Curbing the HIV Epidemic by Supporting Effective Engagement in HIV Care: Recommendations for Health Plans and Health Care Purchasers

The United States is poised to dramatically reduce the scope of its HIV epidemic, but this demands increased leadership and attention from health plans and health care purchasers (including Medicaid, Medicare, marketplaces, and other private purchasers). This new amfAR report identifies changes in policy and practice in clinics, communities, and health care programs to reduce unnecessary health spending, increase the effectiveness of services, and increase the integration of services. Done right, the same steps that lead to appropriate management of care by health plans and purchasers also will help to achieve national public health goals

Meeting the Jewish Community

Bishop Francis J. Mugavero gave this address on March 16, 1969, at the Rego Park Jewish Center in Queens, New York, during an interfaith reception co-sponsored by the Diocese of Brooklyn and the AntiDefamation League of B\u27nai B\u27rith

Sindacato di meritevolezza degli interessi perseguiti ed equilibrio delle prestazioni nel contratto di assicurazione claims made

2016 - 2017The doctoral thesis starts from a complete reconstruction of the normative development that the civil liability insurance contract has adapted to the needs of the production systems of the most advanced economies. The survey develops around the structure of the made claims clauses, the role of private autonomy, their impact on insurable risk, as well as on the advantages and contraindications for companies and for policyholders. The second chapter handles the question of the validity of the clauses made by reviewing the precise objections to the main objections of nullity. The analysis also deals with the problem of the typicality of the insurance contract in the current domestic and international regulatory context. This problem is linked to that of the cause in concrete terms and the limits of the automatic substitution of the clauses considered null, where the jurisprudence of the Court of Cassation plays an important role. The third chapter deals with the profiles of merit and contractual balance. The work is structured through a detailed examination of the various doctrinal positions advanced on the point, to arrive at the numerous jurisprudential rulings that in various sectors of bargaining have dealt with the scope of application of the art. 1322, paragraph 2, c.c. Among these, of great importance was the sentence of the United Sections of 6 May 2016, n. 9140, both for the exegetical ideas offered regarding the merit of the claims made clauses, and for the disorientation that has determined on the subsequent jurisprudence that has applied these parameters. In conclusion, the last chapter is dedicated to the regulation of the most sensitive sectors (of which the critical issues and inconsistencies are showed) and the most recent sentences, put into question by the order of the Court of 2018, which expresses multiple concerns. [edited by Author]XXX cicl

Confiabilidad en el uso de laminografías para el diagnóstico de hiperplasia condilar unilateral

Los pacientes con aparente Hiperplasia Condilar son diagnosticados inicialmente mediante anamnesis y estudios por imágenes de rutina como la radiografía panorámica y la laminografía. Pero estos no serían suficientes para su correcto diagnóstico, por lo que su determinación definitiva se basa en la centellografía ósea y análisis histopatológico en última instancia. El objetivo de este trabajo fue validar el uso de laminografías en el diagnóstico de HC uniltateral. La metodología se realizó mediante una síntesis de revisiones y estudios relacionados con los mecanismos morfológicos que intervienen en la ATM con énfasis en la HC; igualmente se propuso identificar pacientes con asimetrías mandibulares asociadas a HC confirmada con SPECT y pacientes asimétricos sin esta patología, para realizar mediciones de los tamaños condilares sobre las imágenes de las laminografías de ambos grupos de pacientes con el fin de determinar si se podría detectar la patología mediante estas imágenes. Para su ejecución se tomó un grupo de 27 pacientes con HC confirmada con SPECT y otro de 20 pacientes que no padecen esta entidad nosológica.Facultad de Odontologí

Advancing international cooperation in disaster response: the “Center for Disaster, Forensic, and Biometric Sciences”

In our interconnected world, crises and disasters rarely confine themselves to national borders, often affecting citizens from multiple countries. Furthermore, when a major catastrophe strikes, a single country may lack the necessary resources to handle the consequences. Complicating matters, the incident itself may have severely damaged or destroyed emergency infrastructures, making response and recovery a formidable challenge. Mass disaster (MD) involving many victims requires multinational collaboration, utilising a common forensic language and a unified system for gathering, sharing, and comparing data and information. Recognizing the importance of a cooperative approach to disaster management, the “European Centre for Disaster Medicine” has recently formed a dedicated Work Group aimed to establish a specialised centre, known as the “Center for Disaster, Forensic, and Biometric Sciences”, focusing on developing standards and guidelines for the handling of forensic activities in emergencies, disasters, and terrorist attacks. This paper aims to outline the origins, objectives, purposes, and participating bodies of this new entity

Treatment simplification in HIV-infected adults as a strategy to prevent toxicity, improve adherence, quality of life and decrease healthcare costs

Since the advent of highly active antiretroviral therapy (HAART), the treatment of human immunodeficiency virus (HIV) infection has become more potent and better tolerated. While the current treatment regimens still have limitations, they are more effective, more convenient, and less toxic than regimens used in the early HAART era, and new agents, formulations and strategies continue to be developed. Simplification of therapy is an option for many patients currently being treated with antiretroviral therapy (ART). The main goals are to reduce pill burden, improve quality of life and enhance medication adherence, while minimizing short- and long-term toxicities, reducing the risk of virologic failure and maximizing cost-effectiveness. ART simplification strategies that are currently used or are under study include the use of once-daily regimens, less toxic drugs, fixed-dose coformulations and induction-maintenance approaches. Improved adherence and persistence have been observed with the adoption of some of these strategies. The role of regimen simplification has implications not only for individual patients, but also for health care policy. With increased interest in ART regimen simplification, it is critical to study not only implications for individual tolerability, toxicity, adherence, persistence and virologic efficacy, but also cost, scalability, and potential for dissemination and implementation, such that limited human and financial resources are optimally allocated for maximal efficiency, coverage and sustainability of global HIV/AIDS treatment

Social Determinants of Late Presentation to HIV Care

Background: In recent years, increased attention has shifted toward evaluating social determinants of health, and understanding how community, environment, and system factors affect health outcomes. HIV policies and guidelines emphasize the importance of earlier HIV diagnosis and presentation for care. This study evaluated the role of individual and community-level factors in late presentation to HIV care. Methods: HIV-infected patients newly initiating outpatient HIV medical care at an academic medical center between 2005-2010 were included. Patients\u27 self-reported addresses at their first clinic visit were geocoded using geographic information systems software to the appropriate United States census block group. Using data from the U.S. Census Bureau’s 2005-2009 American Community Survey, community-level data was recorded for each patient\u27s census block group. Poisson regression was used to evaluate associations between individual- and community-level factors with late presentation for HIV care, defined as an initial CD4 count /mm3. Results: Among 609 patients, 341 patients (56%) had an initial CD4 count /mm3. At a community level, late presentation was significantly associated with the proportion of African Americans in a census block group (RR=1.47; 95%CI=1.19-1.81); with proportion living in poverty, lack of fuel, and lack of vehicle demonstrating borderline statistical significance. At an individual level, older patients were more likely (1.12; 1.06-1.19), while white females were less likely (0.45; 0.24-0.84) to present with a CD4 count /mm3. Conclusion: Both individual and community-level characteristics were associated with late presentation for HIV medical care. Research and interventions to promote earlier HIV diagnosis and care entry should include geographical information and social determinants of health to define priority populations