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https://www.readbyqxmd.com/read/28636669/exploring-factors-associated-with-art-adherence-and-retention-in-care-under-option-b-strategy-in-malawi-a-qualitative-study
#1
Salem Gugsa, Katy Potter, Hannock Tweya, Sam Phiri, Odala Sande, Pascal Sikwese, Janet Chikonda, Gabrielle O'Malley
Although several studies have documented challenges related to inadequate adherence to antiretroviral therapy (ART) and high loss to follow-up (LTFU) among Option B+ women, there is limited understanding of why these challenges occur and how to address them. This qualitative study examines women's experiences with ART adherence and retention in care. Between July and October 2015, in-depth interviews were conducted with 39 pregnant and lactating women who initiated ART at Bwaila Hospital in Lilongwe, Malawi...
2017: PloS One
https://www.readbyqxmd.com/read/28623838/economic-analysis-of-an-epilepsy-outreach-model-of-care-in-a-university-hospital-setting
#2
Eimer Maloney, Ronan N McGinty, Daniel J Costello
The prevalence of epilepsy in people with intellectual disability is higher than in the general population and prevalence rates increase with increasing levels of disability. Prevalence rates of epilepsy are highest among those living in residential care. The healthcare needs of people with intellectual disability and epilepsy are complex and deserve special consideration in terms of healthcare provision and access to specialist epilepsy clinics, which are usually held in acute hospital campuses. This patient population is at risk of suboptimal care because of significant difficulties accessing specialist epilepsy care which is typically delivered in the environs of acute hospitals...
June 14, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28587943/delivering-direct-acting-antiviral-therapy-for-hepatitis-c-to-highly-marginalised-and-current-drug-injecting-populations-in-a-targeted-primary-health-care-setting
#3
Phillip Read, Rebecca Lothian, Karen Chronister, Rosie Gilliver, John Kearley, Gregory J Dore, Ingrid van Beek
BACKGROUND: The Kirketon Road Centre (KRC) is a community-based public health facility in Sydney, Australia, that provides healthcare to people who inject drugs (PWID) care, including hepatitis C virus (HCV) treatment. From March 2016, the Australian Government has provided access to direct-acting antivirals (DAA) for adults with chronic HCV, without liver disease stage or drug and alcohol use restrictions. The aim of this study was to report DAA treatment outcomes among highly marginalised PWID treated at KRC...
June 3, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28572840/low-levels-of-viral-suppression-among-refugees-and-host-nationals-accessing-antiretroviral-therapy-in-a-kenyan-refugee-camp
#4
Joshua B Mendelsohn, Paul Spiegel, Alison Grant, Sathyanarayanan Doraiswamy, Marian Schilperoord, Natasha Larke, John Wagacha Burton, Jully A Okonji, Clement Zeh, Bosco Muhindo, Ibrahim M Mohammed, Irene N Mukui, Njogu Patterson, Egbert Sondorp, David A Ross
BACKGROUND: Refugees and host nationals who accessed antiretroviral therapy (ART) in a remote refugee camp in Kakuma, Kenya (2011-2013) were compared on outcome measures that included viral suppression and adherence to ART. METHODS: This study used a repeated cross-sectional design (Round One and Round Two). All adults (≥18 years) receiving care from the refugee camp clinic and taking antiretroviral therapy (ART) for ≥30 days were invited to participate. Adherence was measured by self-report and monthly pharmacy refills...
2017: Conflict and Health
https://www.readbyqxmd.com/read/28567280/solar-powered-oxygen-systems-in-remote-health-centers-in-papua-new-guinea-a-large-scale-implementation-effectiveness-trial
#5
Trevor Duke, Ilomo Hwaihwanje, Magdalynn Kaupa, Jonah Karubi, Doreen Panauwe, Martin Sa'avu, Francis Pulsan, Peter Prasad, Freddy Maru, Henry Tenambo, Ambrose Kwaramb, Eleanor Neal, Hamish Graham, Rasa Izadnegahdar
BACKGROUND: Pneumonia is the largest cause of child deaths in Papua New Guinea (PNG), and hypoxaemia is the major complication causing death in childhood pneumonia, and hypoxaemia is a major factor in deaths from many other common conditions, including bronchiolitis, asthma, sepsis, malaria, trauma, perinatal problems, and obstetric emergencies. A reliable source of oxygen therapy can reduce mortality from pneumonia by up to 35%. However, in low and middle income countries throughout the world, improved oxygen systems have not been implemented at large scale in remote, difficult to access health care settings, and oxygen is often unavailable at smaller rural hospitals or district health centers which serve as the first point of referral for childhood illnesses...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28567197/assessing-the-feasibility-of-mobile-phones-for-follow-up-of-acutely-unwell-children-presenting-to-village-clinics-in-rural-northern-malawi
#6
Victoria Hardy, Jenny Hsieh, Baxter Chirambo, Tsung-Shu Joseph Wu, John O'Donoghue, Adamson S Muula, Matthew Thompson
BACKGROUND: Patient follow-up is a routine component of clinical practice and valuable for evaluating the effectiveness of interventions, but because of the broad dispersion of health facilities and lack of standardised medical reporting in Malawi, collecting patient outcome data can be challenging. Increasing accessibility and affordability of mobile technology in resource-poor settings may facilitate patient follow-up in the community. The objective of this study was to evaluate the potential utility of mobile phones for collecting follow-up clinical data from parents or caregivers of acutely unwell under-5 children, for intervention evaluation purposes...
