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1

Fauk, Nelsensius Klau, Maria Silvia Merry, Theodorus Asa Siri, Fabiola Tazrina Tazir, Mitra Andhini Sigilipoe, Kristin Oktanita Tarigan, and Lillian Mwanri. "Facilitators to Accessibility of HIV/AIDS-Related Health Services among Transgender Women Living with HIV in Yogyakarta, Indonesia." AIDS Research and Treatment 2019 (July 1, 2019): 1–10. http://dx.doi.org/10.1155/2019/6045726.

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The study aimed to explore facilitators or enabling factors that enhance accessibility (defined as the opportunity to be able to use) to HIV/AIDS-related health services among HIV positive transgender women, also known as Waria in Yogyakarta, Indonesia. A qualitative study employing one-on-one in-depth interviews was conducted from December 2017 to February 2018. Participants were HIV positive Waria recruited using purposive and snowball sampling techniques. Data were analysed using the framework analysis for qualitative research. The findings showed that participants’ knowledge of HIV/AIDS and the availability of HIV/AIDS-related health services were enablers to the services accessibility. Emotional support from fellow Waria displayed in various ways, such as kind and caring attention, attentive listening, and encouraging words, was an important social support that played a role in supporting Waria’s accessibility to the services. HIV/AIDS-related health service information shared personally or jointly by fellow Waria and instrumental support including helping each other to collect antiretroviral (ARV) from hospitals or community health centres, contacting ambulance in emergency situations, accompanying each other to health service facilities, and helping those without the health insurance to receive free health services were also the social support enabling accessibility to the services among the study participants. Appraisal support such as providing constructive feedback and affirmation was another enabling factor to Waria’s accessibility to the services. The findings indicate the needs to broadly disseminate information and educate Waria populations and their significant others about HIV/AIDS and related health services to raise their awareness of HIV/AIDS and acceptance of HIV/AIDS positive individuals. Educating and broadly disseminating this information in other settings in the country will also increase accessibility to the HIV/AIDS services among Waria, their families, and communities addressing the currently existing inequities in health. The findings also reinforce the importance of the establishment of Waria peer-support groups within Waria communities and the involvement of Waria in HIV/AIDS activities and programs, which may increase their awareness of HIV/AIDS, and accessibility to HIV/AIDS-related health services.
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2

Shi, Song He, and Sheng Wu Xiong. "The Design and Application of the Information Management Platform for the Prevention and Control of AIDS on the Basis of the Residents' Health Records." Advanced Materials Research 989-994 (July 2014): 1097–102. http://dx.doi.org/10.4028/www.scientific.net/amr.989-994.1097.

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Relying on the Acquired Immune Deficiency Syndrome (AIDS) prevention and control system of project areas and existing health information network, according to the requirements of prevention and treatment of AIDS, and the "National Norms of Basic Public Health Services" as well as the "Community Comprehensive Prevention and Control of Major Contagious Diseases Programs and Procedures" and other regulatory requirements, this project, based on the residents' health records, using B/Sstructure, SSHframe, MVCmodel, ORACLE 10.0 database, is to develop residents' health records information management platform for the comprehensive prevention and control of AIDS, and make the existing AIDS epidemic system, the hospital information management system, residents' health records and health information system interconnected. It contributes to the participation of the administrative department of health, centers for disease control and prevention, hospital and community, and easily promotes organizations to provide technical support for the prevention and control system of AIDS. The platform has been successfully run in five project regions in Henan province, and has established 2, 365, 802 residents' health records about HIV/AIDS prevention and control, produced a good social and economic benefits. Its outlook is promising.
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Shaluhiyah, Zahroh, Antono Suryoputro, and Any Setyawati. "The Needs of Information Services on Reproductive Health, STIs and HIV in Middle Adolescence." Jurnal Kesehatan Masyarakat 12, no. 2 (March 14, 2017): 233–42. http://dx.doi.org/10.15294/kemas.v12i2.5366.

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Reproductive health information including STIs and HIV/AIDS has been provided in community health center. In fact, the level of adolescent knowledge in terms of sexual health and its risks is still low. This study aims to identify adolescent needs of information services on sexual and reproductive health including STIs and HIV/AIDS. All adolescent aged 15 to 19 years in Ngesrep village were recruited as a sample. There were 237 adolescents participated in this cross sectional study. The findings showed that half of them have low level of knowledge, nearly half have permissive sexual attitudes, 15% have engaged in sexual intercourse. Adolescents need comprehensive information including pregnancy, sexual diseases and HIV/AIDS which provided by health workers at school health programs.
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Letteney, Susan. "Social Workers' Self-Efficacy and Comfort Providing Services for HIV-Affected Children." Journal of Baccalaureate Social Work 15, no. 2 (January 1, 2010): 47–60. http://dx.doi.org/10.18084/basw.15.2.g07x4u288pj70355.

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As HIV/AIDS prevalence rates continue to rise in the United States, social workers will serve HIV-affected families for years to come. Researchers now consider HIV to be a "family disease"; thus, the children of HIV-positive parents face challenges and uncertainty about their futures. This study describes 46 social workers' perceptions of self-efficacy and comfort providing future care and custody services. Findings reveal that HIV/AIDS information gained through evidence-based sources was significantly correlated with social workers' knowledge and comfort providing services. Social workers' perceived self-efficacy was significantly correlated with perceptions of comfort providing future care and custody services. Self-reported definitions of future care and custody were multidimensional but not uniform. It is recommended that social workers providing HIV-related services to families obtain empirically based training. Schools of social work and professional organizations can play critical roles in disseminating best practices in the evolving area of HIV/AIDS and the family.
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Fauziah, Ayi Nur, Muhammad Amir, and Muhammad Yusuf. "Konstribusi Lembaga Swadaya Masyarakat dalam Penanganan HIV-AIDS di Kota Kendari : Studi Pada Lembaga Advokasi HIV- AIDS Sulawesi Tenggara." NeoRespublica : Jurnal Ilmu Pemerintahan 1, no. 1 (December 20, 2019): 58. http://dx.doi.org/10.52423/neores.v1i1.9699.

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The purpose of this study was to determine how the role of NGOs in handling HIV-AIDS in Kendari City and to find out how to handle NGOs in handling HIV-AIDS in Kendari City. The subjects in this study were the Southeast Sulawesi Province Board of Directors consisting of the Director of Laha, Laha Staff, PLWHA in Kendari City, PLWHA Community, Social Service Apparatus, and Health Service Apparatus The type of research used is descriptive qualitative. The results of the research show that NGO LAHA plays a role as a Facilitator, Broker, Mediator, Defender, Protector in Dealing with HIV-AIDS In the city of Kendari, the HIV-AIDS Management Program, namely Improving Communication,. Information and Education of HIV-AIDS, increases efforts to reduce the prevalence of infectious diseases sexually, increasing universal awareness in the provision of health services and cooperation between the Kendari City Government and the NGO LAHA still lacking in the handling of HIV-AIDS that occurred in Kendari CityKeywords :Handling, HIV-AIDS, NGO, Laha. Role
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6

Men, C., B. Meessen, M. Van Pelt, W. Van Damme, and H. Lucas. "“I Wish I Had AIDS”: A qualitative study on access to health care services for HIV/AIDS and diabetic patients in Cambodia." Health, Culture and Society 2, no. 1 (March 23, 2012): 22–39. http://dx.doi.org/10.5195/hcs.2012.67.

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Financially stricken Cambodian patients with diabetes and HIV/AIDS typically encounter multiple, serious barriers to effective care. This process may extend over many years and involve numerous rounds of diagnosis and treatment as the disease progresses from initial symptoms to longer term complications. Living with both the impact of the disease and this ongoing struggle for care can severely disrupt the everyday life of both sufferers and their families. Our retrospective study adopted qualitative research methods to collect data from HIV/AIDS and diabetic patients enrolled and not enrolled in treatment programs at varying institutions in urban and rural settings. Using purposive sampling techniques, a total of 25 HIV/AIDS and 45 diabetic patients were recruited. Semi-structured and open-ended interviews were used to collect information on patient experiences of different phases in the on-going process of seeking care and treatment. The findings indicate that both HIV/AIDS and diabetic patients encounter multiple supply- and demand-side barriers to care at different stages of their illness. More strikingly, our research findings suggest that supply-side barriers, for example rationing systems or targeting strategies that limit access to free treatment or social assistance, are substantially higher for diabetic patients. This perceived inequity had a profound impact on diabetic patients to the extent that some “wished they had HIV/AIDS”. These findings suggest that there is an urgent need to widen the focus of health care to address the substantial and increasing burden of disease resulting from diabetes and other serious chronic disorders in Cambodia and many other low/middle income countries.
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Ka, Mogan, Aravind Gandhi Periyasamy, Venkatesh U., and Jugal Kishore. "A situation model of integrated health information platform in India: an anticipated review." International Journal Of Community Medicine And Public Health 7, no. 3 (February 27, 2020): 1197. http://dx.doi.org/10.18203/2394-6040.ijcmph20200991.

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Health system in India is fragmented with different kinds of health care providers engaged in the delivery of health services across rural and urban areas. The integration of health information in a single platform aids in strengthening the public health surveillance systems, better decision support system, improvement in the efficiency and effectiveness in the context of health education and monitoring. In order to integrate the public health data and strengthen the surveillance and monitoring, the integrated health information platform (IHIP) was launched as pilot project following the report of the joint monitoring mission of the World Health Organization. IHIP integrates the electronic health records of the citizens on a pan-India basis aids in providing a comprehensive health profile of the population. Integrated disease surveillance programme (IDSP) module of integrated health information platform (IHIP) was the earliest initiative of integrating various health programmes. It is a web-based real-time, village wise, case-based electronic health information system that will aim to provide details about epidemic-prone diseases with geographical information system (GIS) thus reducing the morbidity and mortality and lessening disease burden in the populations. GIS information obtained via IHIP provides information in the form of a geographical map as interface data with real-time monitoring thus contributes to Geospatial Epidemiology in addition to information by IDSP. This article aims to describe the anticipated model of IHIP in the context of providing ‘One Health’ by the integration of health sectors.
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Miranda, Angelica Espinosa, Bettina Moulin Coelho Lima, Alain Giami, Jonathan E. Golub, and Sinesio Talhari. "Behavior assessment of women attending a sexually transmitted disease clinic in Vitória, Brazil." Anais Brasileiros de Dermatologia 87, no. 2 (April 2012): 197–202. http://dx.doi.org/10.1590/s0365-05962012000200002.

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BACKGROUND: Studies about sexual risk behaviors can provide information to support design strategies to control the spread of HIV infection. OBJECTIVE: To assess sexual risk behaviors among women attending a sexually transmitted diseases clinic in Vitória, Brazil. METHODS: A cross-sectional study was performed among women attending an STD/AIDS reference center. Enrolled participants were interviewed and provided a blood sample to determine HIV status. RESULTS: A total of 276 women participated. among 284 selected; 109 (39.5%) were HIV-positive and 167 (60.5%) HIV-negative. Median age was 31 years (interquartile range (IQR)24-36) and 69% of women were between 18 and 34 years of age. Women reported high access to information about STD (87%) and AIDS (90%) but information about sexuality was less common (55%). HIV-positive women asked their partners to use condoms more often than HIV-negatives (31% vs. 5%, p=0.02), and were more likely to have used a condom at last intercourse (65% vs. 33%, p<0.01). Among all patients, questions regarding risk of HIV transmission through sexual intercourse (99.6%) and needle sharing (99.2%) were most frequently answered correctly, while questions regarding risk of HIV transmission through blood donation (57%) were least. CONCLUSION: Though this population reports easy access to information and services for HIV/sexually transmitted diseases, most report little understanding of unsafe sexual behaviors, particularly HIV-negative women.
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Gilenko, Evgenii V., Andrei E. Ivanov, and Ekaterina M. Batueva. "On some approaches to increasing performance and cost-efficiency of Russian regional AIDS centers." Russian Management Journal 19, no. 1 (2021): 35–66. http://dx.doi.org/10.21638/spbu18.2021.102.

