scholarly journals Enhanced Surveillance in a Digital Health Landscape: The Role of the Near-Real Time Right to Care Knowledge Centre within South Africa’s APACE HIV Program

2021 ◽  
Author(s):  
Pisa Pedro ◽  
Potgieter Melinda ◽  
Rennick Marcus ◽  
Chuka Onaga ◽  
Seithati Molefi ◽  
...  
Keyword(s):  
International Development ◽  
Real Time ◽  
Patient Outcomes ◽  
Retention In Care ◽  
The United States ◽  
Hiv Care ◽  
Business Practices ◽  
Program Performance ◽  
Significant Difference ◽  
The Impact

Abstract Introduction: Right to Care (RTC), through support from the United States Agency for International Development (USAID) implements innovations that improve data accessibility and utilization for improved program performance and patient outcomes for large scale HIV care and treatment programs. Frequent and accessible data, coupled with changes to business practices to use that data, allow for targeted and timely HIV program interventions that impact patient outcomes in Ehlanzeni district, Mpumalanga, South Africa.Methods: In South Africa, within the USAID Accelerating Program Achievements to Control the Epidemic (APACE) program, the Knowledge Centre (KC) – an interoperable automated data warehouse and visualization near real-time solution - allow for rapid daily assessment of over- and under-performance cross-sectionally. The authors established the impact of the KC intervention for 29 USAID-selected Siyenza facilities, before the KC intervention (Dec 2018 to Feb 2019) compared to HIV outcomes during the KC intervention (March 2019 to May 2019), stratified by facility classification as included or not included in the Siyenza program using both non-parametric and parametric methodologies.Results: Average facility ART initiations increased by 16% from a monthly average of 54 new initiations pre-Siyenza to 62 new ART initiations during Siyenza; retention increased to a net retention in care ratio of 1.15 indicating that patients labelled as lost to care were brought back. An independent-samples t-test indicated that the net retention in care scores were significantly higher for Siyenza facilities (M =.379, SD =.808) compared to non-Siyenza facilities (M=-.061, SD =1.016), t(208) = 2.224, p < 0.027, d = .445 during the Siyenza period. A significant difference was noted between the means with a 62.3% chance that the Siyenza facilities have a higher observed mean than the non-Siyenza facilities during the intervention period. Results indicate that Siyenza facilities maintain cohort growth, while non-Siyenza facilities continued to lose patients. Conclusion: The accessibility and utilization of near to real-time interoperable data within HIV programs allowed for rapid responses to program performance, needs and improved patient outcomes. Daily data review meetings facilitated precision programming and contributed to the behavior change necessary to institute routine data use for decision making and evaluations within programs.

Anne O. Krueger, Constantine Michalopoulos and Vernon W. Ruttan. Aid and Development. Baltimore: The Johns Hopkins University Press. 1989. xiv + 386 pp.Price: U.S. $ 52.00

1991 ◽  
Vol 30 (2) ◽  
pp. 213-217
Author(s):  
Mir Annice Mahmood
Keyword(s):  
United States ◽  
Economic Development ◽  
International Development ◽  
Western Europe ◽  
Development Assistance ◽  
The United States ◽  
Social Infrastructure ◽  
Low Literacy ◽  
The Subject ◽  
The Impact

