32 research outputs found

    Increasing and sustaining blood-borne virus screening in Spain and Portugal throughout the COVID-19 pandemic: a multi-center quality improvement intervention

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    BackgroundAround 57,000 people in Spain and Portugal currently living with HIV or chronic hepatitis C are unaware of their infection. The COVID-19 pandemic severely disrupted screening efforts for these infections. We designed an intervention to increase and sustain opportunistic blood-borne virus (BBV) screening and linkage to care (SLTC) by implementing the TEST model.MethodsThe Plan Do Study Act (PDSA) method of quality improvement (QI) was implemented in 8 healthcare organizations (HCOs), including four hospitals, two clusters of community health centers, and two community-based organizations (CBOs). Baseline assessment included a review of BBV SLTC practices, testing volume, and results 12 months before the intervention. Changes in BBV testing rates over time were measured before, during, and after the COVID-19 lockdowns in 2020. A mixed ANOVA model was used to analyze the possible effect on testing volumes among HCOs over the three study periods.InterventionBBV testing was integrated into normal clinical flow in all HCOs using existing clinical infrastructure and staff. Electronic health record (EHR) systems were modified whenever possible to streamline screening processes, implement systemic institutional policy changes, and promote QI.ResultsTwo years after the launch of the intervention in screening practices, testing volumes increased by 116%, with formal healthcare settings recording larger increases than CBOs. The start of the COVID-19 lockdowns was accompanied by a global 60% decrease in testing in all HCOs. Screening emergency department patients or using EHR systems to automate screening showed the highest resilience and lowest reduction in testing. HCOs recovered 77% of their testing volume once the lockdowns were lifted, with CBOs making the fullest recovery. Globally, enhanced screening techniques enabled HCOs to diagnose a total of 1,860 individuals over the research period.ConclusionsImplementation of the TEST model enabled HCOs to increase and sustain BBV screening, even during COVID-19 lockdowns. Although improvement in screening was noted in all HCOs, additional work is needed to develop strong patient linkage to care models in challenging times, such as global pandemics

    Characterisation of microbial attack on archaeological bone

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    As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

    AmĂ©rica Latina y el Caribe : un continente, mĂșltiples miradas

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    Esta obra reĂșne cuarenta y tres artĂ­culos producidos por especialistas que integran los Centros Asociados de CLACSO en Venezuela. Los trabajos abarcan una amplia y variada temĂĄtica sobre la realidad de AmĂ©rica Latina y el Caribe, en la que se refleja la multiplicidad de miradas que se han dirigido a indagar en esa problemĂĄtica, tal como evidenciĂł en los debates sostenidos en la Conferencia CLACSO Venezuela, realizada en Caracas entre el 5 y el 8 de noviembre de 2013

    AmĂ©rica Latina y el Caribe : un continente, mĂșltiples miradas

    No full text
    Esta obra reĂșne cuarenta y tres artĂ­culos producidos por especialistas que integran los Centros Asociados de CLACSO en Venezuela. Los trabajos abarcan una amplia y variada temĂĄtica sobre la realidad de AmĂ©rica Latina y el Caribe, en la que se refleja la multiplicidad de miradas que se han dirigido a indagar en esa problemĂĄtica, tal como evidenciĂł en los debates sostenidos en la Conferencia CLACSO Venezuela, realizada en Caracas entre el 5 y el 8 de noviembre de 2013
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