Oral health in Texas 2008

"Publication #E08-12223"--P. [4] of cover.Includes bibliographical references (p. 94-103).Supported by the Division of Oral Health at the Centers for Disease Control and Prevention, Cooperative Agreement U58/CCU622789-02.U58/CCU622789-0

Practical handbook for Sub-Saharan Africa

Home-based HIV testing and counselling (HBHTC) refers to HIV testing and counselling (HTC) services conducted by trained HTC service providers in someone's home. The main purpose of HBHTC is to bring HTC services to households, overcoming some of the barriers of access to testing services and providing testing to individuals who might not otherwise seek services. It has been_used successfully in rural and urban populations of sub-Saharan Africa with a high HIV prevalence and low coverage of HTC services. HBHTC provides services to individuals, couples, and family groups, and may be used to address specific populations (e.g. family members of known HIV-positive patients) and contribute to a family-based approach to HIV prevention and support. Using this approach can lead to decreased stigma in communities, help to diagnose individuals who are HIV-positive earlier, and potentially reach more couples than other HTC models. HBHTC has also led to increased follow-up for HIV-exposed infants.1. Background -- 1.1 Purpose of this practical handbook -- 1.2 Development of this handbook -- 1.3 Target audience -- 2. HBHTC delivery models -- 2.1 Door-to-door -- 2.2 Index-patient -- 2.3 Self-testing -- 3. Coordination at national level -- 3.1 Setting a national strategy for HBHTC -- 3.2 Coordination of partners conducting HBHTC -- 3.3 How organizations are authorized to conduct HBHTC -- 3.4 Human resources for HBHTC -- 3.5 Test kits to be used for HBHTC -- 4. Personnel -- 4.1 Programme structure and composition of a HBHTC team -- 4.2 Roles and responsibilities of different personnel in HBHTC -- 4.3 Recruitment and training of HBHTC service providers -- 4.4 Recruitment and training of community health workers/mobilizers -- 4.5 Staff retention -- 5. Programme planning -- 5.1 Choosing the location -- 5.2 Consulting stakeholders -- 5.3 Mapping of location -- 5.4 Determining availability of follow-up services -- 5.5 Planning return visits -- 5.6 Planning for data collection, protection, and storage -- 5.7 Supplies -- 5.8 Security and transport -- 5.9 Biosafety and waste disposal -- 6. Community and home entry -- 6.1 Community entry -- 6.2 Working with community health workers and/or mobilizers -- 6.3 Preparing the community -- 6.4 Home entry -- 7. Populations tested -- 7.1 Families -- 7.2 Couples and partners -- 7.3 Polygamous groups -- 7.4 Individuals -- 7.5 Child and adolescent testing -- 7.6 Disabled family members -- 7.7 Mental health disorders in the family -- 8. Protocol for HBHTC -- 8.1 Introducing the session -- 8.2 informed consent -- 8.3 Pre-test -- 8.4 Testing -- 8.5 Post-test and disclosure -- 9. Referral and linkages -- 9.1 Linkages to other services -- 9.2 Urgent referrals -- 9.3 Capacity at service-delivery points -- 9.4 Following up linkages and referrals -- 9.5 Understanding barriers to successful linkages -- 9.6 Strategies for improving successful linkages -- 10. Data, monitoring and evaluation -- 10.1 Types of data to collect -- 10.2 Programme indicators -- 10.3 Research data -- 10.4 Data collection methods -- 11. Quality assurance of HBHTC -- 11.1 Quality assurance for rapid HiV testing in HBHTC -- 11.2 Quality assurance for counselling -- 11.3 Involving the community in quality assurance -- 12. Special circumstances -- 12.1 Alcohol -- 12.2 Violence in the home -- 12.3 Sexual abuse -- 12.4 Key populations at higher risk of HIV exposure -- 13. Leaving an area -- 13.1 Determining when to move on -- 13.2 Returning results and following up linkages -- 13.3 Community feedback meetings -- 14. Useful resources.[Miriam Taegtmeyer].The work was funded by: the US Centers for Disease Control and Prevention through the PEPFAR technical working group on HIV testing and counselling.The main writer of this document was Dr Miriam Taegtmeyer of the Liverpool School of Tropical Medicine. The work was coordinated by Kristina Grabbe (CDC, Atlanta), Vincent Wong (USAID, Washington), and Rachel Baggaley, F. Amolo Okero, and Ying-ru Lo (HIV/ AIDS Department, WHO, Geneva).On cover: logos for World Health Organization, PEPFAR, Centers for Disease and Prevention, USAID, Liverpool School of Tropical Medicine.This handbook was first conceived of at a 2009 PEPFAR technical consultation on HBHTC [Home-based counseling and testing: program components and approaches. Technical consultation report. Washington, DC, AIDSTAR-One/USAID, 2010.]. Shortly thereafter, a survey, sent to PEPFAR HTC focal persons in 33 countries, identified 39 partners implementing HBHTC programmes in 10 sub-Saharan African countries in early 2011. Research revealed that the majority of countries surveyed lacked specific guidance for HBHTC. Although some country programmes had developed local operational manuals and guidance documents, there were no unified guidelines in place and no standard quality of implementation. As a result, HTC service providers were often left to develop their own solutions for challenging situations. this practical handbook was developed by WHO in collaboration with the PEPFAR HIV testing and counselling technical Working group (HTC TWG) in 2011, as a response to that problem. This handbook draws on existing guidelines, training and operational manuals, key informant interviews, observed practices, and site visits to HBHTC programmes. the authors specifically sought inputs and experiences of HTC service providers, supervisors, and programme managers using different community-based models, particularly focusing on offering testing in the home in different epidemic settings across Africa, for the development of these materials.Issued by: World Health Organization, Department of HIV/AIDS