Foreign aid has been the subject of much examination and research ever since it entered the economic armamentarium approximately 45 years ago. This was the time when the Second World War had successfully ended for the Allies in the defeat of Germany and Japan. However, a new enemy, the Soviet Union, had materialized at the end of the conflict. To counter the threat from the East, the United States undertook the implementation of the Marshal Plan, which was extremely successful in rebuilding and revitalizing a shattered Western Europe. Aid had made its impact. The book under review is by three well-known economists and is the outcome of a study sponsored by the Department of State and the United States Agency for International Development. The major objective of this study was to evaluate the impact of assistance, i.e., aid, on economic development. This evaluation however, was to be based on the existing literature on the subject. The book has five major parts: Part One deals with development thought and development assistance; Part Two looks at the relationship between donors and recipients; Part Three evaluates the use of aid by sector; Part Four presents country case-studies; and Part Five synthesizes the lessons from development assistance. Part One of the book is very informative in that it summarises very concisely the theoretical underpinnings of the aid process. In the beginning, aid was thought to be the answer to underdevelopment which could be achieved by a transfer of capital from the rich to the poor. This approach, however, did not succeed as it was simplistic. Capital transfers were not sufficient in themselves to bring about development, as research in this area came to reveal. The development process is a complicated one, with inputs from all sectors of the economy. Thus, it came to be recognized that factors such as low literacy rates, poor health facilities, and lack of social infrastructure are also responsible for economic backwardness. Part One of the book, therefore, sums up appropriately the various trends in development thought. This is important because the book deals primarily with the issue of the effectiveness of aid as a catalyst to further economic development.

Diabetes Discharge Planning and Transitions of Care: A Focused Review

2019 ◽  
Vol 15 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Robin L. Black ◽  
Courtney Duval
Keyword(s):  
Patient Outcomes ◽  
Hospital Admissions ◽  
Discharge Planning ◽  
Medication Management ◽  
Hospital Readmissions ◽  
The United States ◽  
Transitions Of Care ◽  
Discharge Process ◽  
The Impact ◽  
Diabetes Patients

Background: Diabetes is a growing problem in the United States. Increasing hospital admissions for diabetes patients demonstrate the need for evidence-based care of diabetes patients by inpatient providers, as well as the importance of continuity of care when transitioning patients from inpatient to outpatient providers. Methods: A focused literature review of discharge planning and transitions of care in diabetes, conducted in PubMed is presented. Studies were selected for inclusion based on content focusing on transitions of care in diabetes, risk factors for readmission, the impact of inpatient diabetes education on patient outcomes, and optimal medication management of diabetes during care transitions. American Diabetes Association (ADA) guidelines for care of patients during the discharge process are presented, as well as considerations for designing treatment regimens for a hospitalized patient transitioning to various care settings. Results: Multiple factors may make transitions of care difficult, including poor communication, poor patient education, inappropriate follow-up, and clinically complex patients. ADA recommendations provide guidance, but an individualized approach for medication management is needed. Use of scoring systems may help identify patients at higher risk for readmission. Good communication with patients and outpatient providers is needed to prevent patient harm. A team-based approach is needed, utilizing the skills of inpatient and outpatient providers, diabetes educators, nurses, and pharmacists. Conclusion: Structured discharge planning per guideline recommendations can help improve transitions in care for patients with diabetes. A team based, patient-centered approach can help improve patient outcomes by reducing medication errors, delay of care, and hospital readmissions.

Abstract 257: Urban Teaching and Non-Teaching Hospitals Outcomes: Myocardial Infarction

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Priscilla O Okunji ◽  
Johnnie Daniel
Keyword(s):  
Myocardial Infarction ◽  
Mortality Rate ◽  
Income Group ◽  
The United States ◽  
Teaching Hospitals ◽  
Age Difference ◽  
Age Group ◽  
Urban Teaching ◽  
Significant Difference ◽  
The Impact

