Log in

Relevant bibliographies by topics / Care cascade / Journal articles

Journal articles on the topic 'Care cascade'

To see the other types of publications on this topic, follow the link: Care cascade.

Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles

Select a source type:

Consult the top 50 journal articles for your research on the topic 'Care cascade.'

Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.

You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.

Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.

1

Kedziora, David J., Romesh Abeysuriya, Cliff C. Kerr, George L. Chadderdon, Vlad-Ștefan Harbuz, Sarah Metzger, David P. Wilson, and Robyn M. Stuart. "The Cascade Analysis Tool: software to analyze and optimize care cascades." Gates Open Research 3 (June 7, 2019): 1488. http://dx.doi.org/10.12688/gatesopenres.13031.1.

Full text

Abstract:

Introduction: Cascades, which track the progressive stages of engagement on the path towards a successful outcome, are increasingly being employed to quantitatively assess progress towards targets associated with health and development responses. Maximizing the proportion of people with successful outcomes within a budget-constrained context requires identifying and implementing interventions that are not only effective, but also cost-effective. Methods: We developed a software application called the Cascade Analysis Tool that implements advanced analysis and optimization methods for understanding cascades, combined with the flexibility to enable application across a wide range of areas in health and development. The tool allows users to design the cascade, collate and enter data, and then use the built-in analysis methods in order to answer key policy questions, such as: understanding where the biggest drop-offs along the cascade are; visualizing how the cascade varies by population; investigating the impact of introducing a new intervention or scaling up/down existing interventions; and estimating how available funding should be optimally allocated among available interventions in order to achieve a variety of different objectives selectable by the user (such as optimizing cascade outcomes in target years). The Cascade Analysis Tool is available via a user-friendly web-based application, and comes with a user guide, a library of pre-made examples, and training materials. Discussion: Whilst the Cascade Analysis Tool is still in the early stages of existence, it has already shown promise in preliminary applications, and we believe there is potential for it to help make sense of the increasing quantities of data on cascades.

APA, Harvard, Vancouver, ISO, and other styles

2

Kedziora, David J., Romesh Abeysuriya, Cliff C. Kerr, George L. Chadderdon, Vlad-Ștefan Harbuz, Sarah Metzger, David P. Wilson, and Robyn M. Stuart. "The Cascade Analysis Tool: software to analyze and optimize care cascades." Gates Open Research 3 (December 24, 2019): 1488. http://dx.doi.org/10.12688/gatesopenres.13031.2.

Full text

Abstract:

Introduction: Cascades, which track the progressive stages of engagement on the path towards a successful outcome, are increasingly being employed to quantitatively assess progress towards targets associated with health and development responses. Maximizing the proportion of people with successful outcomes within a budget-constrained context requires identifying and implementing interventions that are not only effective, but also cost-effective. Methods: We developed a software application called the Cascade Analysis Tool that implements advanced analysis and optimization methods for understanding cascades, combined with the flexibility to enable application across a wide range of areas in health and development. The tool allows users to design the cascade, collate and enter data, and then use the built-in analysis methods in order to answer key policy questions, such as: understanding where the biggest drop-offs along the cascade are; visualizing how the cascade varies by population; investigating the impact of introducing a new intervention or scaling up/down existing interventions; and estimating how available funding should be optimally allocated among available interventions in order to achieve a variety of different objectives selectable by the user (such as optimizing cascade outcomes in target years). The Cascade Analysis Tool is available via a user-friendly web-based application, and comes with a user guide, a library of pre-made examples, and training materials. Discussion: Whilst the Cascade Analysis Tool is still in the early stages of existence, it has already shown promise in preliminary applications, and we believe there is potential for it to help make sense of the increasing quantities of data on cascades.

APA, Harvard, Vancouver, ISO, and other styles

3

Miller, William C., Catherine R. Lesko, and Kimberly A. Powers. "The HIV Care Cascade." Sexually Transmitted Diseases 41, no. 1 (January 2014): 41–42. http://dx.doi.org/10.1097/olq.0000000000000081.

Full text

APA, Harvard, Vancouver, ISO, and other styles

4

Sakhri, Noureddine. "Cascade of HIV Prevention, Care, and Treatment Services in Morocco in 2019." Iproceedings 8, no. 1 (February 2, 2022): e36373. http://dx.doi.org/10.2196/36373.

Full text

Abstract:

Background The HIV care cascade is a way to show the proportion of people living with HIV (PLHIV) engaged at each stage of HIV care. Analyzing an HIV testing, care, and treatment cascade provides a framework for evaluating and improving service delivery. Objective The objective of this study is to analyze the continuums of HIV prevention, care, and treatment services at the national level in Morocco for the period 2015-2019. Methods This is a retrospective study concerning the reference centers for HIV care in Morocco carried out in 2019. Three types of cascades of HIV prevention and care were studied: a transversal cascade at the national level (2019), a longitudinal cascade for newly diagnosed PLHIV (between 2015 and 2017), and a cascade of prevention of mother-to-child transmission of HIV (PMTCT) among pregnant women (2016-2017). Results For the transversal cascade of the year 2019, the objectives of the three 90s were achieved except for the 1st 90 with a difference of 12%. For the longitudinal cascade after the start of treatment between 2015-2017, retention under treatment at 48 months was 83.3%, at 36 months was 83.8%, and at 24 months 91.0%. The 48-month loss to follow-up rate was 12.5%; 7.0% at 36 months; and 4.0% at 24 months. More than 90% of PLHIV started antiretrovirals within 3 months of diagnosis. The 2016-2017 PMTCT cascade conducted on 13 pregnant women according to available data indicated the absence of transmission of HIV from mothers to their children. Conclusions Our 2019 HIV cascade study demonstrated several successes. The achievement of the three 90s except for the first objective (of people who know their status), good retention of PLHIV in long-term treatment, and the success of PMTCT especially since Morocco aims to validate the elimination of mother-to-child transmission.

APA, Harvard, Vancouver, ISO, and other styles

5

Campbell, Jeffrey, Thomas Sandora, and Jessica Haberer. "1643. A scoping review of pediatric latent tuberculosis care cascades: Initial steps are lacking." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S811. http://dx.doi.org/10.1093/ofid/ofaa439.1823.