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The paper discusses the problem of counteracting the spread of HIV/AIDS in Russia. This disease is the main cause of death for the Russian working-age population, which annually takes tens of thousands of lives and hinders the achievement of such goals of the Russian state policy as preserving the health and well-being of Russian people. The principal elements of the system of HIV/AIDS counteraction are regional AIDS prevention and control centers (AIDS centers), whose improvement of performance is required by the “State Strategy for Counteracting the Spread of the HIV Infection in the Russian Federation for the period up to 2020 and beyond”. In this paper, based on the proposed modification of M. Porter’s care delivery value chain model, we demonstrate the ways of enhancing the performance of a regional AIDS center by increasing the value of its services and reducing the costs of their provision due to strengthening the channels of transferring information about HIV/AIDS to the population, improving the accuracy of predicting new registered cases of HIV/AIDS, as well as perfecting public procurement of the necessary medicines and consumables. Our calculations are based on real data of the Perm AIDS center. As a result, relevant recommendations are formulated for the leadership of the Perm AIDS center on the ways of interaction with the population, prediction of new HIV/AIDS cases, and conducting public procurement of drugs and consumables for the needs of the center.
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Gao, Wei, Sumaya Huque, Myfanwy Morgan, and Irene Higginson. "A Population-Based Conceptual Framework for Evaluating the Role of Healthcare Services in Place of Death." Healthcare 6, no. 3 (August 30, 2018): 107. http://dx.doi.org/10.3390/healthcare6030107.

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Background: There is a significant geographical disparity in place of death. Socio-demographic and disease-related variables only explain less than a quarter of the variation. Healthcare service factors may account for some (or much) of the remaining variation but their effects have never been systematically evaluated, partly due to the lack of a conceptual framework. This study aims to propose a population-based framework to guide the evaluation of the role of the healthcare service factors in place of death. Methods: Review and synthesis of health service models that include the impact of a service component on either place of death/end of life care outcomes or service access/utilization. Results: The framework conceptualizes the impact of healthcare services on the place of death as starting from the end of life care policies that in turn influence service commissioning and shape healthcare service characteristics, including service type, service capacity—facilities, service location, and workforce, through which service utilization and ultimately place of death are affected. Patient socio-demographics, disease-related variables, family and community support and social care also influence place of death, but they are not the focus of this framework and therefore are grouped as needs and other environmental factors. Information on service utilization, together with the place of death, creates loop feedback to inform policy and service commission. Conclusions: The framework provides guidance for analysis aiming to understand the role of healthcare services in place of death. It aids the interpretation of results in the light of existing knowledge and potentially identifies service factors that can be addressed to improve end of life care.
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Adams, Audrey, and Franklin D. Lowy. "Infection Control and the Hospitalized AIDS Patient." Infection Control 6, no. 5 (May 1985): 200–201. http://dx.doi.org/10.1017/s0195941700061427.

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Acquired immunodeficiency syndrome (AIDS) has created new and difficult challenges for infection control services. Limited information on the pathogenesis and means of transmission coupled with the reported high mortality rates of this disease, have heightened public fears about the potential risks resulting from exposure to AIDS. Hospitalization of these patients, with the attendant responsibilities for their care by hospital personnel, has served to focus and amplify these public concerns in a relatively small and inter-related community. The result, in some hospitals, has been an increase in incidents which interfere with the proper care of AIDS patients. While a great deal has been written about the appropriate precautions recommended for the care of these patients, little attention has been focused on the practical problems encountered within the institution of these policies and within the education of the concerned and relatively uninformed hospital community. The success of such a program is essential to assure the proper care of these patients. The purpose of the present report is to summarize the experience at our institution and to outline the approach adopted by the Infection Control Unit to deal with these problems.
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Homan, Rick, John Bratt, Gregory Marchand, and Henry Kansembe. "Leveraging existing program data for routine efficiency measurement in Zambia." Gates Open Research 2 (August 31, 2018): 40. http://dx.doi.org/10.12688/gatesopenres.12851.1.

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Background: As donor contributions for HIV/AIDS stagnate globally, national governments must seek ways to improve use of existing resources through interventions to drive efficiency at the facility level. But program managers lack routinely available information on unit expenditures at points of care, and higher-level planners are unable to assess how resources are used throughout the health system. Thus, managers cannot measure current levels of technical efficiency, and are unable to evaluate effectiveness of interventions to increase technical efficiency. Methods: FHI 360 developed the Routine Efficiency Monitoring System (REMS), a relational database that leverages existing budget, expenditure and output data to produce quarterly site-level estimates of unit expenditure per service. Along with the Government of the Republic of Zambia (GRZ) and implementation partner Avencion, we configured REMS to measure technical efficiency of Ministry of Health resources used to deliver HIV/AIDS services in 326 facilities in 17 high-priority districts in Copperbelt and Central Provinces. REMS allocation algorithms were developed through facility assessments and key informant interviews with MoH staff. Existing IFMIS and DHIS-2 data streams provide recurring flows of expenditure and output data needed to estimate service-specific unit expenditures. Trained users access REMS output through user-friendly dashboards delivered through a web-based application. Results: District health management teams are using REMS to identify “outlier” facilities to test performance improvement interventions. Provincial and national planners are using REMS to seek savings and ensure that resources are directed to geographic and programmatic areas with highest need. REMS can support reimbursement for social health insurance and provide time-series data on facility-level costs for modeling purposes. Conclusions: REMS gives managers and planners substantially-improved data on how programs transform resources into services. The GRZ is seeking funding to expand REMS nationally, covering all major disease areas. Improved technical efficiency supports the goal of a sustainable HIV/AIDS response.
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Homan, Rick, John Bratt, Gregory Marchand, and Henry Kansembe. "Leveraging existing program data for routine efficiency measurement in Zambia." Gates Open Research 2 (November 26, 2018): 40. http://dx.doi.org/10.12688/gatesopenres.12851.2.

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Rationale: As donor contributions for HIV/AIDS stagnate globally, national governments must seek ways to improve use of existing resources through interventions to drive efficiency at the facility level. But program managers lack routine information on unit expenditures at points of care, and higher-level planners are unable to assess resource use in the health system. Thus, managers cannot measure current levels of technical efficiency, and are unable to evaluate effectiveness of interventions to increase technical efficiency. Phased Implementation of REMS: FHI 360 developed the Routine Efficiency Monitoring System (REMS)-a relational database leveraging existing budget, expenditure and output data to produce quarterly site-level estimates of unit expenditure per service. Along with the Government of the Republic of Zambia (GRZ) and implementation partner Avencion, we configured REMS to measure technical efficiency of Ministry of Health resources used to deliver HIV/AIDS services in 326 facilities in 17 high-priority districts in Copperbelt and Central Provinces. REMS allocation algorithms were developed through facility assessments, and key informant interviews with MoH staff. Existing IFMIS and DHIS-2 data streams provide recurring flows of expenditure and output data needed to estimate service-specific unit expenditures. Trained users access REMS output through user-friendly dashboards delivered through a web-based application. REMS as a Solution: District health managers use REMS to identify “outlier” facilities to test performance improvement interventions. Provincial and national planners are using REMS to seek savings and ensure that resources are directed to geographic and programmatic areas with highest need. REMS can support reimbursement for social health insurance and provide time-series data on facility-level costs for modeling. Conclusions and Next Steps: REMS gives managers and planners substantially-improved data on how programs transform resources into services. The GRZ is seeking funding to expand REMS nationally, covering all major disease areas. Improved technical efficiency supports the goal of a sustainable HIV/AIDS response.
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Saliu, Abdulsalam, and Babatunde Akintunde. "Knowledge, Attitude, and Preventive Practices among Prison Inmates in Ogbomoso Prison at Oyo State, South West Nigeria." International Journal of Reproductive Medicine 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/364375.

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Prisoners are at special risk for infection with human immunodeficiency virus (HIV) because of overcrowded prisons, unprotected sex and sexual assault, occurrence of sexual practices that are risky to health, unsafe injecting practices, and inadequate HIV prevention, care, and support services. This study aimed to describe the knowledge, attitude, and preventive practices towards HIV/AIDS by male inmates in Ogbomoso Prison at Oyo State, South West Nigeria. This was a cross-sectional study. A simple random sampling method was employed to select 167 male participants and data were collected using pretested structured interviewer-administered questionnaire. The data were collated and analyzed using the Statistical Package for Social Sciences version 17. Fifty (29.9%) were in the age group 20–24 years with mean age of30.99±11.41. About half (50.3%) had been married before incarceration. Family and friends (30%), health care workers (25%), prison staff (20%), and mass media (25%) were the commonest sources of information on HIV/AIDS. Knowledge about HIV was found to be high (94.6%). About 68.9% believed that people with the disease should be avoided. The knowledge about HIV/AIDS among inmates was high, but misconceptions about HIV/AIDS are still rife among the prisoners and educational programs would be required to correct this.
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Memon, Anjum, John Barber, Emma Rumsby, Samantha Parker, Lisa Mohebati, Richard De Visser, Susan Venables, Anna Fairhurst, Kate Lawson, and Josefin Sundin. "Opinions of women from deprived communities on the NHS stop smoking service in England - person-centered perspectives." European Journal for Person Centered Healthcare 4, no. 2 (July 26, 2016): 346. http://dx.doi.org/10.5750/ejpch.v4i2.1101.

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Background In most European countries, women are relatively more susceptible to smoking-related diseases, find it more difficult to quit and more likely to relapse than men. With the aim to improve understanding of women’s needs from smoking cessation services, this qualitative study examines perceptions of women from deprived communities on the National Health Service Stop Smoking Service in England.Methods A qualitative study of 11 women, smokers and ex-smokers, who had used Stop Smoking Services located in disadvantaged communities in East Sussex, England. Data were collected through focus group and semi-structured interviews, and were subjected to thematic analysis.Results Women felt that services tailored to their needs would improve cessation rates. They expect smoking cessation facilitators to be non-judgemental and to offer psychological insight into addiction. However, women’s opinions differed on the importance for facilitators to be female or ex-smokers, and on the preference of group or one-to-one services, some women expressed a preference for women only groups. The women praised the continuity of care, capacity for peer support, flexibility of time and location and free cessation aids offered. Conversely, the women felt that services were poorly advertised, that access was not universally good, and that services at work place and drop-in groups would improve access for working women and women with young children.Conclusion Flexible services that are tailored towards the needs of individual smokers and better dissemination of information regarding the range of services available could facilitate greater uptake of smoking cessation services for women in deprived communities.
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Ferrari, Anna. "AIDS symptoms in America: Close-ups from the underground." Book 2.0 11, no. 1 (August 1, 2021): 19–35. http://dx.doi.org/10.1386/btwo_00040_1.

