·d−1 , while the RUTF supplement provided a fixed amount of energy , 2100 kJ/d . These children  did not receive antiretroviral chemotherapy . Children were followed fortnightly . Children completed the study when they reached 100 % weight‐for‐height , relapsed or died . Outcomes were compared using regression modeling to account for differences in the severity of malnutrition between the dietary groups . Results : 52/93 ( 56 % ) of all children reached 100 % weight‐for‐height . Regression modeling found that the children receiving RUTF  gained weight more rapidly and were more likely to reach 100 % weight‐for‐height than the other two dietary groups ( p<0.05 ) Parenteral nutrition is a part of the nutritional support regimen of patients with AIDS-associated wasting syndrome and gastrointestinal dysfunction . The cholesterol ( CHOL ) level in human immunodeficiency virus ( HIV ) membrane is very high , and recent lipid formulations with high phospholipid ( PL ) content have demonstrated the ability to trap CHOL from endogenous sources , modifying the composition of cell membranes . We administered lipid-based home parenteral nutrition for 3 mo to malnourished AIDS patients . The patients were r and omly divided into two groups : 23 received the regular 20 % fat emulsion formulation , and 27 received a 2 % formulation enriched 10-fold with PLs but containing the same amount of triglycerides . All patients gained weight and improved their activity level . Those receiving the high-PL composition showed increased serum CHOL concentrations ( from 147 to 241 mg/dL ; P < 0.01 ) , but no increase was seen in the number of CD4 cells or improvement in immune function . HIV infectivity was not modified . Patients receiving regular PLs had significantly decreased ( P < 0.02 ) IgA concentrations ( from 776 to 300 mg/dL ) and improved mitogen response to phytohemagglutinin and to concanavalin A. This formula , too , had no effect on HIV infectivity . We conclude that st and ard parenteral nutritional influences the nutritional and immune status of malnourished AIDS patients . A PL-enriched parenteral formulation can trap CHOL , but it does not affect the immune profile or HIV infectivity in patients with advanced disease Objectives : To determine the efficacy of home-based therapy with ready-to-use food ( RTUF ) in producing catch-up growth in  malnourished children and to compare locally produced RTUF with imported RTUF for this purpose . Methods : After a brief inpatient stabilization , 260 children with severe malnutrition were enrolled and systematic ally allocated to receive home therapy with either imported , commercially produced RTUF or locally produced RTUF . Each child received 730 kJ/kg/day and was followed up fortnightly . Children completed the study when they reached a  weight-for-height Z score > −0.5 ( WHZ ) , relapsed , died , or failed to achieve WHZ > −0.5 after 16 weeks . Analyses were stratified by human immunodeficiency virus ( HIV ) status . Results : 78 % of all children reached WHZ > −0.5 , 95 % of those with HIV-negative status and 59 % of those with HIV-positive status . Eighty percent of those receiving locally produced RTUF and 75 % of those receiving imported RTUF reached WHZ > −0.5 . The difference between recovery rates was 5 % ( 95 % confidence interval [ CI ] , −5–15 % ) . The rate of weight gain was 0.4 g/kg/day ( 95 % CI , −0.6 , 1.4 ) greater among children receiving locally produced RTUF . The prevalence of diarrhea reported by mothers was 3.7 % for locally produced RTUF and 4.3 % for imported RTUF . After completion of home therapy and resumption of habitual diet for 6 months , 91 % of all children maintained a normal WHZ . Conclusions : Home-based therapy with RTUF was successful in affecting complete catch-up growth . In this study , locally produced and imported RTUF were similar in efficacy in treating of  severe childhood malnutrition The purpose of this study was to determine the safety and efficacy of home intravenous antibiotic therapy in treating secondary bacterial infections in patients infected with the human immunodeficiency virus ( HIV ) . This study was a subset analysis of 22 patients with HIV , enrolled in two centers of a multicenter , open-label , prospect i ve study . When necessary , patients were stabilized as in patients , followed by home therapy .  