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  • 1
    Online Resource
    Online Resource
    Cost-effectiveness of voluntary HIV screening in Russia
    SAGE Publications ; 2009
    In:  International Journal of STD & AIDS Vol. 20, No. 1 ( 2009-01), p. 46-51
    Details
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 20, No. 1 ( 2009-01), p. 46-51
    Abstract: Russia has one of the world's fastest growing HIV epidemics, and HIV screening has been widespread. Whether such screening is an effective use of resources is unclear. We used epidemiologic and economic data from Russia to develop a Markov model to estimate costs, quality of life and survival associated with a voluntary HIV screening programme compared with no screening in Russia. We measured discounted lifetime health-care costs and quality-adjusted life years (QALYs) gained. We varied our inputs in sensitivity analysis. Early identification of HIV through screening provided a substantial benefit to persons with HIV, increasing life expectancy by 2.1 years and 1.7 QALYs. At a base-case prevalence of 1.2%, once-per-lifetime screening cost $13,396 per QALY gained, exclusive of benefit from reduced transmission. Cost-effectiveness of screening remained favourable until prevalence dropped below 0.04%. When HIV-transmission-related costs and benefits were included, once-per-lifetime screening cost $6910 per QALY gained and screening every two years cost $27,696 per QALY gained. An important determinant of the cost-effectiveness of screening was effectiveness of counselling about risk reduction. Early identification of HIV infection through screening in Russia is effective and cost-effective in all but the lowest prevalence groups.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    URL: Article
    DOI: 10.1258/ijsa.2008.008128
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
    detail.hit.zdb_id: 2009782-7
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  • 2
    Online Resource
    Online Resource
    Is Dupuytren’s Disease Caused by an Imbalance between Proliferation and Cell Death?
    SAGE Publications ; 1999
    In:  Journal of Hand Surgery Vol. 24, No. 5 ( 1999-10), p. 511-514
    Details
    In: Journal of Hand Surgery, SAGE Publications, Vol. 24, No. 5 ( 1999-10), p. 511-514
    Abstract: Dupuytren’s contracture shares certain properties with malignant tumours, characterized by proliferation and lack of apoptosis, which may be induced by the c- myc oncogene. Because of these similarities, the relationship between the c- myc oncogene expression, bcl-2 oncogene (antiapoptotic gene) and proliferation was investigated in Dupuytren’s disease. Proliferation was assessed by immunohistochemical staining of the mib-1 antibody. Results were compared with those from fibrosarcoma specimens, representing a related malignant tumour. Non-diseased fascia from Dupuytren patients and flexor retinaculum from patients undergoing carpal tunnel release without Dupuytren’s disease were used as controls. Expression of c- myc was elevated in primary Dupuytren’s disease and fibrosarcoma specimens, whilst recurrent Dupuytren’s disease, non-diseased Dupuytren fascia and flexor retinaculum exhibited significantly lower levels. Neither bcl-2 nor mib-1 were detected in Dupuytren’s disease, non-diseased fascia or flexor retinaculum, in contrast to fibrosarcoma. The imbalance between proliferation and apoptosis, producing malignant growth was thus confirmed for fibrosarcoma, but not for Dupuytren’s disease.
    Type of Medium: Online Resource
    ISSN: 0266-7681
    URL: Article
    DOI: 10.1054/JHSB.1999.0251
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1999
    detail.hit.zdb_id: 2376920-8
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  • 3
    Online Resource
    Online Resource
    A randomized trial of computer-based reminders and audit and feedback to improve HIV screening in a primary care setting
    SAGE Publications ; 2009
    In:  International Journal of STD & AIDS Vol. 20, No. 8 ( 2009-08), p. 527-533
    Details
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 20, No. 8 ( 2009-08), p. 527-533
    Abstract: Despite recommendations for voluntary HIV screening, few medical centres have implemented screening programmes. The objective of the study was to determine whether an intervention with computer-based reminders and feedback would increase screening for HIV in a Department of Veterans Affairs (VA) health-care system. The design of the study was a randomized controlled trial at five primary care clinics at the VA Palo Alto Health Care System. All primary care providers were eligible to participate in the study. The study intervention was computer-based reminders to either assess HIV risk behaviours or to offer HIV testing; feedback on adherence to reminders was provided. The main outcome measure was the difference in HIV testing rates between intervention and control group providers. The control group providers tested 1.0% ( n = 67) and 1.4% ( n = 106) of patients in the preintervention and intervention period, respectively; intervention providers tested 1.8% ( n = 98) and 1.9% ( n = 114), respectively ( P = 0.75). In our random sample of 753 untested patients, 204 (27%) had documented risk behaviours. Providers were more likely to adhere to reminders to test rather than with reminders to perform risk assessment (11% versus 5%, P 〈 0.01). Sixty-one percent of providers felt that lack of time prevented risk assessment. In conclusion, in primary care clinics in our setting, HIV testing rates were low. Providers were unaware of the high rates of risky behaviour in their patient population and perceived important barriers to testing. Low-intensity clinical reminders and feedback did not increase rates of screening.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    URL: Article