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After the explosion of the AIDS epidemic in the United States was virtually ignored because it was mostly hitting the gay community, gay authors started to employ their work for two main purposes: to protest the situation and, particularly in the beginning, to spread information about the virus. The portrayal of physical details is one of the most interesting devices employed in AIDS texts. In the early AIDS years, when the cause of the epidemic was unknown, literary tools such as the list of symptoms were widely used: authors were addressing their own community, and gave people a way to recognize the early signs of illness, such as the night sweats and the Kaposi’s sarcoma lesions. Even after the discovery of HIV, when there was not a cure yet, AIDS texts represented a crucial source of information: the first official leaflet was provided by Surgeon General Koop in 1986. The act of incorporating medical information in literary texts was considered an act of service within the community: authors such as Paul Monette and Larry Kramer regarded the gay underground as a more credible source of information, since in the beginning people who had gotten through it often knew more than the doctors. Later on, as information became more available, the display of those same physical manifestations of the disease and of AIDS-ridden bodies became an effective way to denounce the persisting silence from the government, with works such as Kushner’s Angels in America and Wojnarowicz’s portraits of Peter Hujar’s body. This article focuses on how the display of symptoms and other physical manifestations of the epidemic turned the cultural production into a key element in shaping the discourse around AIDS, highlighting the evolution in the use of physical medical evidence – from information to outcry.
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Furtado, Francisca Marina de Souza Freire, José Anderson Galdino Santos, Stedile Loredanna, Eunice Araújo, Ana Alayde Werba Saldanha, and Josevânia da Silva. "30 years later: Social Representations about AIDS and sexual practices of rural towns residents." Revista da Escola de Enfermagem da USP 50, spe (June 2016): 74–80. http://dx.doi.org/10.1590/s0080-623420160000300011.

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In the 30 years of the AIDS pandemic in Brazil, it is recognized the HIV virus internalization of the phenomenon as a challenge to care and current health policies. In this sense, it aimed to verify sex practices and social representations that rural towns residents have about the disease. Attended by 789 people, men and women, between 18 and 90 years old, residents in 41 towns with fewer than 11,000 inhabitants in the state of Paraiba / Brazil. Data were collected by a questionnaire and the free association of words test. The results showed low concern about disease, perception of invulnerability to HIV infection and not using condoms during sexual intercourse, and confidence in the major reason related partner. Also showed endure derogatory and stereotypical representations, revealing that still persist in rural areas, beliefs and representations concerning the beginning of the epidemic. From these findings, it is possible to point out deficiencies in the care provided by the health services in these localities, which may result in increased vulnerability of this population to diseases, so there is the need to intensify information campaigns and intervention. The results reveal the existence of three different types of modes of learning health literacy skills in informal context: : i) learning that takes place in action, in achieving daily tasks; ii) learning processes that result from problem solving; iii) learning that occurs in an unplanned manner, resulting from accidental circumstances and, in some cases, devoid of intentionality.
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Maksud, Ivia, Nilo Martinez Fernandes, and Sandra Lucia Filgueiras. "Technologies for HIV prevention and care: challenges for health services." Revista Brasileira de Epidemiologia 18, suppl 1 (September 2015): 104–19. http://dx.doi.org/10.1590/1809-4503201500050008.

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ABSTRACTThis article aims to consider some relevant challenges to the provision of "new prevention technologies" in health services in a scenario where the "advances" in the global response to AIDS control are visible. We take as material for analysis the information currently available on the HIV post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP), treatment as prevention (TASP) and over the counter. The methodology consisted of the survey and analysis of the Biblioteca Virtual em Saúde (BVS: MEDLINE, LILACS, WHOLIS, PAHO, SciELO) articles that addressed the issue of HIV prevention and care in the context of so-called new prevention technologies. The results of the studies show that there is assistance on the ground of clinics for the treatment of disease responses, but there are several challenges related to the sphere of prevention. The articles list some challenges regarding to management, organization of services and the attention given by health professionals to users. The current context shows evidence of the effectiveness of antiretroviral therapy in reducing the risk of HIV transmission, but the challenges for the provision of preventive technologies in health services permeate health professionals and users in their individual dimensions and health services in organizational and structural dimension. Interventions should be made available in a context of community mobilization; there should be no pressure on people to make HIV testing, antiretroviral treatment or for prevention. In the management is responsible for the training of health professionals to inform, clarify and make available to users, partners and family information about the new antiretroviral use strategies.
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Solari, Alessandra. "Effective communication at the point of multiple sclerosis diagnosis." Multiple Sclerosis Journal 20, no. 4 (February 6, 2014): 397–402. http://dx.doi.org/10.1177/1352458514523061.

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As a consequence of the current shortened diagnostic workup, people with multiple sclerosis (PwMS) are rapidly confronted with a disease of uncertain prognosis that requires complex treatment decisions. This paper reviews studies that have assessed the experiences of PwMS in the peri-diagnostic period and have evaluated the efficacy of interventions providing information at this critical moment. The studies found that the emotional burden on PwMS at diagnosis was high, and emphasised the need for careful monitoring and management of mood symptoms (chiefly anxiety). Information provision did not affect anxiety symptoms but improved patients’ knowledge of their condition, the achievement of ‘informed choice’, and satisfaction with the diagnosis communication. It is vital to develop and implement information and decision aids for PwMS, but this is resource intensive, and international collaboration may be a way forward. The use of patient self-assessed outcome measures that appraise the quality of diagnosis communication is also important to allow health services to understand and meet the needs and preferences of PwMS.
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Briceland, Laurie L., John D. Cleary, Courtney V. Fletcher, Daniel P. Healy, and Charles A. Peloquin. "Recent Advances: Antiinfectives." Annals of Pharmacotherapy 29, no. 10 (October 1995): 1035–40. http://dx.doi.org/10.1177/106002809502901015.

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Objective: To update readers on the significant changes in infectious diseases pharmacotherapy. Data Sources: An Index Medians and Iowa Drug Information Service search (1993–1994) of English-language literature pertaining to the selected topic areas was performed. Additional information from abstracts presented at scientific meetings were identified by the authors. Study Selection and Data Extraction: All identified studies were screened and those judged relevant to the update were evaluated. Data Synthesis: New or clinically significant data since 1992 that related to peptic ulcer disease, microbial resistance (e.g., Enterococcus spp., Streptococcus pneumoniae, Mycobacterium tuberculosis, Candida albicans), immunomodulators, and AIDS were evaluated and compared with previous data. Conclusions: There have been several exciting and significant changes in infectious diseases pharmacotherapy evident from this review.
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Job Neto, Francisco, Raquel Barbosa Miranda, Ronaldo de Almeida Coelho, Cinthya Paiva Gonçalves, Eliana Zandonade, and Angelica Espinosa Miranda. "Health morbidity in Brazilian prisons: a time trends study from national databases." BMJ Open 9, no. 5 (May 2019): e026853. http://dx.doi.org/10.1136/bmjopen-2018-026853.

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ObjectiveThe goal of this study was to explore the surveillance data about mandatory reporting diseases, included in the official information systems, and evaluate the historical trend analysis in prisoners in Brazil.DesignA time trends study was performed using secondary data from prisons’ health units.SettingNationwide representative data of Brazilian prisoners obtained from 2007 to 2014 health and prison information systems database were analysed. These data are carried out by units identified as prison health facilities.Primary outcome measuresDiseases diagnosis and individual data were available at the National System of Disease Notification (in Portuguese SINAN), Mortality Information System (in Portuguese SIM) and Prison Registration Systems (in Portuguese INFOPEN and GEO prisons). Analyses of the notification data performed in the SINAN at the national level. SINAN was consolidated with SIM, INFOPEN and GEO prison data.ResultsA total of 23 235 cases of compulsory disease notification causing morbidity were reported in prison units in Brazil; of these cases, 20 003 (85.6%) were men and 3362 (14.4%) were women. Over time, the proportion of prisoners increased from 1.92 per 1000 inhabitants in 2007 to 2.77 per 1000 inhabitants in 2014 (rising trend). From a total of 27 states, 12 of them presented a growth in disease notifications, 14 were stable and in only one state was there a decrease in notifications. There was an increase in notifications in the country as a whole. Tuberculosis (64.4%), dengue (9.1%), AIDS (9.0%) and viral hepatitis (5.9%) were among the most frequently reported diseases during the study period.ConclusionDespite showing stable tendencies, our results show high rates of diseases in Brazilian prisons. Prison health services should not be isolated but integrated into regional and national health and justice systems.
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Spencer, D. C., M. H. Steinberg, and A. S. Kanter. "Development of an HIV Clinical and Research Database for South Africa." Methods of Information in Medicine 36, no. 02 (March 1997): 144–48. http://dx.doi.org/10.1055/s-0038-1634695.

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Abstract:Health service restructuring in South Africa provides an opportunity to introduce appropriate Health Information System (HIS) technology. This is particularly relevant given the emerging HIV epidemic and the need to capture, translate and disseminate new experiences in HIV/AIDS care, support and clinical research. In 1994, a number of clinicians and health-care providers working in South Africa had begun to establish basic computerized databases to assist in research on HIV, but no standardized nomenclature or framework for collaboration was created. This paper describes a clinical and research database that could be used as an example for a standardized system by clinicians working in South Africa. The authors, with assistance from the National AIDS Research Programme of the Medical Research Council, created a prototype relational database using Microsoft Access™. To test the prototype, 1057 HIV-positive patients from the Infectious Disease Clinic at Johannesburg General Hospital were entered.
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Marahatta, SB. "Knowledge on HIV/AIDS amongst bus drivers of Dhulikel, Nepal." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 9, no. 1 (October 18, 2012): 35–38. http://dx.doi.org/10.3126/saarctb.v9i1.6963.

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Introduction: One of the growing epidemics in the world today is HIV/AIDS. In the cities with high mobility, bus drivers and transport workers are considered as the risk group for HIV/AIDS. In Kavre district, the increased mobility along with Araniko highway and Banepa Bardibas highways has drastically increased the vulnerabilities of younger populations in particularly to HIV/AIDS and STDs. Most of these young people do not have access to information, condoms, supportive services which enable them to have safer sex. Methodology: A descriptive cross sectional study was done to assess knowledge about HIV/AIDS among bus drivers of Dhulikhel. Results: After the analysis and interpretation of the data, study revealed that majority of the respondents i.e. 38% (n=19) were between age 20-24 years. Among them vast majority of the respondents i.e 82% (n=41) have heard from media (radio, Television and newspapers). Regarding transmission of HIV/AIDS 90% (n=45) of the respondents mentioned that unsafe sex is the means of transmission. Still 24% (n=12) believe that sharing clothes and 2% (n=1) believe that kissing can transmit HIV/AIDS. As per prevention measures 90% (n=5) have the knowledge that using condom during sexual intercourse can prevent HIV/ AIDS. 8% (n=4) of the respondents still believe that HIV/AIDS is curable and rest of them i.e. 92% (n=46) of the respondents knew that HIV/AIDS is not curable. Conclusion: The present study strongly recommends that there is immediate need of program to create awareness of public motor drivers and co-workers, vulnerable youths and other high risk groups of people including migrant populations. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS 2012; IX (1) 35-38 DOI: http://dx.doi.org/10.3126/saarctb.v9i1.6963
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Kotschan, N. "Advances in Screening and Early Detection." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 147s. http://dx.doi.org/10.1200/jgo.18.87000.

