45 research outputs found
Orthoscape: a cytoscape application for grouping and visualization KEGG based gene networks by taxonomy and homology principles
Trust, confidentiality, and the acceptability of sharing HIV-related patient data: lessons learned from a mixed methods study about Health Information Exchanges
Provision of health care actions and services for the management of HIV/AIDS from the users’ perspective
Electronic health information exchange in underserved settings: examining initiatives in small physician practices & community health centers
BackgroundHealth information exchange (HIE) is an important tool for improving efficiency and quality and is required for providers to meet Meaningful Use certification from the United States Centers for Medicare and Medicaid Services. However widespread adoption and use of HIE has been difficult to achieve, especially in settings such as smaller-sized physician practices and federally qualified health centers (FQHCs). We assess electronic data exchange activities and identify barriers and benefits to HIE participation in two underserved settings.MethodsWe conducted key-informant interviews with stakeholders at physician practices and health centers. Interviews were recorded, transcribed, and then coded in two waves: first using an open-coding approach and second using selective coding to identify themes that emerged across interviews, including barriers and facilitators to HIE adoption and use.ResultsWe interviewed 24 providers, administrators and office staff from 16 locations in two states. They identified barriers to HIE use at three levels-regional (e.g., lack of area-level exchanges; partner organizations), inter-organizational (e.g., strong relationships with exchange partners; achieving a critical mass of users), and intra-organizational (e.g., type of electronic medical record used; integration into organization's workflow). A major perceived benefit of HIE use was the improved care-coordination clinicians could provide to patients as a direct result of the HIE information. Utilization and perceived benefit of the exchange systems differed based on several practice- and clinic-level factors.ConclusionsThe adoption and use of HIE in underserved settings appears to be impeded by regional, inter-organizational, and intra-organizational factors and facilitated by perceived benefits largely at the intra-organizational level. Stakeholders should consider factors both internal and external to their organization, focusing efforts in changing modifiable factors and tailoring HIE efforts based on all three categories of factors. Collective action between organizations may be needed to address inter-organizational and regional barriers. In the interest of facilitating HIE adoption and use, the impact of interventions at various levels on improving the use of electronic health data exchange should be tested
Relationships among nutrient enrichment, detritus quality and quantity, and large-bodied shredding insect community structure
This is a post-peer-review, pre-copyedit version of an article published in Hydrobiologia. The final authenticated version is available online at: https://doi.org/10.1007/s10750-015-2208-2Anthropogenic nutrient enrichment of
forested headwater streams can enhance detrital quality, decrease standing stocks, and alter the community structure of detrivorous insects, reducing nutrient retention and decreasing ecosystem functioning. Our objective was to determine if stoichiometric
principles could be used to predict genus-specific shifts in shredding insect abundance and biomass across a dissolved nutrient and detritus food quality/quantity gradient. Detritus, insect, and water samples were collected from 12 Ozark Highland headwater
streams. Significant correlations were found between stream nutrients and detrital quality but not quantity. Abundance and biomass responses of four out of five tested genera were accurately predicted by consumerresource stoichiometric theory. Low carbon:phosphorus (C:P) shredders responded positively to increased total phosphorus and/or food quality, and high C:P shredders exhibited neutral or negative responses to these variables. Genus-specific declines were
correlated with decreased overall biomass in shredder assemblages, potentially causing disruptions in nutrient flows to higher level consumers with nutrient enrichment. This work provides further evidence that elevated nutrients may negatively impact shredding
insect communities by altering the stoichiometry of detritus–detritivore interactions. A better understanding of stoichiometric mechanisms altering macroinvertebrate populations is needed to help inform water quality criteria for the management of headwater streams
Fertility Desires and Intentions among HIV-Positive Women during the Post-natal period in Uganda
This study describes the fertility intentions and discusses the potential reproductive health needs of post-natal HIV-infected Ugandan women. HIV-infected mothers attending post-natal services in Kampala, Uganda participated in this cross-sectional study using structured interviewer administered questionnaires. Descriptive statistics and logistic regression models were used to identify predictors of desire for more children. Among 403 participants, 35% desired more children. Of these, 25% wanted another child within 2 years and 75% within 3 years or more. In multivariable analyses, believing that one’s partners wanted more children (OR=2.44; 95% CI = 1.30, 4.59) was associated with the desire for future children while having more living children was negatively associated with the desire for future children (OR=0.08; 95% CI = 0.02, 0.39). A minority of women desired future pregnancies, and most wanted to delay pregnancy for 3 years. These women are in need of family planning (FP) methods to meet stated desires to delay or end future pregnancies. Perceived partner desire for children also impacts on women’s fertility intentions, highlighting the importance of engaging men during the post-natal period. (Afr J Reprod Health 2014; 18[3]: 67-77)Keywords: fertility intentions; desire for children; Post-natal women; HIV; reproductive health; contraception
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Impact of expanded antiretroviral use on incidence and prevalence of tuberculosis in children with HIV in Kenya
SettingAntiretroviral therapy (ART) reduces pulmonary tuberculosis (PTB) in human immunodeficiency virus (HIV) infected children. Recent ART recommendations have increased the number of children on ART.ObjectiveTo determine the prevalence and incidence of TB in HIV-infected children after the implementation of expanded ART guidelines.DesignA prospective cohort study including HIV-infected children aged 6 weeks to 14 years was conducted in Kenya. The primary outcome measure was clinically diagnosed TB. Study participants were screened for prevalent TB at enrollment using Kenya's national guidelines and followed at monthly intervals to detect incident TB. Predictors of TB were assessed using logistic regression and Cox proportional hazards regression.ResultsOf 689 participants (median age 6.4 years), 509 (73.9%) were on ART at baseline. There were 51 cases of prevalent TB (7.4%) and 10 incident cases, with over 720.3 child-years of observation (incidence 1.4 per 100 child-years). Months on ART (adjusted hazard ratio [aHR] 0.91, P = 0.003; aOR 0.91, P< 0.001) and months in care before ART (aHR 0.87, P= 0.001; aOR 0.92, P < 0.001) were protective against incident and prevalent TB.ConclusionsART was protective against TB in this cohort of HIV-infected children with high levels of ART use. Optimal TB prevention strategies should emphasize early ART in children
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Pregnancy rates in HIV-positive women using contraceptives and efavirenz-based or nevirapine-based antiretroviral therapy in Kenya: A retrospective cohort study
© 2015 Elsevier Ltd. All rights reserved.BACKGROUND: Concerns have been raised about efavirenz reducing the effectiveness of contraceptive implants. We aimed to establish whether pregnancy rates differ between HIV-positive women who use various contracept
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Evaluation of short message service and peer navigation to improve engagement in HIV care in South Africa: study protocol for a three-arm cluster randomized controlled trial
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