Meet–Test–Treat for HCV management: patients’ and clinicians’ preferences in hospital and drug addiction services in Italy

Abstract Background It has been estimated that the incidence of chronic hepatitis C virus (HCV) will not decline over the next 10 years despite the improved efficacy of antiviral therapy because most patients remain undiagnosed and/or untreated. This study aimed to investigate the opinion of relevant target populations on the practicability, effectiveness and best modalities of the test-and-treat approach in the fight against HCV in Italy. Methods A survey was delivered to patients with HCV from the general population, patients from drug addiction services, hospital physicians and healthcare providers for drug addiction services. Results For both hospital clinicians and SerD HCPs, tolerability is shown as the most important feature of a suitable treatment. Time to treatment (the time from first contact to initiation of treatment) is deemed important to the success of the strategy by all actors. While a tolerable treatment was the main characteristic in a preferred care pathway for general patients, subjects from drug addiction services indicated that a complete Meet–Test–Treat pathway is delivered within the habitual care center as a main preference. This is also important for SerD HCPs who are a strong reference for their patients; hospital clinicians were less aware of the importance of the patient-HCP relationship in this process. Conclusion The health system is bound to implement suitable pathways to facilitate HCV eradication. A Meet–Test–Treat program within the drug addiction services may provide good compliance from subjects mainly concerned with virus transmission.

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Impact of Proactive Case Management by Multiple Sclerosis Specialist Nurses on Use of Unscheduled Care and Emergency Presentation in Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073.2014-011 ◽

2015 ◽

Vol 17 (4) ◽

pp. 159-163 ◽

Cited By ~ 7

Author(s):

Alison Leary ◽

Debbie Quinn ◽

Amy Bowen

Keyword(s):

Multiple Sclerosis ◽

United Kingdom ◽

Hospital Admissions ◽

Care Pathway ◽

Care Center ◽

Emergency Presentation ◽

The United Kingdom ◽

Proactive Management ◽

Bed Days ◽

The Impact

Background: Multiple sclerosis (MS) affects approximately 100,000 people in the United Kingdom, with rising emergency admissions to the hospital. The multiple sclerosis specialist nurse plays a pivotal role in managing MS care in the United Kingdom, and there is anecdotal evidence that this role can help avoid emergency presentations and unnecessary hospital admissions. Methods: A retrospective service evaluation took place in one established MS nursing service. The impact of the introduction of proactive nurse-led management and a rapid response service on rates of emergency presentation, hospital admission, and bed use was examined. The primary intervention was the introduction of extra nursing hours (6 hours per week) and the reallocation of some routine administrative duties, which allowed the service to move to a proactive management model aimed at avoiding the need for unplanned care. In addition, a care pathway was implemented in the emergency department for patients with MS who did present. Results: Reduction in utilization was from a mean of 2700 bed-days per year (2002–2006) to a mean of 198 bed-days per year (2007–2013). Conclusions: During a 10-year period, moving from reactive management to proactive management demonstrated an increase in complex specialist nursing interventions and led to a decrease in emergency presentation and bed use at the local acute-care center.

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Covid-19 prevention by adopting a healthy daily lifestyle

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20204396 ◽

2020 ◽

Vol 7 (10) ◽

pp. 4207

Author(s):

Monalisa Mahajan

Keyword(s):

Preventive Measures ◽

Virus Disease ◽

Healthcare Providers ◽

Virus Transmission ◽

Public Health Emergency ◽

Pharmaceutical Treatment ◽

Safety Measures ◽

Susceptible Population ◽

The People ◽

Novel Coronavirus

The corona virus disease caused by novel coronavirus SARAS-Cov2 is a public health emergency of international concern. Numerous measures have been implemented in many countries to reduce the person to person virus transmission as well as the outbreak. The specific focus of preventive measures is more on the susceptible population of children, healthcare providers, and older people. Many of the people practice safety measures without proper knowledge as to whether these measures are sufficient or not to prevent the spread of the virusAs of this time there has no effective pharmaceutical treatment, there should be adopt a way of prevention that is much helpful than cure.

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Incorporation of Magnetite in Toughened PLA Nanocomposite: Tensile and Thermal Stability

Materials Science Forum ◽

10.4028/www.scientific.net/msf.1048.15 ◽

2022 ◽

Vol 1048 ◽

pp. 15-20

Author(s):

Ruey Shan Chen ◽

Sahrim Ahmad

Keyword(s):

Thermal Stability ◽

Tensile Testing ◽

Treatment Time ◽

Optimum Distribution ◽

Melt Compounding ◽

The Matrix ◽

Liquid Natural Rubber ◽

Suitable Treatment ◽

Ultrasonication Time ◽

Internal Mixer

In this study, liquid natural rubber (LNR) toughened polylactic acid (PLA) incorporated with magnetite (Fe3O4) nanocomposites were fabricated via melt-compounding in an internal mixer and followed by hot/cold pressing. The effects of ultrasonic treatment time (1-3 hours) and Fe3O4 (0.5-4.0 wt%) nanoparticles loading on tensile, morphology and thermal stability were investigated. Based on tensile testing results, the ultrasonication time of 1 hour was served as the most suitable treatment period to achieve the optimum distribution of Fe3O4 within PLA/LNR matrix. Among the investigated nanoparticles loading, 1 wt% Fe3O4 nanocomposite presented the highest tensile strength of 23.7 MPa, Young’s modulus of 1293.5 MPa and strain at break of 2.8%. SEM micrographs showed that the over-treated nanocomposites with 2-3 hours and over-high nanoparticles loading had resulted in the formation of clusters in the matrix. With increasing Fe3O4 loading, the decomposition of PLA/LNR nanocomposites was initiated earlier.

