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https://www.readbyqxmd.com/read/28815325/stumbling-blocks-at-the-clinic-experiences-of-seeking-hiv-treatment-and-care-in-south-africa
#1
Brendan Maughan-Brown, Caroline Kuo, Omar Galárraga, Philip Smith, Mark N Lurie, Linda-Gail Bekker, Abigail Harrison
Prompt antiretroviral therapy (ART) initiation maximises the therapeutic and prevention benefits of a treat-all strategy for HIV therapy. Using in-depth semi-structured interviews with men and women 18 years and older (N = 41), who were highly motivated and seeking treatment, this study examined salient factors that were associated with delays in treatment access and initiation. Results revealed clinic-related barriers including an onerous, inefficient multi-step process to initiate ART. Participants experienced additional delays due to difficulties accessing care (e...
August 16, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28765656/-comparison-of-clinical-features-and-diagnosis-between-the-a-and-b-subgroups-of-respiratory-syncytial-virus
#2
N Viguria Sánchez, L Moreno-Galarraga, A Navascués Ortega, C Ezpeleta Baquedano, A González-Benavides, M Mendizabal Diez, E Bernaola Iturbe, J Castilla Catalán
BACKGROUND: Lower respiratory tract infection by respiratory syncytial virus (RSV) is the most frequent cause of admission in children under 2 years old. The RSV subgroups A and B may circulate simultaneously. We aimed to determine whether clinical differences exist between RSV subgroups A and B. Additionally, we tested the sensitivity of the rapid antigen detection test (RADT) based on immunochromatography in diagnosing subgroups A and B, taking the polymerase chain reaction assay (RT-PCR) as reference...
July 28, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28752353/readiness-for-antiretroviral-therapy-implications-for-linking-hiv-infected-individuals-to-care-and-treatment
#3
Brendan Maughan-Brown, Philip Smith, Caroline Kuo, Abigail Harrison, Mark N Lurie, Linda-Gail Bekker, Omar Galárraga
Using survey data collected immediately after referral for ART (N = 87), this study examined ART-readiness among individuals (18 years and older) attending a mobile health clinic in South Africa. Most participants reported being very ready (84%) and motivated (85%) to start ART, but only 72% were assessed as ready for ART on all measures. Treatment readiness was lower among individuals who did not think they would test HIV-positive (aOR 0.26, p < 0.05) and among individuals who reported being in good health (aOR 0...
July 25, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28700393/ten-year-trends-in-antiretroviral-therapy-persistence-among-us-medicaid-beneficiaries
#4
Bora Youn, Theresa I Shireman, Yoojin Lee, Omar Galárraga, Aadia I Rana, Amy C Justice, Ira B Wilson
OBJECTIVE: Whether the rate of HIV antiretroviral therapy (ART) persistence has improved over time in the United States is unknown. We examined ART persistence trends between 2001 and 2010, using non-HIV medications as a comparator. METHODS: We conducted a retrospective cohort study using Medicaid claims. We defined persistence as the duration of treatment from the first to the last fill date before a 90-day permissible gap and used Kaplan-Meier curves and Cox proportional hazard models to assess crude and adjusted nonpersistence...
July 31, 2017: AIDS
https://www.readbyqxmd.com/read/28673344/the-association-of-health-insurance-with-institutional-delivery-and-access-to-skilled-birth-attendants-evidence-from-the-kenya-demographic-and-health-survey-2008-09
#5
Lawrence P O Were, Edwin Were, Richard Wamai, Joseph Hogan, Omar Galarraga
BACKGROUND: Healthcare financing through health insurance is gaining traction as developing countries strive to achieve universal health coverage and address the limited access to critical health services for specific populations including pregnant women and their children. However, these reforms are taking place despite limited evaluation of impact of health insurance on maternal health in developing countries including Kenya. In this study we evaluate the association of health insurance with access and utilization of obstetric delivery health services for pregnant women in Kenya...