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Background and context: Although breast, cervical and prostate cancer screening are provided to communities in support of the Early Detection Saves Lives campaign in South Africa, it is crucial to collaborate with other health partners for services such as HIV/AIDS, tuberculosis, social services and screening for noncommunicable diseases. This is due to the high prevalence of HIV/AIDS, tuberculosis and noncommunicable diseases in the country. HIV/AIDS-related cancers are rising with other diseases and this impacts on the patient's treatment, care and quality of life. Aim: The primary objective of the introduction of these health partners and other sectors (education, women in presidency, commission for gender equality, transport and home affairs) are to ensure that the patient receives holistic care and postscreening runs effectively where both patient and medical professional hold updated records. Strategy/Tactics: 1. We worked closely with respective Community-Based Primary Healthcare Centres (PHC) on corporate funded outreaches scheduled in five provinces of SA, using our mobile units for screening purposes. 2. Remote areas with reduced access to specialized healthcare services were specifically targeted. 3. Captured patient histories, identification, and treatment (pre- and postscreening) provided PinkDrive/MBTM with sufficient information to run streamlined screening processes. 4. Patients were first screened for HIV-AIDS, tuberculosis and thereafter screened for noncommunicable diseases, e.g., gender-related cancers and obesity. Outcomes: 1. In a collaborative structure, we have found that the patient is privy to understanding the level, importance and stage of cancer with other related illnesses. 2. Results are more controlled and the patient's health record is captured at the relevant health institutions. 3. Holistic healthcare services and medical treatments are monitored, measured and managed appropriately at the relevant healthcare institution. 4. A relatively high demand for Pap smear screening was noted at many PHCs as many were still utilizing outdated Pap smear kits. What was learned: Collaborative initiatives are good success stories incorporating best practices and also benefitting the patients and medical professional. We are living in a digital age and yet our equipment and machinery is not state of the art. The mobile truck, in many instances, has to travel to the most remote areas with poor road infrastructure. New technology will make a remarkable difference, especially if it is systemised to the relevant institution, upgraded, built-in with latest developments so that the mobile truck is able to travel on all road types. For South Africa, PinkDrive/MBTM have grown tremendously and are continuously building public private partnerships.
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Newland, Jamee, Dwi Lestari, Mashoeroel Noor Poedjanadi, and Angela Kelly-Hanku. "Co-locating art and health: engaging civil society to create an enabling environment to respond to HIV in Indonesia." Sexual Health 18, no. 1 (2021): 84. http://dx.doi.org/10.1071/sh20125.

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Background This paper will report on the successful co-location of a community-based arts and sexual health project that aimed to engage, educate and create testing, treatment and care pathways at a co-located mobile sexual health clinic and community-controlled art gallery in Yogyakarta, Indonesia. Methods: Mixed methods were used to evaluate the project, including a visitor (n = 1181) and artist (n = 85) log book, a convenience audience survey (n = 231), and qualitative semi-structured interviews (n = 13) with artists and audience to explore the effect of arts-based activities on access to sexual health information and services, and stigma and discrimination. Results: In total, 85 artists curated five separate exhibitions that were attended by 1181 people, of which 62% were aged ≤24 years. Gallery attendance improved awareness and participatory and interactive engagement with sexual health information through a medium described as interesting, fun, cool, and unique. The co-located clinic facilitated informal pathways to sexual health services, including HIV/AIDS testing, treatment, and care. Importantly, the project created shared understandings and empathy that challenged stereotypes and myths, reducing stigmatising beliefs and practices. Conclusions: Arts-based programs are transformative and can be effectively implemented, replicated and scaled up in low-resource settings to create awareness and initiate for HIV prevention, testing, treatment, and care. Art-based health programs engages people in their communities, mobilises civil society, builds enabling environments to reduce stigma and discrimination and improves access to testing and prevention; essential features needed to end AIDS in Indonesia (and the Southeast Asia region) while improving the lives of those most vulnerable to infection.
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Petzoldt, D., U. Jappe, M. Hartmann, and O. Hamouda. "Sexually transmitted diseases in Germany." International Journal of STD & AIDS 13, no. 4 (April 1, 2002): 246–53. http://dx.doi.org/10.1258/0956462021925045.

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In the former West Germany, in specific venereal diseases legislation passed in 1953, only syphilis, gonorrhoea, ulcus molle, and lymphogranuloma venereum were defined as venereal diseases and subject to mandatory notification. The proportion of unreported cases was as high as 75% for syphilis and up to 90% for gonorrhoea. Epidemiological data for the past 10 years exist only on selected populations from research studies and are summarized in this article. In the former East Germany reporting of sexually transmitted infections (STIs) was mandatory and, due to the centralized organization, underreporting was considered to be low, although no specific studies have examined this. After the unification in 1990 of the two German states the West German laws were adopted in East Germany. Since 1982 - when the first AIDS case was reported in Germany - information on AIDS cases has voluntarily been collected at the national register at the AIDS Centre of the Robert Koch Institute in Berlin. The law governing the reporting of infectious diseases has recently been revised. Under the new Protection against Infection Act, which became effective on 1 January 2001, clinical diagnoses of STIs (with the exception of hepatitis B) are no longer notifiable diseases. Laboratory reporting of positive test results for Treponema pallidum has been introduced. With T. pallidum and HIV notifications, additional disaggregated data are collected. Since T. pallidum and HIV remain the only notifiable STIs, all other STIs have to be monitored through sentinel surveillance systems. These surveillance systems are currently being established. Under the new legislation, local health authorities have to provide adequate counselling and testing services for STIs, which may be provided free of charge if necessary.
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Kloppers, J. M., L. N. Nelumbu, T. Nauiseb, P. Angula M. B. Tibinyane, and N. G. Sumpi. "Experience of a health day at the university of Namibia: A community service." International Journal of Medicine 3, no. 2 (October 14, 2015): 108. http://dx.doi.org/10.14419/ijm.v3i2.5098.

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<p>The School of Nursing and Public Health conducted an annual health day at the main campus in Windhoek. The clinic on campus was not operational, at this time. This service is much appreciated by students and staff. The Community Health Nursing lecturers and second year diploma students participated in the Health day. The services that were rendered included blood pressure; weight and height and body mass index; blood-glucose test; eye test; neck massage. Health education on HIV/AIDS and cancer prevention was given to those who took part. The health day targeted non-communicable diseases (NCD) in order to promote prevention strategies. NCD is a medical condition or disease that can be defined as non-infectious and non-transmissible among people. It is further described as chronic diseases which last for long periods of time and progress slowly. Sometimes, NCDs result in rapid deaths as seen in certain types of diseases such as autoimmune diseases, heart diseases, stroke, most cancers, asthma, diabetes, chronic kidney disease, osteoporosis, Alzheimer's disease, cataracts, and many more (World Health Organization (WHO).</p><p><strong>Aim:</strong> The health day was done to promote and to provide necessary information and to raise awareness to students and staff on their health and on how to prevent non –communicable diseases.</p><p><strong>Method:</strong> No actual research was done.</p><p><strong>Results:</strong> Data analysis was done based on the findings from the users of the service. The total number of the people who used the blood pressure service were 161. Of which 38 were found to have high blood pressure while 10 were found with low blood pressure and were advised to visit the hospital or clinic and 113 had normal blood pressure. Many people, who were detected with high blood pressure, or hypertension, had no idea of having it. The people who came for weight were 130 out of which 63 had normal weight, 32 were overweight, 16 were obese, and 15 were underweight. Health education was given on nutrition, specifically on balance diet. 20 people were found with high blood-glucose level ranging between 7-21.8 mml. Total number of people who attend eye test were 63 of which 4 had poor vision and were referred to eye clinic. Neck massage attracted many people, and they enjoyed it.</p><p><strong>Conclusion:</strong> The results of health day indicated the need of such services in order to detect abnormalities and to improve the knowledge and understanding of the community members on non-communicable diseases and how to prevent them.</p>
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DOUGAN, S., B. G. EVANS, N. MACDONALD, D. J. GOLDBERG, O. N. GILL, K. A. FENTON, and J. ELFORD. "HIV in gay and bisexual men in the United Kingdom: 25 years of public health surveillance." Epidemiology and Infection 136, no. 2 (July 30, 2007): 145–56. http://dx.doi.org/10.1017/s0950268807009120.

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SUMMARYIt is more than 25 years since the first case of AIDS was reported in the United Kingdom. In December 1981 a gay man was referred to a London hospital with opportunistic infections indicative of immunosuppression. National surveillance began the following year, in September 1982, with the notification of deaths and clinical reports of AIDS and Kaposi's sarcoma plus laboratory reports of opportunistic infections. Since then epidemiological surveillance systems have evolved, adapting to, and taking advantage of advances in treatments and laboratory techniques. The introduction of the HIV antibody test in 1984 led to the reporting of HIV-positive tests by laboratories and the establishment of an unlinked anonymous survey in 1990 measuring undiagnosed HIV infection among gay men attending sexual health clinics. The widespread use of highly active antiretroviral therapies (HAART) since 1996 has averted many deaths among HIV-positive gay men and has also resulted in a large reduction in AIDS cases. This led to a need for an enumeration of gay men with HIV accessing NHS treatment and care services (1995 onwards), more clinical information on HIV diagnoses for epidemiological surveillance (2000 onwards) and the routine monitoring of drug resistance (2001 onwards). Twenty-five years after the first case of AIDS was reported, gay and bisexual men remain the group at greatest risk of acquiring HIV in the United Kingdom. Latest estimates suggest that in 2004, 26 500 gay and bisexual men were living with HIV in the United Kingdom, a quarter of whom were undiagnosed. In this review, we examine how national surveillance systems have evolved over the past 25 years in response to the changing epidemiology of HIV/AIDS among gay and bisexual men in the United Kingdom as well as advances in laboratory techniques and medical treatments. We also reflect on how they will need to continue evolving to effectively inform health policy in the future.
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Ratna Frenty Nurkhalim. "Gambaran Tingkat Pengetahuan Wanita Usia Subur Tentang HIV/AIDS di Wilayah Kerja Puskesmas Gurah Kabupaten Kediri." Masokan: Ilmu Sosial dan Pendidikan 1, no. 1 (June 24, 2021): 12–27. http://dx.doi.org/10.34307/misp.v1i1.4.