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An Assessment of the Representativeness of the SSI DA&A Study Panels

Contemporary Drug Problems ◽

10.1177/00914509030301-205 ◽

2003 ◽

Vol 30 (1-2) ◽

pp. 123-136 ◽

Cited By ~ 10

Author(s):

David Wittenburg ◽

David Stapleton ◽

Adam Tucker ◽

Rick Harwood

Keyword(s):

Drug Addiction ◽

Supplemental Security Income ◽

Study Data ◽

Administrative Records ◽

National Population ◽

Target Populations ◽

Drugs And Alcohol ◽

Catchment Areas ◽

Study Sites ◽

Age Range

In this study, we used data derived from SSA administrative records to compare the composition of study panels, study samples, and the national population of former recipients of Supplemental Security Income (SSI) for drug addiction and alcoholism (DA&A). We found that the panels represented the selected samples in the nine-study sites in terms of demographics, SSI program status, and medical eligibility. However, the selected samples varied in how well they represented their target populations. Additionally, compared with the national DA&A population, SSI Study respondents were more likely to be black, to abuse both drugs and alcohol, to be more concentrated in the 30-49 age range, and to have been medically eligible for SSI in January and June 1997. Thus while the SSI Study data can be used to draw inferences about former DA&A SSI-only recipients in the study catchment areas, results should not be assumed to apply to the national population of such recipients.

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Criminal justice pathways to psychiatric care for psychosis

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.153882 ◽

2015 ◽

Vol 207 (6) ◽

pp. 523-529 ◽

Cited By ~ 12

Author(s):

Kamaldeep Bhui ◽

Simone Ullrich ◽

Constantinos Kallis ◽

Jeremy W. Coid

Keyword(s):

Criminal Justice ◽

Drug Use ◽

Psychiatric Care ◽

Care Pathway ◽

Population Based ◽

First Episode ◽

Black African ◽

Black Caribbean ◽

African Patients ◽

First Contact

BackgroundSome patients are at higher risk of contact with criminal justice agencies when experiencing a first episode of psychosis.AimsTo investigate whether violence explains criminal justice pathways (CJPs) for psychosis in general, and ethnic vulnerability to CJPs.MethodTwo-year population-based survey of people presenting with a first-episode of psychosis. A total of 481 patients provided information on pathways to psychiatric care. The main outcome was a CJP at first contact compared with other services on the care pathway.ResultsCJPs were more common if there was violence at first presentation (odds ratio (OR) = 4.23, 95% CI 2.74–6.54, P<0.001), drug use in the previous year (OR = 2.28, 95% CI 1.50–3.48, P<0.001) and for high psychopathy scores (OR = 2.54, 95% CI 1.43–4.53, P = 0.002). Compared with White British, CJPs were more common among Black Caribbean (OR = 2.97, 95% CI 1.54–5.72, P<0.001) and Black African patients (OR = 1.95, 95% CI 1.02–3.72, P = 0.01). Violence mediated 30.2% of the association for Black Caribbeans, but was not a mediator for Black African patients. These findings were sustained after adjustment for age, marital status, gender and employment.ConclusionsCJPs were more common in violent presentations, for greater psychopathy levels and drug use. Violence presentations did not fully explain ethnic vulnerability to CJPs.

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Consumer Input in the Evaluation of Drug Addiction Services

International Journal of the Addictions ◽

10.3109/10826088109038819 ◽

1981 ◽

Vol 16 (1) ◽

pp. 165-171 ◽

Cited By ~ 4

Author(s):

Joyce H. Lowinson ◽

Pedro Ruiz ◽

John Langrod ◽

Humberto L. Martinez

Keyword(s):

Drug Addiction ◽

Addiction Services

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Postnatally Acquired Zika Virus Disease Among Children, United States, 2016–2017

Clinical Infectious Diseases ◽

10.1093/cid/ciz195 ◽

2019 ◽

Vol 70 (2) ◽

pp. 227-231 ◽

Cited By ~ 4

Author(s):

Nicole P Lindsey ◽

Charsey C Porse ◽

Emily Potts ◽

Judie Hyun ◽

Kayleigh Sandhu ◽

...