Full text

Abstract:

Abstract Background Each year an estimated 1 million children develop and ~200,000 die from tuberculosis (TB). The WHO has named identification and treatment of latent tuberculosis infection (LTBI) one of the cornerstones of efforts to eliminate TB by 2030. Identification and treatment of pediatric LTBI requires completion of a complex care cascade. While attention has been given to LTBI care cascades in adults, to date there has been no attempt to map literature on the pediatric LTBI care cascade. Facilitators and barriers to retention in steps of the pediatric LTBI care cascade Methods We systematically searched PubMed, CINAHL, Cochrane and Embase databases for papers and abstracts describing screening, diagnosis, and treatment of pediatric LTBI. We categorized literature using seven step-offs in the pediatric LTBI care cascade, extrapolated from prior studies focused on adults: 1) intention to screen to initial test, 2) initial test to receipt of results, 3) receipt to referral for evaluation, 4) referral to completion of evaluation, 5) completion to treatment recommendation, 6) recommendation to treatment acceptance/initiation, and 7) initiation to treatment completion. Our aim was to assess factors that facilitated and inhibited completion of each cascade step, and to identify knowledge gaps in this literature. Results We identified 137 studies that met inclusion criteria. Most studies described multiple step-offs in the care cascade, although the focus of most (120/137 studies) was on initiation and completion of LTBI therapy (the final step in the care cascade). Several effective strategies to improve medication adherence were described, including selective use of nursing visits, directly observed therapy, shorter treatment regimens, and peer counseling. Reports of facilitators and barriers for retention in upstream step-offs in the cascade were scarce, revealing a lack of published evidence for how to retain children from pre-screening to treatment initiation (Table). Conclusion While existing literature describes LTBI treatment initiation and completion in children, our analysis reveals a lack of data guiding retention of children from LTBI screening through treatment initiation. This review highlights the need to further understand early steps of the care cascade, in order to help alleviate the burden of TB in children. Disclosures Jessica Haberer, MD, MS, Merck (Consultant)

APA, Harvard, Vancouver, ISO, and other styles

6

King, Shannon, Rebecca Heidkamp, Ashley Sheffel, Yvonne Yiru Xu, and Melinda Munos. "Effective Coverage for Nutrition: Operationalizing Effective Coverage Cascades for Nutrition Interventions Delivered to Pregnant Women and Children." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 853. http://dx.doi.org/10.1093/cdn/nzaa053_058.

Full text

Abstract:

Abstract Objectives Many low and middle income country (LMIC) decision makers rely on data from multi-topic household surveys to identify the proportion of the population that has been reached with nutrition services, but these surveys do not always account for the quality of the services. Effective coverage cascades, commonly used in health systems research, capture measures of both coverage and quality to generate actionable information to improve nutrition programs, interventions, and policies. This study aims to describe the operationalization of effective coverage cascades for maternal and child nutrition interventions delivered through the health system using extant data in LMICs. Methods By linking household survey and health facility assessment data from seven LMICs, effective coverage cascades were developed for nutrition interventions delivered through antenatal care visits and sick-child visits. Facility readiness and provision of care index scores were defined for each intervention from clinical guidelines and an expert survey, then refined based on data availability. The facility readiness and provision of care scores were linked to individual care-seeking episodes from household survey data based on geographic domain and facility type. Finally, steps of the coverage cascade for each service in each country were estimated. Results National estimates of the effective coverage cascade for each set of nutrition interventions will be presented. Analysis is ongoing, however preliminary findings show gaps in service readiness such as lack of provider training and gaps in provision of care such as limited nutrition counseling. A substantial drop is seen from service contact to input-adjusted coverage to quality-adjusted coverage for both antenatal care and sick child care. Conclusions The cascade approach yielded summary measures that were useful for identifying high-level barriers to effective coverage; however, detailed measures within the cascade may be more useful for evidence-based decision making. Data availability on quality of care for nutrition interventions is scant, highlighting an opportunity to expand facility-based surveys to include nutrition interventions delivered through the health system. Funding Sources Bill & Melinda Gates Foundation through the DataDENT initiative and the Improving Measurement and Program Design grant.

APA, Harvard, Vancouver, ISO, and other styles

7

Yang, Zhangsheng, Milomir O. Simovic, Bin Liu, Matthew B. Burgess, Andrew P. Cap, Jurandir J. DalleLucca, and Yansong Li. "Indices of complement activation and coagulation changes in trauma patients." Trauma Surgery & Acute Care Open 7, no. 1 (September 2022): e000927. http://dx.doi.org/10.1136/tsaco-2022-000927.

Full text

Abstract:

ObjectivesEarly complementopathy and coagulopathy are shown often after trauma. However, the prevalence of any interplay between complement cascade (ComC) and coagulation cascade (CoaC) after trauma remains unclear. This study intended to explore whether complement-coagulation crosstalk exists, which may provide a reliable guide to clinical implications in trauma patients.MethodsThis single-center cohort study of trauma patients enrolled 100 patients along with 20 healthy volunteers. Blood samples from patients were collected at admission, 45, 90, 135 minutes, and 18 hours after admission. Demographic characteristics were recorded, blood levels of ComC and CoaC factors, and inflammatory cytokines were measured by ELISA, clot-based assays, or luminex multiplex assay, and partial thromboplastin (PT) and partial thromboplastin time (PTT) were assessed using a Behring blood coagulation system.ResultsCompared with the healthy controls, plasma levels of complement factors (C5b-9 and Bb) and 11 tested inflammatory cytokines increased in moderately and severely injured patients as early as 45 minutes after admission and sustained higher levels up to 18 hours after admission. C5b-9 correlated positively to patients’ hospital stay. In parallel, the consumption of coagulation factors I, II, X, and XIII was shown throughout the first 18 hours after admission in moderately and severely injured patients, whereas PT, PTT, D-dimer, factor VII, and factor VIII values significantly increased from the admission to 135 minutes in moderately and severely injured patients. Along with an inverse correlation between plasma Bb, factors I and II, a positive correlation between C5b-9, Bb, D-dimer, PT, and PTT was evident.ConclusionsThis study demonstrates trauma-induced early activation of plasma cascades including ComC, CoaC, and fibrinolytic cascade, and their correlation between plasma cascades in severe trauma patients. Our study suggests that the simultaneous modulation of plasma cascades might benefit clinical outcomes for trauma patients.Level of evidenceProspective study, level III.

APA, Harvard, Vancouver, ISO, and other styles

8

Kohler, Philipp, Axel J. Schmidt, Matthias Cavassini, Hansjakob Furrer, Alexandra Calmy, Manuel Battegay, Enos Bernasconi, Bruno Ledergerber, and Pietro Vernazza. "The HIV care cascade in Switzerland." AIDS 29, no. 18 (November 2015): 2509–15. http://dx.doi.org/10.1097/qad.0000000000000878.

Full text

APA, Harvard, Vancouver, ISO, and other styles

9

Haber, Noah, Deenan Pillay, Kholoud Porter, and Till Bärnighausen. "Constructing the cascade of HIV care." Current Opinion in HIV and AIDS 11, no. 1 (January 2016): 102–8. http://dx.doi.org/10.1097/coh.0000000000000212.

Full text

APA, Harvard, Vancouver, ISO, and other styles

10

Hull, Mark W., Zunyou Wu, and Julio S. G. Montaner. "Optimizing the engagement of care cascade." Current Opinion in HIV and AIDS 7, no. 6 (November 2012): 579–86. http://dx.doi.org/10.1097/coh.0b013e3283590617.

Full text

APA, Harvard, Vancouver, ISO, and other styles

11

Gardner, Edward M., and Benjamin Young. "The HIV care cascade through time." Lancet Infectious Diseases 14, no. 1 (January 2014): 5–6. http://dx.doi.org/10.1016/s1473-3099(13)70272-x.

Full text

APA, Harvard, Vancouver, ISO, and other styles

12

Murphy, E. "Community care: "the cascade of change"." BMJ 304, no. 6828 (March 14, 1992): 655. http://dx.doi.org/10.1136/bmj.304.6828.655.

