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Medicare, Hospitals, Prevention, And More

Medicare, Hospitals, Prevention, And More

KNOWLEDGE & AWARENESS OF HIV TESTING IN PREGNANT WOMEN AND THEIR HUSBAND ATTENDING OBSTETRICS & GYNAECOLOGY DEPARTMENT AT A TERTIARY CARE CENTRE IN CENTRAL INDIA DURING ANTENATAL CARE

Background: 3.4 million people worldwide are estimated to be living with HIV in 2009. In 2007, only 33 percent of HIV-positive women received antiretroviral drugs to minimise the risk of infection from mother to child.
 Aims and Objective: To study Awareness of HIV testing in pregnant women and their husband during ANC attending in OBGY Department.
 Methodology: This was a cross-sectional analysis carried out over the one-year period of the ANC women attending the OBGY department. By taking the written consent included in the report, there were 108 ANC women in the one year period. By interviewing the pair, knowledge of HIV testing and HIV transmission was assessed. The responses were noted and evaluated by excel software for Windows 10 in the excel sheet.
 Result: In our study we have seen that the majority of the ANC women were in the age group of 26-30 were 32 %. The awareness regarding the various questions like Does HIV transmitted to foetus by mother?- 9 % were Yes, 22 %-No, 69 %-Don’t Know; Do you know tests are there for detection of HIV?- 7 %-Yes, 13 %-No, 80 %-Don’t know; Are you at a risk of Infection?- 4% were Yes, 52% -No, 44 % were Don’t know; Can the disease prevented ? 6 %- Yes, 22 % were No, 72 % were don’t know; Is HIV a Sexually transmitted disease? 33 %-Yes, 22 %-No, 45 %-Don’t know; Can HIV be transmitted by contaminated blood? 32 %-Yes, 20 %-No, 48 %-Don’t know; Can HIV be transmitted by Kissing ?-35 % say Yes, 17 % -No, 48 %-Don’t know; Can HIV be transmitted by sharing food ?- 24 % Yes , 35 %-No, 41 %-Don’t know. From our research, we found that while there is good understanding of the HIV disease, the availability of preventive services through HIV testing is very poor, so subsequent prevention administration drugs are very low, although some myths about the transmission of the disease still remain, such as transmitting through sharing food or transmitting casual hugging or shaking.
 Conclusion: From our research, it can be concluded that the awareness of the PPTCT services with respect to HIV testing during the ANC era was very low, so that the awareness of it should be increased so that HIV transmission from mother to foetus can be effectively carried out.
 Key words: HIV testing during pregnancy, PPTCT (Prevention of Parent to Child Transmission)

The association between GP organisational factors and the effectiveness of a prevention programme for cardiometabolic diseases: a prospective intervention study.

BackgroundOwing to the rising disease burden of cardiometabolic diseases (CMD), prevention programmes for CMD are increasingly implemented in primary care. Organisational practice characteristics and availability of preventive services may be associated with a more effective programme.AimTo identify possible organisational success factors from general practices related to an effective primary prevention programme for CMD.Design & settingA prospective intervention study involving 37 Dutch general practices was undertaken.MethodPatients aged 45–70 years without known CMD, hypertension, or hypercholesterolemia were invited for the prevention programme. The outcome measures were an improvement (yes/no) in four different CMD risk factors between baseline and 1-year follow-up on an individual level (body mass index [BMI], smoking, systolic blood pressure, and cholesterol ratio). Multivariate logistic regression analysis was used for assessing associations between practice organisational characteristics and outcomes.ResultsJust over half of the participants showed an improvement on one or more risk factors. Marginal differences were found in the four different outcomes between the practices with different organisational characteristics. None of the practice characteristics that were tested showed a significant association with an improvement in one of the outcome measures.ConclusionIn this study, general practice organisational and preventive service characteristics showed no impact on the effectiveness of a CMD prevention programme. Possible explanations could be the effectiveness of protocolised pharmaceutical treatment and only limited contribution of lifestyle programmes on the improvement of CMD risk factors.

The Patient Protection and Affordable Care Act and Utilization of Preventive Health Care Services Among Asian Americans in Michigan during Pre- and Post-Affordable Care Act Implementation.

