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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
#1
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
#2
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
https://www.readbyqxmd.com/read/28296301/imaging-acquisition-display-performance-an-evaluation-and-discussion-of-performance-metrics-and-procedures
#3
Michael S Silosky, Rebecca M Marsh, Ann L Scherzinger
When The Joint Commission updated its Requirements for Diagnostic Imaging Services for hospitals and ambulatory care facilities on July 1, 2015, among the new requirements was an annual performance evaluation for acquisition workstation displays. The purpose of this work was to evaluate a large cohort of acquisition displays used in a clinical environment and compare the results with existing performance standards provided by the American College of Radiology (ACR) and the American Association of Physicists in Medicine (AAPM)...
July 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28293286/who-seeks-child-and-adolescent-mental-health-care-in-kenya-a-descriptive-clinic-profile-at-a-tertiary-referral-facility
#4
Judy Wanjiru Kamau, Olayinka O Omigbodun, Tolulope Bella-Awusah, Babatunde Adedokun
BACKGROUND: The presence of psychiatric morbidity in the child and adolescent age group is demonstrable in various studies conducted in various settings in Kenya. This study set out to determine the psychiatric morbidity and socio-demographic profile of patients who eventually present for care at a tertiary specialist child and adolescent mental health clinic in Kenya. Knowledge of the patterns of presentation of disorders is crucial for planning of service scale up as well as serving as a useful training guide...
2017: Child and Adolescent Psychiatry and Mental Health
https://www.readbyqxmd.com/read/28264670/examining-the-quality-of-childhood-tuberculosis-diagnosis-in-cambodia-a-cross-sectional-study
#5
Julia B Frieze, Rajendra-Prasad Yadav, Khann Sokhan, Song Ngak, Team Bak Khim
BACKGROUND: Cambodia is one of the 22 countries with the highest TB burden. While childhood TB is estimated to make up 10-20% of total TB cases in high-burden settings, this proportion ranges from 1.3 to 39.4% throughout Cambodia's provinces, suggesting potential under- and over-diagnosis of childhood TB, subnationally. The proportion of case notifications classified as extrapulmonary TB out of total TB case notifications in children is 87%, greatly exceeding the expected global range of 20-30%...
March 6, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28256158/treatment-outcomes-and-patterns-of-radiologic-appearance-after-hypofractionated-image-guided-radiotherapy-delivered-with-helical-tomotherapy-hht-for-lung-tumours
#6
Stefano Arcangeli, Lorenzo Falcinelli, Stefano Bracci, Alessandro Greco, Alessia Monaco, Jessica Dognini, Cinzia Chiostrini, Rita Bellavita, Cynthia Aristei, Vittorio Donato
OBJECTIVE: To evaluate treatment outcomes and patterns of CT lung injury after hypofractionated image-guided radiotherapy delivered with helical tomotherapy (HHT) in a series of inoperable lung lesions. METHODS: 68 patients who were medically inoperable (69 lesions) without evidence of viable extrathoracic disease were included. Dose prescription was driven by tumour location (hilar/pericentral vs peripheral) and/or target volume. 52% of the lesions received a biological equivalent dose (BED10) ≥100 Gy...
March 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28245264/longitudinal-analysis-of-antibody-responses-in-symptomatic-malaria-cases-do-not-mirror-parasite-transmission-in-peri-urban-area-of-cote-d-ivoire-between-2010-and-2013
#7
David Koffi, Marie-Louise Varela, Cheikh Loucoubar, Sylvain Beourou, Inès Vigan-Womas, Aissatou Touré, Joseph Allico Djaman, André Offianan Touré, Ronald Perraut
BACKGROUND: In the agenda towards malaria eradication, assessment of both malaria exposure and efficacy of anti-vectorial and therapeutic strategies is a key component of management and the follow-up of field interventions. The simultaneous use of several antigens (Ags) as serological markers has the potential for accurate evaluation of malaria exposure. Here we aimed to measure the longitudinal evolution of the background levels of immunity in an urban setting in confirmed clinical cases of malaria...
2017: PloS One
https://www.readbyqxmd.com/read/28231265/resist-diabetes-a-randomized-clinical-trial-for-resistance-training-maintenance-in-adults-with-prediabetes
#8
Brenda M Davy, Richard A Winett, Jyoti Savla, Elaina L Marinik, Mary Elizabeth Baugh, Kyle D Flack, Tanya M Halliday, Sarah A Kelleher, Sheila G Winett, David M Williams, Soheir Boshra
OBJECTIVE: To determine whether a social cognitive theory (SCT)-based intervention improves resistance training (RT) maintenance and strength, and reduces prediabetes prevalence. RESEARCH DESIGN AND METHODS: Sedentary, overweight/obese (BMI: 25-39.9 kg/m2) adults aged 50-69 (N = 170) with prediabetes participated in the 15-month trial. Participants completed a supervised 3-month RT (2×/wk) phase and were randomly assigned (N = 159) to one of two 6-month maintenance conditions: SCT or standard care...
2017: PloS One
https://www.readbyqxmd.com/read/28216782/indian-psychiatric-society-survey-on-clinical-practice-guidelines
#9
Sandeep Grover, Ajit Avasthi
AIM: This survey aimed to assess the utility of the earlier published clinical practice guidelines (CPGs) by IPS and to understand the expectations of members of Indian Psychiatric Society from the proposed revised CPGs. In addition, the survey also evaluated the current level of practice of psychiatry in terms of availability of different investigation facilities, prescription patterns in terms of use of polypharmacy, and competence in carrying out certain nonpharmacological treatments...
January 2017: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/28182618/the-evolving-landscape-of-hiv-drug-resistance-diagnostics-for-expanding-testing-in-resource-limited-settings
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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