March 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28554882/diagnosis-prevalence-awareness-treatment-prevention-and-control-of-hypertension-in-cameroon-protocol-for-a-systematic-review-and-meta-analysis-of-clinic-based-and-community-based-studies
#7
Barthelemy Kuate Defo, Jean Claude Mbanya, Jean-Claude Tardif, Olugbemiga Ekundayo, Sylvie Perreault, Louise Potvin, Robert Cote, Andre Pascal Kengne, Simeon Pierre Choukem, Felix Assah, Samuel Kingue, Lucie Richard, Roland Pongou, Katherine Frohlich, Jude Saji, Pierre Fournier, Eugene Sobngwi, Valery Ridde, Marie-Pierre Dubé, Simon De Denus, Wilfred Mbacham, Jean-Philippe Lafrance, Dickson Shey Nsagha, Warner Mampuya, Anastase Dzudie, Lyne Cloutier, Christina Zarowsky, Agatha Tanya, Paul Ndom, Marie Hatem, Evelyne Rey, Louise Roy, Roxane Borgès Da Silva, Christian Dagenais, David Todem, Robert Weladji, Dora Mbanya, Elham Emami, Zakariaou Njoumemi, Laurence Monnais, Carl-Ardy Dubois
BACKGROUND: Hypertension holds a unique place in population health and health care because it is the leading cause of cardiovascular disease and the most common noncommunicable condition seen in primary care worldwide. Without effective prevention and control, raised blood pressure significantly increases the risk of stroke, myocardial infarction, chronic kidney disease, heart failure, dementia, renal failure, and blindness. There is an urgent need for stakeholders-including individuals and families-across the health system, researchers, and decision makers to work collaboratively for improving prevention, screening and detection, diagnosis and evaluation, awareness, treatment and medication adherence, management, and control for people with or at high risk for hypertension...
May 29, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28542441/dot-or-sat-for-rifampicin-resistant-tuberculosis-a-non-randomized-comparison-in-a-high-hiv-prevalence-setting
#8
Erika Mohr, Johnny Daniels, Busisiwe Beko, Petros Isaakidis, Vivian Cox, Sarah Jane Steele, Odelia Muller, Leigh Snyman, Virginia De Azevedo, Amir Shroufi, Laura Trivino Duran, Jennifer Hughes
BACKGROUND: Daily directly-observed therapy (DOT) is recommended for rifampicin-resistant tuberculosis (RR-TB) patients throughout treatment. We assessed the impact of self-administered treatment (SAT) in a South African township with high rates of RR-TB and HIV. METHODS: Community-supported SAT for patients who completed the intensive phase was piloted in five primary care clinics in Khayelitsha. We compared final treatment outcomes among RR-TB patients initiating treatment before (standard-of-care (SOC)-cohort, January 2010-July 2013) and after the implementation of the pilot (SAT-cohort, January 2012-December 2014)...
2017: PloS One
https://www.readbyqxmd.com/read/28523026/are-we-missing-the-diagnosis-of-depression-in-patients-with-rheumatoid-arthritis-at-a-tertiary-care-facility
#9
Ammara Masood, Babur Salim, Amjad Nasim, Ziaullah Khalid, Amir Afzal
OBJECTIVES: To determine if we are missing clinical depression in patients with Rheumatoid Arthritis and its relationship with functional disability and level of formal education in such patients. METHODS: The data for this cross-sectional, analytical study was gathered from May 2015 till December 2015 and comprised of 128 with Rheumatoid arthritis diagnosed according to ACR/EULAR 2010 criteria. The study was conducted at Fauji Foundation Hospital Rawalpindi. Functional status was assessed with Modified Health Assessment Questionnaire (mHAQ) and Beck's Depression Inventory (BDI) was used for evaluation of symptoms of depression...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28453429/anti-microbial-coating-innovations-to-prevent-infectious-diseases-amici-cost-action-ca15114
#10
Colum P Dunne, Minna M Keinänen-Toivola, Anne Kahru, Birgit Teunissen, Hulya Olmez, Isabel Gouveia, Luis Melo, Kazimierz Murzyn, Martina Modic, Merja Ahonen, Pete Askew, Theofilos Papadopoulos, Christian Adlhart, Francy R L Crijns
Worldwide, millions of patients are affected annually by healthcare-associated infection (HCAI), impacting up to 80,000 patients in European Hospitals on any given day. This represents not only public health risk, but also an economic burden. Complementing routine hand hygiene practices, cleaning and disinfection, antimicrobial coatings hold promise based, in essence, on the application of materials and chemicals with persistent bactericidal or -static properties onto surfaces or in textiles used in healthcare environments...