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HIV / AIDS is an infectious disease caused by infection with the Human Immunodeficiency Virus (HIV) which attacks the immune system. (RI Ministry of Health, 2017). The high case of HIV / AIDS in women is feared to have an impact on the increase in cases of HIV / AIDS in children who get from perinatal transmission or transmission of infections that occur during pregnancy or childbirth. Another contributing factor is the lack of knowledge and awareness about HIV / AIDS that has threatened ordinary people including women of childbearing age. This study aims to determine the level of knowledge of women of childbearing age about HIV / AIDS in the Gurah Health Center area of ​​Kediri Regency. The method used was cross-sectional by distributing questionnaires to a group of women of childbearing age with a total sample of 98 respondents. With variables including the characteristics of respondents and knowledge of HIV / AIDS. Based on the research results obtained for the most age at the end of adulthood (35.7%), the most education was high school / vocational school (62.2%), IRT work (65.3%), electronic media information sources (41.8%). While knowledge of HIV / AIDS was sufficient as much as 43.9%, knowledge about transmission is low (49.9%), knowledge of prevention about limiting sexual relations (70.4%), condom use (55.1%), knowledge of signs and symptoms of people appear healthy (73.5%) , knowledge of characteristics affected by HIV / AIDS (59.2%), knowledge of prevention of HIV / AIDS testing (54.1%), and place of testing services (53.1%). The conclusion that can be taken was the level of knowledge of women of childbearing age about HIV / AIDS was in the sufficient category and was expected to be further improved so that it becomes a high level by conducting counseling by health workers in the Puskesmas and other agencies. HIV/AIDS merupakan penyakit menular yang disebabkan oleh infeksi Human Immunodeficiency Virus (HIV) yang menyerang sistem kekebalan tubuh. (Kemenkes RI, 2017). Tingginya kasus HIV/AIDS pada perempuan dikhawatirkan akan ikut berdampak pada peningkatan kasus HIV/AIDS pada anak-anak yang didapat dari penularan melalui perinatal atau penularan infeksi yang terjadi pada saat kehamilan atau persalinan. Faktor penyebab lainnya adalah kurangnya pengetahuan dan kesadaran tentang HIV/AIDS yang telah mengancam kalangan orang biasa termasuk wanita usia subur. Penelitian ini bertujuan untuk mengetahui tingkat pengetahuan wanita usia subur tentang HIV/AIDS di wilayah Puskesmas Gurah Kabupaten Kediri. Metode yang digunakan adalah cross-sectional dengan menyebarkan kuesioner ke kelompok wanita usia subur dengan jumlah sampel sebanyak 98 responden. Dengan variabel meliputi karakteristik responden dan pengetahuan HIV/AIDS. Berdasarkan penelitian diperoleh hasil untuk usia terbanyak pada dewasa akhir (35.7%), pendidikan terbanyak yaitu SMA/SMK (62.2%), pekerjaan IRT (65.3%), sumber informasi media elektronik ( 41.8%). Sedangkan pengetahuan HIV/AIDS yaitu cukup sebanyak 43.9%, pengetahuan mengenai penularan yaitu rendah (49.9%), pengetahuan pencegahan tentang membatasi hubungan seksual (70.4%), pemakaian kondom (55.1%), pengetahuan tanda dan gejala orang tampak sehat (73.5%), pengetahuan ciri terkena HIV/AIDS (59.2%), pengetahuan penanggulangan adanya tes HIV/AIDS (54.1%), dan tempat pelayanan tes (53.1%). Simpulan yang dapat diambil adalah tingkat pengetahuan wanita usia subur tentang HIV/AIDS berada pada kategori cukup dan diharapkan dapat lebih ditingkatkan sehingga menjadi tingkatan yang tinggi dengan dilakukan penyuluhan oleh tenaga kesehatan yang ada di Puskesmas maupun instansi lainnya.
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Shahmanesh, Mohsen, and Charles Lacey. "The clinical load of HIV and AIDS for genitourinary physicians." International Journal of STD & AIDS 9, no. 10 (October 1, 1998): 567–70. http://dx.doi.org/10.1258/0956462981921134.

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We aimed to investigate the extent of genitourinary medicine (GUM) involvement in the clinical management of HIV. A questionnaire survey was conducted on GUM consultants in the UK and the Irish Republic. Clinics were divided into teaching hospitals (THs) undertaking both undergraduate and postgraduate training in GUM, non-teaching training (NTT) centres undertaking specialist training only and non-teaching (NT) centres. Information was obtained on 241 of the 250 consultants on the Royal College of Physician's GUM Committee's records from 117 GUM clinics (including all THs and NTT centres). Four (1 TH and 2 NTT centres) GUM clinics did not see HIV-positive patients, 62 saw 10-99 patients, 18 reported 100-999 and 4 with over 1000 patients attending in 1996. Thirty-five per cent of the 55 THs and NTT centres had over 100 HIV patients. Consultants were involved in the outpatient care of HIV patients in 99.5% and GUM trainees in 85.5% clinics. Overall 47 clinics have their own inpatient HIV beds and 176 consultants (73%) had full (100) or significant (76) input to inpatient HIV management. Only 29% of THs and 12.5% of NTT centres had none or minor input into HIV care. HIV inpatient on-call commitment by the GUM trainees was reported by 64% of training centres. GUM services provide a major input into outpatient and inpatient care of HIV-infected patients in the UK.
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Fukunaga, Rena, David Lowrance, Adam MacNeil, Teeb Al-Samarrai, Joseph Cavanaugh, Annabel Baddeley, Catherine Nichols, et al. "Collect Once, Use Many Times: Attaining Unified Metrics for Tuberculosis Preventive Treatment for People Living With HIV." JMIR Public Health and Surveillance 7, no. 4 (April 30, 2021): e27013. http://dx.doi.org/10.2196/27013.

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The World Health Organization (WHO) recommends providing tuberculosis preventive treatment (TPT) to all persons living with HIV and to all household contacts of persons with bacteriologically confirmed pulmonary tuberculosis disease. Regrettably, the absence of a harmonized data collection and management approach to TPT indicators has contributed to programmatic challenges at local, national, and global levels. However, in April 2020, the WHO launched the Consolidated HIV Strategic Information Guidelines, with an updated set of priority indicators. These guidelines recommend that Ministries of Health collect, report, and use data on TPT completion in addition to TPT initiation. Both indicators are reflected in the WHO’s list of 15 core indicators for program management and are also required by the US President’s Emergency Plan for AIDS Relief’s Monitoring, Evaluation, and Reporting (MER) guidance. Although not perfectly harmonized, both frameworks now share essential indicator characteristics. Aligned indicators are necessary for robust strategic and operational planning, resource allocation, and data communication. “Collect once, use many times” is a best practice for strategic information management. Building harmonized and sustainable health systems will enable countries to successfully maintain essential HIV, tuberculosis, and other health services while combatting new health threats.
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Molparia, Bhuvan, Brian N. Schrader, Eli Cohen, Jennifer L. Wagner, Sandeep R. Gupta, Sherrie Gould, Nelson Hwynn, Emily G. Spencer, and Ali Torkamani. "Combined accelerometer and genetic analysis to differentiate essential tremor from Parkinson’s disease." PeerJ 6 (July 20, 2018): e5308. http://dx.doi.org/10.7717/peerj.5308.

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Essential tremor (ET) and Parkinson’s disease (PD) are among the most common adult-onset tremor disorders. Clinical and pathological studies suggest that misdiagnosis of PD for ET, and vice versa, occur in anywhere from 15% to 35% of cases. Complex diagnostic procedures, such as dopamine transporter imaging, can be powerful diagnostic aids but are lengthy and expensive procedures that are not widely available. Preliminary studies suggest that monitoring of tremor characteristics with consumer grade accelerometer devices could be a more accessible approach to the discrimination of PD from ET, but these studies have been performed in well-controlled clinical settings requiring multiple maneuvers and oversight from clinical or research staff, and thus may not be representative of at-home monitoring in the community setting. Therefore, we set out to determine whether discrimination of PD vs. ET diagnosis could be achieved by monitoring research subject movements at home using consumer grade devices, and whether discrimination could be improved with the addition of genetic profiling of the type that is readily available through direct-to-consumer genetic testing services. Forty subjects with PD and 27 patients with ET were genetically profiled and had their movements characterized three-times a day for two weeks through a simple procedure meant to induce rest tremors. We found that tremor characteristics could be used to predict diagnosis status (sensitivity = 76%, specificity = 65%, area under the curve (AUC) = 0.75), but that the addition of genetic risk information, via a PD polygenic risk score, did not improve discriminatory power (sensitivity = 80%, specificity = 65%, AUC = 0.73).
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Bilal, Arebu Issa, Bruck Messele, Dawit Teshome, Zelalem Tilahun, and Teferi Gedif Fenta. "Concomitant use of medicinal plants with antiretroviral drugs among HIV/AIDS patients in Ethiopia: A cross-sectional study." Ethiopian Pharmaceutical Journal 35, no. 1 (April 29, 2020): 59–66. http://dx.doi.org/10.4314/epj.v35i1.6.

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In spite of an increase in the health service coverage of the country, studies reported that significant proportion of the Ethiopian population still relies on traditional medicine, particularly on the herbal aspect, for their healthcare. The aim of the present study was to determine the extent of the concomitant use of herbal medicines with modern antiretroviral medicines and identify the commonly used herbs among patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in Ethiopia. A cross-sectional study was conducted from May to June, 2017 among HIV/AIDS patients in five hospitals selected from four regions and one city Administration (Addis Ababa). A total of 768 HIV/AIDS patients were successfully interviewed and included in the analysis. Most 480 (62.5%) of them were on tenofovir-disoproxil fumarate (TDF) plus lamivudine (3TC)and efavirenz (EFV) regimen. Two hundred nineteen (28.5%) patients reported that they had used herbal medicines to treat their illness; of these 145 (66.2%) used herbal products along with modern medicine. Of those who reported to have used herbal medicine with modern medicine, 53 (40.8%) claimed that they took the herbal medicines for the treatment of HIV/AIDS, while 51(39.2%) used for treating co-morbid diseases. Only 33 (15.0%) of those who used herbal medicines along with modern drugs discussed the issue either with their physicians or pharmacists. A total of 31 plant species were reported to be used for the treatment as well as alleviation of symptoms associated with the disease. The most commonly cited herbal medicines that have been used by HIV/AIDS patients to treat their comorbid diseases were Moringa stenopetala (Baker f.) Cufod. (Moringaceae) (35.6%) followed by Ocimum lamiifolium Hochst. (Lamiaceae) (18.0%), Zheneria scabra Sond. (Cucurbitaceae) (7.2%), Allium sativum L. (Alliaceae) (5.7%), and Ruta chalapensis L. (Rutaceae) (5.7%). The study revealed that close to one-third of HIV/AIDS patients interviewed reported use of herbal medicine and almost two-thirds of them did so concomitantly with modern medicine. Only small percentage of the patients who used herbal medicines along with modern drugs disclose the use either to their treating physicians or to counselling pharmacists. Practitioners involved in antiretroviral therapy (ART) clinics, therefore, need to inquire information related to the use of herbal medicines and accordingly advise the patients. Keywords: HIV/AIDS, medicinal plant, cross-sectional study, concomitant use, Ethiopia
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Singh, Amresh Kumar, Vivek Gaur, Ankur Kumar, Jayesh Pandey, and Vandana Upadhyay. "Incidence of HIV infection in eastern Uttar Pradesh: HIV counseling and testing services record based retrospective study." International Journal of Research in Medical Sciences 7, no. 6 (May 29, 2019): 2286. http://dx.doi.org/10.18203/2320-6012.ijrms20192514.

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Background: India has approximately 2.4 million of people living with HIV and out of these two thirds live in rural areas. This study may yield significant data to understand epidemiology of HIV/AIDS in this region that would help in designing techniques for effective implementation to prevent this infection.Methods: The present study was a comprehensive retrospective hospital-based investigation of the HIV infection in eastern Uttar Pradesh, India based on a large number of clinical samples at HCTS centre, representing different geographic regions and has been functional since 2002, conducting HIV tests, counselling of patients as well as maintains proper records.Results: A total of 444 HIV positive clients were registered in this retrospective study. The male and female ratio among all positive clients was 1.67:1 and the most common age group for both the genders was 35-49 years. Among 444 HIV positive clients, HIV-TB co-infection found in 72 (16.21%) cases. Out of 444 clients, 177 (40%) and 167 (38%) found extremely immunocompromised with low CD4 cells count in range between of 0-100 cells/mm3 and >100-350 cells/mm3 respectively. Mortality was seen in 72 (16%) out of 444 HIV positive clients.Conclusions: There is an urgent need of information, education about this disease and by providing suitable occupation or to make them aware, which will markedly help in preventing the spread of HIV pandemic in this geographical region.
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Waehrer, Geetha, J. Paul Leigh, and Ted R. Miller. "Costs of Occupational Injury and Illness within the Health Services Sector." International Journal of Health Services 35, no. 2 (April 2005): 343–59. http://dx.doi.org/10.2190/rnq3-0c13-u09m-tenp.