    DOI: 10.1258/ijsa.2008.008423
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
    detail.hit.zdb_id: 2009782-7
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  • 4
    Online Resource
    Online Resource
    Provider perceptions on the management of lupus during pregnancy: barriers to improved care
    SAGE Publications ; 2019
    In:  Lupus Vol. 28, No. 1 ( 2019-01), p. 86-93
    Details
    In: Lupus, SAGE Publications, Vol. 28, No. 1 ( 2019-01), p. 86-93
    Abstract: More than half of pregnancies in women with systemic lupus erythematosus (lupus) result in adverse outcomes for the mother or the fetus. We sought to identify aspects of current rheumatologic care that could be improved to decrease the frequency of poor outcomes. Methods Focus groups with clinical rheumatologists, based on the PRECEDE/PROCEED framework, identified factors that influenced care. A group of women with lupus on their reproductive journey contributed to our understanding of the dilemmas and care provided. Results Medically ill-timed pregnancies and medication non-adherence during pregnancy were identified by rheumatologists as the two key dilemmas in care. We identified several communication gaps as key modifiable barriers to optimal management. The approach to physician–patient communication was often unsuitable to sensitive discussions about pregnancy planning. The communication of treatment plans was frequently hampered by gaps in knowledge and both physician and patient confidence in the data, encouraging non-adherence among nervous patients. Finally, local rheumatologists and obstetricians/gynecologists providers frequently did not communicate, leading to varying treatment plans and confusion for patients. Conclusions To decrease the frequency of ill-timed pregnancy and medication non-adherence it will be essential to empower rheumatologists, and women with lupus to have open and accurate conversations about pregnancy planning and management.
    Type of Medium: Online Resource
    ISSN: 0961-2033 , 1477-0962
    URL: Article
    DOI: 10.1177/0961203318815594
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2008035-9
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  • 5
    Online Resource
    Online Resource
    Nomenclature for Pediatric and Congenital Cardiac Care: Unification of Clinical and Administrative Nomenclature – The 2021 International Paediatric and Congenital Cardiac Code (IPCCC) and the Eleventh Revision of the International Classification of Diseases (ICD-11)
    SAGE Publications ; 2021
    In:  World Journal for Pediatric and Congenital Heart Surgery Vol. 12, No. 5 ( 2021-10), p. E1-E18
    Details
    In: World Journal for Pediatric and Congenital Heart Surgery, SAGE Publications, Vol. 12, No. 5 ( 2021-10), p. E1-E18
    Abstract: Substantial progress has been made in the standardization of nomenclature for paediatric and congenital cardiac care. In 1936, Maude Abbott published her Atlas of Congenital Cardiac Disease, which was the first formal attempt to classify congenital heart disease. The International Paediatric and Congenital Cardiac Code ( IPCCC) is now utilized worldwide and has most recently become the paediatric and congenital cardiac component of the Eleventh Revision of the International Classification of Diseases (ICD-11). The most recent publication of the IPCCC was in 2017. This manuscript provides an updated 2021 version of the IPCCC. The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD), in collaboration with the World Health Organization (WHO), developed the paediatric and congenital cardiac nomenclature that is now within the eleventh version of the International Classification of Diseases (ICD-11). This unification of IPCCC and ICD-11 is the IPCCC ICD-11 Nomenclature and is the first time that the clinical nomenclature for paediatric and congenital cardiac care and the administrative nomenclature for paediatric and congenital cardiac care are harmonized. The resultant congenital cardiac component of ICD-11 was increased from 29 congenital cardiac codes in ICD-9 and 73 congenital cardiac codes in ICD-10 to 318 codes submitted by ISNPCHD through 2018 for incorporation into ICD-11. After these 318 terms were incorporated into ICD-11 in 2018, the WHO ICD-11 team added an additional 49 terms, some of which are acceptable legacy terms from ICD-10, while others provide greater granularity than the ISNPCHD thought was originally acceptable. Thus, the total number of paediatric and congenital cardiac terms in ICD-11 is 367. In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature. This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature. The members of ISNPCHD realize that the nomenclature published in this manuscript will continue to evolve. The version of the IPCCC that was published in 2017 has evolved and changed, and it is now replaced by this 2021 version. In the future, ISNPCHD will again publish updated versions of IPCCC, as IPCCC continues to evolve.
