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https://www.readbyqxmd.com/read/28107703/how-universal-is-coverage-and-access-to-diagnosis-and-treatment-for-chagas-disease-in-colombia-a-health-systems-analysis
#1
Zulma M Cucunubá, Jennifer M Manne-Goehler, Diana Díaz, Pierre Nouvellet, Oscar Bernal, Andrea Marchiol, María-Gloria Basáñez, Lesong Conteh
Limited access to Chagas disease diagnosis and treatment is a major obstacle to reaching the 2020 World Health Organization milestones of delivering care to all infected and ill patients. Colombia has been identified as a health system in transition, reporting one of the highest levels of health insurance coverage in Latin America. We explore if and how this high level of coverage extends to those with Chagas disease, a traditionally marginalised population. Using a mixed methods approach, we calculate coverage for screening, diagnosis and treatment of Chagas...
January 4, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28100562/healthcare-organisation-and-delivery-for-people-with-dementia-and-comorbidity-a-qualitative-study-exploring-the-views-of-patients-carers-and-professionals
#2
Frances Bunn, Anne-Marie Burn, Louise Robinson, Marie Poole, Greta Rait, Carol Brayne, Johan Schoeman, Sam Norton, Claire Goodman
OBJECTIVES: People living with dementia (PLWD) have a high prevalence of comorbidty. The aim of this study was to explore the impact of dementia on access to non-dementia services and identify ways of improving service delivery for this population. DESIGN: Qualitative study involving interviews and focus groups. Thematic content analysis was informed by theories of continuity of care and access to care. SETTING: Primary and secondary care in the South and North East of England...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28100208/access-to-primary-health-care-for-acute-vascular-events-in-rural-low-income-settings-a-mixed-methods-study
#3
Shyfuddin Ahmed, Muhammad Ashique Haider Chowdhury, Md Alfazal Khan, Nafisa Lira Huq, Aliya Naheed
BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of global mortality. Among the CVDs, acute vascular events (AVE) mainly ischemic heart diseases and stroke are the largest contributors. To achieve 25% reduction in preventable deaths from CVDs by 2025, health systems need to be equipped with extended service coverage in order to provide person-centered care. The overall goal of this proposed study is to assess access to health care in-terms of service availability, care seeking patterns and barriers to access care after AVE in rural Bangladesh...
January 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28100143/end-of-life-in-high-security-prisons-in-switzerland
#4
Irene Marti, Ueli Hostettler, Marina Richter
Similar to other institutions, the Swiss prison system faces a growing number of elderly prisoners, trends toward securitization, and, in consequence, more prisoners who will spend the end-of-life (EOL) period of time in prison. By law, prisoners should have the same access to care as the rest of the population. However, custody makes meeting the demands of medical and palliative care difficult. This article focuses on the organizational challenges related to EOL care. Based on ethnographic and documentary research, it examines the institutional logic of the prison and the competing "new" logic emerging with EOL care...
January 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28096064/evaluation-of-financial-burdens-following-complications-after-major-surgery-in-france-potential-returns-after-perioperative-goal-directed-therapy
#5
Alain Landais, Morgane Morel, Jacques Goldstein, Jerôme Loriau, Annie Fresnel, Corinne Chevalier, Gilles Rejasse, Pascal Alfonsi, Claude Ecoffey
OBJECTIVE: Perioperative goal directed therapy (PGDT) has been demonstrated to improve postoperative outcomes and reduce the length of hospital stays. The objective of our analysis was to evaluate the cost of complications, derived from French hospital payments, and calculate the potential cost savings and length of hospital stay reductions. METHODS: The billing of 2,388 patients who underwent scheduled high-risk surgery (i.e. major abdominal, gynaecologic, urological, vascular, and orthopaedic interventions) over three years was retrospectively collected from three French hospitals (one public - teaching, one public, and one private hospital)...
