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https://www.readbyqxmd.com/read/28182618/the-evolving-landscape-of-hiv-drug-resistance-diagnostics-for-expanding-testing-in-resource-limited-settings
#1
Seth C Inzaule, Raph L Hamers, Roger Paredes, Chunfu Yang, Rob Schuurman, Tobias F Rinke de Wit
Global scale-up of antiretroviral treatment (ART) has dramatically changed the prospects of HIV/AIDS disease rendering life-long chronic care and treatment a reality for millions of HIV-infected patients. Affordable technologies to monitor ART are needed to ensure long-term durability of limited available drug regimens. HIV drug resistance tests can complement existing strategies in optimizing clinical decision-making for patients with treatment failure, in addition to facilitating population-based surveillance of HIV drug resistance...
February 9, 2017: AIDS Reviews
https://www.readbyqxmd.com/read/28166795/ethical-framework-for-the-detection-management-and-communication-of-incidental-findings-in-imaging-studies-building-on-an-interview-study-of-researchers-practices-and-perspectives
#2
Eline M Bunnik, Lisa van Bodegom, Wim Pinxten, Inez D de Beaufort, Meike W Vernooij
BACKGROUND: As thousands of healthy research participants are being included in small and large imaging studies, it is essential that dilemmas raised by the detection of incidental findings are adequately handled. Current ethical guidance indicates that pathways for dealing with incidental findings should be in place, but does not specify what such pathways should look like. Building on an interview study of researchers' practices and perspectives, we identified key considerations for the set-up of pathways for the detection, management and communication of incidental findings in imaging research...
February 6, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28153000/effectiveness-of-the-cardiac-diabetes-transcare-program-protocol-for-a-randomised-controlled-trial
#3
Chiung-Jung Jo Wu, John J Atherton, Richard J MacIsaac, Mary Courtney, Anne M Chang, David R Thompson, Karam Kostner, Andrew I MacIsaac, Michael d'Emden, Nick Graves, Steven M McPhail
BACKGROUND: This paper presents a protocol for a randomised controlled trial of the Cardiac-Diabetes Transcare program which is a transitional care, multi-modal self-management program for patients with acute coronary syndrome comorbid with type 2 diabetes. Prior research has indicated people hospitalised with dual cardiac and diabetes diagnoses are at an elevated risk of hospital readmissions, morbidity and mortality. The primary aim of this study is to evaluate the effectiveness (and cost-effectiveness) of a Cardiac-Diabetes Transcare intervention program on 6-month readmission rate in comparison to usual care...
February 2, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28137702/assessing-mobile-phone-access-and-perceptions-for-texting-based-mhealth-interventions-among-expectant-mothers-and-child-caregivers-in-remote-regions-of-northern-kenya-a-survey-based-descriptive-study
#4
Abdul Momin Kazi, Jason-Louis Carmichael, Galgallo Waqo Hapanna, Patrick Gikaria Wangoo, Sarah Karanja, Denis Wanyama, Samuel Opondo Muhula, Lennie Bazira Kyomuhangi, Mores Loolpapit, Gilbert Bwire Wangalwa, Koki Kinagwi, Richard Todd Lester
BACKGROUND: With a dramatic increase in mobile phone use in low- and middle-income countries, mobile health (mHealth) has great potential to connect health care services directly to participants enrolled and improve engagement of care. Rural and remote global settings may pose both significant challenges and opportunities. OBJECTIVE: The objective of our study was to understand the demographics, phone usage and ownership characteristics, and feasibility among patients in rural and remote areas of Kenya of having text messaging (short messaging service, SMS)-based mHealth intervention for improvements in antenatal care attendance and routine immunization among children in Northern Kenya...
