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"Care continuum"

Collins C Iwuji, Nuala McGrath, Tulio de Oliveira, Kholoud Porter, Deenan Pillay, Martin Fisher, Melanie Newport, Marie-Louise Newell
INTRODUCTION: Remarkable strides have been made in controlling the HIV epidemic, although not enough to achieve epidemic control. More recently, interest in biomedical HIV control approaches has increased, but substantial challenges with the HIV cascade of care hinder successful implementation. We summarise all available HIV prevention methods and make recommendations on how to address current challenges. DISCUSSION: In the early days of the epidemic, behavioural approaches to control the HIV dominated, and the few available evidence-based interventions demonstrated to reduce HIV transmission were applied independently from one another...
November 30, 2015: Journal of AIDS & Clinical Research
Ashly E Jordan, David C Perlman
BACKGROUND: Hepatitis C virus (HCV) infection is hyperendemic among people who inject drugs; nonsterile drug injection is the principle risk for HCV acquisition. Due to gaps in the HCV care continuum, there have been recommendations in the United States emphasizing age-rather than risk-based testing strategies. The central research focus of this project is to explore the meanings and implications of the shift in emphasis from risk-based to age-based HCV testing with regard to people who use drugs...
October 21, 2016: Substance Use & Misuse
Madhukar Pai, Mark P Nicol, Catharina C Boehme
Rapid and accurate diagnosis is critical for timely initiation of anti-tuberculosis (TB) treatment, but many people with TB (or TB symptoms) do not have access to adequate initial diagnosis. In many countries, TB diagnosis is still reliant on sputum microscopy, a test with known limitations. However, new diagnostics are starting to change the landscape. Stimulated, in part, by the success and rollout of Xpert MTB/RIF, an automated, molecular test, there is now considerable interest in new technologies. The landscape looks promising with a pipeline of new tools, particularly molecular diagnostics, and well over 50 companies actively engaged in product development, and many tests have been reviewed by WHO for policy endorsement...
October 2016: Microbiology Spectrum
Courtenay Sprague, Michael L Scanlon, Bharathi Radhakrishnan, David W Pantalone
Incarcerated women face significant barriers to achieve continuous HIV care. We employed a descriptive, exploratory design using qualitative methods and the theoretical construct of agency to investigate participants' self-reported experiences accessing HIV services in jail, in prison, and post-release in two Alabama cities. During January 2014, we conducted in-depth interviews with 25 formerly incarcerated HIV-positive women. Two researchers completed independent coding, producing preliminary codes from transcripts using content analysis...
October 14, 2016: Qualitative Health Research
Melissa C Brouwers, Marija Vukmirovic, Jennifer R Tomasone, Eva Grunfeld, Robin Urquhart, Mary Ann O'Brien, Melanie Walker, Fiona Webster, Margaret Fitch
OBJECTIVE: To report on the findings of the CanIMPACT (Canadian Team to Improve Community-Based Cancer Care along the Continuum) Casebook project, which systematically documented Canadian initiatives (ie, programs and projects) designed to improve or support coordination and continuity of cancer care between primary care providers (PCPs) and oncology specialists. DESIGN: Pan-Canadian environmental scan. SETTING: Canada. PARTICIPANTS: Individuals representing the various initiatives provided data for the analysis...
October 2016: Canadian Family Physician Médecin de Famille Canadien
Li Jiang, Aisha Lofters, Rahim Moineddin, Kathleen Decker, Patti Groome, Cynthia Kendell, Monika Krzyzanowska, Dongdong Li, Mary L McBride, Nicole Mittmann, Geoff Porter, Donna Turner, Robin Urquhart, Marcy Winget, Yang Zhang, Eva Grunfeld
OBJECTIVE: To describe primary care physician (PCP) use and continuity of PCP care across the breast cancer care continuum. DESIGN: Population-based, retrospective cohort study using provincial cancer registries linked to health administrative databases. SETTING: British Columbia, Manitoba, and Ontario. PARTICIPANTS: All women with incident invasive breast cancer from 2007 to 2012 in Manitoba and Ontario and from 2007 to 2011 in British Columbia...
October 2016: Canadian Family Physician Médecin de Famille Canadien
Julie Easley, Baukje Miedema, June C Carroll, Mary Ann O'Brien, Donna P Manca, Eva Grunfeld
OBJECTIVE: To explore patient perspectives on and experiences with the coordination and continuity of cancer care. DESIGN: Qualitative study using semistructured telephone interviews. SETTING: Canada. PARTICIPANTS: Thirty-eight breast and colorectal cancer survivors 1 to 4 years after diagnosis. METHODS: Using a constructivist grounded theory approach, semistructured telephone interviews were conducted with the participants...