Full text

APA, Harvard, Vancouver, ISO, and other styles

13

Iwamoto, Aikichi, Rikizo Taira, Yoshiyuki Yokomaku, Tomohiko Koibuchi, Mahbubur Rahman, Yoko Izumi, and Kenji Tadokoro. "The HIV care cascade: Japanese perspectives." PLOS ONE 12, no. 3 (March 20, 2017): e0174360. http://dx.doi.org/10.1371/journal.pone.0174360.

Full text

APA, Harvard, Vancouver, ISO, and other styles

14

Bastos, Mayara Lisboa, Luca Melnychuk, Jonathon R. Campbell, Olivia Oxlade, and Dick Menzies. "The latent tuberculosis cascade-of-care among people living with HIV: A systematic review and meta-analysis." PLOS Medicine 18, no. 9 (September 7, 2021): e1003703. http://dx.doi.org/10.1371/journal.pmed.1003703.

Full text

Abstract:

Background Tuberculosis preventive therapy (TPT) reduces TB-related morbidity and mortality in people living with HIV (PLHIV). Cascade-of-care analyses help identify gaps and barriers in care and develop targeted solutions. A previous latent tuberculosis infection (LTBI) cascade-of-care analysis showed only 18% of persons in at-risk populations complete TPT, but a similar analysis for TPT among PLHIV has not been completed. We conducted a meta-analysis to provide this evidence. Methods and findings We first screened potential articles from a LTBI cascade-of-care systematic review published in 2016. From this study, we included cohorts that reported a minimum of 25 PLHIV. To identify new cohorts, we used a similar search strategy restricted to PLHIV. The search was conducted in Medline, Embase, Health Star, and LILACS, from January 2014 to February 2021. Two authors independently screened titles and full text and assessed risk of bias using the Newcastle–Ottawa Scale for cohorts and Cochrane Risk of Bias for cluster randomized trials. We meta-analyzed the proportion of PLHIV completing each step of the LTBI cascade-of-care and estimated the cumulative proportion retained. These results were stratified based on cascades-of-care that used or did not use LTBI testing to determine eligibility for TPT. We also performed a narrative synthesis of enablers and barriers of the cascade-of-care identified at different steps of the cascade. A total of 71 cohorts were included, and 70 were meta-analyzed, comprising 94,011 PLHIV. Among the PLHIV included, 35.3% (33,139/94,011) were from the Americas and 29.2% (27,460/94,011) from Africa. Overall, 49.9% (46,903/94,011) from low- and middle-income countries, median age was 38.0 [interquartile range (IQR) 34.0;43.6], and 65.9% (46,328/70,297) were men, 43.6% (29,629/67,947) were treated with antiretroviral therapy (ART), and the median CD4 count was 390 cell/mm3 (IQR 312;458). Among the cohorts that did not use LTBI tests, the cumulative proportion of PLHIV starting and completing TPT were 40.9% (95% CI: 39.3% to 42.7%) and 33.2% (95% CI: 31.6% to 34.9%). Among cohorts that used LTBI tests, the cumulative proportions of PLHIV starting and completing TPT were 60.4% (95% CI: 58.1% to 62.6%) and 41.9% (95% CI:39.6% to 44.2%), respectively. Completion of TPT was not significantly different in high- compared to low- and middle-income countries. Regardless of LTBI test use, substantial losses in the cascade-of-care occurred before treatment initiation. The integration of HIV and TB care was considered an enabler of the cascade-of-care in multiple cohorts. Key limitations of this systematic review are the observational nature of the included studies, potential selection bias in the population selection, only 14 cohorts reported all steps of the cascade-of-care, and barriers/facilitators were not systematically reported in all cohorts. Conclusions Although substantial losses were seen in multiple stages of the cascade-of-care, the cumulative proportion of PLHIV completing TPT was higher than previously reported among other at-risk populations. The use of LTBI testing in PLHIV in low- and middle-income countries was associated with higher proportion of the cohorts initiating TPT and with similar rates of completion of TPT.

APA, Harvard, Vancouver, ISO, and other styles

15

Pickering, Aimee N., Xinhua Zhao, Florentina E. Sileanu, Elijah Z. Lovelace, Liam Rose, Aaron L. Schwartz, Allison H. Oakes, et al. "Assessment of Care Cascades Following Low-Value Prostate-Specific Antigen Testing Among Veterans Dually Enrolled in the US Veterans Health Administration and Medicare Systems." JAMA Network Open 5, no. 12 (December 15, 2022): e2247180. http://dx.doi.org/10.1001/jamanetworkopen.2022.47180.

Full text

Abstract:

ImportanceOlder US veterans commonly receive health care outside of the US Veterans Health Administration (VHA) through Medicare, which may increase receipt of low-value care and subsequent care cascades.ObjectiveTo characterize the frequency, cost, and source of low-value prostate-specific antigen (PSA) testing and subsequent care cascades among veterans dually enrolled in the VHA and Medicare and to determine whether receiving a PSA test through the VHA vs Medicare is associated with more downstream services.Design, Setting, and ParticipantsThis retrospective cohort study used VHA and Medicare administrative data from fiscal years (FYs) 2017 to 2018. The study cohort consisted of male US veterans dually enrolled in the VHA and Medicare who were aged 75 years or older without a history of prostate cancer, elevated PSA, prostatectomy, radiation therapy, androgen deprivation therapy, or a urology visit. Data were analyzed from December 15, 2020, to October 20, 2022.ExposuresReceipt of low-value PSA testing.Main Outcomes and MeasuresDifferences in the use and cost of cascade services occurring 6 months after receipt of a low-value PSA test were assessed for veterans who underwent low-value PSA testing in the VHA and Medicare compared with those who did not, adjusted for patient- and facility-level covariates.ResultsThis study included 300 393 male US veterans at risk of undergoing low-value PSA testing. They had a mean (SD) age of 82.6 (5.6) years, and the majority (264 411 [88.0%]) were non-Hispanic White. Of these veterans, 36 459 (12.1%) received a low-value PSA test through the VHA, which was associated with 31.2 (95% CI, 29.2 to 33.2) additional cascade services per 100 veterans and an additional $24.5 (95% CI, $20.8 to $28.1) per veteran compared with the control group. In the same cohort, 17 981 veterans (5.9%) received a PSA test through Medicare, which was associated with 39.3 (95% CI, 37.2 to 41.3) additional cascade services per 100 veterans and an additional $35.9 (95% CI, $31.7 to $40.1) per veteran compared with the control group. When compared directly, veterans who received a PSA test through Medicare experienced 9.9 (95% CI, 9.7 to 10.1) additional cascade services per 100 veterans compared with those who underwent testing within the VHA.Conclusions and RelevanceThe findings of this cohort study suggest that US veterans dually enrolled in the VHA and Medicare commonly experienced low-value PSA testing and subsequent care cascades through both systems in FYs 2017 and 2018. Care cascades occurred more frequently through Medicare compared with the VHA. These findings suggest that low-value PSA testing has substantial downstream implications for patients and may be especially challenging to measure when care occurs in multiple health care systems.

APA, Harvard, Vancouver, ISO, and other styles

16

&NA;. "Preventing ???prescribing cascade??? improves care, saves money." Inpharma Weekly &NA;, no. 1111 (November 1997): 21. http://dx.doi.org/10.2165/00128413-199711110-00048.

