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Universal health access

Sarah A Pendergrass, Dana C Crawford
Electronic health records contain patient-level data collected during and for clinical care. Data within the electronic health record include diagnostic billing codes, procedure codes, vital signs, laboratory test results, clinical imaging, and physician notes. With repeated clinic visits, these data are longitudinal, providing important information on disease development, progression, and response to treatment or intervention strategies. The near universal adoption of electronic health records nationally has the potential to provide population-scale real-world clinical data accessible for biomedical research, including genetic association studies...
December 5, 2018: Current Protocols in Human Genetics
Annarita Marrano, Pedro J Martínez-García, Luca Bianco, Gina M Sideli, Erica A Di Pierro, Charles A Leslie, Kristian A Stevens, Marc W Crepeau, Michela Troggio, Charles H Langley, David B Neale
Over the last 20 years, global production of Persian walnut (Juglans regia L.) has grown enormously, likely reflecting increased consumption due to its numerous benefits to human health. However, advances in genome-wide association (GWA) studies and genomic selection (GS) for agronomically important traits in walnut remain limited due to the lack of powerful genomic tools. Here, we present the development and validation of a high-density 700K single nucleotide polymorphism (SNP) array in Persian walnut. Over 609K high-quality SNPs have been thoroughly selected from a set of 9...
November 22, 2018: Plant Biotechnology Journal
Lisa L Abuogi, John M Humphrey, Christian Mpody, Marcel Yotebieng, Pamela M Murnane, Kate Clouse, Lindah Otieno, Craig R Cohen, Kara Wools-Kaloustian
The implementation of the 2013 World Health Organization Option B+ recommendations for HIV treatment during pregnancy has helped drive significant progress in achieving universal treatment for pregnant and postpartum women in sub-Saharan Africa (SSA). Yet, critical research and implementation gaps exist in achieving the UNAIDS 90-90-90 targets. To help guide researchers, programmers and policymakers in prioritising these areas, we undertook a comprehensive review of the progress, gaps and research needs to achieve the 90-90-90 targets for this population in the Option B+ era, including early infant HIV diagnosis (EID) for HIV-exposed infants...
November 15, 2018: Journal of Virus Eradication
Temmy Sunyoto, Marleen Boelaert, Filip Meheus
Leishmaniasis is a poverty-related disease that causes a significant socioeconomic burden to affected households. Visceral leishmaniasis is fatal if untreated, yet illness costs may lead to delays in accessing care. Skin manifestations of leishmaniasis cause a psychological burden and even longer treatment trajectories. The objective of this review is to evaluate illness costs associated with leishmaniasis across different settings (Asia, Africa, and Latin America) and the consequences to households. Areas covered: Through a systematic review of cost-of-illness studies, we documented the distribution of costs, the health-seeking behavior, and the consequences of leishmaniasis...
December 4, 2018: Expert Review of Anti-infective Therapy
Adriana Velazquez Berumen, Gabriela Jimenez Moyao, Natalia M Rodriguez, André M Ilbawi, Antonio Migliore, Lawrence N Shulman
Medical devices are indispensable for cancer management across the entire cancer care continuum, yet many existing medical interventions are not equally accessible to the global population, contributing to disparate mortality rates between countries with different income levels. Improved access to priority medical technologies is required to implement universal health coverage and deliver high-quality cancer care. However, the selection of appropriate medical devices at all income and hospital levels has been difficult because of the extremely large number of devices needed for the full spectrum of cancer care; the wide variety of options within the medical device sector, ranging from small inexpensive disposable devices to sophisticated diagnostic imaging and treatment units; and insufficient in-country expertise, in many countries, to prioritise cancer interventions and to determine associated technologies...
December 2018: Lancet Oncology
J M Petit, S Loubiere, M J Vargas-Moniz, A Tinland, F Spinnewijn, R M Greenwood, M Santinello, J R Wolf, A Bokszczanin, R Bernad, H Kallmen, J Ornelas, P Auquier
Background: Most European countries report rising numbers of people experiencing homelessness. For those with mental disorders, interventions are centered on achieving mental health and drug rehabilitation alongside housing readiness, often to the detriment of access to housing. Notwithstanding, more European countries are investing in a new model, Housing First (HF), which postulates immediate access to permanent housing with no initial requirements for treatment. While results of the European HF programs are published on individual-level data, little is known about the opinions of the general population about homelessness and the societal value of the HF model, which can represent barriers to the model's dissemination...