Background: Patients with myocardial infarction reportedly have different outcomes on discharge according to hospital characteristics. In the present study, we evaluated the differences between urban teaching hospitals (UTH) and non-teaching hospitals (NTH), discharged in 2012. We also investigated on the outcomes. Methods: Sample of 117,808 subjects diagnosed with myocardial infarction were extracted from a nationwide inpatient stay dataset using the International Classification Data, ICD 9 code 41000 in the United States, according to hospital location, size, and teaching status. Results: The analysis of the data showed that more whites were admitted to both teaching and non teaching hospitals with more males (~24%) admitted than their female counterparts. However, blacks were admitted more (~15%) in urban teaching hospitals than medium urban non teaching hospitals. Age difference was noted as well, while age group (60-79 years) were admitted more in UTH, inversely urban non-teaching hospitals admitted more older (80 years or older) age group. A significant difference (~28%) was observed in both hospital categories with UTH admitting more patients of $1.00 - $38,999.00 income group than other income categories. In addition, it was observed that patients with MI stayed more (~5%) for 14 or more days, and charged more especially for income group of $80,000 or above in UTH than NTH. No significant difference was found in the mortality rate for both hospital categories. Conclusion: The overall outcomes showed that the mortality rate between urban teaching and non-teaching hospitals were non significant, though the inpatients MI stayed longer and were charged more in UTH than NTH. The authors call for the study to be replicated with a higher level of statistical measures to ascertain the impact of the variables on the outcomes for a more validated result.

Evolving oncology provider perspectives on care delivery during the COVID-19 pandemic.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18609-e18609
Author(s):  
Divya Ahuja Parikh ◽  
Meera Vimala Ragavan ◽  
Sandy Srinivas ◽  
Sarah Garrigues ◽  
Eben Lloyd Rosenthal ◽  
...  
Keyword(s):  
Cancer Care ◽  
Care Delivery ◽  
The United States ◽  
Advanced Practice ◽  
Curative Surgery ◽  
Time Points ◽  
Patients With Cancer ◽  
Provider Perspectives ◽  
Significant Difference ◽  
The Impact

e18609 Background: The COVID-19 pandemic prompted rapid changes in cancer care delivery. We sought to examine oncology provider perspectives on clinical decisions and care delivery during the pandemic and to compare provider views early versus late in the pandemic. Methods: We invited oncology providers, including attendings, trainees and advanced practice providers, to complete a cross-sectional online survey using a variety of outreach methods including social media (Twitter), email contacts, word of mouth and provider list-serves. We surveyed providers at two time points during the pandemic when the number of COVID-19 cases was rising in the United States, early (March 2020) and late (January 2021). The survey responses were analyzed using descriptive statistics and Chi-squared tests to evaluate differences in early versus late provider responses. Results: A total of 132 providers completed the survey and most were white (n = 73/132, 55%) and younger than 49 years (n = 88/132, 67%). Respondents were attendings in medical, surgical or radiation oncology (n = 61/132, 46%), advanced practice providers (n = 48/132, 36%) and oncology fellows (n = 16/132, 12%) who predominantly practiced in an academic medical center (n = 120/132, 91%). The majority of providers agreed patients with cancer are at higher risk than other patients to be affected by COVID-19 (n = 121/132, 92%). However, there was a significant difference in the proportion of early versus late providers who thought delays in cancer care were needed. Early in the pandemic, providers were more likely to recommend delays in curative surgery or radiation for early-stage cancer (p < 0.001), delays in adjuvant chemotherapy after curative surgery (p = 0.002), or delays in surveillance imaging for metastatic cancer (p < 0.001). The majority of providers early in the pandemic responded that “reducing risk of a complication from a COVID-19 infection to patients with cancer” was the primary reason for recommending delays in care (n = 52/76, 68%). Late in the pandemic, however, providers were more likely to agree that “any practice change would have a negative impact on patient outcomes” (p = 0.003). At both time points, the majority of providers agreed with the need for other care delivery changes, including screening patients for infectious symptoms (n = 128/132, 98%) and the use of telemedicine (n = 114/132, 86%) during the pandemic. Conclusions: We found significant differences in provider perspectives of delays in cancer care early versus late in the pandemic which reflects the swiftly evolving oncology practice during the COVID-19 pandemic. Future studies are needed to determine the impact of changes in treatment and care delivery on outcomes for patients with cancer.

scholarly journals Impact of a child -friendly clinic on retention of HIV-infected children in care: an intervention study

1970 ◽  
Vol 44 (4) ◽  
pp. 175-179
Author(s):  
OR Ugwu
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Retention Rate ◽  
Retention In Care ◽  
Hiv Care ◽  
Satisfaction Survey ◽  
Loss To Follow Up ◽  
Child Friendly ◽  
Children In Care ◽  
The Impact