Full text

APA, Harvard, Vancouver, ISO, and other styles

17

&NA;. "Preventing 'prescribing cascade' improves care, saves money." Reactions Weekly &NA;, no. 675 (November 1997): 2. http://dx.doi.org/10.2165/00128415-199706750-00001.

Full text

APA, Harvard, Vancouver, ISO, and other styles

18

Ghosh, Rishi, and Paul Pepe. "The critical care cascade: a systems approach." Current Opinion in Critical Care 15, no. 4 (August 2009): 279–83. http://dx.doi.org/10.1097/mcc.0b013e32832faef2.

Full text

APA, Harvard, Vancouver, ISO, and other styles

19

Edun, Babatunde, Medha Iyer, Helmut Albrecht, and Sharon Weissman. "The South Carolina HIV Cascade of Care." Southern Medical Journal 108, no. 11 (November 2015): 670–74. http://dx.doi.org/10.14423/smj.0000000000000368.

Full text

APA, Harvard, Vancouver, ISO, and other styles

20

Osetinsky, Brianna, Grace Mhalu, Sally Mtenga, and Fabrizio Tediosi. "Care cascades for hypertension and diabetes: Cross-sectional evaluation of rural districts in Tanzania." PLOS Medicine 19, no. 12 (December 5, 2022): e1004140. http://dx.doi.org/10.1371/journal.pmed.1004140.

Full text

Abstract:

Background Noncommunicable diseases (NCDs), especially hypertension and diabetes, are rapidly rising in sub-Saharan Africa, necessitating health systems transformations. In Tanzania, current policies aim to improve control of hypertension and diabetes, but information is still needed to assess the gaps in treatment. Methods and findings We conducted a cross-sectional household survey of 784 adults in two districts in Tanzania from December 2020 to January 2021, capturing the cascade-of-care for hypertension and diabetes. The ages of the respondents ranged from 18 to 89 years. Of those screened positive for these conditions, we measured the proportion in each step of the cascades: awareness, care engagement, treatment, and control. We conducted multivariable logistic regression analyses for all four steps along the hypertension care cascade with the independent variables of social health protection schemes, and prior diagnosis of comorbid diabetes, and demographic information. In our sample, of the 771 who had their blood pressure measured, 41% (95% confidence interval (CI): 38% to 44%) were screened positive for hypertension, and of the 707 who had their blood sugar measured, 6% (95% CI: 4% to 8%) were screened positive for diabetes. Of those with hypertension, 43% (95% CI: 38% to 49%) had a prior diagnosis, 25% (95% CI: 21% to 31%) were engaged in care, 21% (95% CI: 3% to 25%) were on treatment, and 11% (95% CI: 8% to 15%) were controlled. Of the 42 respondents with diabetes, 80% (95% CI: 69% to 93%) had a prior diagnosis. The diabetes care cascade had much less drop-off, so 66% of those with diabetes (95% CI: 52% to 82%) were engaged in care and on treatment, and 48% (95% CI: 32% to 63%) had their diabetes controlled at the point of testing. Healthcare fee exemptions were independently associated with higher odds of being previously diagnosed (OR 5.81; 95% CI [1.98 to 17.10] p < 0.005), engaged in care (OR 4.71; 95% CI [1.59 to 13.90] p 0.005), and retained in treatment (OR 2.93; 95% CI [1.03 to 8.35] p < 0.05). Prior diagnosis of comorbid diabetes was highly associated with higher odds of being engaged in care for hypertension (OR 3.26; 95% CI [1.39 to 7.63] p < 0.005). The two primary limitations of this study were reliance on screening at a single time point only of people available at the village at the time of the sample and dependence on self-report for to inform the three cascade steps of prior diagnosis, healthcare visits for engagement in care, and treatment use. Conclusions The high burden of hypertension and low levels of control in our study underscores the importance of improving the awareness and treatment of hypertension. The differences in the care cascades for hypertension and diabetes demonstrates that chronic NCD treatment is possible in this setting, but efforts will be needed across the entire care cascade to improve hypertension control.

APA, Harvard, Vancouver, ISO, and other styles

21

Brooks, Meredith B., Melanie M. Dubois, Amyn A. Malik, Junaid F. Ahmed, Sara Siddiqui, Salman Khan, Manzoor Brohi, et al. "Age-specific effectiveness of a tuberculosis screening intervention in children." PLOS ONE 17, no. 2 (February 18, 2022): e0264216. http://dx.doi.org/10.1371/journal.pone.0264216.

Full text

Abstract:

Objective To apply a cascade-of-care framework to evaluate the effectiveness—by age of the child—of an intensified tuberculosis patient-finding intervention. Design From a prospective screening program at four hospitals in Pakistan (2014–2016) we constructed a care cascade comprising six steps: screened, positive screen, evaluated, diagnosed, started treatment, and successful outcome. We evaluated the cascade by each year of age from 0 to 14 and report the age-specific mean proportion and standard deviation. Results On average across all ages, only 12.5% (standard deviation: 2.0%) of children with a positive screen were not evaluated. Among children who had a complete evaluation, the highest percentages of children diagnosed with tuberculosis were observed in children 0–4 (mean: 31.9%; standard deviation: 4.8%), followed by lower percentages in children 5–9 (mean: 22.4%; standard deviation: 2.2%), and 10–14 (mean: 26.0%; standard deviation:5.4%). Nearly all children diagnosed with tuberculosis initiated treatment, and an average of 93.3% (standard deviation: 3.3%) across all ages had successful treatment outcomes. Conclusions This intervention was highly effective across ages 0–14 years. Our study illustrates the utility of applying operational analyses of age-stratified cascades to identify age-specific gaps in pediatric tuberculosis care that can guide future, novel interventions to close these gaps.

APA, Harvard, Vancouver, ISO, and other styles

22

Schranz, Asher J., Michael Kovasala, Candice Givens, Alison Hilton, Courtney Maierhofer, and Arlene Sena. "296. The Hepatitis C Cascade of Care across Four Safety Net Settings in the Southeast." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S160—S161. http://dx.doi.org/10.1093/ofid/ofz360.371.

Full text

Abstract:

Abstract Background Despite advances in antivirals, disparities in hepatitis C (HCV) treatment remain. We evaluated persons diagnosed with HCV in 4 safety net sites in a large Southeastern county, using care cascades to conceptualize milestones in treatment. Methods Persons diagnosed with HCV in 4 screening sites across Durham County, North Carolina, from December 2015 to May 2018 were included, allowing for 9 months of follow-up. Sites included the county health department (CHD), a federally qualified health center (FQHC) where providers trained in HCV care, jail and community outreach. Persons with HCV were eligible for a bridge counselor intervention to enhance linkage to care with an HCV-treating provider (either primary care or specialist). Outcomes were monitored by chart review. Persons linked to care in the prison (n = 36) were censored from subsequent cascade steps due to inability to obtain records. Cascades were compared by the site of diagnosis. Multivariable logistic regression was used to evaluate predictors of being prescribed antivirals. Results 505 persons were diagnosed with HCV: 216 in the FQHC, 158 in the jail, 72 in the CHD, and 59 in community outreach. Overall, 89% were counseled on their diagnosis, 65% were linked to care, 41% prescribed antivirals, 38% started medications, 34% completed medications and 24% achieved sustained viral response at 12 weeks (SVR-12). Progression through the cascade was highest for those diagnosed at the FQHC (figure). In analyses adjusted for demographics and risk factors, diagnosis in a community outreach setting had lower odds of antiviral prescription, compared with diagnosis in the FQHC (OR 0.33, 95% CI 0.12–0.89). Linkage to care at a specialist clinic (vs. primary care) was associated with antiviral prescription (OR 3.82, CI 1.95–7.46). Sex, race/ethnicity, insurance status and HCV risk factors were not associated with antiviral prescription. Conclusion Among persons diagnosed with HCV across four safety net sites, a quarter achieved SVR-12. Those diagnosed in community outreach had lower odds of antiviral prescription, and those who were linked to a specialist were more likely to receive antiviral prescription. Improving progression through cascade milestones across safety-net settings is integral to improving population-based HCV outcomes. Disclosures All authors: No reported disclosures.