January 13, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28086893/seasonal-variation-in-geographical-access-to-maternal-health-services-in-regions-of-southern-mozambique
#6
Prestige Tatenda Makanga, Nadine Schuurman, Charfudin Sacoor, Helena Edith Boene, Faustino Vilanculo, Marianne Vidler, Laura Magee, Peter von Dadelszen, Esperança Sevene, Khátia Munguambe, Tabassum Firoz
BACKGROUND: Geographic proximity to health facilities is a known determinant of access to maternal care. Methods of quantifying geographical access to care have largely ignored the impact of precipitation and flooding. Further, travel has largely been imagined as unimodal where one transport mode is used for entire journeys to seek care. This study proposes a new approach for modeling potential spatio-temporal access by evaluating the impact of precipitation and floods on access to maternal health services using multiple transport modes, in southern Mozambique...
January 13, 2017: International Journal of Health Geographics
https://www.readbyqxmd.com/read/28076631/targeting-stroke-risk-and-improving-outcomes-in-patients-with-atrial-fibrillation-in-latin-america
#7
Bruce Stambler, Fernando Scazzuso
CONTEXT AND OBJECTIVE: To examine stroke risk factors, including atrial fibrillation, management and prevention, and stroke outcomes across Latin America. DESIGN AND SETTING: Narrative review conducted at Piedmont Heart Institute, United States. METHODS: The PubMed, Embase and Cochrane databases were searched for stroke AND "Latin America" AND epidemiology (between January 2009 and March 2015). Further studies in the SciELO, World Health Organization and Pan-American Health Organization databases were used to address specific points...
November 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28075641/the-transgender-women-of-color-initiative-implementing-and-evaluating-innovative-interventions-to-enhance-engagement-and-retention-in-hiv-care
#8
Gregory Rebchook, JoAnne Keatley, Robert Contreras, Judy Perloff, Luis Freddy Molano, Cathy J Reback, Kelly Ducheny, Tooru Nemoto, Royce Lin, Jeffrey Birnbaum, Tiffany Woods, Jessica Xavier
To improve health outcomes among transgender women of color living with HIV, the Health Resources and Services Administration's Special Programs of National Significance program funded the Enhancing Engagement and Retention in Quality HIV Care for Transgender Women of Color Initiative in 2012. Nine demonstration projects in four US urban areas implemented innovative, theory-based interventions specifically targeting transgender women of color in their jurisdictions. An evaluation and technical assistance center was funded to evaluate the outcomes of the access to care interventions, and these findings will yield best practices and lessons learned to improve the care and treatment of transgender women of color living with HIV infection...
February 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28070913/does-identification-of-previously-undiagnosed-conditions-change-care-seeking-behavior
#9
Rebecca M Myerson, Lisandro D Colantonio, Monika M Safford, Elbert S Huang
OBJECTIVE: To determine whether identification of previously undiagnosed high cholesterol, hypertension, and/or diabetes during an in-home assessment impacts care seeking among Medicare beneficiaries. DATA SOURCES/STUDY SETTING: Data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, which recruited African American and white participants across the continental United States from 2003-2007, were linked to Medicare claims. STUDY DESIGN: We used panel data models to analyze changes in doctor visits for evaluation and management of conditions after participants were assessed, utilizing the study's rolling recruitment to control for secular trends...
January 10, 2017: Health Services Research
https://www.readbyqxmd.com/read/28068907/hospitalized-care-for-mdr-tb-in-port-harcourt-nigeria-a-qualitative-study
#10
Kingsley Lezor Bieh, Ralf Weigel, Helen Smith
BACKGROUND: In Nigeria multidrug-resistant tuberculosis (MDR-TB) is prevalent in 2.9% of new TB cases and 14% of retreatment cases, and the country is one of 27 with high disease burden globally. Patients are admitted and confined to one of ten MDR-TB treatment facilities throughout the initial 8 months of treatment. The perspectives of MDR-TB patients shared on social media and in academic research and those of providers are limited to experiences of home-based care. In this study we explored the views of hospitalised MDR-TB patients and providers in one treatment facility in Nigeria, and describe how their experiences are linked to accessibility of care and support services, in line with international goals...
