Uveitis [Only for Educational Purpose]

Uveitis is a general term describing a group of inflammatory diseases that produces swelling anddestroys eye tissues. These diseases can slightly reduce vision or lead to severe vision loss.The uvea is the middle layer of the eye. It lies beneath the white part of the eye (the sclera). It ismade of the iris, ciliary body, and choroid. These structures control many eye functions,including adjusting to different levels of light or distances of objects. The term “uveitis” is used because the diseases often affect a part of the eye called the uvea.Nevertheless, uveitis is not limited to the uvea. These diseases also affect the lens, retina, opticnerve, and vitreous, producing reduced vision or blindness.It is characterized as seen in young adults with both eyes affected to it, mostly recurrent and cancause blindness.Uveitis may be caused by problems or diseases occurring in the eye or it can be part of aninflammatory disease affecting other parts of the body.It can happen at all ages and primarily affects people between 20-60 years old.Uveitis can last for a short (acute) or a long (chronic) time. The severest forms of uveitis reoccurmany times.

How to develop a digital culture

Purpose There is a grey area when it comes to learning and organizations, and it is something that goes right to the heart of learning itself. If we use the story of the black swan being discovered as an example, up until that point there was a piece of learning which was that all swans were white – part of ‘swan-ness’ was that it was white. However, that piece of knowledge became invalid when black swans were discovered in Australia. Suddenly, not all swans were white, and swan-ness was about being black or white. Design/methodology/approach This briefing is prepared by an independent writer who adds his/her own impartial comments and places the articles in context. Findings There is a grey area when it comes to learning and organizations, and it is something that goes right to the heart of learning itself. If we use the story of the black swan being discovered as an example, up until that point there was a piece of learning which was that all swans were white – part of ‘swan-ness’ was that it was white. However, that piece of knowledge became invalid when black swans were discovered in Australia. Suddenly, not all swans were white, and swan-ness was about being black or white. Originality/value The briefing saves busy executives and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format.

PROMISE (Program Refinements to Optimize Model Impact and Scalability based on Evidence): a cluster-randomised, stepped-wedge trial assessing effectiveness of the revised versus original Ryan White Part A HIV Care Coordination Programme for patients with barriers to treatment in the USA

IntroductionGrowing evidence supports combining social, behavioural and biomedical strategies to strengthen the HIV care continuum. However, combination interventions can be resource-intensive and challenging to scale up. Research is needed to identify intervention components and delivery models that maximise uptake, engagement and effectiveness. In New York City (NYC), a multicomponent Ryan White Part A-funded medical case management intervention called the Care Coordination Programme (CCP) was launched at 28 agencies in 2009 in order to address barriers to care and treatment. Effectiveness estimates based on >7000 clients enrolled by April 2013 and their controls indicated modest CCP benefits over ‘usual care’ for short-term and long-term viral suppression, with substantial room for improvement.Methods and analysisIntegrating evaluation findings and CCP service-provider and community-stakeholder input on modifications, the NYC Health Department packaged a Care Coordination Redesign (CCR) in a 2017 request for proposals. Following competitive re-solicitation, 17 of the original CCP-implementing agencies secured contracts. These agencies were randomised within matched pairs to immediate or delayed CCR implementation. Data from three 9-month periods (pre-implementation, partial implementation and full implementation) will be examined to compare CCR versus CCP effects on timely viral suppression (TVS, within 4 months of enrolment) among individuals with unsuppressed HIV viral load newly enrolling in the CCR/CCP. Based on current enrolment (n=933) and the pre-implementation outcome probability (TVS=0.54), the detectable effect size with 80% power is an OR of 2.75 (relative risk: 1.41).Ethics and disseminationThis study was approved by the NYC Department of Health and Mental Hygiene Institutional Review Board (IRB, Protocol 18–009) and the City University of New York Integrated IRB (Protocol 018–0057) with a waiver of informed consent. Findings will be disseminated via publications, conferences, stakeholder meetings, and Advisory Board meetings with implementing agency representatives.Trial registration numberRegistered with ClinicalTrials.gov under identifier: NCT03628287, V.2, 25 September 2019; pre-results.

Παρατηρήσεις στο θραύσμα ερυθρόμορφου σκύφου από την αρχαία Κυδωνία με αριθμό ευρετηρίου Αρχαιολογικού Μουσείου Χανίων Π 12489

The Attic red-figured fragment in the Archaeological Museum of Hania, inv. Π 12489, published here in detail, was found during a rescue excavation conducted by the κε´ Ephorate of Antiquities) in Hania (ancient Kydonia) at the former Agricultural Bank Property in Skalidi str. The findspot is within the western limits of the ancient settlement of Kydonia. οnly a small part of a skyphos is preserved. The incomplete scene depicts the upper part of two figures, a beardless Herakles, named by an inscription in white ηρακλησ, probably seated and a Nike offering a phiale. There is also a tripod with ribbons in white, part of a wreath and a stylized blossom, all suspended. Above the picture a band filled with an olive sprig. The depiction can symbolically imply a festive or competitive event in honor of Herakles echoing at the same time the cult background that is attested in Kydonia through a significant inscribed votive offering of a local named Aischylos. Based on the elements of style and iconography the fragment is attributed to Dinos painter, and can be dated around 420 BC

2015–2016, Georgia Department of Public Health Districts, Evaluating Oral Health Services in Ryan White Part B Clinics

Background Poor dental health adversely affects overall health, and people living with HIV/AIDS (PLWHA) have a higher prevalence of dental disease than the general population. This study evaluated dental care access and utilization among PLWHA who receive services at Ryan White Part B (RWPB) Clinics in Georgia using three different measurement instruments. Methods Of the 19 Georgia Department of Health (GA-DPH) districts, HIV coordinators from all 16 districts that receive RWPB funding completed a web-based dental care needs assessment survey in October 2016, evaluating July 2015 to June 2016 (FY16). We compared findings to metrics obtained from two other sources: CAREWare, a national HIV electronic health system; and manual chart audits, performed using a weighted analysis of 32–42 clients per district. We analyzed the survey data and compared the three instruments descriptively. Results Of the 9,461 total active clients with HIV in the 16 DPH districts evaluated in the survey, 20% had at least one dental visit during FY16. All 16 districts had established relationships with dental providers. The average waiting period to see a dentist was <4 weeks in 13 (81%) of districts. Coordinators most frequently identified lack of transportation, health literacy, and high cost as important barriers to care. Though the overall average of clients with at least one dental visit during FY16 was similar between the survey, CAREWare, and audit data (20%, 16%, and 19%, respectively), the three instruments demonstrated notable variability within sites. Proportion of clients with dental visits across Georgia showed regional variation, with fewer visits reported centrally and more dental visits reported in the northeastern and southeastern areas. Conclusion Even though all DPH districts had access to dental providers with short waiting periods, PLWHA served by RWPB received limited dental services and faced many barriers to care during FY16. Three measurement tools demonstrated poor consistency between and across districts, highlighting the challenges in reporting and evaluating data in this population. By developing targeted quality improvement initiatives, GA-DPH will use these finding to improve annual dental visit rates, reduce barriers to care, and more accurately measure specific health outcomes for PLWHA. Disclosures All authors: No reported disclosures.