Enrolled patients had diagnoses of pneumonia , skin and soft-tissue infections , bacteremia/septicemia , or other infections requiring parenteral therapy . A third-generation cephalosporin , cefotaxime , 1 - 2 g every 8 hours , was delivered intravenously using an ambulatory delivery system ( ADS ) . Home therapy with cefotaxime/ADS produced a clinical response rate of 95 % and bacteriologic response of 88.2 % . The requirement for and duration of inpatient therapy was markedly reduced compared with diagnosis-related group ( DRG ) allotments . In conclusion , home intravenous antibiotic therapy with cefotaxime in patients infected with HIV is effective and safe . It may improve quality of life by reducing the length of hospital stay Diarrhea is frequent among persons infected with human immunodeficiency virus ( HIV ) but few interventions are available for people in Africa . We conducted a r and omized controlled trial of a home-based , safe water intervention on the incidence and severity of diarrhea among persons with HIV living in rural Ug and a. Between April 2001 and November 2002 , households of 509 persons with HIV and 1,521 HIV-negative household members received a closed-mouth plastic container , a dilute chlorine solution , and hygiene education ( safe water system [ SWS ] ) or simply hygiene education alone . After five months , HIV-positive participants received daily cotrimoxazole prophylaxis ( 160 mg of trimethoprim and 800 mg of sulfamethoxazole ) and were followed for an additional 1.5 years . Persons with HIV using SWS had 25 % fewer diarrhea episodes ( adjusted incidence rate ratio [ IRR ] = 0.75 , 95 % confidence interval [ CI ] = 0.59 - 0.94 , P = 0.015 ) , 33 % fewer days with diarrhea ( IRR = 0.67 , 95 % CI = 0.48 - 0.94 , P = 0.021 ) , and less visible blood or mucus in stools ( 28 % versus 39 % ; P < 0.0001 ) . The SWS was equally effective with or without cotrimoxazole prophylaxis ( P = 0.73 for interaction ) , and together they reduced diarrhea episodes by 67 % ( IRR = 0.33 , 95 % CI = 0.24 - 0.46 , P < 0.0001 ) , days with diarrhea by 54 % ( IRR = 0.46 , 95 % CI = 0.32 - 0.66 , P < 0.0001 ) , and days of work or school lost due to diarrhea by 47 % ( IRR = 0.53 , 95 % CI = 0.34 - 0.83 , P < 0.0056 ) . A home-based safe water system reduced diarrhea frequency and severity among persons with HIV living in Africa and large scale implementation should be considered Effects of case management on quality of life were tested with 57 home care patients with AIDS , r and omly assigning individuals to either  usual care or case-managed care over the duration of home services ( ranging from 5 days to over 2 years ) . Participants were primarily male ( 93 % ) , white ( 79 % ) , and never married ( 82 % ) .  Quality of life was measured monthly using the quality of Well-Being Index ( QWB ) .  Case-managed patients showed advantages over the usual care group in descriptive analyses of quality of life and survival . Large st and ard deviations in the QWB scores result ing from high fatality among subjects impeded statistical analyses of effects CHESS ( the Comprehensive Health Enhancement Support System ) is an interactive , computer-based system to support people facing AIDS/HIV Infection and other health-related crises or concerns .  CHESS provides information , referral to service providers , support in making tough decisions and networking to experts and others facing the same concerns . CHESS is design ed to improve access to health and human services for people who would otherwise face psychological , social , economic or geographic barriers to receiving services . CHESS has been evaluated in a r and om-assignment study with over 200 men and women living with AIDS and HIV infection . When CHESS was placed in subjects ' homes for 3 - 6 months , use of CHESS was extremely heavy , with the average subject using CHESS 138 times for 39 hours . Compared with a control group which did not receive CHESS , subjects who used CHESS reported significantly higher quality of life in several dimensions , including social support and cognitive functioning . Users also reported significant reductions in some types of health care costs , especially inpatient services ( hospitalizations ) . All segments of the study population used and benefited from CHESS , including women , minorities and those subjects with lower levels of education . Thus , CHESS appears to be an effective means of delivering education and support to the diverse population s which are affected by AIDS and HIV infection BACKGROUND Women infected with 
    Output:
    
Intensive home-based nursing significantly improved self-reported knowledge of HIV and medications , self-reported adherence and difference in pharmacy drug refill ( 1 study ) .
Home total parenteral nutrition had no significant impact on overall survival and rate of re-hospitalisation .
Home-based safe water systems reduced diarrhea frequency and severity among persons with HIV in Africa .
There was a lack of studies truly looking at the effect of home based care itself or looking at significant end points ( death and progression to AIDS ) .
However , the range of interventions and HBC models evaluated can assist in making evidence -based decisions about HIV care and support