January 10, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28065799/experiences-in-care-by-parental-citizenship-and-language-use-among-latino-children-in-california
#11
Alexander N Ortega, Ryan M McKenna, Brent A Langellier, Héctor E Alcalá, Dylan H Roby
OBJECTIVE: To assess differences in healthcare access, utilization, and experiences among Latino children in California by parental citizenship status and language use. METHODS: Data are from the 2011 and 2012 California Health Interview Survey (CHIS) public use child files. A total of 2,841 interviews of parents of Latino children under the age of twelve years were conducted. Analyses were conducted to determine the associations between access (usual of source of care, delay in receiving needed care, health insurance), utilization (physician visits in past year, emergency department visits) and experiences (doctor listens, doctor explains instructions clearly, communication by telephone or email) by parental citizenship status and household language use after adjusting for confounders...
January 5, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28065558/the-availability-of-community-health-center-services-and-access-to-medical-care
#12
James B Kirby, Ravi Sharma
BACKGROUND: Community Health Centers (CHCs) funded by Section 330 of the Public Health Service Act are an essential part of the health care safety net in the US. The Patient Protection and Affordable Care Act expanded the program significantly, but the extent to which the availability of CHCs improve access to care in general is not clear. In this paper, we examine the associations between the availability of CHC services in communities and two key measures of ambulatory care access - having a usual source of care and having any office-based medical visits over a one year period...
January 5, 2017: Healthcare
https://www.readbyqxmd.com/read/28064508/assessing-the-effect-of-pharmacist-care-on-diabetes-related-outcomes-in-a-rural-outpatient-clinic
#13
Cynthia Moreau, Karen R Sando, Daniel H Zambrano
BACKGROUND: The care of diabetic patients in rural areas is complicated by factors such as poor health literacy, cultural barriers, and primary care provider (PCP) shortages. Integrating pharmacist care in diabetes management in these settings may increase access to care and improve patient outcomes. OBJECTIVE: To evaluate differences in diabetes-related outcomes in patients with type 2 diabetes (T2DM) managed by a pharmacist diabetes clinic compared with patients only managed by PCPs in a rural family medicine clinic...
December 1, 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28060177/influence-of-insurance-type-on-the-access-to-pediatric-care-for-children-with-distal-radius-torus-fractures
#14
Harrison Potak, Christopher A Iobst
BACKGROUND: Previous literature has demonstrated that pediatric orthopaedic patients with private insurance have less difficulty obtaining appointments than those with Medicaid. Not all injuries of an orthopaedic nature, however, require specialist care. This study evaluated the willingness of pediatricians to provide care for minor orthopaedic injuries and whether or not the patient's insurance status influenced the decision to provide care. METHODS: Ninety-nine pediatric primary care offices were randomly selected from 2 regions in Florida...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28057388/evaluation-of-focused-obstetric-ultrasound-examinations-by-health-care-personnel-in-the-democratic-republic-of-congo-guatemala-kenya-pakistan-and-zambia
#15
Robert O Nathan, Jonathan O Swanson, David L Swanson, Elizabeth M McClure, Victor Lokomba Bolamba, Adrien Lokangaka, Irma Sayury Pineda, Lester Figueroa, Walter López-Gomez, Ana Garces, David Muyodi, Fabian Esamai, Nancy Kanaiza, Waseem Mirza, Farnaz Naqvi, Sarah Saleem, Musaku Mwenechanya, Melody Chiwila, Dorothy Hamsumonde, Dennis D Wallace, Holly Franklin, Robert L Goldenberg
Prior studies have suggested that obstetrical (OB) ultrasound in low- and middle-income countries has aided in detection of high-risk conditions, which in turn could improve OB management. We are participating in a cluster-randomized clinical trial of OB ultrasound, which is designed to assess the effect of basic OB ultrasound on maternal mortality, fetal mortality, neonatal mortality, and maternal near-miss in 5 low-income countries. We designed a 2-week course in basic OB ultrasound, followed by 12 weeks of oversight, to train health care professionals with no prior ultrasound experience to perform basic OB ultrasound to screen for high-risk pregnancies...
