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Continuum of care

Rogério M Pinto, Susan S Witte, Prema L Filippone, C Jean Choi, Melanie Wall
The U.S. Centers for Disease Control and Prevention (CDC) Diffusion of Effective Behavioral Interventions project has disseminated HIV behavioral interventions (EBIs) across the United States since the 1990s. In 2011, the CDC launched the High-Impact HIV Prevention (HIP) project, providing EBIs plus high-impact services (HIV testing, primary care, and support services). Providers (nurses, social workers, educators) are unable to consistently make linkages; thus, numerous at-risk individuals are not benefitting from HIP...
March 1, 2018: Health Education & Behavior: the Official Publication of the Society for Public Health Education
William J Meurer, Bradley Barth, Michael Abraham, Jerome Hoffman, Gary M Vilke, Gerard DeMers
BACKGROUND: Stroke treatment is a continuum that begins with the rapid identification of symptoms and treatment with transition to successful rehabilitation. Therapies for acute ischemic stroke (AIS) may vary based on anatomic location, interval from symptom onset, and coexisting health conditions. Successful therapy requires a seamless systematic approach with coordination from prehospital environment through acute management at medical facilities to disposition and long-term care of the patient...
March 12, 2018: Journal of Emergency Medicine
Lauren Brinkley-Rubinstein, Nickolas Zaller, Sarah Martino, David H Cloud, Erin McCauley, Andrew Heise, David Seal
The United States (US) is in the midst of an epidemic of opioid use; however, overdose mortality disproportionately affects certain subgroups. For example, more than half of state prisoners and approximately two-thirds of county jail detainees report issues with substance use. Overdose is one of the leading causes of mortality among individuals released from correctional settings. Even though the criminal justice (CJ) system interacts with a disproportionately high number of individuals at risk of opioid use and overdose, few CJ agencies screen for opioid use disorder (OUD)...
February 24, 2018: Addictive Behaviors
Alexandra Wollum, Rose Gabert, Claire R McNellan, Jessica M Daly, Priscilla Reddy, Paurvi Bhatt, Miranda Bryant, Danny V Colombara, Pamela Naidoo, Belinda Ngongo, Anam Nyembezi, Zaino Petersen, Bryan Phillips, Shelley Wilson, Emmanuela Gakidou, Herbert C Duber
BACKGROUND: The HealthRise initiative seeks to implement and evaluate innovative community-based strategies for diabetes, hypertension and hypercholesterolemia along the entire continuum of care (CoC)-from awareness and diagnosis, through treatment and control. In this study, we present baseline findings from HealthRise South Africa, identifying gaps in the CoC, as well as key barriers to care for non-communicable diseases (NCDs). METHODS: This mixed-methods needs assessment utilized national household data, health facility surveys, focus group discussions, and key informant interviews in Umgungundlovu and Pixley ka Seme districts...
2018: PloS One
Bibb Allen, Mythreyi Chatfield, Judy Burleson, William T Thorwarth
In September of 2014, the American College of Radiology joined a number of other organizations in sponsoring the 2015 National Academy of Medicine report, Improving Diagnosis In Health Care. Our presentation to the Academy emphasized that although diagnostic errors in imaging are commonly considered to result only from failures in disease detection or misinterpretation of a perceived abnormality, most errors in diagnosis result from failures in information gathering, aggregation, dissemination and ultimately integration of that information into our patients' clinical problems...
September 26, 2017: Diagnosis
Marion Waite, Clare Martin, Rachel Franklin, David Duce, Rachel Harrison
BACKGROUND: People with type 1 diabetes (T1D) undertake self-management to prevent short and long-term complications. Advanced technology potentially supports such activities but requires consideration of psychological and behavioral constructs and usability issues. Economic factors and health care provider capacity influence access and uptake of advanced technology. Previous reviews have focused upon clinical outcomes or were descriptive or have synthesized studies on adults with those on children and young people where human factors are different...
March 15, 2018: JMIR Human Factors
William E Cunningham, Robert E Weiss, Terry Nakazono, Mark A Malek, Steve J Shoptaw, Susan L Ettner, Nina T Harawa
Importance: Diagnosis of human immunodeficiency virus (HIV) infection, linkage and retention in care, and adherence to antiretroviral therapy are steps in the care continuum enabling consistent viral suppression for people living with HIV, extending longevity and preventing further transmission. While incarcerated, people living with HIV receive antiretroviral therapy and achieve viral suppression more consistently than after they are released. No interventions have shown sustained viral suppression after jail release...