October 2016: Canadian Family Physician Médecin de Famille Canadien
Suzette C Brémault-Phillips, Jasneet Parmar, Steven Friesen, Laura G Rogers, Ashley Pike, Bryan Sluggett
BACKGROUND: The Decision-Making Capacity Assessment (DMCA) Model includes a best-practice process and tools to assess DMCA, and implementation strategies at the organizational and assessor levels to support provision of DMCAs across the care continuum. A Developmental Evaluation of the DMCA Model was conducted. METHODS: A mixed methods approach was used. Survey (N = 126) and focus group (N = 49) data were collected from practitioners utilizing the Model. RESULTS: Strengths of the Model include its best-practice and implementation approach, applicability to independent practitioners and inter-professional teams, focus on training/mentoring to enhance knowledge/skills, and provision of tools/processes...
September 2016: Canadian Geriatrics Journal: CGJ
Joshua O Akinyemi, Rotimi F Afolabi, Olutosin A Awolude
BACKGROUND: The maternal, newborn and child health care continuum require that mother/child pair should receive the full package of antenatal, intrapartum and postnatal care in order to derive maximum benefits. Continuity of care is a challenge in sub-Saharan Africa. In this study, we investigate the patterns and factors associated with dropout in the continuum of maternity (antenatal, delivery and postnatal) care in Nigeria. METHOD: Using women recode file from the 2013 Nigeria Demographic and Health Survey, we analysed data on 20,467 women with an index birth within 5 years prior to data collection...
September 27, 2016: BMC Pregnancy and Childbirth
Arden Handler, Kay Johnson
Objectives The broad maternal and child health community has witnessed increased attention to the entire continuum of reproductive and perinatal health concerns over the past few years. However, both recent discouraging trends in prenatal care access and utilization and a renewed understanding of prenatal care as a critical anchor of the reproductive/perinatal health continuum for women who do get pregnant demand a new effort to focus on the prenatal period as a gateway for maternal and infant health. Methods This commentary: describes the Medicaid expansions and the momentum for universal access to prenatal care of the 1980-1990s; examines the pivot away from this goal and its aftermath; provides a rationale for why renewed attention to prenatal care and the prenatal period is essential; and, explores the potential focus of an updated prenatal care agenda...
September 23, 2016: Maternal and Child Health Journal
John A Schneider, Michael Kozloski, Stuart Michaels, Britt Skaathun, Dexter Voisin, Nicola Lancki, Ethan Morgan, Aditya Khanna, Keith Green, Robert W Coombs, Samuel R Friedman, Edward Laumann, Phil Schumm
OBJECTIVE: To examine how history of criminal justice involvement(CJI) is related to HIV care continuum metrics among young Black men who have sex with men (YBMSM) 16-29 years of age. DESIGN: Population-based survey. METHODS: From 2013-2014 a representative sample of YBMSM was generated using Respondent Driven Sampling (RDS) in Chicago (n = 618). HIV antibody/Ag and RNA testing were performed using dry blood spots. Factors assessed in the care continuum included HIV testing, HIV diagnosis, linkage-to-care within 6 months, retention-in-care, adherence to antiretrovirals, and viral suppression...
September 20, 2016: AIDS
Rebecca J Bartlett Ellis, Janet L Welch
AIMS AND OBJECTIVES: This meta-ethnographic study identified behaviors associated with taking medications and medication adherence reported in qualitative studies of adults with chronic kidney disease (CKD) and co-existing multiple chronic conditions (MCCs). BACKGROUND: To inform medication adherence interventions, information is needed to clarify the nature of the relationships between behaviors that support medication-taking and medication adherence in MCCs. STUDY DESIGN: Meta-ethnographic review and synthesis...
September 20, 2016: Journal of Clinical Nursing
Elizabeth A Reddy, Chris Bernard Agala, Venance P Maro, Jan Ostermann, Brian W Pence, Dafrosa K Itemba, Donna Safley, Jia Yao, Nathan M Thielman, Kathryn Whetten
BACKGROUND: Linkage to HIV care is crucial to the success of antiretroviral therapy (ART) programs worldwide, loss to follow up at all stages of the care continuum is frequent, and long-term prospective studies of care linkage are currently lacking. METHODS: Consecutive clients who tested HIV-positive were enrolled from four HIV testing centers (1 health facility and 3 community-based centers) in the Kilimanjaro region of Tanzania as part of the larger Coping with HIV/AIDS in Tanzania (CHAT) prospective observational study...