July 3, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28630651/improving-antiretroviral-therapy-adherence-in-resource-limited-settings-at-scale-a-discussion-of-interventions-and-recommendations
#6
Jessica E Haberer, Lora Sabin, K Rivet Amico, Catherine Orrell, Omar Galárraga, Alexander C Tsai, Rachel C Vreeman, Ira Wilson, Nadia A Sam-Agudu, Terrence F Blaschke, Bernard Vrijens, Claude A Mellins, Robert H Remien, Sheri D Weiser, Elizabeth Lowenthal, Michael J Stirratt, Papa Salif Sow, Bruce Thomas, Nathan Ford, Edward Mills, Richard Lester, Jean B Nachega, Bosco Mwebesa Bwana, Fred Ssewamala, Lawrence Mbuagbaw, Paula Munderi, Elvin Geng, David R Bangsberg
Introduction: Successful population-level antiretroviral therapy (ART) adherence will be necessary to realize both the clinical and prevention benefits of antiretroviral scale-up and, ultimately, the end of AIDS. Although many people living with HIV are adhering well, others struggle and most are likely to experience challenges in adherence that may threaten virologic suppression at some point during lifelong therapy. Despite the importance of ART adherence, supportive interventions have generally not been implemented at scale...
2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28562627/unconditional-government-cash-transfers-in-support-of-orphaned-and-vulnerable-adolescents-in-western-kenya-is-there-an-association-with-psychological-wellbeing
#7
Sylvia Shangani, Don Operario, Becky Genberg, Kipruto Kirwa, Miriam Midoun, Lukoye Atwoli, David Ayuku, Omar Galárraga, Paula Braitstein
BACKGROUND: Orphaned and vulnerable adolescents (OVA) in sub-Saharan Africa are at greater risk for adverse psychological outcomes compared with their non-OVA counterparts. Social interventions that provide cash transfers (CTs) have been shown to improve health outcomes among young people, but little is known about their impact on the psychological wellbeing of OVA. OBJECTIVE: Among OVA in western Kenya, we assessed the association between living in a household that received monthly unconditional government CTs and psychological wellbeing...
2017: PloS One
https://www.readbyqxmd.com/read/28514280/ten-year-trends-in-anti-retroviral-therapy-persistence-among-us-medicaid-beneficiaries-2001-2010
#8
Bora Youn, Theresa I Shireman, Yoojin Lee, Omar Galárraga, Aadia I Rana, Amy C Justice, Ira B Wilson
OBJECTIVE: Whether the rate of HIV antiretroviral therapy (ART) persistence has improved over time in the U.S. is unknown. We examined ART persistence trends between 2001 and 2010, using non-HIV medications as a comparator. METHODS: We conducted a retrospective cohort study using Medicaid claims. We defined persistence as the duration of treatment from the first to the last fill date before a 90-day permissible gap, and used Kaplan-Meier curves and Cox proportional hazard models to assess crude and adjusted non-persistence...
May 16, 2017: AIDS
https://www.readbyqxmd.com/read/28435119/linear-accelerator-stereotactic-radiosurgery-of-central-nervous-system-arteriovenous-malformations-a-15-year-analysis-of-outcome-related-factors-in-a-single-tertiary-center
#9
José Luis Thenier-Villa, Raúl Alejandro Galárraga-Campoverde, Rosa María Martínez Rolán, Adolfo Ramón De La Lama Zaragoza, Pedro Martínez Cueto, Víctor Muñoz Garzón, Manuel Salgado Fernández, Cesáreo Conde Alonso
BACKGROUND: Linear accelerator stereotactic radiosurgery is one of the modalities available for the treatment of central nervous system arteriovenous malformations (AVMs). The aim of this study was to describe our 15-year experience with this technique in a single tertiary center and the analysis of outcome-related factors. METHODS: From 1998 to 2013, 195 patients were treated with linear accelerator-based radiosurgery; we conducted a retrospective study collecting patient- and AVM-related variables...
July 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28410917/the-relative-contribution-of-provider-and-ed-level-factors-to-variation-among-the-top-15-reasons-for-ed-admission
#10
MULTICENTER STUDY
Imad Khojah, Suhui Li, Qian Luo, Griffin Davis, Jessica E Galarraga, Michael Granovsky, Ori Litvak, Samuel Davis, Robert Shesser, Jesse M Pines
STUDY OBJECTIVE: We examine adult emergency department (ED) admission rates for the top 15 most frequently admitted conditions, and assess the relative contribution in admission rate variation attributable to the provider and hospital. METHODS: This was a retrospective, cross-sectional study of ED encounters (≥18years) from 19 EDs and 603 providers (January 2012-December 2013), linked to the Area Health Resources File for county-level information on healthcare resources...