Since the implementation of the Patient Protection and Affordable Care Act (ACA), significant increases in the percent of insured United States residents has steadily increased. Studies have shown that there is an increase in preventative services usage and a decrease in chronic disease burden with increased access to insurance. However, very little has been studied about how the implementation of ACA has impacted utilization of health services and health status among Asian Americans. In this study, we recruited 427 Asian Americans who attended health fairs and examined (1) changes in health care coverage and utilization of preventive health services before and after ACA, (2) health status on chronic disease risk factors, (3) comparing health services utilization by insurance status and types of insurance, and (4) identifying relationships between health care utilization and demographic factors. Study results indicate that even though the percentage of insured Asian Americans in Michigan increased significantly over study periods, health care utilization and chronic disease burden did not change significantly. The insured tended to utilize preventive health services more than the uninsured, but the types of insurance did not affect health care utilization. Gender and having a primary care physician were significant predictors in determining health care utilization. There is a need in this population for language-appropriate and culturally-sensitive education about the importance and availability of preventive services, which could improve adherence to preventive health services, thereby reducing health disparities.

Availability of Medical Care Services in Drug Treatment Clinics Associated With Lower Repeated Emergency Department Use

Drug users rely heavily on emergency departments (EDs) for care. Medical and other services in outpatient drug treatment clinics may reduce demand for ED care. The objective of this study was to examine the association of services in drug treatment clinics with repeated ED use by clinic patients. This study consisted of telephone interviews of directors of a stratified random sample of 125 New York state outpatient drug treatment clinics linked to Medicaid claims for patients with long-term (>or=6 months) treatment at these clinics. This study comprised a total of 8397 Medicare enrollees in surveyed clinics in 1996 to 1997. The surveys addressed drug treatment; general medical, HIV, alcohol, and social support services; location of selected services; primary care, HIV specialty, and mental health provider staffing levels; accessibility; and academic affiliation. From Medicaid claims, we defined patient demographic, clinical, and healthcare variables. Logistic regression models examined associations of availability of onsite medical services with repeated (2 or more) ED visits in 1997, adjusted for patient characteristics and patient clustering in clinics. Repeated ED visits occurred in 15% of the cohort and were less likely when medical services were all onsite versus more distant (12.9% vs 16.8%, P<0.001). An interaction showed that onsite medical care was associated with less ED use only in low-volume (<or=1350 visits/wk, adjusted odds ratio [AOR] 0.64 [0.47-0.88]) and moderate volume (1351-2500 visits/wk, AOR 0.79 [0.64-0.97]) clinics. The availability of preventive services and HIV specialists onsite appear to mediate the beneficial effect of onsite medical care. Greater onsite medical care in low- and moderate-volume drug treatment clinics was associated with less repeated ED use.

Ecologically-Minded Reconstruction of Experiments in HIV Prevention: Reduce, Reuse, and Recycle

The field of HIV risk and prevention research has labored under the assumption that the randomized trial is the single best way to test the efficacy of behavioral interventions. Medical model conventions for trial design and analysis have been adopted whole cloth. However, the usual approaches used to analyze randomized trial data focus on identification of overall treatment effects in aggregate samples. This universal, mechanistic approach is contrary to the daily realities encountered by prevention practitioners and investigators, that different people change in different ways, that group characteristics influence participant outcomes, and that what people get out of an intervention depends upon individual, historical and cultural differences. This paper presents the case for re-examining data from randomized prevention studies, using methods to discern diversity in the ways that people respond to programs and to identify contextual factors that may influence outcomes. Specific methods include the examination of individual outcome trajectories, the identification of dynamic interactions among determinants of risk behavior, the analysis of group-level influences on individual outcomes, and the incorporation of historical data on availability of prevention services in analysis of treatment trials. A meta-analytic framework is proposed to synthesize findings generated by these and other exploratory approaches. HIV prevention science may be best served by methods optimized to discover, highlight and weigh the implications of diversity, rather than relying on approaches that emphasize central tendencies and simple, linear effects.

Cancer knowledge and misconceptions among immigrant Salvadorean men in the Washington, D.C. area.

Although Salvadoreans are the fourth largest group of Hispanics in the United States, little is known about their cancer knowledge, attitudes, and practices. There are no publications assessing cancer knowledge among Salvadorean men. In this cross-sectional survey, information was gathered from 706 immigrant Salvadorean men in Washington, D.C. The majority of these men knew that smoking causes cancer and that some cancers can be cured if detected early. However, the men in this survey had inadequate knowledge about symptoms of cancer and early detection methods. The most important predictor of cancer screening among older participants was enrollment in health insurance plans. Our study suggests that Salvadorean men would participate in cancer screening efforts if they had access to medical care. Educational programs to increase awareness of cancer and availability of preventive services may help prevent cancer in this population.