April 28, 2017: Bioengineered
https://www.readbyqxmd.com/read/28446232/continuous-quality-improvement-interventions-to-improve-long-term-outcomes-of-antiretroviral-therapy-in-women-who-initiated-therapy-during-pregnancy-or-breastfeeding-in-the-democratic-republic-of-congo-design-of-an-open-label-parallel-group-randomized-trial
#11
Marcel Yotebieng, Frieda Behets, Bienvenu Kawende, Noro Lantoniaina Rosa Ravelomanana, Martine Tabala, Emile W Okitolonda
BACKGROUND: Despite the rapid adoption of the World Health Organization's 2013 guidelines, children continue to be infected with HIV perinatally because of sub-optimal adherence to the continuum of HIV care in maternal and child health (MCH) clinics. To achieve the UNAIDS goal of eliminating mother-to-child HIV transmission, multiple, adaptive interventions need to be implemented to improve adherence to the HIV continuum. METHODS: The aim of this open label, parallel, group randomized trial is to evaluate the effectiveness of Continuous Quality Improvement (CQI) interventions implemented at facility and health district levels to improve retention in care and virological suppression through 24 months postpartum among pregnant and breastfeeding women receiving ART in MCH clinics in Kinshasa, Democratic Republic of Congo...
April 26, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28422968/the-impact-of-a-point-of-care-testing-device-on-cvd-risk-assessment-completion-in-new-zealand-primary-care-practice-a-cluster-randomised-controlled-trial-and-qualitative-investigation
#12
RANDOMIZED CONTROLLED TRIAL
Sue Wells, Natasha Rafter, Timothy Kenealy, Geoff Herd, Kyle Eggleton, Rose Lightfoot, Kim Arcus, Angela Wadham, Yannan Jiang, Chris Bullen
OBJECTIVES: To assess the effect of a point of care (POC) device for testing lipids and HbA1c in addition to testing by community laboratory facilities (usual practice) on the completion of cardiovascular disease (CVD) risk assessments in general practice. METHODS: We conducted a pragmatic, cluster randomised controlled trial in 20 New Zealand general practices stratified by size and rurality and randomised to POC device plus usual practice or usual practice alone (controls)...
2017: PloS One
https://www.readbyqxmd.com/read/28404502/modelling-adverse-treatment-outcomes-of-hiv-infected-adolescents-attending-public-sector-hiv-clinics-in-lusaka
#13
I Fwemba, P Musonda
BACKGROUND: In resource-limited setting, there is scarce evidence comparing antiretroviral therapy (ART) outcomes among HIV-infected adolescents to that of other age groups. METHODS AND STUDY DESIGN: We analysed data from 25 ART facilities in Lusaka District, comparing treatment-naïve ART-eligible young adolescents (10-14 years), older adolescents (15-19) and young adults (20-24 years) initiating first-line ART to those aged 24 years or older. The adjusted relative risk (RR) of failure to achieve an adequate CD4 response (defined as failure to increase CD4 count by ≥ 50 cells/mm(3) at 6 months or by ≥ 100 cells/mm(3)) at 6 or 12 months after ART initiation was modelled using log-binomial regression...
March 6, 2017: Public Health
https://www.readbyqxmd.com/read/28397559/cost-analysis-of-a-multidisciplinary-aerodigestive-clinic-are-such-clinics-financially-feasible
#14
Pamela A Mudd, Allison L Silva, Susan S Callicott, Nancy M Bauman
OBJECTIVE: Multidisciplinary clinics offer important value to pediatric patients with complex conditions that overlap specialties; however, such labor-intensive clinics are difficult to facilitate. We performed a cost analysis of our pediatric multidisciplinary aerodigestive clinic (MADC) to assess its financial feasibility at our tertiary care institution. METHOD: Revenue was based on net collections for clinic, professional, and hospital setting charges generated during 12 consecutive monthly MADCs beginning August 2013...
