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Richard Aschbacher, Elisabetta Pagani, Massimo Confalonieri, Claudio Farina, Paolo Fazii, Francesco Luzzaro, Pier Giorgio Montanera, Aurora Piazza, Laura Pagani
BACKGROUND: Rates of colonization and infection with multidrug-resistant (MDR) bacteria are increasing worldwide, in both acute care hospitals and long-term care facilities (LTCFs). Italy has one of the highest prevalence of MDR bacteria in European countries, especially with regard to methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase (ESBL) or carbapenemase producing Enterobacteriaceae (CPE). METHOD: Review of studies on colonization by MDR bacteria from Italian LTCFs, risk factors for colonization and molecular characteristics of surveillance and clinical isolates, compared with other European countries...
2016: Antimicrobial Resistance and Infection Control
Canna Ghia, Shashank Akerkar, Shailaja Sabnis, Urk Rao, Gautam Rambhad
BACKGROUND / OBJECTIVES: Biologic anti-TNFs in India have improved the patient management. Significant proportions of patients lose response over time or do not respond. Possible explanations are suboptimal trough anti-TNFa concentrations or antibodies to anti-TNFs. The aim of this project was to set up and standardize an independent laboratory to test immunogenicity of anti-TNF biologics (infliximab and etanercept). METHODS: Three rheumatologists piloted this project approved by independent ethics committee and carried out in compliance with ICH/GCP guidelines...
September 2016: Journal of the Association of Physicians of India
Sytske Anne Bergstra, Pedro M M C Machado, Rosaline van den Berg, Robert B M Landewé, Tom W J Huizinga
OBJECTIVES: Ten years ago, the METEOR tool was developed to simulate treatment-to-target and create an international research database. The development of the METEOR tool and database, research opportunities and future perspectives are described. METHODS: The METEOR tool is a free, online, internationally available tool in which daily practice visits of all rheumatoid arthritis patients visiting a rheumatologist can be registered. In the tool, disease characteristics, patient- and physician-reported outcomes and prescribed treatment could be entered...
September 2016: Clinical and Experimental Rheumatology
Henry Zakumumpa, Modupe Oladunni Taiwo, Alex Muganzi, Freddie Ssengooba
BACKGROUND: Human resources for health (HRH) constraints are a major barrier to the sustainability of antiretroviral therapy (ART) scale-up programs in Sub-Saharan Africa. Many prior approaches to HRH constraints have taken a top-down trend of generalized global strategies and policy guidelines. The objective of the study was to examine the human resources for health strategies adopted by front-line providers in Uganda to sustain ART delivery beyond the initial ART scale-up phase between 2004 and 2009...
October 19, 2016: Human Resources for Health
Abebe Megerso, Sileshi Garoma
BACKGROUND: Antiretroviral treatment (ART) service scaling up has been practiced in the Ethiopia since 2006. Regardless of increasing number of primary health care centers providing the service, the existing hospitals are still overcrowded with ART service seeking patients may be because of the common belief that treatment outcome is better for hospital patients than those treated at the primary health centers. However, documented evidence comparing the treatment outcome for the two categories of health facilities is scarce in the study setting...
October 18, 2016: BMC Health Services Research
Solomon Kadiri
Hypertension prevalence rates in most urbanized areas of Africa range from 20-30%, with a recent systematic review reporting 16.2% for sub-Saharan Africa. These rates are lower than those in the West but the age standardized rates are higher than in other regions of the world. The attendant morbidity and mortality are disproportionately high. For example, failure of nocturnal dipping and microalbuminuria, predictive of vascular disease, occur relatively early in the course of hypertension and predispose to early vascular disease...
September 2016: Journal of Hypertension
Angela M Bengtson, Dawn Kopp, Jennifer H Tang, Ennet Chipungu, Margaret Moyo, Jeffrey Wilkinson
OBJECTIVE: To develop a risk score to identify women with vesicovaginal fistula at high risk of residual urinary incontinence after surgical repair. METHODS: We conducted a prospective cohort study among 401 women undergoing their first vesicovaginal fistula repair at a referral fistula repair center in Lilongwe, Malawi, between September 2011 and December 2014, who returned for follow-up within 120 days of surgery. We used logistic regression to develop a risk score to identify women with a high likelihood of residual urinary incontinence, defined as incontinence grade 2-5 within 120 days of vesicovaginal fistula repair, based on preoperative clinical and demographic characteristics (age, number of years with fistula, human immunodeficiency virus status, body mass index, previous repair surgery at an outside facility, revised Goh classification, Goh vesicovaginal fistula size, circumferential fistula, vaginal scaring, bladder size, and urethral length)...