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Knowledge of costs is essential to allocate medical resources efficiently. The authors' goal was to estimate and compare costs across occupations, industries, gender, race, and types of nonfatal injuries and illnesses. This is an incidence study of nationwide data, 1993. Nonfatal incidence data were drawn from the Bureau of Labor Statistics Annual Survey. Medical costs were from the Detailed Claims Information data set. Productivity (wage) costs were calculated using the Current Population Survey. Pain and suffering costs were estimated from data on jury verdicts. Injuries and illnesses to nursing aides and orderlies cost $2,200 million; costs were $900 million for registered nurses and $40 million for licensed practical nurses. The ranking of health services industries in terms of costs was: hospitals (52 percent of all costs), nursing care facilities (38 percent), home care services (6 percent), physicians' offices (4 percent), and laboratories (<1 percent). Types of injuries (sprains, strains, fractures) were similar across occupations and industries, but types of illness (carpal tunnel syndrome, respiratory diseases) varied. The most costly injured body parts were: back, shoulder, knee, wrist, and neck. Injuries and illnesses comprised roughly 90 percent and 10 percent, respectively, of total costs. The hospital industry was the third most expensive of 313 U.S. industries. Costs of occupational injury and illness in the health services industry were high and varied across occupation, industry, disease, race, and gender.
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Rasul, Md Maqsudur, Amina Hasnat Chowdhury, Md Sazzad Hosen Romel, Fahad Mohammad Sadat, and Bonny Sadar Hoque. "Prevalence of Common Diseases among Internally Displaced Persons in a Selected Region of Central African Republic." Journal of Armed Forces Medical College, Bangladesh 15, no. 2 (December 20, 2020): 181–85. http://dx.doi.org/10.3329/jafmc.v15i2.50831.

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Introduction: Central African Republic (CAR) is one of the most war-affected countries in the world. The number of forcibly displaced people has grown significantly along with the emergence of many infectious and non-infectious diseases in this region. Very little information is available regarding the health of internally displaced persons (IDPs) of this country. Objectives: To find out the prevalence of common diseases among IDPs of a selected region of CAR. Materials and Methods: This descriptive cross-sectional study was conducted at a United Nations level-II hospital, run by Bangladesh medical contingent from November 2017 to October 2018. Patients of both sex irrespective of age who attended at least once to the medical outpatient department of the hospital included in the study. Results: Out of 1561 respondents 57% were female with a female to male ratio1.3:1. Among the health problems identified, communicable diseases were 65.59% and non-communicable diseases 34.40%. Malaria (21.19%), diarrhoeal disease (17.86%) respiratory tract infection (15.52%) and HIV/AIDS (9.96%) were the most common communicable diseases. Non-communicable diseases mainly affected the adult population where the prevalent diseases were hypertension 18.99% followed by diabetes mellitus 15.08%, severe malnutrition 11.91% and mental and post-traumatic stress disorder (PTSD) 08.93%. Conclusion: Limited provisions on healthcare facilities imposes a huge health risk for the IDPs especially, easily preventable communicable diseases. An integrated effort from local and international bodies is required for the restoration of the basic health services to continued provision of medicines, medical appliance and provide community health education and thereby, improve the overall health status of this region. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 181-185
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Mackay, K., H. Kelly, M. Clemence, and R. Penford. "AB1347-HPR DIGITAL SOLUTIONS TO AID SELF-MANAGEMENT: DEVELOPING A RHEUMATOLOGY APP FOR USE BY ANY PATIENT ATTENDING OUR DEPARTMENT." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1961.2–1962. http://dx.doi.org/10.1136/annrheumdis-2020-eular.5635.

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Background:Managing complex rheumatological conditions requires information about the disease itself, treatments regimes and side effects. This is particularly important for those with a new diagnosis.A local patient focus group identified the need for trustworthy information, written and reviewed by their rheumatology team to aid self-management. They felt information should be readily accessible, in one place, to re-read / re-listen to, as required.Objectives:To develop a Rheumatology App, for any patient attending our department, to support self-management.Methods:We worked with a number of rheumatology patients, of differing ages, the Rheumatology multi-disciplinary team (MDT) and an industry partner, hci.digital, to develop our App, called ‘Rheumatology Connect’.We developed over 30 short videos, provided links to other valuable patient websites e.g. Versus Arthritis, NRAS, NASS, and wrote short articles, to provide basic headline information about various different diseases, common treatments e.g. Methotrexate. We provided easily accessible contact details and information about our clinic locations (including postcodes, bus links, car parking). Video content was written by the clinical authors and filmed by hci.digital.Patient involvement in designing the layout was particularly important for the App to be easily navigable by all.We launched the App, in June 2018, at a local patient educational conference. We encourage all patients on regular follow up to download it /use it and remind everyone about it in our clinic letters.Results:Downloads have been ongoing since launch, with over 1953 downloads and 21930 page views, with peaks around the time of our monthly education sessions when we advertise the App to new patients.Over 54% spent between 2 to 5+ minutes in the App at a time. Most of the videos in the App are about 2 minutes long. Common hits include: videos on medications, various conditions, contact details, clinic locations, and services available.We have had a number of spontaneous contacts from patients saying how valuable they find the information we have given them.The App aids efficiency by allowing direct phone calls to the correct member of the MDT e.g. rheumatology physio, rather than going through the secretaries. We are also encouraging direct email contact via the App. These aspects are helping us make our services more efficient.Conclusion:The App continues to be downloaded and used by our patients. It has become an important part of our patient education efforts, especially for those with a new diagnosis.We have had a significant increase in email contact from patients, allowing us to be more efficient by responding more quickly to patient queries, avoid additional telephone calls and avoid ansa-phone messages.To date, the App continues to be downloaded by patients and we have received very positive feedback. Having surveyed the users, our next step is to develop interactive PROMS, a calendar reminder function and medicines management function as these have been identified as additions users would find helpful to manage their disease. We have raised funds to develop the App. The updated app should be available by May 2020Download free from App store (search ‘Rheumatology Connect’) or go towww.rheumatologyconnect.info.Disclosure of Interests:None declared
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Afifah, Efy. "FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN PERILAKU PENCARIAN PENGOBATAN PADA PRIA DENGAN PENYAKIT MENULAR SEKSUAL (PMS)-HIV/AIDS DI JAKARTA, SURABAYA DAN MENADO TAHUN 2000." Jurnal Keperawatan Indonesia 8, no. 2 (April 24, 2014): 41–49. http://dx.doi.org/10.7454/jki.v8i2.146.

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AbstrakMasalah Penyakit Menular Seksual (PMS)-HIV/AIDS di Indonesia saat ini merupakan hal yang patut diwaspadai dan diantisipasi lebih dini, mengingat prevalensinya yang meningkat. Salah satu faktor yang berperan dalam penanggulangan PMS-HIV/AIDS adalah perilaku pencarian pengobatan yang masih rendah khususnya pada kelompok pria. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan perilaku pencarian pengobatan pada pria dengan PMS-HIV/AIDS di Jakarta, Surabaya, dan Menado. Rancangan penelitian ini adalah deskriptif dengan menggunakan pendekatan studi potong lintang (cross sectional), dengan pengolahan data menggunakan analisis regresi logistik ganda yang menggunakan data Behavioral Surveillance Survey PMS-HIV/AIDS tahun 2000. Jumlah sampel yang terlibat 624 responden. Hasil penelitian ini menunjukkan 75,3% proporsi perilaku pencarian pengobatan kurang baik. Tidak ada hubungan yang bermakna antara umur, status perkawinan, sumber informasi dengan perilaku pencarian pengobatan. Variabel pengetahuan dan pendidikan berhubungan secara bermakna dengan perilaku pencarian pengobatan dan tidak ada interaksi antara pendidikan dan pengetahuan. Responden yang berpengetahuan kurang berpeluang 1,8 kali (95% CI: 1,1724-2,6442) melakukan pencarian pengobatan kurang baik dibandingkan dengan responden yang berpengetahuan baik setelah dikontrol variabel pendidikan. Responden yang berpendidikan rendah berpeluang 1,7 kali (95% CI: 1,0236- 2,5805) melakukan pencarian pengobatan kurang baik dibandingkan responden yang berpendidikan tinggi setelah dikontrol variabel pengetahuan. Rekomendasi telah disampaikan pada pemerintah untuk menjadikan program tetap dan pengalokasian dana tidak hanya untuk pengobatan juga untuk pelayanan kesehatan dan konseling dan penelitian lebih lanjut untuk menggali lebih dalam alasan responden yang tidak melakukan pencarian pengobatan perlu pula untuk dilakukan. AbstractCurrenly, a sexual transmitted disease (STD)-HIV/AIDS in Indonesia, is an issue that every individual should concern and anticipate, this is because its prevalency increases. The strategic position of Indonesia is considered susceptible to the pandemy of HIV/ AIDS. One of the factors which play an important role in controlling the STD-HIV/AIDS is a low rate health seeking behavior among male subjects. The purpose of the study was to identify factors influencing to health seeking behaviour of male subjects with STD–HIV/AIDS in Jakarta, Surabaya, and Manado. The design of the study was descriptive explorative using cross sectional approach. A multiple logistic regression was used to analyse the secondary data from behavioral surveillance survey of STD–HIV/ AIDS in 2000. The number of sampel was 624 respondents. The findings showed that the proportion of male health seeking behaviour is low (75, 3% N= 624). There are no relationships between age, marital status, and information sources with the health seeking behaviour. The variables of education and knowledge have relationship with health seeking behaviour and there is no interaction between education and knowledge. Respondents with limited knowledge have the possibilities 1.8 times to have poor health seeking behaviour (95% CI: 1, 1725 – 2, 6442) compared to those who have sufficient knowledge after being controlled by the education variable. Respondents who have lower education have the possibilities of 1,7 times to have poor health seeking behaviour ( 95% CI: 1,00236 – 2,5805) compared to those who have higher education after being controlled by knowledge variable. Some recommendations were contributed to government to create the prevention program of STD–HIV/AIDS as an annual program and to allocate fund which is not only for medication but also for the health and counseling services. Further study needs to be done to explore more detailed explanations why respondents do not seek for health care.
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Slaymaker, Emma, Estelle McLean, Alison Wringe, Clara Calvert, Milly Marston, Georges Reniers, Chodziwadziwa Whiteson Kabudula, et al. "The Network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA): Data on mortality, by HIV status and stage on the HIV care continuum, among the general population in seven longitudinal studies between 1989 and 2014." Gates Open Research 1 (November 6, 2017): 4. http://dx.doi.org/10.12688/gatesopenres.12753.1.

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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. Neither routine statistics nor observational clinical studies can estimate mortality prior to linkage to care nor following disengagement from care. For this, population-based data are required. The Network for Analysing Longitudinal Population-based HIV/AIDS data on Africa brings together studies in Kenya, Malawi, South Africa, Tanzania, Uganda, and Zimbabwe. Eight studies have the necessary data to estimate mortality by HIV status, and seven can estimate mortality at different stages of the HIV care continuum. This data note describes a harmonised dataset containing anonymised individual-level information on survival by HIV status for adults aged 15 and above. Among PLHIV, the dataset provides information on survival during different periods: prior to diagnosis of infection; following diagnosis but before linkage to care; in pre-antiretroviral treatment (ART) care; in the first six months after ART initiation; among people continuously on ART for 6+ months; and among people who have ever interrupted ART.
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QIU, Ren-Zong. "艾滋病防治中的倫理和政策問題." International Journal of Chinese & Comparative Philosophy of Medicine 1, no. 4 (January 1, 1998): 7–60. http://dx.doi.org/10.24112/ijccpm.11348.