A simulation study of the economic and health impact of a diabetes prevention programme in Ireland.

AIMS: Type 2 diabetes is a major public health issue that has a large effect on society including its health and social services. The aims of this paper are to generate a projection of the number of cases and explore the potential impact of a preventive intervention targeted at people with pre-diabetes on disease prevalence, complications, mortality and cost. METHODS: A Markov simulation model of diabetes and pre-diabetes in Ireland, for the period 1991 to 2036, was generated based on international epidemiological data. The simulation was calibrated with the available Irish data on the prevalence of pre-diabetes, diabetes and diabetic complications. The economic and health impact of a hypothetical nationwide preventive intervention programme, which reduces the incidence by a factor consistent with the international literature, was estimated under three scenarios of alternative effectiveness and uptake. RESULTS: The estimated number of people over 40 years of age with type 2 diabetes in Ireland is projected to increase from 216,000 in 2020 to 414,000 in 2036. A prevention programme, based on the NHS Diabetes Prevention Programme, is estimated to result in a reduction of between 2000 (0.5%) and 19,000 (4.6%) in the number of prevalent cases of diabetes in 2036 resulting in substantial health and quality of life benefits. CONCLUSIONS: A wide range of initiatives with uncertain outcomes will be required to reduce the impact of obesity and type 2 diabetes. A diabetes prevention programme seems likely to be worth pursuing as one element of this set of initiatives

HHS action plan to prevent healthcare-associated infections

"The Department of Health and Human Services (HHS) "Action Plan to Prevent Healthcare-Associated Infections" represents a culmination of several months of research, deliberation, and public comment to identify the key actions needed to achieve and sustain progress in protecting patients from the transmission of serious, and in some cases, deadly infections. In response to the increasing threat of HAIs and national and international concern, the Department has composed a Steering Committee of senior-level representatives from the Offices and Operating Divisions of HHS and conducted a number of in-person meetings and conferences with Federal experts. The Department's Action Plan toward the prevention and elimination of HAIs includes goals toward which the healthcare and public health communities have been moving over the past several years." p 1-2Executive summary -- Introduction -- Prevention: metrics and targets -- Prevention: prioritized recommendations -- Research -- Information systems and technology -- Incentives and oversight -- Outreach and messaging -- Coordination, evaluation, and conclusion -- AppendicesAgency for Healthcare Research and Quality, Office of the Assistant Secretary for Public Affairs, Office of the Assistant Secretary for Planning and Evaluation, Centers for Disease Control and Prevention, Centers for Medicare & Medicaid Services, Food and Drug Administration, National Institutes of Health, Office of the National Coordinator for Health Information Technology, Office of Public Health and Science."06222009."Title from title screen (viewed on March 17, 2011)

Management of tuberculosis: training for health facility staff

Module A: Introduction -- Module B: Detect Cases of TB -- Module C: Treat TB Patients -- Module D: Inform Patients about TB -- Module E: Identify and Supervise Community TB Treatment Supporters -- Module F: Manage Drugs and Supplies for TB -- Module G: Ensure Continuation of TB Treatment -- Module H: Monitor TB Case Detection and Treatment -- Module I: TB Infection Control in your Health Facility -- Module J: Field Exercise - Observe TB Management -- Module K: Management of Tuberculosis Reference Booklet -- Module L: Facilitator Guide -- Module M: Answer Sheets."WHO/HTM/TB/2009.423.""The following organizations contributed to the development of the modules through the Tuberculosis Control Assistance Program (TB-CAP): the American Thoracic Society (ATS), Management Sciences for Health (MSH), the United States Centers for Disease Control and Prevention (CDC), and the KNCV Tuberculosis Foundation.""This updated version was tested through the support of the Division of Tuberculosis Elimination of the United States Centers for Disease Control and Prevention.