UFTI : The 0.8-2.5 mu m fast track imager for the UK infrared telescope

In 1996, it was proposed to build a near-infrared imager for the 3.8-m UK Infrared Telescope in Hawaii, to exploit the 1024 pixel format detectors that were then becoming available. In order to achieve a fast delivery, the instrument was kept simple and existing designs were reused or modified where possible. UFTI was delivered within 2.5 years of the project start. The instrument is based around a 1k Rockwell Hawaii detector and a LSR Astrocam controller and uses the new Mauna Kea optimised J,H,K filter set along with I and Z broad-band filters and several narrow-band line filters. The instrument is cooled by a CTI cry-cooler, while the mechanisms are operated by cold, internal, Bergelahr stepping motors. On UKIRT it can be coupled to a Fabry-Perot etalon for tunable narrow-band imaging at K, or a waveplate for imaging polarimetry through 1-2.5mum; the cold analyser is a Barium Borate Wollaston prism. UFTI was designed to take full advantage of the good image quality delivered by UKIRT on conclusion of the upgrades programme, and has a fine scale of 0.09 arcsec/pixel. It is used within the UKIRT observatory environment and was the first instrument integrated into ORAC, the Observatory Reduction and Acquisition Control System. Results obtained during instrument characterisation in the lab and over the last 3 years on UKIRT are presented, along with performance figures. UFTI has now been used on UKIRT for several hundred nights, and aspects of instrument performance are discussed

Engagement in Outpatient Care for Persons Living with HIV in the United States

Prior studies that have assessed engagement within the various stages of care for persons living with HIV (PLWH) studied patients receiving care in HIV medical care facilities. These data are not representative of care received throughout the United States, as not all PLWH receive care in HIV clinics. This study evaluated engagement in outpatient care and healthcare utilization for PLWH, beyond facilities that specialize in HIV. Cross-sectional data were from the 2009–2010 National Hospital Ambulatory Medical Care Survey. Levels of care included receiving any care, receiving HIV-related care, established in care, engaged in care, and prescribed antiretroviral therapy (ARV). Factors associated with ARV prescription were determined by logistic regression. We analyzed data for ∼2.6 million outpatient clinic visits for PLWH. Of these, 90% were receiving HIV-related care, 86% were established in care, 75% were engaged in care, and 65% were prescribed ARV. In stratified analysis, the proportion of PWLH who were engaged in care varied by race/ethnicity (p<0.001) and ARV prescription varied significantly across the three age groups (p=0.004). Clinic visits within the past year did not differ for those prescribed ARV vs. not prescribed ARV [median, IQR=3.3 visits (1.8–5.6) vs. 3.6 visits (1.3–5.9); p=0.7]. Seeing a physician was associated with ARV prescription (OR=0.27, 95% CI=0.15–0.51), whereas routine engagement in care was not associated with ARV prescription (OR=0.99, 95% CI=0.96–1.03). Given that non-ARV-treated PLWH utilized outpatient care services at rates similar to ARV-treated PLWH, these routine clinic visits are missed opportunities for increasing ARV prescription in untreated patients

Streamlining tasks and roles to expand treatment and care for HIV: randomised controlled trial protocol

<p>Abstract</p> <p>Background</p> <p>A major barrier to accessing free government-provided antiretroviral treatment (ART) in South Africa is the shortage of suitably skilled health professionals. Current South African guidelines recommend that only doctors should prescribe ART, even though most primary care is provided by nurses. We have developed an effective method of educational outreach to primary care nurses in South Africa. Evidence is needed as to whether primary care nurses, with suitable training and managerial support, can initiate and continue to prescribe and monitor ART in the majority of ART-eligible adults.</p> <p>Methods/design</p> <p>This is a protocol for a pragmatic cluster randomised trial to evaluate the effectiveness of a complex intervention based on and supporting nurse-led antiretroviral treatment (ART) for South African patients with HIV/AIDS, compared to current practice in which doctors are responsible for initiating ART and continuing prescribing. We will randomly allocate 31 primary care clinics in the Free State province to nurse-led or doctor-led ART. Two groups of patients aged 16 years and over will be included: a) 7400 registering with the programme with CD4 counts of ≤ 350 cells/mL (mainly to evaluate treatment initiation) and b) 4900 already receiving ART (to evaluate ongoing treatment and monitoring). The primary outcomes will be time to death (in the first group) and viral suppression (in the second group). Patients' survival, viral load and health status indicators will be measured at least 6-monthly for at least one year and up to 2 years, using an existing province-wide clinical database linked to the national death register.</p> <p>Trial registration</p> <p>Controlled Clinical Trials ISRCTN46836853</p

Community-based organizations in the health sector: A scoping review

<p>Abstract</p> <p>Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues), we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry.</p> <p>We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed.</p> <p>We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff), the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks).</p> <p>Given the range of terms used to describe community-based organizations, this scoping review can be used to further map their meanings/definitions to develop a more comprehensive typology and understanding of community-based organizations. This information can be used in further investigations about the ways in which community-based organizations can be engaged in health system decision-making and the mechanisms available for facilitating or supporting their engagement.</p