March 12, 2018: JAMA Internal Medicine
Zsolt J Nagykaldi, Huibert Tange, Jan De Maeseneer
Electronic health records (EHRs) have been in place for decades; however, most existing systems were designed in the prevailing disease- and payment-focused care paradigm that often loses sight of the goals, needs, and values of patients and clinicians. The goal-directed health care model was proposed more than 20 years ago, but no design principles have been developed for corresponding electronic record systems. Newly designed EHRs are needed to facilitate health care that is anchored by patient life and health goals...
March 2018: Annals of Family Medicine
Dea J Kent, Jody N Scardillo, Barbara Dale, Caitlin Pike
PURPOSE: The purpose of this article is to examine the evidence and provide recommendations for the use of clean or sterile dressing technique with dressing application to prevent wound infection. QUESTION: In all persons with acute or chronic wounds, does the use of clean or sterile dressing technique affect incidence of wound infection? SEARCH STRATEGY: A search of the literature was performed by a trained university librarian, which resulted in 473 articles that examined any age group that dealt with application of a wound dressing using either sterile or nonsterile technique...
March 9, 2018: Journal of Wound, Ostomy, and Continence Nursing
Emma Slaymaker, Estelle McLean, Alison Wringe, Clara Calvert, Milly Marston, Georges Reniers, Chodziwadziwa Whiteson Kabudula, Amelia Crampin, Alison Price, Denna Michael, Mark Urassa, Daniel Kwaro, Maquins Sewe, Jeffrey W Eaton, Rebecca Rhead, Jessica Nakiyingi-Miiro, Tom Lutalo, Dorean Nabukalu, Kobus Herbst, Victoria Hosegood, Basia Zaba
Timely progression of people living with HIV (PLHIV) from the point of infection through the pathway from diagnosis to treatment is important in ensuring effective care and treatment of HIV and preventing HIV-related deaths and onwards transmission of infection.  Reliable, population-based estimates of new infections are difficult to obtain for the generalised epidemics in sub-Saharan Africa.  Mortality data indicate disease burden and, if disaggregated along the continuum from diagnosis to treatment, can also reflect the coverage and quality of different HIV services...
November 6, 2017: Gates Open Res
Ronnye Rutledge, Lynn Madden, Onyema Ogbuagu, Jaimie P Meyer
Women involved in the criminal justice system (WICJ) are at high risk of acquiring HIV and would benefit from HIV pre-exposure prophylaxis (PrEP) but there are no studies in this population to inform PrEP implementation programs. We conducted a cross-sectional survey of HIV-uninfected, cis-gender women on probation, parole and/or recently released from prison/jail to assess PrEP awareness, eligibility, potential barriers to uptake, and the PrEP care continuum. The 125 WICJ surveyed reported high rates of HIV risk behaviors including recent transactional sex (22...
March 11, 2018: AIDS Care
R Modi, K R Amico, A Knudson, A O Westfall, J Keruly, H M Crane, E B Quinlivan, C Golin, J Willig, A Zinski, R Moore, S Napravnik, L Bryan, M S Saag, M J Mugavero
In the first year after HIV diagnosis, patients are simultaneously processing with their diagnosis, typically with an emotional component, while also developing a routine of regular medical care visits and antiretroviral therapy (ART) adherence. Maintaining "HIV adherence" and integrating it into one's daily life is required to sustain viral load suppression (VS) over time. The HIV care continuum or "treatment cascade," an epidemiological snapshot of the national epidemic in the United States (US), indicates that a minority of persons living with HIV (PLWH) have achieved VS...
March 8, 2018: Contemporary Clinical Trials
Lizhou Liu, Simone Petrich, Blair McLaren, Lyndell Kelly, G David Baxter
BACKGROUND: Breast cancer patients experience various side effects during cancer therapy, often resulting in reduced quality of life and poor adherence to treatment. A limited range of proven interventions has been developed to target such side effects. While Tai Chi offers benefits for the health and well-being of breast cancer survivors, the effectiveness of Tai Chi across the treatment continuum has not been evaluated. Improved patient education and support has been suggested as a priority for breast cancer care...