September 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28364569/improving-antiretroviral-therapy-adherence-in-resource-limited-settings-at-scale-a-discussion-of-interventions-and-recommendations
#11
Jessica E Haberer, Lora Sabin, K Rivet Amico, Catherine Orrell, Omar Galárraga, Alexander C Tsai, Rachel C Vreeman, Ira Wilson, Nadia A Sam-Agudu, Terrence F Blaschke, Bernard Vrijens, Claude A Mellins, Robert H Remien, Sheri D Weiser, Elizabeth Lowenthal, Michael J Stirratt, Papa Salif Sow, Bruce Thomas, Nathan Ford, Edward Mills, Richard Lester, Jean B Nachega, Bosco Mwebesa Bwana, Fred Ssewamala, Lawrence Mbuagbaw, Paula Munderi, Elvin Geng, David R Bangsberg
INTRODUCTION: Successful population-level antiretroviral therapy (ART) adherence will be necessary to realize both the clinical and prevention benefits of antiretroviral scale-up and, ultimately, the end of AIDS. Although many people living with HIV are adhering well, others struggle and most are likely to experience challenges in adherence that may threaten virologic suppression at some point during lifelong therapy. Despite the importance of ART adherence, supportive interventions have generally not been implemented at scale...
March 22, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28351364/task-shifting-alcohol-interventions-for-hiv-persons-in-kenya-a-cost-benefit-analysis
#12
Omar Galárraga, Burke Gao, Benson N Gakinya, Debra A Klein, Richard G Wamai, John E Sidle, Rebecca K Papas
BACKGROUND: Among HIV+ patients, alcohol use is a highly prevalent risk factor for both HIV transmission and poor adherence to HIV treatment. The large-scale implementation of effective interventions for treating alcohol problems remains a challenge in low-income countries with generalized HIV epidemics. It is essential to consider an intervention's cost-effectiveness in dollars-per-health-outcome, and the long-term economic impact -or "return on investment" in monetary terms. METHODS: We conducted a cost-benefit analysis, measuring economic return on investment, of a task-shifted cognitive-behavioral therapy (CBT) intervention delivered by paraprofessionals to reduce alcohol use in a modeled cohort of 13,440 outpatients in Kenya...
March 28, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28304386/effect-of-pregnancy-in-myopia-progression-the-sun-cohort
#13
A Fernández-Montero, M Bes-Rastrollo, J Moreno-Montañés, L Moreno-Galarraga, M Á Martínez-González
PurposePrevious studies have suggested that pregnancy may induce myopia progression. However, no longitudinal study with a large sample size and long-term follow-up has assessed this association. Our objective was to investigate whether pregnancy was related to mid- or long-term myopic refraction changes.Patients and methodsA prospective study was conducted in a Mediterranean cohort. The study included 10 401 women (20-50 years old) from the SUN Project. SUN project is a multipurpose, prospective, and dynamic cohort of university graduates conducted in Spain...
July 2017: Eye
https://www.readbyqxmd.com/read/28263451/inhibition-of-multi-species-oral-biofilm-by-bromide-doped-bioactive-glass
#14
M E Galarraga-Vinueza, B Passoni, C A M Benfatti, J Mesquita-Guimarães, B Henriques, R S Magini, M C Fredel, B V Meerbeek, W Teughels, J C M Souza
Bioactive glass is an attractive biomaterial that has shown excellent osteogenic and angiogenic effects for oral bone repairing procedures. However, anti-biofilm potential related to such biomaterial has not been completely validated, mainly against multi-species biofilms involved in early tissue infections. The aim of the present study was to evaluate the anti-biofilm effect of 58 S bioactive glass embedding calcium bromide compounds at different concentrations. Bioactive glass free or containing 5, or 10 wt % CaBr2 was synthesized by alkali sol-gel method and then characterized by physco-chemical analyses and scanning electron microscopy (SEM)...
March 6, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28207060/do-national-drug-policies-influence-antiretroviral-drug-prices-evidence-from-the-southern-african-development-community
#15
Yao Liu, Omar Galárraga
Background: The efficacy of low- and middle-income countries’ (LMIC) national drug policies in managing antiretroviral (ARV) pharmaceutical prices is not well understood. Though ARV drug prices have been declining in LMIC over the past decade, little research has been done on the role of their national drug policies. This study aims to (i) analyse global ARV prices from 2004 to 2013 and (ii) examine the relationship of national drug policies to ARV prices. Methods: Analysis of ARV drug prices utilized data from the Global Price Reporting Mechanism from the World Health Organization (WHO)...