2016: BMC Infectious Diseases
Chaitra Gopalappa, Paul G Farnham, Yao-Hsuan Chen, Stephanie L Sansom
BACKGROUND: HIV transmission is the result of complex dynamics in the risk behaviors, partnership choices, disease stage and position along the HIV care continuum-individual characteristics that themselves can change over time. Capturing these dynamics and simulating transmissions to understand the chief sources of transmission remain important for prevention. METHODS: The Progression and Transmission of HIV/AIDS (PATH 2.0) is an agent-based model of a sample of 10,000 people living with HIV (PLWH), who represent all men who have sex with men (MSM) and heterosexuals living with HIV in the U...
September 19, 2016: Medical Decision Making: An International Journal of the Society for Medical Decision Making
Coleen Ranaghan, Kathleen Boyle, Maureen Meehan, Shadiatu Moustapha, Patrice Fraser, Catherine Concert
BACKGROUND: One approach to overcoming healthcare system barriers and facilitating timely access to quality care and patient satisfaction is with a patient navigator. A patient navigator is a trained person who individually assists patients, families and caregivers navigate the healthcare system barriers efficiently and effectively at any point along the care continuum, improving patient care at all levels of an organization. OBJECTIVES: To synthesize the best available evidence on the effectiveness of a patient navigator on patient satisfaction in adult patients 18 years and older in ambulatory care settings...
August 2016: JBI Database of Systematic Reviews and Implementation Reports
Nikoloz Chkhartishvili, Otar Chokoshvili, Natia Dvali, Akaki Abutidze, Lali Sharvadze, Tengiz Tsertsvadze
The objective of this report was to assess Georgia's progress toward Joint United Nations Programme on HIV/AIDS 90-90-90 targets over the period between 2011 and 2015. The number of HIV-positive persons was estimated using Spectrum software. Number of persons diagnosed, on antiretroviral therapy (ART) and virally suppressed were quantified using data from the national AIDS health information system. By the end of 2015, out of the estimated 7100 persons living with HIV, 62% were diagnosed, 38% were on ART, and 32% were virally suppressed...
September 14, 2016: Journal of the International Association of Providers of AIDS Care
Allison Magnuson, James Wallace, Beverly Canin, Selina Chow, William Dale, Supriya G Mohile, Lauren M Hamel
We present the case of a 92-year-old man, MH, who was given a diagnosis of colorectal cancer. His primary care physician, surgeon, geriatric oncologist, and family members all played important roles in his care. MH's case is an example of a lack of explicit shared goal setting by the health care providers with the patient and family members and how that impeded care planning and health. This case demonstrates the importance of explicitly discussing and establishing shared goals in team-based cancer care delivery early on and throughout the care process, especially for older adults...
September 13, 2016: Journal of Oncology Practice
John A Nelson, Anna Kinder, Anna Satcher Johnson, H Irene Hall, Xiaohong Hu, Donna Sweet, Alyssa Guido, Harold Katner, Jennifer Janelle, Maribel Gonzalez, Natalia Martínez Paz, Charlotte Ledonne, Jason Henry, Theresa Bramel, Jeanne Harris
PURPOSE: The HIV care continuum is used to monitor success in HIV diagnosis and treatment among persons living with HIV in the United States. Significant differences exist along the HIV care continuum between subpopulations of people living with HIV; however, differences that may exist between residents of rural and nonrural areas have not been reported. METHODS: We analyzed the Centers for Disease Control and Prevention's National HIV Surveillance System data on adults and adolescents (≥13 years) with HIV diagnosed in 28 jurisdictions with complete reporting of HIV-related lab results...
September 13, 2016: Journal of Rural Health
Kali Zhou, Thomas Fitzpatrick, Nick Walsh, Ji Young Kim, Roger Chou, Mellanye Lackey, Julia Scott, Ying-Ru Lo, Joseph D Tucker
BACKGROUND: Advances in therapy for hepatitis B virus (HBV) and hepatitis C virus (HCV) have ushered in a new era in chronic hepatitis treatment. To maximise the effectiveness of these medicines, individuals must be engaged and retained in care. We analysed operational interventions to enhance chronic viral hepatitis testing, linkage to care, treatment uptake, adherence, and viral suppression or cure. METHODS: We did a systematic review of operational interventions, and did meta-analyses for sufficiently comparable data...
September 5, 2016: Lancet Infectious Diseases
Allison Magnuson, Beverly Canin, G J van Londen, Beatrice Edwards, Pamela Bakalarski, Ira Parker
A significant proportion of cancer patients and survivors are age 65 and over. Older adults with cancer often have more complex medical and social needs than their younger counterparts. Geriatric medicine providers (GMPs) such as geriatricians, geriatric-trained advanced practice providers, and geriatric certified registered nurses have expertise in caring for older adults, managing complex medical situations, and optimizing function and independence for this population. GMPs are not routinely incorporated into cancer care for older adults; however, their particular skill set may add benefit at many points along the cancer care continuum...
November 2016: Current Oncology Reports
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