January 30, 2017: JMIR Public Health and Surveillance
https://www.readbyqxmd.com/read/28123964/evaluation-of-the-integrated-clinic-model-for-hiv-aids-services-in-ho-chi-minh-city-viet-nam-2013-2014
#5
V Hung, S T Nguyen, V T T Tieu, T T T Nguyen, T H Duong, S Lyss, J E Oeltmann
Setting: Ho Chi Minh City (HCMC), Viet Nam. Objective: To evaluate a new integrated service model for human immunodeficiency virus/acquired immune-deficiency syndrome (HIV/AIDS) care. Design: In HCMC, co-located services, including voluntary HIV counseling and testing (VCT), HIV treatment at out-patient clinics (OPC), and methadone maintenance therapy (MMT) for persons who inject drugs, have operated under different administrative structures. In the context of decreasing international financial support, integration of these services into one administrative structure with reduced staff occurred in seven districts in HCMC between October 2013 and June 2014...
December 21, 2016: Public Health Action
https://www.readbyqxmd.com/read/28119389/citizenship-status-and-engagement-in-hiv-care-an-observational-cohort-study-to-assess-the-association-between-reporting-a-national-id-number-and-retention-in-public-sector-hiv-care-in-johannesburg-south-africa
#6
Kate Shearer, Kate Clouse, Gesine Meyer-Rath, William MacLeod, Mhairi Maskew, Ian Sanne, Lawrence Long, Matthew P Fox
OBJECTIVE: In many resource-limited settings, people from rural areas migrate to urban hubs in search of work. Thus, urban public-sector HIV clinics in South Africa (SA) often cater to both local residents and patients from other provinces and/or countries. The objective of this analysis was to compare programmatic treatment outcomes by citizenship status in an urban clinic in SA. SETTING: An urban public-sector HIV treatment facility in Johannesburg, SA. PARTICIPANTS: We included all antiretroviral therapy (ART)-naïve, non-pregnant patients who initiated standard first-line treatment from January 2008 to December 2013...
January 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28109296/design-of-simulation-based-medical-education-and-advantages-and-disadvantages-of-in-situ-simulation-versus-off-site-simulation
#7
EDITORIAL
Jette Led Sørensen, Doris Østergaard, Vicki LeBlanc, Bent Ottesen, Lars Konge, Peter Dieckmann, Cees Van der Vleuten
BACKGROUND: Simulation-based medical education (SBME) has traditionally been conducted as off-site simulation in simulation centres. Some hospital departments also provide off-site simulation using in-house training room(s) set up for simulation away from the clinical setting, and these activities are called in-house training. In-house training facilities can be part of hospital departments and resemble to some extent simulation centres but often have less technical equipment. In situ simulation, introduced over the past decade, mainly comprises of team-based activities and occurs in patient care units with healthcare professionals in their own working environment...
January 21, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28077751/performance-of-health-workers-using-an-electronic-algorithm-for-the-management-of-childhood-illness-in-tanzania-a-pilot-implementation-study
#8
Clotilde Rambaud-Althaus, Amani Shao, Josephine Samaka, Ndeniria Swai, Seneca Perri, Judith Kahama-Maro, Marc Mitchell, Valérie D'Acremont, Blaise Genton
In low-resource settings, where qualified health workers (HWs) are scarce and childhood mortality high, rational antimicrobial prescription for childhood illnesses is a challenge. To assess whether smartphones running guidelines, as compared with paper support, improve consultation process and rational use of medicines for children, a pilot cluster-randomized controlled study was conducted in Tanzania. Nine primary health-care facilities (HFs) were randomized into three arms: 1) paper algorithm, 2) electronic algorithm on a smartphone, and 3) control...