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LANGUAGE NOTE | Document text in Chinese; abstract also in English.本文討論了艾滋病在中國大陸傳播引起的倫理和政策問題。作者首先指出在預防控制艾滋病問題上中國正處在十字路口。挨著作者分析了中國會不會成為艾滋病和艾滋病病毒感染的高發國,討論了制訂有效而合乎倫理的艾滋病防治政策的理論預設和價值以及評價政策的倫理學框架,討論了艾滋病治療和預防中的倫理和政策問題。The AIDS/HIV prevention and control in China is at crossroad. At present, there are insufficient grounds for us to say that China will definitely become a country with a high HIV infection rate in the future. However, we have much less sufficient grounds for saying that China will never reach that stage. On the contrary, we have much more reason to say that it is very probable for China to become a country with high HIV infection rate if we leave the current policy unchanged. The reasons are: economic reforms associated with large scale population movements in unprecedented way; proliferation of all sorts of high risk behavior, presence of other STDs which facilitate the spread of HIV; the risk of iatrogenic spread through untested blood transfusion; the "sex revolution" with changes in patterns of sex behaviour and increased casual sex, multiple sex partners among the younger generation; most Chinese still do not know how to protect themselves; and the ethical and legal atmosphere necessary for effectively preventing the HIV epidemic has not been formed.The conventional public health approach is not sufficient to prevent or control an HIV epidemic. When the cases of HIV infection were detected one by one in China, health professionals and programmers believed that they could take a conventional public health approach to cope with HIV epidemic. But they are wrong. HIV infection is an epidemic so special that the conventional public health measures such as testing, reporting, contact tracing, isolation are inadequate or ineffective to control the epidemic. HIV is often spread among those groups who are usually marginalized or stigmatized by society through behaviours both confidential or private.An effective policy of preventing HIV cannot be insensitive to ethical issues. However, many of health professionals and programmers bypassed ethical issues emerged in the prevention of the HIV epidemic. Even some health educators, sexologists and officials believe that "AIDS is the punishment by God" or "AIDS is the punishment for promiscuity". For them suffering AIDS is not morally irrelevant, and thus the ancient conception of disease was revived. But this conception of disease has already proved wrong and harmful to the treatment and prevention of any disease, especially to HIV. The consequence entailed by this conception is that the IIIV positive and AIDS patients were discriminated against and stigmatized. When their positive serological status was disclosed, they were faced with the risk of being expelled from school or fired from working unit, even rejected for admission into hospital, and their tights to confidentiality and privacy were often infringed upon. If all these ethical issues cannot be properly treated, how can those persons in danger or risk get access to information, services, education, counselling and techniques necessary to prevent HIV infection? One Chinese adage says that "You cannot have fish and bear palm both". In the prevention of HIV epidemic we have to have the protection of public health and the safeguarding of individual rights.For controlling HIV epidemic what we need is not a repressive law, but a supportive law to build a supportive environment in treatment and prevention of AIDS/HIV. So the policy and law involving AIDS/ HIV should be reformed.DOWNLOAD HISTORY | This article has been downloaded 19 times in Digital Commons before migrating into this platform.
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Beck, E. J., and K. Tolley. "Financing HIV service provision in England: estimated impact of the cost of antiretroviral combination therapy." International Journal of STD & AIDS 9, no. 9 (September 1, 1998): 512–17. http://dx.doi.org/10.1258/0956462981922746.

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The objective of this study was to provide population based estimates on the cost of HIV service provision in England and the use of dual or triple antiretroviral combination therapy. Contemporary cost estimates of treating HIV infected individuals by clinical stage of HIV infection indexed to 1995 96 prices were linked to the number of diagnosed HIV infected individuals using statutory medical services in England during 1996. Two cost measures were used: the first one was based on average hospital prices derived from a number of English HIV units. These results were compared with those estimated using standard unit costs obtained through specific costing studies performed at a national HIV referral centre. Overall annual expenditure on HIV service provision was estimated for different treatment scenarios as was expenditure by clinical stage of HIV infection. Using hospital prices, in 1996 the total annual cost estimate for HIV service provision amounted to 131 m range 83 m to 233 m , or 150 m 95 CI 126 m to 173 m using standard costs, if all patients with HIV disease were treated with AZT monotherapy. For all eligible patients to be treated with dual therapy, cost estimates amounted to 161 m range 126 m to 173 m per year using hospital prices or 180 m 95 CI 156 m to 203 m when using standard cost estimates, while for triple therapy annual estimated expenditure amounted to 204 m per year range 157 m to 306 m when using hospsital prices or 223 m 95 CI 199 m to 246 m using standard costs. Increasingly costs will be more evenly distributed across the 3 stages of HIV infection, with a greater proportion of costs generated by HIV infected individuals before the onset of AIDS. Using non standardized hospital prices may systematically underestimate the real cost of service provision. Monitoring prospectively the use, cost and outcome of HIV service provision in a standardized format will provide information on the actual cost impact over the next 2-3 years of combination therapy compared with the scenario based estimates produced in this paper.
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Singh, Rishi P., Sunil S. Patel, Jared S. Nielsen, Jordana K. Schmier, and Yamina Rajput. "Patient-, Caregiver-, and Eye Care Professional-reported Burden of Geographic Atrophy Secondary to Age-related Macular Degeneration." American Journal of Ophthalmic Clinical Trials 2 (April 5, 2019): 1. http://dx.doi.org/10.25259/ajoct-9-2018.

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Objective Geographic atrophy (GA) is a progressive, irreversible advanced form of age-related macular degeneration. There is limited information on the burden of illness of GA from patient, caregiver, and eye care professional perspectives. This study identifies key factors that should be included for assessment in future studies of patients with GA. Methods In this cross-sectional qualitative study, patients with symptomatic GA (n = 8), their caregivers (n = 6), and eye care professionals who treat patients with GA (n = 5) were interviewed at US sites. Interview guides were designed to evaluate the understanding of the disease, costs and burden of illness, use of vision aids or services, and impact on emotional or psychological well-being and on daily activities. Results Half of the patients mentioned social, psychological, or helplessness issues. Patients reported the impact of GA on sports and outdoor hobbies, meals or food preparation, religious activities, and long-distance travel. Patients reported having stopped driving or changing driving patterns as a major concern. 38% of all patients reported previously modifying their work schedules due to vision impairment. All patients reported the use of at least one vision aid, with 88% of patients purchasing the aids out of pocket. Caregivers reported modifying their schedules to provide assistance as needed and expressed frustration over their inability to improve patients’ health. Eye care professionals noted the emotional impact of vision loss, accidents, and injuries, and identified mental health as a key topic for patients with GA. Conclusions Although limited by size, this study indicates that GA has a major negative impact on patients’ and caregivers’ social functioning and health-related quality of life. This study has identified indirect resource use, including caregiving needs, and direct patient out-of-pocket costs as factors relevant to patients with GA. Future larger studies are needed to further characterize the burden of illness of GA for patients and caregivers.
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Kassler, William J., Mary Grace Alwano-Edyegu, Elizabeth Marum, Benon Biryahwaho, Peter Kataaha, and Beth Dillon. "Rapid HIV testing with same-day results: a field trial in Uganda." International Journal of STD & AIDS 9, no. 3 (March 1, 1998): 134–38. http://dx.doi.org/10.1258/0956462981921882.

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Rapid, on-site HIV testing with same-day results may improve services and increase the number of clients who learn their serostatus in developing countries. To validate test performance under field conditions and assess the change in the proportion of clients who learn their serostatus, we conducted a field trial using the Capillus HIV-1/HIV-2 assay (Cambridge Diagnostics) at the AIDS Information Centre counselling and testing sites in Uganda. Compared to the standard 2-EIA testing algorithm, the sensitivity of Capillus was 99.6% (95% CI; 98.5%, 99.9%), the specificity was 98.8% (95% CI; 98.1%, 99.3%), the positive predictive value was 96.5% (95% CI; 94.5%, 97.8%), and the negative predictive value was 99.9% (95% CI; 99.5%, 100%). It took less than 5 min to perform a single test, and results were returned to clients in less than an hour, during which time clients were counselled. This resulted in a 27% increase in the proportion of clients who learned their serostatus and received counselling. We conclude that simple, rapid HIV tests can be performed accurately on-site within the time frame of a clinic visit, increasing the number of clients who learn their serostatus and receive post-test counselling.
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Zens, Martin, Arne Brammertz, Juliane Herpich, Norbert Südkamp, and Martin Hinterseer. "App-Based Tracking of Self-Reported COVID-19 Symptoms: Analysis of Questionnaire Data." Journal of Medical Internet Research 22, no. 9 (September 9, 2020): e21956. http://dx.doi.org/10.2196/21956.

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Background COVID-19 is an infectious disease characterized by various clinical presentations. Knowledge of possible symptoms and their distribution allows for the early identification of infected patients. Objective To determine the distribution pattern of COVID-19 symptoms as well as possible unreported symptoms, we created an app-based self-reporting tool. Methods The COVID-19 Symptom Tracker is an app-based daily self-reporting tool. Between April 8 and May 15, 2020, a total of 22,327 individuals installed this app on their mobile device. An initial questionnaire asked for demographic information (age, gender, postal code) and past medical history comprising relevant chronic diseases. The participants were reminded daily to report whether they were experiencing any symptoms and if they had been tested for SARS-CoV-2 infection. Participants who sought health care services were asked additional questions regarding diagnostics and treatment. Participation was open to all adults (≥18 years). The study was completely anonymous. Results In total, 11,829 (52.98%) participants completed the symptom questionnaire at least once. Of these, 291 (2.46%) participants stated that they had undergone an RT-PCR (reverse transcription-polymerase chain reaction) test for SARS-CoV-2; 65 (0.55%) reported a positive test result and 226 (1.91%) a negative one. The mean number of reported symptoms among untested participants was 0.81 (SD 1.85). Participants with a positive test result had, on average, 5.63 symptoms (SD 2.82). The most significant risk factors were diabetes (odds ratio [OR] 8.95, 95% CI 3.30-22.37) and chronic heart disease (OR 2.85, 95% CI 1.43-5.69). We identified chills, fever, loss of smell, nausea and vomiting, and shortness of breath as the top five strongest predictors for a COVID-19 infection. The odds ratio for loss of smell was 3.13 (95% CI 1.76-5.58). Nausea and vomiting (OR 2.84, 95% CI 1.61-5.00) had been reported as an uncommon symptom previously; however, our data suggest a significant predictive value. Conclusions Self-reported symptom tracking helps to identify novel symptoms of COVID-19 and to estimate the predictive value of certain symptoms. This aids in the development of reliable screening tools. Clinical screening with a high pretest probability allows for the rapid identification of infections and the cost-effective use of testing resources. Based on our results, we suggest that loss of smell and taste be considered cardinal symptoms; we also stress that diabetes is a risk factor for a highly symptomatic course of COVID-19 infection.
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Koprowski, Christopher, Ej Johnson, Kenneth Trzepkowski, Karen Sites, and Nicholas J. Petrelli. "Introducing enhanced navigation and supportive care into the curative treatment of cancer (SCOOP pathway)." Journal of Clinical Oncology 36, no. 30_suppl (October 20, 2018): 142. http://dx.doi.org/10.1200/jco.2018.36.30_suppl.142.