Background: Certain researchers have reported that a child-friendly clinic may improve patient/caregiver satisfaction at clinic attendance. This could serve as an innovation for reducing loss-to-follow up and increasing retention in care.Aim: To assess the impact of making the clinic more child-friendly on clinic experience, retention in care and loss-to-follow up of HIV -infected children.Method: The study was carried out in three phases. Phase one was a satisfaction survey to find out the patient/caregivers’ satisfaction of the clinic environment and services provided using a selfadministered questionnaire. Phase two was the creation of the childfriendly environment and phase three was a post-provision of child-friendly clinic satisfaction survey. The loss-to-follow up rate (failure to return to clinic ≥3months after the last scheduled clinic appointment in a child not known to be dead or transferred out of the facility) and retention rate (remaining alive and receiving highly active antiretroviral therapy) were also determined before and after setting up the childfriendly clinic.Results: There were 146 respondents before the study and 206 respondents after the intervention. The retention rate increased from 62.5% to 82% (p=0.02), while the loss-to-follow up rate dropped from 27.7% to 7.0% (p=0.00).Conclusion: Making the clinic area child-friendly can impact greatly on HIV care by improving patient satisfaction and retention of HIVinfected children in care and reducing loss-to-follow up.Key words: HIV, child-friendly environment, retention in care, loss to follow-up.

scholarly journals Impact of Gulfstream-IV Dropsondes on Tropical Cyclone Prediction in a Regional OSSE System

2019 ◽  
Vol 147 (8) ◽  
pp. 2961-2977 ◽  
Author(s):  
Kelly Ryan ◽  
Lisa Bucci ◽  
Javier Delgado ◽  
Robert Atlas ◽  
Shirley Murillo
Keyword(s):  
Tropical Cyclone ◽  
Real Time ◽  
Environmental Conditions ◽  
The United States ◽  
Track Forecast ◽  
Deterministic Models ◽  
Research Division ◽  
Sensitivity Studies ◽  
Potential Impact ◽  
The Impact

Abstract Aircraft reconnaissance missions remain the primary means of collecting direct measurements of marine atmospheric conditions affecting tropical cyclone formation and evolution. The National Hurricane Center tasks the NOAA G-IV aircraft to sample environmental conditions that may impact the development of a tropical cyclone threatening to make landfall in the United States or its territories. These aircraft data are assimilated into deterministic models and used to produce real-time analyses and forecasts for a given tropical cyclone. Existing targeting techniques aim to optimize the use of reconnaissance observations and partially rely on regions of highest uncertainty in the Global Ensemble Forecast System. Evaluating the potential impact of various trade-offs in the targeting process is valuable for determining the ideal aircraft flight track for a prospective mission. AOML’s Hurricane Research Division has developed a system for performing regional observing system simulation experiments (OSSEs) to assess the potential impact of proposed observing systems on hurricane track and intensity forecasting. This study focuses on improving existing targeting methods by investigating the impact of proposed aircraft observing system designs through various sensitivity studies. G-IV dropsonde retrievals were simulated from a regional nature run, covering the life cycle of a rapidly intensifying Atlantic hurricane. Results from sensitivity studies provide insight into improvements for real-time operational synoptic surveillance targeting for hurricanes and tropical storms, where dropsondes released closer to the vortex–environment interface provide the largest impact on the track forecast. All dropsonde configurations provide a positive 2-day impact on intensity forecasts by improving the environmental conditions known to impact tropical cyclone intensity.

scholarly journals Social Vulnerability, Gender and Disasters. The Case of Haiti in 2010

2020 ◽  
Vol 12 (9) ◽  
pp. 3574 ◽  
Author(s):  
Mar Llorente-Marrón ◽  
Montserrat Díaz-Fernández ◽  
Paz Méndez-Rodríguez ◽  
Rosario González Arias
Keyword(s):  
Natural Disasters ◽  
International Development ◽  
Social Vulnerability ◽  
Negative Impact ◽  
Research Work ◽  
The United States ◽  
Negative Effects ◽  
Unequal Distribution ◽  
And Gender ◽  
The Impact