November 10, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28055103/cancer-statistics-2017
#16
Rebecca L Siegel, Kimberly D Miller, Ahmedin Jemal
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data were collected by the National Center for Health Statistics. In 2017, 1,688,780 new cancer cases and 600,920 cancer deaths are projected to occur in the United States...
January 2017: CA: a Cancer Journal for Clinicians
https://www.readbyqxmd.com/read/28052820/disparities-in-obesity-physical-activity-rates-and-breast-cancer-survival
#17
M E Ford, G Magwood, E T Brown, K Cannady, M Gregoski, K D Knight, L L Peterson, R Kramer, A Evans-Knowell, D P Turner
The significantly higher breast cancer (BCa) mortality rates of African-American (AA) women compared to non-Hispanic (NHW) white women constitute a major US health disparity. Investigations have primarily focused on biological differences in tumors to explain more aggressive forms of BCa in AA women. The biology of tumors cannot be modified, yet lifestyle changes can mitigate their progression and recurrence. AA communities have higher percentages of obesity than NHWs and exhibit inefficient access to care, low socioeconomic status, and reduced education levels...
2017: Advances in Cancer Research
https://www.readbyqxmd.com/read/28047409/su-f-t-37-dosimetric-evaluation-of-planned-versus-decay-corrected-treatment-plans-for-the-treatment-of-tandem-based-cervical-hdr-brachytherapy
#18
M Goyal, J Manjhi, T Kehwar, D Rai, J Barker, B Heintz, K Shide
PURPOSE: This study evaluated dosimetric parameters for actual treatment plans versus decay corrected treatment plans for cervical HDR brachytherapy. METHODS: 125 plans of 25 patients, who received 5 fractions of HDR brachytherapy, were evaluated in this study. Dose was prescribed to point A (ICRU-38) and High risk clinical tumor volume (HR-CTV) and organs at risk (OAR) were, retrospectively, delineated on original CT images by treating physician. First HDR plan was considered as reference plan and decay correction was applied to calculate treatment time for subsequent fractions, and was applied, retrospectively, to determine point A, HR-CTV D90, and rectum and bladder doses...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28040840/black-patients-with-colorectal-cancer-have-more-advanced-cancer-stage-at-time-of-diagnosis-a-community-based-safety-net-hospital-experience
#19
Chuck Chan, Aristeo Lopez, Garland Castaneda, Taft Bhuket, Benny Liu, Stephen Yee, David Irwin, Robert J Wong
Colorectal cancer (CRC) remains a leading cause of morbidity and mortality in the U.S. Disparities in access to care contribute to advanced CRC stage at diagnosis, and these disparities are most pronounced among underserved populations and ethnic minorities. We aim to evaluate race/ethnicity-specific disparities in CRC stage at diagnosis among an ethnically diverse, urban safety-net hospital. We retrospectively evaluated all adult CRC patients diagnosed from January 1, 2009 to October 1, 2015. CRC cases were confirmed by histopathology specimens from biopsies and/or surgical resection...
December 31, 2016: Journal of Community Health
https://www.readbyqxmd.com/read/28031959/averting-the-legacy-of-kidney-disease-focus-on-childhood
#20
REVIEW
Julie R Ingelfinger, Kamyar Kalantar-Zadeh, Franz Schaefer
World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD) in childhood differs from that in adults, as the largest diagnostic group among children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease in the setting of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertension and CKD in later childhood or in adult life...
June 2016: Future Science OA
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