October 6, 2016: Obstetrics and Gynecology
Kamila Rasova, Jenny Freeman, Patricia Martinkova, Marketa Pavlikova, Davide Cattaneo, Johanna Jonsdottir, Thomas Henze, Ilse Baert, Paul Van Asch, Carme Santoyo, Tori Smedal, Antonie Giæver Beiske, Małgorzata Stachowiak, Mariusz Kovalewski, Una Nedeljkovic, Daphne Bakalidou, José Manuel Alves Guerreiro, Ylva Nilsagård, Erieta Nikolikj Dimitrova, Mario Habek, Kadriye Armutlu, Cécile Donzé, Elaine Ross, Ana Maria Ilie, Andrej Martić, Anders Romberg, Peter Feys
BACKGROUND: Understanding the organisational set-up of physiotherapy services across different countries is increasingly important as clinicians around the world use evidence to improve their practice. This also has to be taken into consideration when multi-centre international clinical trials are conducted. This survey aimed to systematically describe organisational aspects of physiotherapy services for people with multiple sclerosis (MS) across Europe. METHODS: Representatives from 72 rehabilitation facilities within 23 European countries completed an online web-based questionnaire survey between 2013 and 2014...
October 6, 2016: BMC Health Services Research
S K Sah, S K Sahu, B Lamichhane, G K Bhatta, K B Bhandari, P Owiti, S S Majumdar
Setting: The three government tertiary care hospitals providing care for people living with the human immunodeficiency virus (PLHIV) in Kathmandu, Nepal. Objectives: To assess 1) the screening cascades for intensified case finding for tuberculosis (TB), 2) isoniazid preventive therapy (IPT), including demographic and clinical factors associated with treatment interruption, and 3) TB infection control (IC) in the health facilities. Design: A cross-sectional study of new PLHIV enrolled from January 2012 to December 2014...
September 2016: Public Health Action
Mihai Oltean, Paolo Sassu, Mats Hellström, Peter Axelsson, Lars Ewaldsson, Anders G Nilsson, Michael Axelsson
OBJECTIVE: Microsurgical techniques are increasingly used in routine surgical practice as well as in biomedical research. The training opportunities at standardised training courses are limited, and no microsurgical training facility or programme existed in Scandinavia before 2013. METHODS: A microsurgery laboratory was set up and two different courses were started, aiming separately at biomedical researchers and surgeons. The course for biomedical researchers teaches basic microsurgical skills such as vessel isolation, cannulation, and arterial microvascular suture under magnification...
August 12, 2016: Journal of Plastic Surgery and Hand Surgery
Jennie Jaribu, Suzanne Penfold, Fatuma Manzi, Joanna Schellenberg, Constanze Pfeiffer
OBJECTIVE: To describe health workers' perceptions of a quality improvement (QI) intervention that focused on improving institutional childbirth services in primary health facilities in Southern Tanzania. DESIGN: A qualitative design was applied using in-depth interviews with health workers. SETTING: This study involved the Ruangwa District Reproductive and Child Health Department, 11 dispensaries and 2 health centres in rural Southern Tanzania...
2016: BMJ Open
Gideon Amanyire, Fred C Semitala, Jennifer Namusobya, Richard Katuramu, Leatitia Kampiire, Jeanna Wallenta, Edwin Charlebois, Carol Camlin, James Kahn, Wei Chang, David Glidden, Moses Kamya, Diane Havlir, Elvin Geng
BACKGROUND: In Africa, up to 30% of HIV-infected patients who are clinically eligible for antiretroviral therapy (ART) do not start timely treatment. We assessed the effects of an intervention targeting prevalent health systems barriers to ART initiation on timing and completeness of treatment initiation. METHODS: In this stepped-wedge, non-blinded, cluster-randomised controlled trial, 20 clinics in southwestern Uganda were randomly assigned in groups of five clinics every 6 months to the intervention by a computerised random number generator...
August 27, 2016: Lancet HIV
Solomon Kadiri
Hypertension prevalence rates in most urbanized areas of Africa range from 20-30%, with a recent systematic review reporting 16.2% for sub-Saharan Africa. These rates are lower than those in the West but the age standardized rates are higher than in other regions of the world. The attendant morbidity and mortality are disproportionately high. For example, failure of nocturnal dipping and microalbuminuria, predictive of vascular disease, occur relatively early in the course of hypertension and predispose to early vascular disease...
September 2016: Journal of Hypertension
Zemene Tigabu Kebede, Belaynew Wasie Taye
INTRODUCTION: Numerous challenges exist in provision of prevention of mother-to-child transmission of HIV (PMTCT) such as linking HIV exposed infants (HEI) and their mothers to chronic cares services, and tackling loss to follow up. Limited evidence exists in Ethiopian setting that explains the persisting high HIV infection rate among HEIs and extent of linkage to chronic care. The study assessed the proportion of HIV infection; children linked to chronic care and determinants of HIV infection among HEI in Northern Ethiopia...