The study of vulnerability constitutes a central axis in research work on sustainability. Social vulnerability (SV) analyzes differences in human capacity to prepare, respond and recover from the impact of a natural hazard. Although disasters threaten all the people who suffer from them, they do not affect all members of society in the same way. Social and economic inequalities make certain groups more vulnerable. Factors such as age, sex, social class and ethnic identity increase vulnerability to a natural disaster. Ten years after the earthquake in Haiti in 2010, this work deepens the relationship between natural disasters, SV and gender, exploring the unequal distribution of the SV in the face of a seismic risk. The source of statistical information has been obtained from the Demographic and Health Survey (DHS), developed by the United States Agency for International Development (USAID). Multicriteria decision techniques (TOPSIS) and the differences in differences (DID) technique are used to analyze variations in gender inequality in SV as a result of the catastrophic event. The results obtained reinforce the idea of the negative impact of the disaster on the SV. Additionally, an intensification of the negative effects is observed when the household is headed by a woman, increasing the gap in SV between households headed by women and the rest of the households. The conclusions obtained show additional evidence of the negative effects caused by natural disasters on women, and important implications for disaster risk management are derived that should not be ignored.

scholarly journals 1310. The Impact of Recent Incarceration on Post-Release HIV Linkage to Care and Risk-Taking Behaviors in the Setting of Enhanced Linkage to Care Policies in Florida

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S472-S473
Author(s):  
Greg Matthew E Teo ◽  
Suraj Nagaraj ◽  
Nisha Sunku ◽  
Sadaf Aslam ◽  
Rahul Mhaskar ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Behaviors ◽  
Barriers To Care ◽  
Linkage To Care ◽  
The United States ◽  
Self Report ◽  
Hiv Care ◽  
High Risk Behaviors ◽  
Persons Living With Hiv ◽  
The Impact

Abstract Background The United States has the largest incarcerated population in the world with 6.61 million adults in 2016.1 While incarceration is a known risk factor for difficulties in linkage to care2–3 and adverse health outcomes4–6, little is published on post-release incarcerated persons living with HIV (PLWH) in Florida. Methods Data were acquired from the Florida Cohort, an ongoing, longitudinal, cross-sectional study of PLWH recruited across HIV clinics in the state of Florida, from 2014 to 2018. Chi-square and multiple regression analyses correlated recent incarceration (within last 12 months) with demographics, HIV care adherence, perceived barriers to care, and self-reported high-risk behaviors. Results Of 936 participants, 6.4% (n = 60) reported recent incarceration within the last 12 months. Those recently incarcerated were more likely to report missing at least one appointment in the last 6 months (46.7% vs. 22.2%; P < 0.0001), to have an excessively long travel time ( >60 minutes) to a HIV provider (34.5% vs. 16.6%, P = 0.002; OR 2.66 [95% CI: 1.20–5.92]), and to lack reliable transportation (70% vs. 47.5%, P = 0.0007; OR 1.70 [95% CI: 0.82–3.52]) Those not recently incarcerated reported having completed a high school education (OR: 0.69 [95% CI: 0.5–0.97]) and stated they “never missed an appointment” (OR: 0.42 [95% CI: 0.22–0.81]). Recently incarcerated PLWH also had higher occurrence of high-risk behaviors such as receiving (40.4% vs. 8.7%; P = 0.001) or providing (30.4% vs. 10.4%; P = 0.000) money or drugs for sex, having used IV drugs (15% vs. 4%; P = 0.001), and not using condoms during exchange of drugs for sex (OR: 9.43 [95% CI: 3.78–23.52]). Conclusion Recently incarcerated PLWH continue to have significant geographical and logistical barriers to care and self-report more high-risk behaviors than nonincarcerated peers. Enhanced case management and telehealth services may be useful in linkage to care when PLWH transition from correctional to community healthcare systems in the Florida setting. Disclosures All authors: No reported disclosures.