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142 Background: We hypothesized that introducing supportive care management and enhanced electronic aids to nurse navigation in selective curative cases could result in cost savings and enhanced patient experience of the sort demonstrated in patients with advanced disease. Methods: To test this hypothesis, we introduced a clinical pathway in November 2016 called the Supportive Care of Oncology Patients (SCOOP) program. We limited the scope to patients receiving radiation and chemotherapy concurrently at the Helen F. Graham Cancer Center and diagnosed with potentially curable thoracic, colorectal or head and neck malignancies and seen in our mulitdisciplinary clinics (MDCs). 1. A nurse navigation check list was developed for nurse navigators in the Aerial information system to support standardization of care. The navigator has to opt out of ancillary service consults such as nutrition, behavioral health and social work. The check list includes other mandatory tasks that must be completed at various time points before, during and after the patient’s concurrent treatment. Examples include: Prescribed communication dates with the patient; capturing of scheduled consults; assessing additional/unmet needs before, during and after treatment phase. 2. A mandatory supportive and palliative care service screening during the MDC visit, and, if indicated, urgent or timely consultation. 3. Flags in the inpatient information system that alert in real time the supportive care service, the navigators and the oncologists whenever a patient is seen in the emergency room, admitted or discharged. Results: During the first year nurse navigation compliance increased from 94% to 99%.ED visits declined from 54% to 32% of SCOOP patients , admissions from 34% to 25% and readmissions from 32% to 20% . Opportunity cost savings were $1500.00 per patient. Conclusions: Much like the results observed in advanced disease, the early introduction of enhanced nurse navigation and palliative/supportive care in high acuity patients treated curatively improves the patient experience and reduces societal costs.
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Talikowski, Luke, and Sue Gillieatt. "Female sex work in Yangon, Myanmar." Sexual Health 2, no. 3 (2005): 193. http://dx.doi.org/10.1071/sh04043.

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Background: Myanmar (Burma), with an upper estimate of 400 000 people living with HIV/AIDS, faces a dangerous and potentially devastating epidemic. Female sex workers in the country are one of the most affected populations, with high prevalence rates of both HIV and sexually transmitted infections (STIs). Methods: A qualitative study was undertaken in Yangon at the end of 2002 to investigate the social and demographic features contributing to the transmission of HIV among female sex workers in urban Myanmar. Twenty-seven key informants from the government, non-government organisations (NGOs), international non-government organisations (INGOs), private sector and the United Nations system agencies and 25 women currently working in the sex trade were interviewed. Results: The sex trade in Yangon is rapidly growing and is characterised by a high degree of complexity. The number of female sex workers is estimated to be between 5000 and 10 000 and there are ~100 brothels operating in various townships around the city. Nearly one-third of the women in the study reported previous imprisonment for offences related to sex work as well as fear of harassment, sexual exploitation, violence and gang rape. Almost half reported using condoms with clients at all times. Contradicting views exist as to the level of awareness about STIs and HIV among Yangon sex workers, with the majority never having been tested for HIV. Only one-quarter of women were regular patients of the limited number of STI clinics operated by INGOs. Conclusions: Female sex workers in Myanmar remain a highly marginalised group almost inaccessible due to a variety of legal, political, cultural and social factors and are particularly vulnerable to HIV and STIs. It is important to encourage partnerships between INGOs by promoting service coordination and information sharing to increase the availability of services for sex workers and to build political support for an unpopular cause.
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McMorris, Tressa, Gary Sweet, Christopher J. Sullivan, Nicole B. Washington, and Nancy Brahm. "A design and focus group evaluation of dietary choices tools for an underserved population." Mental Health Clinician 6, no. 2 (March 1, 2016): 101–8. http://dx.doi.org/10.9740/mhc.2016.03.101.

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Abstract Introduction: Our objective was to develop and evaluate dietary teaching tools for a select population diagnosed with a severe mental illness and limited financial ability. Patients with severe mental illnesses face many challenges, including common health comorbidities of diabetes, high blood pressure, high cholesterol, and obesity. Cognitive deficits may limit educational programming; financial resources can affect access to a healthy diet. The Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT) program, a university-based program, provides individualized services to this population. One focus is healthy nutritional choices. Methods: In Phase One, a clinical pharmacist and a first-year pharmacy resident created visual aids. These cards were given to health care providers (HCPs) to be used with IMPACT members. HCPs were asked to participate in a focus group and provide feedback. Phase Two: Based on specific focus group feedback, additional resources were created to address identified nutritional needs. Results: Phase One: Ten cards were created and distributed to the HCPs. A focus group was conducted. HCPs reported the cards were useful in opening dietary choices dialogues and were able to give more specific information on alternative choices. Phase Two: From focus group feedback, specific cards for disease states, calorie guidelines, and budget limitations were developed. HCPs immediately utilized them. Discussion: This pilot project was used to design and create educational cards to facilitate discussions on healthy or healthier dietary choices. Feedback from the HCPs participating in the focus group was positive, and they were enthusiastic about both sets of cards, particularly those pertaining to budget choices.
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Kalsi, H., H. Do, and Z. Gu. "15. RISKS, CHOICES AND CONSEQUENCES: INTERNATIONAL STUDENTS AND SEXUAL HEALTH PROMOTION." Sexual Health 4, no. 4 (2007): 290. http://dx.doi.org/10.1071/shv4n4ab15.

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International students are the 4th most revenue raising industry in Australia brining in $6 billion in 2006. December 2006 reports show 383 818 international students were enrolled across Australia with 61�019 in Queensland. The vast majority of students come from Asian countries with a high prevalence of HIV/AIDS and STIs combined with minimal sexual health knowledge. Through workshops and discussion groups with international students they have been identified as a high risk in relation to sexual health problems due to their lack of sexual health knowledge, their tendency to engage in risk behaviour without adequate knowledge of risks, consequences and protection mechanisms. As a result, sexual health issues are increasingly presenting to professionals working directly with international students and health services in claims related to pregnancy, abortion rates, sexual assault, rape and reports of international students from high risk countries found to be HIV+. Further, international students reported receiving no information prior to arrival and on arrival of risk behaviour, safety issues, health or laws in Australia. In order to promote safe sex behaviour among international students we have formulated various strategies to raise awareness of international students, from print material on arrival, to information stalls at O-week, intermittent workshops for international students, student leaders and professionals working directly with international students. The feedback from the students is very positive and new strategies are being developed to target students facing language barriers. Our program findings demonstrate that the international student population is a high risk group facing sexual health issues where increased education and support must occur to prevent and reduce sexual health related problems.
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49

Paul, Gabriel, Judy Lewis, and Bette Gebrian. "Haitian Men’s Health and Health Seeking Behavior." International Journal of Mens Social and Community Health 3, no. 3 (October 30, 2020): e1-e8. http://dx.doi.org/10.22374/ijmsch.v3i3.45.

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The notion that earlier medical interventions result in better patient outcomes is a widely held assumption in the medical community that is supported by extensive research. However, the decision to seek medical care in a timely manner is complex, especially in low- and middle-income countries (LMICs). A significant number of deaths in LMICs result from conditions for which effective treatments are available, such as high blood pressure. In Haiti, the greater life expectancy for women compared to men (67 vs. 62) may be par-tially explained by investments into maternal and reproductive services; however, several other factors are likely contributing to this difference. Given the limited research on men’s health and care-seeking behaviors in Haiti, this study was conducted to investigate the factors that influence men’s health-seeking behaviors and overall knowledge of health and disease. The long-term goal of this research is to identify, and implement, effective interventions that promote primary disease prevention by positively influencing the health-seeking behaviors of Haitian men in Jérémie and the Grand’Anse. MethodsThis study was a cross-sectional survey. A structured questionnaire was used to conduct 115 in-depth inter-views with Haitian men recruited from five churches of different denominations equidistant from Jérémie, Haiti. Questions investigated factors pertaining to socioeconomic status, church involvement, household composition, awareness of family and own health, health-seeking behaviors, and levels of knowledge of health and disease. Each participant had the opportunity to receive a blood pressure reading, and health education sessions were conducted at the conclusion of the study. ResultsMean age was 48 years, average household size was six, and 48% were married. Sixteen percent of men reported having multiple occupations, with 83% engaging in manual labor. Sixty seven percent reported being the primary decision-makers for health care. Sixty three percent had seen a health care provider in the last year; however, 70% had not sought care when sick due to cost (54%) or perceived severity (35%). Men reported they knew an average of 2.2 illnesses or diseases, with HIV/AIDs (30%) and cancer (30%) being the most common. Fifty eight percent of men thought disease and illness are preventable, and 9% believed early care was required for successful treatment. The preferred method of receiving health care information among men included health care provider (HCP) (33%), hospitals (26%), community health workers (22%), church (18%), and radio (18%). Sixty four percent had their blood pressure taken within the past year, and 32% were told that it was high. Only three of the 25 men, who were told their BP was high, reported HTN as a chronic (long-term) disease. Of the 115 men who received a BP measurement as part of the study, 28% had high blood pressure readings (>130/90). ConclusionMen in the community of rural Jérémie, Haiti, have limited knowledge of illness and disease, which may stem from insufficient resources being allocated to their health care. The cumulative effect of this may have negatively influenced their understanding of chronic, yet life-threatening, conditions such as high blood pressure. Consequently, a greater emphasis on health education and healthy lifestyle choices could have a substantial impact on not only primary prevention, but early detection and management of diseases as well. Therefore, in order to improve the health of both the men and their family members in this community, novel and targeted approaches to disseminate important health information to these men should be further investigated and readily implemented.
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50

Maunsell, Rose, Suzanne Bloomfield, Clare Erridge, Claire Foster, Maggi Hardcastle, Anne Hogden, Alison Kidd, et al. "Developing a web-based patient decision aid for gastrostomy in motor neuron disease: a study protocol." BMJ Open 9, no. 12 (December 2019): e032364. http://dx.doi.org/10.1136/bmjopen-2019-032364.

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IntroductionMotor neuron disease (MND) is a progressive, incurable disease, characterised by degeneration of the nerves in the brain and spinal cord. Due to the multisystem effects of the disease, patients are faced with many complex, time-sensitive decisions, one of which is the decision on gastrostomy feeding. There are currently no published decision aids (DAs) to support patients making this decision in the UK. This study will develop and pilot a patient DA to provide evidence-based information on gastrostomy placement and feeding that is relevant to people with MND; communicate the risks and benefits associated with each option; check understanding and clarify personal values and preferences, enabling patients to make a decision congruent with their values and appropriate for them.Methods and analysisA two-phase process, observing the International Patient Decision Aid Standards, will be used to develop the DA, over 24 months starting January 2019. Phase 1 will use literature reviews and stakeholder interviews and surveys to identify essential content for the DA, and explore the best way to present this. In the second phase, a prototype DA will be developed and revised using stakeholder feedback in an iterative process. Stakeholders will include individuals with MND, their carers and the healthcare professionals working with them.Ethics and disseminationEthical approval for the study has been granted by West of Scotland Research Ethics Service, reference 19/WS/0078. Study findings will be disseminated through academic and non-academic publications, conference presentations, stakeholder websites and social media. A feasibility study will follow to explore the acceptability and practicality of the DA for patients, carers and HCPs in practice and to assess whether the DA shows promise of being beneficial for the intended population.
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