January 11, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28048903/su-f-e-17-a-dedicated-teaching-and-research-linac-as-a-stepping-stone-to-introduce-medical-physics-to-students
#9
L Beaulieu, L Gingras, M Bergeron, L Archambault
PURPOSE: This work describes how a non-clinical, research and teaching Linac is used as an extremely motivating and exciting way to introduce students to medical physics. METHODS: The dedicated facility was inaugurated in 2014. The facility is composed of a fully equipped and functional state-of-the-art Varian TrueBeam Linac and a complete set of physics instruments and QA phantoms for the Linac and onboard imaging. The Linac bunker and treatment console are oversized such that a class of 12-15 can comfortably fit, seated if needed for longer sessions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048683/tu-fg-brb-08-challenges-limitations-and-future-outlook-towards-clinical-translation-of-proton-acoustic-range-verification
#10
S Yousefi, M Ahmad, L Xiang, S Tang, Y Chen, M Zhang, J Zou, K Umegaki, H Shirato, L Xing
PURPOSE: To report our investigations of proton acoustic imaging, including computer simulations and preliminary experimental studies at clinical facilities. The ultimate achievable accuracy, sensitivity and clinical translation challenges are discussed. METHODS: The acoustic pulse due to pressure rise was estimated using finite element model. Since the ionoacoustic pulse is highly dependent on the proton pulse width and energy, multiple pulse widths were studied...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048018/su-f-j-52-a-novel-approach-to-x-ray-tube-quality-assurance-for-cbct-systems-in-order-to-better-assess-the-patient-imaging-dose-in-a-large-multi-unit-treatment-facility
#11
L Buckley, R Webb, C Lambert, B Nyiri, L Gerig
PURPOSE: To standardize the tube calibration for Elekta XVI cone beam CT (CBCT) systems in order to provide a meaningful estimate of the daily imaging dose and reduce the variation between units in a large centre with multiple treatment units. METHODS: Initial measurements of the output from the CBCT systems were made using a Farmer chamber and standard CTDI phantom. The correlation between the measured CTDI and the tube current was confirmed using an Unfors Xi detector which was then used to perform a tube current calibration on each unit...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047658/we-fg-bra-05-potential-clinical-benefit-of-linac-flattening-filter-free-fff-mode-improvement-of-treatment-therapeutic-ratio
#12
S Chang, J Rivera, H Tian, A Price, C Santos, Y Zhang
PURPOSE: Ultrahigh dose-rate radiation at >40Gy/s has demonstrated astonishing normal-tissue sparing and tumor control in recent preclinical naive and tumor-bearing rodent studies when compared to the same radiation dose at a conventional dose-rate. The working mechanism of this fascinating dose-rate effect is currently under investigation. The aims of this work include investigating 1) whether LINAC FFF mode radiation at approximately 1Gy/s also has an improved therapeutic ratio compared to the same radiation dose at the conventional dose-rate of 0...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28027338/effect-of-an-intensive-outpatient-program-to-augment-primary-care-for-high-need-veterans-affairs-patients-a-randomized-clinical-trial
#13
Donna M Zulman, Christine Pal Chee, Stephen C Ezeji-Okoye, Jonathan G Shaw, Tyson H Holmes, James S Kahn, Steven M Asch
Importance: Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes. Objective: To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high-need patients' costs, health care utilization, and experience. Design, Setting, and Participants: Randomized clinical trial at a single VA facility...
February 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28003248/development-of-a-smartphone-enabled-hypertension-and-diabetes-mellitus-management-package-to-facilitate-evidence-based-care-delivery-in-primary-healthcare-facilities-in-india-the-mpower-heart-project
#14
Vamadevan S Ajay, Devraj Jindal, Ambuj Roy, Vidya Venugopal, Rakshit Sharma, Abha Pawar, Sanjay Kinra, Nikhil Tandon, Dorairaj Prabhakaran
BACKGROUND: The high burden of undetected and undertreated hypertension and diabetes mellitus is a major health challenge worldwide. The mPower Heart Project aimed to develop and test a feasible and scalable intervention for hypertension and diabetes mellitus by task-sharing with the use of a mobile phone-based clinical decision support system at Community Health Centers in Himachal Pradesh, India. METHODS AND RESULTS: The development of the intervention and mobile phone-based clinical decision support system was carried out using mixed methods in five Community Health Centers...
December 21, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27993376/unplanned-readmission-after-lung-resection-complete-follow-up-in-a-1-year-cohort-with-identification-of-associated-risk-factors
#15
Karen J Dickinson, James B Taswell, Mark S Allen, Shanda H Blackmon, Francis C Nichols, Robert Shen, Dennis A Wigle, Stephen D Cassivi
BACKGROUND: Unplanned readmissions are adverse clinical events that negatively impact patients and affect the use of health care resources. Identifying risk factors that can predict readmissions might permit individualized patient management. We compiled a complete account of readmissions after all lung resections over a year to identify potentially modifiable risk factors. METHODS: All patients undergoing elective lung resection between August 1, 2013 and July 31, 2014 were contacted directly to determine whether they had been readmitted to any institution within 30 days of discharge from our service...