Single-Occupancy Patient Rooms: A Systematic Review of the Literature Since 2006

2018 ◽  
Vol 11 (1) ◽  
pp. 85-100 ◽  
Author(s):  
Ellen Taylor ◽  
Alan J. Card ◽  
Melissa Piatkowski
Keyword(s):  
Patient Outcomes ◽  
Methodological Quality ◽  
Complex Adaptive System ◽  
The United States ◽  
Appraisal System ◽  
Advantages And Disadvantages ◽  
Individual Outcomes ◽  
Trade Offs ◽  
Meta Analyses ◽  
The Impact

Aim: Our review evaluated both the effects of single-occupancy patient rooms (SPRs) on patient outcomes for hospitalized adults and user opinion related to SPRs. Background: In 2006, a requirement for SPRs in hospitals was instituted in the United States. This systematic literature review evaluates research published since that time to evaluate the impact of SPRs. Methods: The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Databases searched included MEDLINE, CINAHL, and Scopus. Supplemental searches were performed. We included studies reporting patient outcomes or user opinion related to SPRs. Appraisal was conducted using a dual appraisal system of evidence levels and methodological quality. Results: Forty-three studies qualified for appraisal. Three were excluded due to methodological quality (no appraisal score). One study was appraised for three individual outcomes (i.e., falls, infections, and user opinion). Eleven studies with low methodological quality scores were not included in the narrative synthesis. Overall, 87% of studies reported advantages associated with SPRs (some a combination of advantages and disadvantages or a combination of advantages and neutral results). Outcomes with the best evidence of benefit include communication, infection control, noise reduction/perceived sleep quality, and preference/perception. Conclusion: SPRs seem to result in more advantages than disadvantages. However, healthcare is a complex adaptive system, and decisions for 100% SPRs should be reviewed alongside related issues, such as necessary workflow modifications, unit configuration and other room layout decisions, patient populations, staffing models, and inherent trade-offs (e.g., the advantages of privacy compared to disadvantage of isolation).

Potential impacts of blockchain technology on business practices of bricks and mortar (B&M) grocery stores

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mohammed T. Nuseir
Keyword(s):  
Service Providers ◽  
Resistance To Change ◽  
The United States ◽  
Grocery Stores ◽  
Business Practices ◽  
Exploratory Research ◽  
Content Type ◽  
Functional Perspective ◽  
Blockchain Technology ◽  
The Impact

PurposeThis paper investigates the impact of blockchain technology on the Bricks and Mortar (B&M) grocery sector from a technological and functional perspective.Design/methodology/approachThe research adopted an exploratory research design and the data comprises 17 semi-structured interviews with personnel at the top grocery retail chains in the United States, for example, Wal-Mart, Tesco, Stop and Shop and Meijer. Additionally, two major US-based blockchain service providers are included – SumatoSoft and Accubits.FindingsBlockchain technology affects the business processes of B&M grocery retail by offering payment via tokens, secure payments and contracts between stakeholders, an end-to-end solution in the supply chain and secure management of the stock. However, this process is hampered by a number of challenges such as integrity and security concerns, difficulty in adapting sound logistics, lack of adequate skills and resistance to change by store managers and employees. This can be addressed by imparting education/training and creating awareness about the benefits of blockchain and generating industry-wide collaboration in which regulations can work.Practical implicationsThe research has benefits for B&M grocery stores, governments and the wider society. For example, the findings of this study will help B&M grocery retailers to confront the competition by online retailers such as Amazon, AliExpress or eBay and promote the development of a systematic collaboration to achieve the changes they need.Originality/valueThe study is original and innovative in that no research to date has focused on how blockchain can help the B&M grocery sector and address its challenges.

Sign in / Sign up

Export Citation Format

Share Document