2016: Pan African Medical Journal
Zachary Keenum, Gerald McGwin, C Douglas Witherspoon, Julia A Haller, Mark E Clark, Cynthia Owsley
Importance: The public health success of diabetic retinopathy (DR) screening programs depends on patients' adherence to the timetable of follow-up eye care recommended by the screening program. African Americans are among those at highest risk for DR and have one of the lowest rates of eye care use. Objectives: To assess the rate of adhering to recommended follow-up eye care in a DR screening program administered in a safety-net health care facility and to examine factors associated with follow-up eye care use...
September 15, 2016: JAMA Ophthalmology
Yaser Abdallah, Flavia Namiiro, Jamir Mugalu, Jolly Nankunda, Yvonne Vaucher, Douglas McMillan
OBJECTIVES: To identify reasons for neonatal admission and death with the aim of determining areas needing improvement. METHOD: A retrospective chart review was conducted on records for neonates admitted to Mulago National Referral Hospital Special Care Baby Unit (SCBU) from 1(st) November 2013 to 31(st) January 2014. Final diagnosis was generated after analyzing sequence of clinical course by 2 paediatricians. RESULTS: A total of 1192 neonates were admitted...
June 2016: African Health Sciences
Megan E Kassick, Margaret A Chinbuah, Magdalena Serpa, Goldy Mazia, Alice M Tang, Isabella Sagoe-Moses, Mira Taylor, Adoma Dwomo-Fokuo, Nihad Salifu, Daniel K Arhinful, Cyril Engmann, Thomas F Burke, Patience Cofie, Brett D Nelson
OBJECTIVE: To validate a novel objective structured clinical examination (OSCE) tool for assessing neonatal care skills among delivery attendants trained as part of the Essential Care for Every Baby (ECEB) program and to assess ECEB training effectiveness. METHODS: Between August 1 and September 30, 2015, a cross-sectional study enrolled ECEB-trained healthcare providers who attended deliveries from the Brong Ahafo and Eastern regions of Ghana. Participants completed a previously developed 21-item OSCE tool that assessed neonatal-care competency...
August 20, 2016: International Journal of Gynaecology and Obstetrics
Soter Ameh, Kerstin Klipstein-Grobusch, Lucia D'ambruoso, Kathleen Kahn, Stephen M Tollman, Francesc Xavier Gómez-Olivé
The integrated chronic disease management (ICDM) model was introduced as a response to the dual burden of HIV/AIDS and non-communicable diseases (NCDs) in South Africa, one of the first of such efforts by an African Ministry of Health. The aim of the ICDM model is to leverage HIV programme innovations to improve the quality of chronic disease care. There is a dearth of literature on the perspectives of healthcare providers and users on the quality of care in the novel ICDM model. This paper describes the viewpoints of operational managers and patients regarding quality of care in the ICDM model...
September 1, 2016: Health Policy and Planning
J Megan Sions, Peter C Coyle, Teonette O Velasco, James M Elliott, Gregory E Hicks
OBJECTIVE: The purpose of this study was to determine if multifidi size and/or intramuscular fat were associated with self-reported and performance-based physical function in older adults with and without chronic LBP. DESIGN: Case-control study SETTING: Individuals participated in a standardized evaluation in a clinical laboratory and underwent magnetic resonance imaging (MRI) of the lumbar spine at a nearby facility. PATIENT SAMPLE: A volunteer sample of 106 community-dwelling older adults, aged 60-85 years, with (n=57) and without (n=49) chronic LBP were included in this secondary data analysis...
August 30, 2016: Archives of Physical Medicine and Rehabilitation
J P M Burbach, S A Kurk, R R J Coebergh van den Braak, V K Dik, A M May, G A Meijer, C J A Punt, G R Vink, M Los, N Hoogerbrugge, P C Huijgens, J N M Ijzermans, E J Kuipers, M E de Noo, J P Pennings, A M T van der Velden, C Verhoef, P D Siersema, M G H van Oijen, H M Verkooijen, M Koopman
BACKGROUND: Systematic evaluation and validation of new prognostic and predictive markers, technologies and interventions for colorectal cancer (CRC) is crucial for optimizing patients' outcomes. With only 5-15% of patients participating in clinical trials, generalizability of results is poor. Moreover, current trials often lack the capacity for post-hoc subgroup analyses. For this purpose, a large observational cohort study, serving as a multiple trial and biobanking facility, was set up by the Dutch Colorectal Cancer Group (DCCG)...
November 2016: Acta Oncologica
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