Keyword(s):

Zika Virus ◽

Virus Disease ◽

Healthcare Providers ◽

Clinical Signs ◽

Virus Transmission ◽

Signs And Symptoms ◽

Clinical Findings ◽

Case Definition ◽

Illness Onset ◽

Clinical Signs And Symptoms

Abstract Background The clinical findings among children with postnatally acquired Zika virus disease are not well characterized. We describe and compare clinical signs and symptoms for children aged <18 years. Methods Zika virus disease cases were included if they met the national surveillance case definition, had illness onset in 2016 or 2017, resided in a participating state, and were reported to the Centers for Disease Control and Prevention. Pediatric cases were aged <18 years; congenital and perinatal infections were excluded. Pediatric cases were matched to adult cases (18‒49 years). Clinical information was compared between younger and older pediatric cases and between children and adults. Results A total of 141 pediatric Zika virus disease cases were identified; none experienced neurologic disease. Overall, 28 (20%) were treated in an emergency department, 1 (<1%) was hospitalized; none died. Of the 4 primary clinical signs and symptoms associated with Zika virus disease, 133 (94%) children had rash, 104 (74%) fever, 67 (48%) arthralgia, and 51 (36%) conjunctivitis. Fever, arthralgia, and myalgia were more common in older children (12‒17 years) than younger children (1‒11 years). Arthralgia, arthritis, edema, and myalgia were more common in adults compared to children. Conclusions This report supports previous findings that Zika virus disease is generally mild in children. The most common symptoms are similar to other childhood infections, and clinical findings and outcomes are similar to those in adults. Healthcare providers should consider a diagnosis of Zika virus infection in children with fever, rash, arthralgia, or conjunctivitis, who reside in or have traveled to an area where Zika virus transmission is occurring.

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Predictive values of referrals for transient ischaemic attack from first-contact health care: a systematic review

British Journal of General Practice ◽

10.3399/bjgp17x693677 ◽

2017 ◽

Vol 67 (665) ◽

pp. e871-e880 ◽

Cited By ~ 4

Author(s):

Rebecca Kandiyali ◽

Daniel S Lasserson ◽

Penny Whiting ◽

Alison Richards ◽

Jonathan Mant

Keyword(s):

Systematic Review ◽

Transient Ischaemic Attack ◽

Care Pathway ◽

Recurrent Stroke ◽

Sufficient Information ◽

Vascular Events ◽

Predictive Values ◽

Number Of Patients ◽

Ischaemic Attack ◽

First Contact

BackgroundOver 150 000 cases of suspected transient ischaemic attack (TIA) are referred to outpatient clinics in England each year. The majority of referrals are made by GPs.AimThis study aimed to identify how many patients referred to a TIA clinic actually have TIA (that is, calculate the positive predictive value [PPV] of first-contact healthcare referral) and to record the alternative diagnoses in patients without TIA, in order to determine the optimal service model for patients with suspected TIA.Design and settingA systematic review of TIA clinic referrals from first-contact health professionals (GPs and emergency department [ED] doctors) was undertaken.MethodFour databases were searched using terms for TIA and diagnostic accuracy. Data on the number of patients referred to a TIA clinic who actually had a TIA (PPVs) were extracted. Frequencies of differential diagnoses were recorded, where reported. Study quality was assessed using the QUADAS-2 tool.ResultsNineteen studies were included and reported sufficient information on referrals from GPs and ED doctors to derive PPVs (n = 15 935 referrals). PPVs for TIA ranged from 12.9% to 72.5%. A formal meta-analysis was not conducted due to heterogeneity across studies. Of those not diagnosed with TIA, approximately half of the final diagnoses were of neurological or cardiovascular conditions.ConclusionThis study highlights the variation in prevalence of true vascular events in patients referred to TIA clinics. For patients without a cerebrovascular diagnosis, the high prevalence of conditions that also require specialist investigations and management are an additional burden on a care pathway that is primarily designed to prevent recurrent stroke. Service commissioners need to assess whether the existing outpatient provision is optimal for people with pathologies other than cerebrovascular disease.

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Who should be Prioritized for COVID-19 Vaccination in China? A Descriptive Study

10.20944/preprints202009.0446.v1 ◽

2020 ◽

Author(s):

Juan Yang ◽

Wen Zheng ◽

Huilin Shi ◽

Xuemei Yan ◽

Kaige Dong ◽

...

Keyword(s):

Healthcare Workers ◽

Virus Transmission ◽

Descriptive Study ◽

Health Conditions ◽

Policy Makers ◽

Target Populations ◽

Vaccination Strategies ◽

Vaccine Product ◽

Essential Services ◽

Chinese Policy

All countries are facing decisions about which groups to prioritise for COVID-19 vaccination after the first vaccine product has been licensed, at which time supply shortages are inevitable. Here we define the key target populations and their size in China for a phased introduction of COVID-19 vaccination with evolving goals, accounting for the risk of illness and transmission. Essential workers (47.2 million) like healthcare workers could be prioritized for vaccination to maintain essential services. Subsequently, older adults, individuals with underlying health conditions and pregnant women (616.0 million) could be targeted to reduce severe COVID-19 outcomes. Then it could be further extended to target adults without underlying health conditions and children (738.7 million) to reduce symptomatic infections and/or to stop virus transmission. The proposed framework could assist Chinese policy-makers in the design of a vaccination program, and could be generalized to inform other national and regional COVID-19 vaccination strategies.

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