March 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28185745/how-emergency-department-ed-admission-decisions-differ-when-the-same-physician-works-in-two-different-eds
#16
Jesse M Pines, Jessica E Galarraga, Michael Granvosky, Ori Litvak, Samuel Davis, Leah Honigman Warner
STUDY OBJECTIVE: Emergency physicians often work in multiple hospital emergency departments (EDs). We study how emergency physician admission decisions vary in different settings. METHODS: We conducted a retrospective, cross-sectional study over two years (2012-3) in six EDs in three states. Included physicians had ≥200 encounters per site in two different EDs. "Admissions" were ED encounters resulting in admission to the hospital or transfer to another hospital...
February 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28110864/sexual-behavior-among-orphaned-adolescents-in-western-kenya-a-comparison-of-institutional-and-family-based-care-settings
#17
Lonnie Embleton, Joram Nyandat, David Ayuku, Edwin Sang, Allan Kamanda, Samuel Ayaya, Winstone Nyandiko, Peter Gisore, Rachel Vreeman, Lukoye Atwoli, Omar Galarraga, Mary A Ott, Paula Braitstein
PURPOSE: This study sought to assess whether risky sexual behaviors and sexual exploitation of orphaned adolescents differed between family-based and institutional care environments in Uasin Gishu County, Kenya. METHODS: We analyzed baseline data from a cohort of orphaned adolescents aged 10-18 years living in 300 randomly selected households and 19 charitable children's institutions. The primary outcomes were having ever had consensual sex, number of sex partners, transactional sex, and forced sex...
April 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28069845/at-federally-funded-health-centers-medicaid-expansion-was-associated-with-improved-quality-of-care
#18
Megan B Cole, Omar Galárraga, Ira B Wilson, Brad Wright, Amal N Trivedi
In 2014 many uninsured, low-income nonelderly adults gained access to health insurance in states that expanded Medicaid eligibility under the Affordable Care Act. Federally funded community health centers were likely to be particularly affected by this expansion because many of their patients were uninsured and low income. We used a difference-in-differences approach to compare changes among 1,057 such centers in expansion versus nonexpansion states from 2011 to 2014, in terms of their patients' insurance coverage, the number of patients they served, and the quality of care they provided...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/27974611/activation-of-glutamatergic-fibers-in-the-anterior-nac-shell-modulates-reward-activity-in-the-anacsh-the-lateral-hypothalamus-and-medial-prefrontal-cortex-and-transiently-stops-feeding
#19
Luis Prado, Jorge Luis-Islas, Osvaldo I Sandoval, Liliana Puron, Moreno M Gil, Alvaro Luna, Mario A Arias-García, Elvira Galarraga, Sidney A Simon, Ranier Gutierrez
Although the release of mesoaccumbal dopamine is certainly involved in rewarding responses, recent studies point to the importance of the interaction between it and glutamate. One important component of this network is the anterior nucleus accumbens shell (aNAcSh), which sends GABAergic projections into the lateral hypothalamus (LH) and receives extensive glutamatergic inputs from, among others, the medial prefrontal cortex (mPFC). The effects of glutamatergic activation of aNAcSh on the ingestion of rewarding stimuli as well as its effect in the LH and mPFC are not well understood...
December 14, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/27902652/circulating-antibody-1-and-2-years-after-vaccination-with-the-13-valent-pneumococcal-conjugate-vaccine-in-preterm-compared-with-term-infants
#20
Federico Martinón-Torres, Jacek Wysocki, Kimberly J Center, Hanna Czajka, Ewa Majda-Stanislawska, Felix Omeñaca, Ana Concheiro-Guisan, Francisco Gimenez-Sanchez, Leszek Szenborn, Daniel Blázquez-Gamero, Laura Moreno-Galarraga, Peter C Giardina, Gang Sun, William C Gruber, Daniel A Scott, Alejandra Gurtman
BACKGROUND: Premature infants have lower short-term immune responses to vaccination than term infants, but patterns of antibody persistence in preterm infants over longer periods are not well established. This study assessed the persistence of antibody response to the 13-valent pneumococcal conjugate vaccine (PCV13) in formerly preterm versus term infants. METHODS: In total, 100 preterm and 100 term infants received PCV13 with routine vaccines at ages 2, 3, 4 and 12 months...
March 2017: Pediatric Infectious Disease Journal
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