APA, Harvard, Vancouver, ISO, and other styles

23

Larrick, James W. "Antibody inhibition of the immunoinflammatory cascade." Journal of Critical Care 4, no. 3 (September 1989): 211–24. http://dx.doi.org/10.1016/0883-9441(89)90008-7.

Full text

APA, Harvard, Vancouver, ISO, and other styles

24

Lungu, Patrick, Andrew D. Kerkhoff, Clara C. Kasapo, Judith Mzyece, Sulani Nyimbili, Rhehab Chimzizi, Andrew Silumesii, et al. "Tuberculosis care cascade in Zambia - identifying the gaps in order to improve outcomes: a population-based analysis." BMJ Open 11, no. 8 (August 2021): e044867. http://dx.doi.org/10.1136/bmjopen-2020-044867.

Full text

Abstract:

ObjectiveTuberculosis (TB) remains a leading cause of morbidity and mortality in Zambia, especially for people living with HIV (PLHIV). We undertook a care cascade analysis to quantify gaps in care and align programme improvement measures with areas of need.DesignRetrospective, population-based analysis.SettingWe derived national-level estimates for each step of the TB care cascade in Zambia. Estimates were informed by WHO incidence estimates, nationally aggregated laboratory and notification registers, and individual-level programme data from four provinces.ParticipantsParticipants included all individuals with active TB disease in Zambia in 2018. We characterised the overall TB cascade and disaggregated by drug susceptibility results and HIV status.ResultsIn 2018, the total burden of TB in Zambia was estimated to be 72 495 (range, 40 495–111 495) cases. Of these, 43 387 (59.8%) accessed TB testing, 40 176 (55.4%) were diagnosed with TB, 36 431 (50.3%) were started on treatment and 32 700 (45.1%) completed treatment. Among all persons with TB lost at any step along the care cascade (n=39 795), 29 108 (73.1%) were lost prior to accessing diagnostic services, 3211 (8.1%) prior to diagnosis, 3745 (9.4%) prior to initiating treatment and 3731 (9.4%) prior to treatment completion. PLHIV were less likely than HIV-negative individuals to successfully complete the care cascade (42.8% vs 50.2%, p<0.001). Among those with rifampicin-resistant TB, there was substantial attrition at each step of the cascade and only 22.8% were estimated to have successfully completed treatment.ConclusionsLosses throughout the care cascade resulted in a large proportion of individuals with TB not completing treatment. Ongoing health systems strengthening and patient-centred engagement strategies are needed at every step of the care cascade; however, scale-up of active case finding strategies is particularly critical to ensure individuals with TB in the population reach initial stages of care. Additionally, a renewed focus on PLHIV and individuals with drug-resistant TB is urgently needed to improve TB-related outcomes in Zambia.

APA, Harvard, Vancouver, ISO, and other styles

25

Campbell, Jeffrey I., Thomas J. Sandora, and Jessica E. Haberer. "A scoping review of paediatric latent tuberculosis infection care cascades: initial steps are lacking." BMJ Global Health 6, no. 5 (May 2021): e004836. http://dx.doi.org/10.1136/bmjgh-2020-004836.

Full text

Abstract:

Background and objectivesIdentifying and treating children with latent tuberculosis infection (TB infection) is critical to prevent progression to TB disease and to eliminate TB globally. Diagnosis and treatment of TB infection requires completion of a sequence of steps, collectively termed the TB infection care cascade. There has been no systematic attempt to comprehensively summarise literature on the paediatric TB infection care cascade.MethodsWe performed a scoping review of the paediatric TB infection care cascade. We systematically searched PubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane and Embase databases. We reviewed articles and meeting abstracts that included children and adolescents ≤21 years old who were screened for or diagnosed with TB infection, and which described completion of at least one step of the cascade. We synthesised studies to identify facilitators and barriers to retention, interventions to mitigate attrition and knowledge gaps.ResultsWe identified 146 studies examining steps in the paediatric TB infection care cascade; 31 included children living in low-income and middle-income countries. Most literature described the final cascade step (treatment initiation to completion). Studies identified an array of patient and caregiver-related factors associated with completion of cascade steps. Few health systems factors were evaluated as potential predictors of completion, and few interventions to improve retention were specifically tested.ConclusionsWe identified strengths and gaps in the literature describing the paediatric TB infection care cascade. Future research should examine cascade steps upstream of treatment initiation and focus on identification and testing of at-risk paediatric patients. Additionally, future studies should focus on modifiable health systems factors associated with attrition and may benefit from use of behavioural theory and implementation science methods to improve retention.

APA, Harvard, Vancouver, ISO, and other styles

26

Campbell, Jeffrey I., and Dick Menzies. "Testing and Scaling Interventions to Improve the Tuberculosis Infection Care Cascade." Journal of the Pediatric Infectious Diseases Society 11, Supplement_3 (October 1, 2022): S94—S100. http://dx.doi.org/10.1093/jpids/piac070.

Full text

Abstract:

Abstract Tuberculosis (TB) preventive therapy (TPT) is increasingly recognized as the key to eliminating tuberculosis globally and is particularly critical for children with TB infection or who are in close contact with individuals with infectious TB. But many barriers currently impede successful scale-up to provide TPT to those at high risk of TB disease. The cascade of care in TB infection (and the related contact management cascade) is a conceptual framework to evaluate and improve the care of persons who are potential candidates for TPT. This review summarizes recent literature on barriers and solutions in the TB infection care cascade, focusing on children in both high- and low-burden settings, and drawing from studies on children and adults. Identifying and closing gaps in the care cascade will require the implementation of tools that are new (e.g. computer-assisted radiography) and old (e.g. efficient contact tracing), and will be aided by innovative implementation study designs, quality improvement methods, and shared clinical practice with primary care providers.

APA, Harvard, Vancouver, ISO, and other styles

27

Barss, L., S. Moayedi-Nia, J. R. Campbell, O. Oxlade, and D. Menzies. "Interventions to reduce losses in the cascade of care for latent tuberculosis: a systematic review and meta-analysis." International Journal of Tuberculosis and Lung Disease 24, no. 1 (January 1, 2020): 100–109. http://dx.doi.org/10.5588/ijtld.19.0185.