March 2018: Journal of Integrative Medicine
Sikhumbuzo A Mabunda, Leslie London, David Pienaar
BACKGROUND: A comprehensive primary healthcare (PHC) approach requires clear referral and continuity of care pathways. South Africa is a lower-middle income country (LMIC) that lacks data on the role of intermediate care (IC) services in the health system. This study described the model of service provision at one facility in Cape Town, including reason for admission, the mix of services and skills provided and needed, patient satisfaction, patient outcome and articulation with other services across the spectrum of care...
May 14, 2017: International Journal of Health Policy and Management
Abigail R Koch, Pamela T Roesch, Caitlin E Garland, Stacie E Geller
CONTEXT: Severe maternal morbidity (SMM) rates in the United States more than doubled between 1998 and 2010. Advanced maternal age and chronic comorbidities do not completely explain the increase in SMM or how to effectively address it. The Centers for Disease Control and Prevention and American College of Obstetricians and Gynecologists have called for facility-level multidisciplinary review of SMM for potential preventability and have issued implementation guidelines. IMPLEMENTATION: Within Illinois, SMM was identified as any intensive or critical care unit admission and/or 4 or more units of packed red blood cells transfused at any time from conception through 42 days postpartum...
March 7, 2018: Journal of Public Health Management and Practice: JPHMP
Sandra Braaf, Shanthi Ameratunga, Andrew Nunn, Nicola Christie, Warwick Teague, Rodney Judson, Belinda J Gabbe
BACKGROUND: Navigating complex health care systems during the multiple phases of recovery following major trauma entails many challenges for injured patients. Patients' experiences communicating with health professionals are of particular importance in this context. The aim of this study was to explore seriously injured patients' perceptions of communication with and information provided by health professionals in their first 3-years following injury. METHODS: A qualitative study designed was used, nested within a population-based longitudinal cohort study...
March 7, 2018: BMC Health Services Research
David Kershenobich, Aldo Torre-Delgadillo, Luz María Aguilar-Valenzuela
Chronic hepatitis C is often asymptomatic and may progress over the years to cirrhosis and hepatocellular carcinoma. Although the prevalence and incident cases are decreasing, the peak mortality of hepatitis C virus (HCV)-related complications is ahead of us in most countries. The economic impact of this burden is enormous. Scaling up the identification of new opportunities to facilitate the road toward HCV elimination includes increasing screening, awareness, and the number of prescribing physicians. Screening should occur within the context of linkage-to-care and patient retention across the care continuum...
2018: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
Filippo Baldacci, Simone Lista, Sid E O'Bryant, Roberto Ceravolo, Nicola Toschi, Harald Hampel
The discovery, development, and validation of novel candidate biomarkers in Alzheimer's disease (AD) and other neurodegenerative diseases (NDs) are increasingly gaining momentum. As a result, evolving diagnostic research criteria of NDs are beginning to integrate biofluid and neuroimaging indicators of pathophysiological mechanisms. More than 10% of people aged over 65 suffer from NDs. There is an urgent need for a refined two-stage diagnostic model to first initiate an early, sensitive, and noninvasive process in primary care settings...
2018: Methods in Molecular Biology
M J Rothmann, P R Jakobsen, C M Jensen, A P Hermann, A C Smith, J Clemensen
This systematic review provides synthesised knowledge and guidance to health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient's point of view. Using individuals' experiences and meanings can promote tailored and targeted information and guidance on osteoporosis, bone care and treatment at different stages of the osteoporosis trajectory. INTRODUCTION: To be diagnosed with osteoporosis with or without fragility fractures affects individuals differently...
March 6, 2018: Archives of Osteoporosis
Preeti Pathela, Kelly Jamison, Sarah L Braunstein, Julia A Schillinger, Olga Tymejczyk, Denis Nash
BACKGROUND: Linkage/re-linkage to HIV care for virally unsuppressed persons with new sexually transmitted infections is critical for ending the HIV epidemic. We quantified HIV care continuum gaps, and viral suppression, among HIV-positive patients attending New York City (NYC) sexual health clinics (SHC). METHODS: 1,649 HIV-positive patients and a 10% sample of 11,954 patients with unknown HIV status on clinic visit date (DOV) were matched against the NYC HIV registry...
March 2, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
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