2018: Archives of Public Health, Archives Belges de Santé Publique
Sharon M Gordon, Gerard A Camargo, Gloria C Mejia, James N Sutherland
Dental schools in the United States increasingly emphasize community-based practice targeting underserved populations. However, the impact on target populations remains largely undocumented. East Carolina University School of Dental Medicine (ECU SoDM) developed an integrated electronic health record database that aggregates patient data from all clinics in the ECU SoDM system and enables longitudinal assessment of the impact of clinical care on oral health outcomes. The aim of this study was to analyze the demographic and oral health characteristics data for eligible patients from June 2012 to March 2016...
December 2018: Journal of Dental Education
Andrea Yupanqui Concha, Victoria A Ferrer Pérez
OBJECTIVE: To explore world scientific production in forced sterilization of women with disabilities between 1997 and 2016, written in English and Spanish. METHOD: We carried out a descriptive, retrospective longitudinal study. The bibliometrics indicators of productivity, collaboration and subject-matter were studied. Critical Appraisal Skills Programme (CASP) was used as an evidence-based framework to evaluate original articles and literature reviews. RESULTS: A total of 139 documents were studied, in which 114 institutions from 24 countries participated...
November 29, 2018: Gaceta Sanitaria
Karen M Tuesley, Susan J Jordan, Dan J Siskind, Bradley J Kendall, Steve Kisely
OBJECTIVE: People with severe mental illness have similar cancer incidence, but higher mortality than the general population. Participation in cancer screening may be a contributing factor but existing studies are conflicting. The aim of this study was to investigate the frequency of colorectal, prostate and cervical cancer screening among people with and without severe mental illness in Australia, who have access to universal health care. METHODS: We followed three cohorts using de-identified data from a random 10% sample of people registered for Australia's universal health care system: those aged 50-69 years ( n = 760,058) for colorectal cancer screening; women aged 18-69 years ( n = 918,140) for cervical cancer screening and men aged 50-69 years ( n = 380,238) for prostate cancer screening...
December 2, 2018: Australian and New Zealand Journal of Psychiatry
Jikui Wu, Ruinan Wang, Yunfei Lu, Min Jia, Juan Yan, Xiaojun Bian
The effective identification and quantification of pathogenic bacteria is essential for addressing serious public health issues. Here we demonstrate a simple and universal impedimetric sensor for highly selective and sensitive detection of pathogenic bacteria based on the recognition by a bacteria-imprinted polypyrrole (BIP) film. The BIP film was facilely prepared via one-step electro-polymerization followed by in-situ removal of the bacterial template. The film structure is novel with non-cavity-like imprinted sites situated at the surface of the polypyrrole (PPy) matrix, which are more accessible for the target bacteria and should enhance the mass transfer and the binding kinetics...
December 3, 2018: Analytical Chemistry
Annie Madden, Max Hopwood, Joanne Neale, Carla Treloar
Recent advances in the efficacy and tolerability of hepatitis C treatments and the introduction of a universal access scheme for the new Direct Acting Antiviral (DAA) therapies in March 2016, has resulted in a rapid increase in the uptake of hepatitis C treatment in Australia. Despite these positive developments, recent data suggest a plateauing of treatment numbers, indicating that more work may need to be done to identify and address ongoing barriers to hepatitis C treatment access and uptake. This paper aims to contribute to our understanding of the ongoing barriers to DAA therapies, with a focus on people who inject drugs...
2018: PloS One
Mark W Skinner, Rachel V Herron, Rachel J Bar, Pia Kontos, Verena Menec
INTRODUCTION: This study examines the potential of dance to improve social inclusion for people living with dementia and carers. Research suggests that arts-based programmes can improve the health of people living with dementia and carers; however, little is known about how these programmes might address barriers to social inclusion. Addressing barriers requires the development and evaluation of accessible, non-stigmatising and affordable programmes that facilitate social inclusion across the continuum of institutional, community and household care settings...
November 28, 2018: BMJ Open
Alice Moult, Heather Burroughs, Tom Kingstone, Carolyn A Chew-Graham
BACKGROUND: Anxiety and depression are common in older adults, but often under-recognised by GPs. Rather than perceiving themselves as suffering from anxiety or depression, older adults are more likely to self-identify as experiencing low mood, stress or distress. Older people may also feel responsible for managing their own mood problems. The Internet has the potential to support the self-management of distress through accessing health information or social support. METHODS: This study was approved by Keele University's ethical review panel...