Full text

Abstract:

BACKGROUND: Losses can occur throughout the latent tuberculosis infection (LTBI) cascade of care. This can result in suboptimal rates of effective treatment for LTBI. We conducted a systematic review and meta-analysis to estimate the effect of different interventions to reduce losses in the LTBI cascade before treatment completion.METHODS: We searched several databases for articles reporting outcomes for interventions designed to strengthen the LTBI cascade. We included papers published in English from January 1990 until February 2018. Where possible, estimates were pooled using random-effects meta-analysis.RESULTS: We identified 30 studies that evaluated 32 different interventions aimed at reducing losses in the LTBI cascade. In pooled analysis, interventions that improved completion of cascade steps included patient incentives (respectively 42 [95% CI 34–51] and 48 [95% CI 15–81] additional patients completing initial assessment and medical evaluation per 100 starting); health care worker education (28 [95% CI 4–52] additional patients initiating initial assessment per 100 identified; home visits (additional 13 [95% CI 4–21] patients completing initial assessment per 100 starting); digital solutions (additional 11 [95% CI 4–21] patients initiating initial assessment per 100 identified); and patient reminders (additional 7 [95% CI 0.3–13] patients completing initial assessment per 100 starting). Several other interventions reduced losses at specific cascade steps, but evidence for these interventions came from single studies and could not be pooled.CONCLUSIONS: Although there is limited evidence that any single intervention significantly improves the LTBI cascade, many studies provide information about effective ways to strengthen it.

APA, Harvard, Vancouver, ISO, and other styles

28

Thomas, David L. "State of the Hepatitis C Virus Care Cascade." Clinical Liver Disease 16, no. 1 (July 2020): 8–11. http://dx.doi.org/10.1002/cld.915.

Full text

APA, Harvard, Vancouver, ISO, and other styles

29

Liou, Iris W., and Mindie H. Nguyen. "The Cascade of Care in Chronic Hepatitis B." Current Hepatology Reports 15, no. 4 (October 28, 2016): 209–19. http://dx.doi.org/10.1007/s11901-016-0316-8.

Full text

APA, Harvard, Vancouver, ISO, and other styles

30

Mandrola, John, and Daniel J. Morgan. "The Important but Rarely Studied Cascade of Care." JAMA Network Open 2, no. 10 (October 16, 2019): e1913315. http://dx.doi.org/10.1001/jamanetworkopen.2019.13315.

Full text

APA, Harvard, Vancouver, ISO, and other styles

31

Bos, Philippe, Veerle Buffel, Katrien Danhieux, Josefien Van Olmen, Roy Remmen, and Edwin Wouters. "Evaluating the Cascade of Hypertension Care in Belgium." International Journal of Integrated Care 22, S3 (November 4, 2022): 305. http://dx.doi.org/10.5334/ijic.icic22154.

Full text

APA, Harvard, Vancouver, ISO, and other styles

32

Kuper, M., and N. C. Soni. "Oxygen transfer: cascade or whirlpool?" Current Anaesthesia & Critical Care 14, no. 2 (April 2003): 58–65. http://dx.doi.org/10.1016/s0953-7112(03)00034-6.

Full text

APA, Harvard, Vancouver, ISO, and other styles

33

Blanchard, Jeremy R., Neal Hadro, Mark Calkins, Brian Keith Day, Mary Maniscalco-Theberge, Daniel Otchy, and Geoffrey Ling. "THE CYTOKINE CASCADE IN CONTROLLED ABDOMINAL TRAUMA." Critical Care Medicine 27, Supplement (December 1999): A153. http://dx.doi.org/10.1097/00003246-199912001-00436.

Full text

APA, Harvard, Vancouver, ISO, and other styles

34

ROHRER, MICHAEL J., and ANITA M. NATALE. "Effect of hypothermia on the coagulation cascade." Critical Care Medicine 20, no. 10 (October 1992): 1402–5. http://dx.doi.org/10.1097/00003246-199210000-00007.

Full text

APA, Harvard, Vancouver, ISO, and other styles

35

Cavaillon, J. M. "Rôle des glucocorticoïdes dans la cascade inflammatoire." Réanimation Urgences 9, no. 8 (December 2000): 605–12. http://dx.doi.org/10.1016/s1164-6756(00)90035-5.

Full text

APA, Harvard, Vancouver, ISO, and other styles

36

Elgalib, A., S. Shah, A. Al-Wahaibi, Z. Al-Habsi, M. Al-Fouri, R. Lau, H. Al-Kindi, B. Al-Rawahi, and S. Al-Abri. "Disparities between HIV patient subgroups in Oman: An analysis of the 2019 cascade of care." PLOS ONE 16, no. 7 (July 9, 2021): e0254474. http://dx.doi.org/10.1371/journal.pone.0254474.

Full text

Abstract:

Background The HIV cascade of care is a framework for monitoring HIV care, identifying gaps and informing appropriate interventions. This study aimed to describe the cascade of care in Oman in 2019 and highlight disparities at the sub-population level. Methods We used the UNAIDS Spectrum modelling software to estimate the number of people living with HIV. A national HIV surveillance database was used to identify Omani people (≥13 years old) diagnosed with HIV from 1984 through December 2019. We calculated the cascade indicators as of 31 December 2019 stratified by sex, age, HIV risk factor, residence, and region of HIV care. We also performed multivariate logistic regression to determine the predictors of attrition at linkage, retention, on ART, and viral suppression. Results As of December 2019, the estimated number of people living with HIV in Oman was 2440. Out of the estimated number of people living with HIV, 69% were diagnosed, 66% were linked to care, 61% were retained in care, 60% were on ART, and 55% were virally suppressed. Of the 1673 diagnosed individuals, 96% were linked to care, 88% were retained in care, 87% were on ART, and 81% were virally suppressed. People who received HIV care outside Muscat had the largest attrition (11% loss) in the transition from linkage (97%) to retention (86%). Similarly, people aged 13–24 years had the largest attrition (13% loss) from “on ART” (88%) to viral suppression (75%). Logistic regression showed that both not reporting a specific HIV risk factor and receipt of HIV care outside Muscat independently predicted attrition at each cascade stage from linkage to care through viral suppression. Conclusions Our findings identified substantial disparities across various subpopulations along the cascade of care in Oman. This analysis will be invaluable in informing future interventions targeting patient subgroups who are at the highest risk of attrition.

APA, Harvard, Vancouver, ISO, and other styles

37

Chicumbe, Sérgio, and Maria do Rosário Oliveira Martins. "Factors Associated with Underutilization of Maternity Health Care Cascade in Mozambique: Analysis of the 2015 National Health Survey." International Journal of Environmental Research and Public Health 19, no. 13 (June 27, 2022): 7861. http://dx.doi.org/10.3390/ijerph19137861.

Full text

Abstract:

Maternity health care services utilization determines maternal and neonate outcomes. Evidence about factors associated with composite non-utilization of four or more antenatal consultations and intrapartum health care services is needed in Mozambique. This study uses data from the 2015 nationwide Mozambique’s Malaria, Immunization and HIV Indicators Survey. At selected representative households, women (n = 2629) with child aged up to 3 years answered a standardized structured questionnaire. Adjusted binary logistic regression assessed associations between women-child pairs characteristics and non-utilization of maternity health care. Seventy five percent (95% confidence interval (CI) = 71.8–77.7%) of women missed a health care cascade step during their last pregnancy. Higher education (adjusted odds ratio (AOR) = 0.65; 95% CI = 0.46–0.91), lowest wealth (AOR = 2.1; 95% CI = 1.2–3.7), rural residency (AOR = 1.5; 95% CI = 1.1–2.2), living distant from health facility (AOR = 1.5; 95% CI = 1.1–1.9) and unknown HIV status (AOR = 1.9; 95% CI = 1.4–2.7) were factors associated with non-utilization of the maternity health care cascade. The study highlights that, by 2015, recommended maternity health care cascade utilization did not cover 7 out of 10 pregnant women in Mozambique. Unfavorable sociodemographic and economic factors increase the relative odds for women not being covered by the maternity health care cascade.