December 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27990259/anterior-single-odontoid-screw-placement-for-type-ii-odontoid-fractures-our-modified-surgical-technique-and-initial-results-in-a-cohort-study-of-15-patients
#16
Binod Bhattarai, Sunil Munakomi, Karuna Tamrakar, Pramod Kumar Chaudhary
Objective: Anterior odontoid screw fixation for type II odontoid fracture is the ideal management option. However in the context of unavailability of an O-arm or neuro-navigation and poor images from the available C-arm may be an obstacle to ideal trajectory and placement of the odontoid screw. We herein detail  our surgical technique so as to ensure a correct trajectory and subsequent good fusion in Type II odontoid fractures. This may be advantageous  in clinical set ups lacking state of the art facilities...
2016: F1000Research
https://www.readbyqxmd.com/read/27984031/polestriding-intervention-improves-gait-and-axial-symptoms-in-mild-to-moderate-parkinson-s-disease
#17
Narayanan Krishnamurthi, Holly Shill, Darolyn O'Donnell, Padma Mahant, Johan Samanta, Abraham Lieberman, James Abbas
OBJECTIVE: To evaluate the effects of 12-week polestriding intervention on gait and disease severity in people with mild to moderate Parkinson's disease DESIGN: A-B-A withdrawal study design SETTING: Outpatient movement disorder center and community facility. PARTICIPANTS: Individuals (9 females and 8 males; mean age: 63.7 ± 4.9 years; range 53 - 72 years) with mild to moderate PD according to UK brain bank criteria with Hoehn and Yahr (H&Y) score from 2.5 to 3...
October 27, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27974996/performance-reliability-usability-and-safety-of-the-id-cap-system-for-ingestion-event-monitoring-in-healthy-volunteers-a-pilot-study
#18
Glen P Flores, Brian Peace, Tony C Carnes, Susan L Baumgartner, D Eric Buffkin, Neil R Euliano, Larry N Smith
Background: Nonadherence to prescribed medications is an important consideration in the clinical management of patients and in clinical research and drug development. The ID-Cap System is a novel technology that provides an objective measure of medication ingestion and enables real-time reporting of verified medication adherence data at the dose level. The ID-Cap System consists of an ingestible microsensor that is embedded in an oral dosage form and, once activated by stomach fluid, communicates digital messages to an external wearable reader to confirm ingestion...
September 2016: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/27965033/medication-management-policy-practice-and-research-in-australian-residential-aged-care-current-and-future-directions
#19
Janet K Sluggett, Jenni Ilomäki, Karla L Seaman, Megan Corlis, J Simon Bell
Eight percent of Australians aged 65 years and over receive residential aged care each year. Residents are increasingly older, frailer and have complex care needs on entry to residential aged care. Up to 63% of Australian residents of aged care facilities take nine or more medications regularly. Together, these factors place residents at high risk of adverse drug events. This paper reviews medication-related policies, practices and research in Australian residential aged care. Complex processes underpin prescribing, supply and administration of medications in aged care facilities...
February 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27941328/upper-extremity-function-predicts-adverse-health-outcomes-among-older-adults-hospitalized-for-ground-level-falls
#20
Bellal Joseph, Nima Toosizadeh, Tahereh Orouji Jokar, Michelle R Heusser, Jane Mohler, Bijan Najafi
BACKGROUND: Despite National Surgical Quality Improvement guidelines to integrate frailty into surgical elder assessments, a quick, accurate, and simple frailty assessment tool suitable for busy clinical settings is still not available. Recently, we have demonstrated that a simple upper-extremity function (UEF) test based on wearable sensors could identify frailty with high agreement with conventional assessments by testing 20-s repetitive elbow flexion and extension. OBJECTIVE: We examined whether UEF parameters are sensitive for predicting adverse health outcomes in bedbound older adults admitted to hospital due to ground-level fall injuries...
December 10, 2016: Gerontology
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