November 29, 2018: BMC Family Practice
Afsan Bhadelia, Liliana De Lima, Héctor Arreola-Ornelas, Xiaoxiao Jiang Kwete, Natalia M Rodriguez, Felicia Marie Knaul
Annually, more than 61 million people worldwide experience about 6 billion days of serious health-related suffering that could be alleviated with access to palliative care and pain relief. However, palliative care is limited or nonexistent in most parts of the world. The access abyss is so stark that 50% of the world's poorest populations live in countries that receive only 1% of the opioid analgesics distributed worldwide. By contrast, the richest 10% of the world's population live in countries that receive nearly 90% of the opioid pain relief medications...
November 29, 2018: American Journal of Public Health
S Abd Elwahab, P McGough, G Cooley, R McLaughlin
Geographical access is a cornerstone of health care provision. However, prolonged waiting for breast clinic appointments in local services results in delayed diagnosis and excessive anxiety for patients. In this study, we present a patient satisfaction survey results of an initiative to offer out-patient clinic appointments for non-urgent patients referred to the breast unit in Letterkenny General Hospital (LGH), Ireland, and exceeded the recommended waiting period of 12 weeks. These patients were offered appointment in University Hospital Galway (UCHG), which is an average travel time of about 3...
May 10, 2018: Irish Medical Journal
Mayte Mosquera-Romero, Lina Zuluaga-Idárraga, Alberto Tobón-Castaño
BACKGROUND: Ecuador is on the verge of eliminating malaria according to the World Health Organization criteria. Nevertheless, active transmission foci still persist in the country, and these represent an important challenge for achieving the objectives set out. Diagnosis and treatment are a mainstay in the control and elimination of this disease. This study aimed to explore the barriers hindering the implementation of malaria diagnosis and treatment strategies in a focus of active transmission in the San Lorenzo canton, Ecuador...
November 28, 2018: Malaria Journal
María Buti, Raquel Domínguez-Hernández, Miguel Ángel Casado, Eliazar Sabater, Rafael Esteban
BACKGROUND: Elimination of hepatitis C virus (HCV) infection requires high diagnostic rates and universal access to treatment. Around 40% of infected individuals are unaware of their infection, which indicates that effective screening strategies are needed. We analyzed the efficiency (incremental cost-utility ratio, ICUR) of 3 HCV screening strategies: a) general population of adults, b) high-risk groups, and c) population with the highest anti-HCV prevalence plus high-risk groups. METHODS: An analytical decision model, projecting progression of the disease over a lifetime, was used to establish the candidate population for HCV screening...
2018: PloS One
Takafumi Hayashi, Yoshinori Arai, Toru Chikui, Sachiko Hayashi-Sakai, Kazuya Honda, Hiroko Indo, Taisuke Kawai, Kaoru Kobayashi, Shumei Murakami, Masako Nagasawa, Munetaka Naitoh, Eiji Nakayama, Yutaka Nikkuni, Hideyoshi Nishiyama, Noriaki Shoji, Shigeaki Suenaga, Ray Tanaka
Dental cone-beam computed tomography (CBCT) received regulatory approval in Japan in 2000 and has been widely used since being approved for coverage by the National Health Insurance system in 2012. This imaging technique allows dental practitioners to observe and diagnose lesions in the dental hard tissue in three dimensions (3D). When performing routine radiography, the examination must be justified, and optimal protection should be provided according to the ALARA (as low as reasonably achievable) principles laid down by the International Commission on Radiological Protection...
May 2018: Oral Radiology
Camilla Wattrus, Jorge Zepeda, Ruth Vania Cornick, Ronaldo Zonta, Matheus Pacheco de Andrade, Lara Fairall, Daniella Georgeu-Pepper, Lauren Anderson, Tracy Eastman, Eric D Bateman, Alvaro A Cruz, Max O Bachmann, Sonia Natal, Tanya Doherty, Rafael Stelmach
Brazil's Sistema Único de Saúde, or Unified Health System policy, has delivered major improvements in health coverage and outcomes, but challenges remain, including the rise of non-communicable diseases (NCDs) and variations in quality of care across the country. Some of these challenges may be met through the adaptation and implementation of a South African primary care strategy, the Practical Approach to Care Kit (PACK). Developed by the University of Cape Town's Knowledge Translation Unit (KTU), PACK is intended for in-country adaptation by employing a mentorship model...
2018: BMJ Global Health
Carla Tsampiras
Celebration, frustration, contestation and imagination all manifest themselves when examining the evolution of the field of Medical and Health Humanities (MHH) at the University of Cape Town (UCT). That this field has been growing at the same time as access to, inclusion in, and social justice issues linked to higher education have come under the spotlight has the potential to shape how we think and plan for the future of the field. Doing this will require treks up hills, journeys through difficult histories and dynamic dances in-between disciplines...
December 2018: Medical Humanities
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