APA, Harvard, Vancouver, ISO, and other styles

38

Taghavi, Katayoun, Ardele Mandiriri, Tinei Shamu, Eliane Rohner, Lukas Bütikofer, Serra Asangbeh, Tsitsi Magure, et al. "Cervical Cancer Screening Cascade for women living with HIV: A cohort study from Zimbabwe." PLOS Global Public Health 2, no. 2 (February 2, 2022): e0000156. http://dx.doi.org/10.1371/journal.pgph.0000156.

Full text

Abstract:

Countries with high HIV prevalence, predominantly in sub-Sahahran Africa, have the highest cervical cancer rates globally. HIV care cascades successfully facilitated the scale-up of antiretroviral therapy. A cascade approach could similarly succeed to scale-up cervical cancer screening, supporting WHO’s goal to eliminate cervical cancer. We defined a Cervical Cancer Screening Cascade for women living with HIV (WLHIV), evaluating the continuum of cervical cancer screening integrated into an HIV clinic in Zimbabwe. We included WLHIV aged ≥18 years enrolled at Newlands Clinic in Harare from June 2012–2017 and followed them until June 2018. We used a cascade approach to evaluate the full continuum of secondary prevention from screening to treatment of pre-cancer and follow-up. We report percentages, median time to reach cascade stages, and cumulative incidence at two years with 95% confidence intervals (CI). We used univariable Cox proportional hazard regressions to calculate cause-specific hazard ratios with 95% CIs for factors associated with completing the cascade stages. We included 1624 WLHIV in the study. The cumulative incidence of cervical screening was 85.4% (95% CI 83.5–87.1) at two years. Among the 396 WLHIV who received screen-positive tests in the study, the cumulative incidence of treatment after a positive screening test was 79.5% (95% CI 75.1–83.2) at two years. The cumulative incidence of testing negative at re-screening after treatment was 36.1% (95% CI 31.2–40.7) at two years. Using a cascade approach to evaluate the full continuum of cervical cancer screening, we found less-than 80% of WLHIV received treatment after screen-positive tests and less-than 40% were screen-negative at follow-up. Interventions to improve linkage to treatment for screen-positive WLHIV and studies to understand the clinical significance of screen-positive tests at follow-up among WLHIV are needed. These gaps in the continuum of care must be addressed in order to prevent cervical cancer.

APA, Harvard, Vancouver, ISO, and other styles

39

Marley, Gifty, Xia Zou, Juan Nie, Weibin Cheng, Yewei Xie, Huipeng Liao, Yehua Wang, et al. "Improving cascade outcomes for active TB: A global systematic review and meta-analysis of TB interventions." PLOS Medicine 20, no. 1 (January 3, 2023): e1004091. http://dx.doi.org/10.1371/journal.pmed.1004091.

Full text

Abstract:

Background To inform policy and implementation that can enhance prevention and improve tuberculosis (TB) care cascade outcomes, this review aimed to summarize the impact of various interventions on care cascade outcomes for active TB. Methods and findings In this systematic review and meta-analysis, we retrieved English articles with comparator arms (like randomized controlled trials (RCTs) and before and after intervention studies) that evaluated TB interventions published from January 1970 to September 30, 2022, from Embase, CINAHL, PubMed, and the Cochrane library. Commentaries, qualitative studies, conference abstracts, studies without standard of care comparator arms, and studies that did not report quantitative results for TB care cascade outcomes were excluded. Data from studies with similar comparator arms were pooled in a random effects model, and outcomes were reported as odds ratio (OR) with 95% confidence interval (CI) and number of studies (k). The quality of evidence was appraised using GRADE, and the study was registered on PROSPERO (CRD42018103331). Of 21,548 deduplicated studies, 144 eligible studies were included. Of 144 studies, 128 were from low/middle-income countries, 84 were RCTs, and 25 integrated TB and HIV care. Counselling and education was significantly associated with testing (OR = 8.82, 95% CI:1.71 to 45.43; I2 = 99.9%, k = 7), diagnosis (OR = 1.44, 95% CI:1.08 to 1.92; I2 = 97.6%, k = 9), linkage to care (OR = 3.10, 95% CI = 1.97 to 4.86; I2 = 0%, k = 1), cure (OR = 2.08, 95% CI:1.11 to 3.88; I2 = 76.7%, k = 4), treatment completion (OR = 1.48, 95% CI: 1.07 to 2.03; I2 = 73.1%, k = 8), and treatment success (OR = 3.24, 95% CI: 1.88 to 5.55; I2 = 75.9%, k = 5) outcomes compared to standard-of-care. Incentives, multisector collaborations, and community-based interventions were associated with at least three TB care cascade outcomes; digital interventions and mixed interventions were associated with an increased likelihood of two cascade outcomes each. These findings remained salient when studies were limited to RCTs only. Also, our study does not cover the entire care cascade as we did not measure gaps in pre-testing, pretreatment, and post-treatment outcomes (like loss to follow-up and TB recurrence). Conclusions Among TB interventions, education and counseling, incentives, community-based interventions, and mixed interventions were associated with multiple active TB care cascade outcomes. However, cost-effectiveness and local-setting contexts should be considered when choosing such strategies due to their high heterogeneity.

APA, Harvard, Vancouver, ISO, and other styles

40

Hillier, Sean Arthur, Eliot Winkler, and Lynn Lavallée. "Decolonising the HIV Care Cascade: Policy and Funding Recommendations from Indigenous Peoples Living with HIV and AIDS." International Journal of Indigenous Health 15, no. 1 (November 5, 2020): 48–60. http://dx.doi.org/10.32799/ijih.v15i1.34001.

Full text

Abstract:

Indigenous Peoples in settler colonial nations, like Canada, continue to experience the intergenerational trauma, racism, socioeconomic disadvantages, and pervasive health disparities resulting from centuries of systemic oppression. Among these is the disproportionate burden of HIV in Canada’s Indigenous population, coupled with a lack of access to care and services. One method of assessing systems-level gaps is by using the HIV care cascade, whereby individuals are diagnosed, antiretroviral treatment is initiated, and viral suppression is achieved and maintained. The cascade, as it stands today, does not yield positive outcomes for Indigenous Peoples living with HIV. In order to close existing gaps, the authors sought to decolonise the HIV care cascade by rooting it in funding and policy recommendations provided directly by Indigenous Peoples living with HIV. This research presents 29 recommendations that arose when First Nations participants living with HIV partook in traditional storytelling interviews to share their life’s journey and offer suggestions for improving access to care and services. Said recommendations are to localize testing and diagnosis (while upholding confidentiality), improve access to culturally-appropriate care and services, provide targeted programming for Indigenous women and heterosexual men, and increase funding for provincial disability benefits; important steps in decolonising the HIV care cascade.