May 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28381246/-fit-for-school-a-school-based-water-sanitation-and-hygiene-programme-to-improve-child-health-results-from-a-longitudinal-study-in-cambodia-indonesia-and-lao-pdr
#15
Denise Duijster, Bella Monse, Jed Dimaisip-Nabuab, Pantjawidi Djuharnoko, Roswitha Heinrich-Weltzien, Martin Hobdell, Katrin Kromeyer-Hauschild, Yung Kunthearith, Maria Carmela Mijares-Majini, Nicole Siegmund, Panith Soukhanouvong, Habib Benzian
BACKGROUND: The Fit for School (FIT) programme integrates school health and Water, Sanitation and Hygiene interventions, which are implemented by the Ministries of Education in four Southeast Asian countries. This paper describes the findings of a Health Outcome Study, which aimed to assess the two-year effect of the FIT programme on the parasitological, weight, and oral health status of children attending schools implementing the programme in Cambodia, Indonesia and Lao PDR. METHODS: The study was a non-randomized clustered controlled trial with a follow-up period of two years...
April 5, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28376834/modifications-to-art-service-delivery-models-by-health-facilities-in-uganda-in-promotion-of-intervention-sustainability-a-mixed-methods-study
#16
Henry Zakumumpa, Sara Bennett, Freddie Ssengooba
BACKGROUND: In November 2015, WHO released new treatment guidelines recommending that all diagnosed as HIV positive be enrolled on antiretroviral therapy (ART). Sustaining and expanding ART scale-up programs in resource-limited settings will require adaptations and modifications to traditional ART delivery models to meet the rapid increase in demand. We identify modifications to ART service delivery models by health facilities in Uganda to sustain ART interventions over a 10-year period (2004-2014)...
April 4, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28362063/adherence-to-antiretroviral-therapy-for-hiv-in-sub-saharan-africa-and-asia-a-comparative-analysis-of-two-regional-cohorts
#17
Rimke Bijker, Awachana Jiamsakul, Cissy Kityo, Sasisopin Kiertiburanakul, Margaret Siwale, Praphan Phanuphak, Sulaimon Akanmu, Romanee Chaiwarith, Ferdinand W Wit, Benedict Lh Sim, Tamara Sonia Boender, Rossana Ditangco, Tobias F Rinke De Wit, Annette H Sohn, Raph L Hamers
INTRODUCTION: Our understanding of how to achieve optimal long-term adherence to antiretroviral therapy (ART) in settings where the burden of HIV disease is highest remains limited. We compared levels and determinants of adherence over time between HIV-positive persons receiving ART who were enrolled in a bi-regional cohort in sub-Saharan Africa and Asia. METHODS: This multicentre prospective study of adults starting first-line ART assessed patient-reported adherence at follow-up clinic visits using a 30-day visual analogue scale...
March 3, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28350153/-smoking-policy-in-mental-health-care
#18
P Hopman, M Blankers, G Dom, R Keet
BACKGROUND: People with mental illnesses tend to smoke more often and more heavily than other members of the public and their addiction to tobacco also has harmful effects on their physical health. So far, however, limited priority was given to smoking cessation in mental health care settings. AIM: To provide insight into the formal and informal smoking policies of Dutch mental health care organisations and into the nature and extent of the smoking cessation support they offer, and, additionally, to look at the opportunities for improvement in clinical settings...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/28330486/relationships-between-structure-process-and-outcome-to-assess-quality-of-integrated-chronic-disease-management-in-a-rural-south-african-setting-applying-a-structural-equation-model
#19
Soter Ameh, Francesc Xavier Gómez-Olivé, Kathleen Kahn, Stephen M Tollman, Kerstin Klipstein-Grobusch
BACKGROUND: South Africa faces a complex dual burden of chronic communicable and non-communicable diseases (NCDs). In response, the Integrated Chronic Disease Management (ICDM) model was initiated in primary health care (PHC) facilities in 2011 to leverage the HIV/ART programme to scale-up services for NCDs, achieve optimal patient health outcomes and improve the quality of medical care. However, little is known about the quality of care in the ICDM model. The objectives of this study were to: i) assess patients' and operational managers' satisfaction with the dimensions of ICDM services; and ii) evaluate the quality of care in the ICDM model using Avedis Donabedian's theory of relationships between structure (resources), process (clinical activities) and outcome (desired result of healthcare) constructs as a measure of quality of care...
March 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28325236/improving-quality-and-access-to-radiation-therapy-an-iaea-perspective
#20
REVIEW
May Abdel-Wahab, Eduardo Zubizarreta, Alfredo Polo, Ahmed Meghzifene
The International Atomic Energy Agency (IAEA) has been involved in radiation therapy since soon after its creation in 1957. In response to the demands of Member States, the IAEA׳s activities relating to radiation therapy have focused on supporting low- and middle-income countries to set up radiation therapy facilities, expand the scope of treatments, or gradually transition to new technologies. In addition, the IAEA has been very active in providing internationally harmonized guidelines on clinical, dosimetry, medical physics, and safety aspects of radiation therapy...
April 2017: Seminars in Radiation Oncology
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