APA, Harvard, Vancouver, ISO, and other styles

41

Jones, Austin Taylor, Lisa Moreno-Walton, Kanayo R. Okeke-Eweni, Keanan M. McGonigle, David H. Yang, Morris Kim, Jenna Miller, and Patricia Kissinger. "3382 Assessing Racial Disparities in Hepatitis C Retention of Care." Journal of Clinical and Translational Science 3, s1 (March 2019): 118–19. http://dx.doi.org/10.1017/cts.2019.270.

Full text

Abstract:

OBJECTIVES/SPECIFIC AIMS: The objective of this study is to assess differences in outcomes between African Americans (AAs) and whites along the HCV care cascade. Primary outcome was retention in the HCV care cascade, measured in two ways. For viral RNA confirmation, retention was a percentage of those having screened antibody reactive. For hepatic ultrasound, primary care, HCV specialty clinic, treatment initiation, and sustained viral load (SVR), retention was a percentage of those found chronically infected by positive RNA viral load. Secondary outcome was time to follow-up from antibody screening to each subsequent step in the care cascade. METHODS/STUDY POPULATION: A retrospective cohort study was performed. AA and white patients who tested HCV antibody reactive from March to October 2015 at the University Medical Center (UMC) Emergency Department in New Orleans, LA were included in this study. Outcomes were assessed using the HCV Continuum of Care model, delineating successive stages of care from identification to cure. RESULTS/ANTICIPATED RESULTS: A total of 728 patients screened HCV antibody reactive, including 446 AAs and 282 whites. AAs (53.5 years, SD 10.2) were disproportionately older than whites (46.7 years, SD 11.9) (p <0.001), more likely to be insured (89.2% vs 78.7%, p<0.001), had higher rates of Medicare (28.0% vs 12.1%, p<0.001), and less frequent history of intravenous drug use (IVDU) (32.3% vs 46.1%, p<0.001). For AAs, retention in the treatment cascade was 96.2% for viral RNA confirmation, 50.9% for hepatic ultrasound, 26.8% for primary care, 35.2% for HCV specialty clinic, 14.5% for treatment initiation, and 9.6% for sustained viral response (SVR). Among whites, retention in the treatment cascade was 96.8% for viral RNA confirmation, 37.8% for hepatic ultrasound, 16.1% for primary care, 23.3% for HCV specialty clinic, 8.8% for treatment initiation, and 7.8% for SVR. AAs had a higher likelihood of receiving a hepatic ultrasound (OR=1.70; CI=1.19-2.25; p<0.005), following up with primary care (OR = 1.91, CI=1.21-3.02, p<0.005), and attending the viral hepatitis specialty clinic (OR=1.79, CI=1.20-2.68, p<0.005), as compared to their white counterparts. After adjusting for age, insurance, and history of IVDU, AAs did not have a higher likelihood of receiving a hepatic ultrasound (aOR=1.09, CI=0.995-1.19) or seeking primary care (aOR=1.05, CI=0.98-1.14). AAs had attenuated odds of attending viral hepatitis specialty clinic (aOR=1.09, CI = 1.01-1.19). There was no statistically significant difference in follow-up time in the treatment cascade for AAs versus whites. DISCUSSION/SIGNIFICANCE OF IMPACT: Race alone cannot explain differences in achievement along the care cascade. Significant differences in retention along the HCV care cascade appear to be related primarily to differences in age and insurance status. In our population, older AAs are disproportionately insured through Medicare, thereby expanding their access to health resources. Their white counterparts are younger and more uninsured, leading to decreased access to care and ability to attend HCV follow-up appointments. ED HCV screening programs are still in their infancy and have opportunities to improve their linkage to care rates. Additional interventions are needed to better connect patients screened positive in the ED to HCV specialist care, preserving equity across racial groups.

APA, Harvard, Vancouver, ISO, and other styles

42

Altangerel, Enkhjargal, Nandintsetseg Tsoggerel, Suvd Batbaatar, and Uyanga Bat-Osor. "Challenges with the cascade of HDV care in Mongolia." Journal of Hepatology 77 (July 2022): S824. http://dx.doi.org/10.1016/s0168-8278(22)01944-4.

Full text

APA, Harvard, Vancouver, ISO, and other styles

43

Mold, James W., and Howard F. Stein. "The Cascade Effect in the Clinical Care of Patients." New England Journal of Medicine 314, no. 8 (February 20, 1986): 512–14. http://dx.doi.org/10.1056/nejm198602203140809.

Full text

APA, Harvard, Vancouver, ISO, and other styles

44

Syvertsen, Jennifer L., Hannah Toneff, Danielle R. Madden, and John D. Clapp. "Conceptualizing Neonatal Abstinence Syndrome as a Cascade of Care." Advances in Neonatal Care 18, no. 6 (December 2018): 488–99. http://dx.doi.org/10.1097/anc.0000000000000552.

Full text

APA, Harvard, Vancouver, ISO, and other styles

45

Wong, Robert J., and Aijaz Ahmed. "Understanding Gaps in the Hepatocellular Carcinoma Cascade of Care." Journal of Clinical Gastroenterology 54, no. 10 (September 2, 2020): 850–56. http://dx.doi.org/10.1097/mcg.0000000000001422.

Full text

APA, Harvard, Vancouver, ISO, and other styles

46

Pokrovskaya, Anastasia, Anna Popova, Natalia Ladnaya, and Oleg Yurin. "The cascade of HIV care in Russia, 2011-2013." Journal of the International AIDS Society 17 (November 2014): 19506. http://dx.doi.org/10.7448/ias.17.4.19506.

Full text

APA, Harvard, Vancouver, ISO, and other styles

47

MacCarthy, Sarah, Michael Hoffmann, Laura Ferguson, Amy Nunn, Risha Irvin, David Bangsberg, Sofia Gruskin, and Ines Dourado. "The HIV care cascade: models, measures and moving forward." Journal of the International AIDS Society 18, no. 1 (January 2015): 19395. http://dx.doi.org/10.7448/ias.18.1.19395.

Full text

APA, Harvard, Vancouver, ISO, and other styles

48

Stover, S., N. Laufer, A. Falak, G. Poblete, A. López Noé, A. Martinez, M. J. Rolon, and H. Pérez. "Cascade of HCV care among HIV/HCV coinfected patients." International Journal of Infectious Diseases 73 (August 2018): 236. http://dx.doi.org/10.1016/j.ijid.2018.04.3951.

Full text

APA, Harvard, Vancouver, ISO, and other styles

49

Knopf, Alison. "Cascade of Care model to be used in SUDs." Alcoholism & Drug Abuse Weekly 29, no. 21 (May 29, 2017): 4–6. http://dx.doi.org/10.1002/adaw.30963.

Full text

APA, Harvard, Vancouver, ISO, and other styles

50

Seckinelgin, Hakan. "People don’t live on the care cascade: The life of the HIV care cascade as an international AIDS policy and its implications." Global Public Health 15, no. 3 (October 9, 2019): 321–33. http://dx.doi.org/10.1080/17441692.2019.1673784.

Full text

APA, Harvard, Vancouver, ISO, and other styles

We offer discounts on all premium plans for authors whose works are included in thematic literature selections. Contact us to get a unique promo code!