    Type of Medium: Online Resource
    ISSN: 2150-1351 , 2150-136X
    URL: Article
    DOI: 10.1177/21501351211032919
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2550261-X
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  • 6
    Online Resource
    Online Resource
    Future Directions for Cost-effectiveness Analyses in Health and Medicine
    SAGE Publications ; 2018
    In:  Medical Decision Making Vol. 38, No. 7 ( 2018-10), p. 767-777
    Details
    In: Medical Decision Making, SAGE Publications, Vol. 38, No. 7 ( 2018-10), p. 767-777
    Abstract: Objectives. In 2016, the Second Panel on Cost-effectiveness in Health and Medicine updated the seminal work of the original panel from 2 decades earlier. The Second Panel had an opportunity to reflect on the evolution of cost-effectiveness analysis (CEA) and to provide guidance for the next generation of practitioners and consumers. In this article, we present key topics for future research and policy. Methods. During the course of its deliberations, the Second Panel discussed numerous topics for advancing methods and for improving the use of CEA in decision making. We identify and consider 7 areas for which the panel believes that future research would be particularly fruitful. In each of these areas, we highlight outstanding research needs. The list is not intended as an exhaustive inventory but rather a set of key items that surfaced repeatedly in the panel’s discussions. In the online Appendix , we also list and expound briefly on 8 other important topics. Results. We highlight 7 key areas: CEA and perspectives (determining, valuing, and summarizing elements for the analysis), modeling (comparative modeling and model transparency), health outcomes (valuing temporary health and path states, as well as health effects on caregivers), costing (a cost catalogue, valuing household production, and productivity effects), evidence synthesis (developing theory on learning across studies and combining data from clinical trials and observational studies), estimating and using cost-effectiveness thresholds (empirically representing 2 broad concepts: opportunity costs and public willingness to pay), and reporting and communicating CEAs (written protocols and a quality scoring system). Conclusions. Cost-effectiveness analysis remains a flourishing and evolving field with many opportunities for research. More work is needed on many fronts to understand how best to incorporate CEA into policy and practice.
    Type of Medium: Online Resource
    ISSN: 0272-989X , 1552-681X
    URL: Article
    DOI: 10.1177/0272989X18798833
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2040405-0
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  • 7
    Online Resource
    Online Resource
    Stomaching the pain of spinal fusion: Gastrointestinal discomfort is as severe as back pain in 50% of adolescent idiopathic scoliosis patients following posterior spinal fusion
    SAGE Publications ; 2018
    In:  Journal of Children's Orthopaedics Vol. 12, No. 5 ( 2018-10), p. 539-543
    Details
    In: Journal of Children's Orthopaedics, SAGE Publications, Vol. 12, No. 5 ( 2018-10), p. 539-543
    Abstract: There have been no prospective studies investigating gastrointestinal (GI) symptoms of patients with adolescent idiopathic scoliosis (AIS) following posterior spinal fusion (PSF). The purpose of this study was to evaluate the incidence and severity of self-reported GI symptoms following PSF. Methods In all, 40 AIS patients undergoing PSF were prospectively enrolled between March 2015 and October 2016. Patients completed a survey on each postoperative, inpatient day regarding nausea, emesis, constipation, abdominal pain and back pain, rating their pain on a scale of 1 to 10. Results Abdominal pain (50%), emesis (63%), nausea (65%) and constipation (68%) were experienced by the majority of patients. Of those reporting back pain, the mean pain level during the postoperative period was 5.1 (0.2 to 9.6). Of those reporting abdominal pain, the mean pain level during the postoperative period was 5.5 (1.4 to 8.6), which was not different than the severity of their back-pain levels (mean = 6.0, p = 0.31). Conclusions Gastrointestinal issues in AIS patients following PSF are common. Abdominal pain was as severe as the back pain for half of the patients. Level of Evidence II
    Type of Medium: Online Resource
    ISSN: 1863-2521 , 1863-2548
    URL: Article
    DOI: 10.1302/1863-2548.12.180037
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2268264-8
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  • 8
    Online Resource
    Online Resource
    I131 Blood Levels Correlated with Gastric Emptying Determined Radiographically. II. Fat Test Meal
    SAGE Publications ; 1955
    In:  Experimental Biology and Medicine Vol. 89, No. 1 ( 1955-05-01), p. 54-56
    Details
    In: Experimental Biology and Medicine, SAGE Publications, Vol. 89, No. 1 ( 1955-05-01), p. 54-56
    Type of Medium: Online Resource
    ISSN: 1535-3702 , 1535-3699
    URL: Article
    DOI: 10.3181/00379727-89-21714
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1955
    detail.hit.zdb_id: 2020856-X
    SSG: 12
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  • 9
    Online Resource
    Online Resource
    Obstacles to Meeting Army National Guard Aviator Training Requirements
    SAGE Publications ; 1986
    In:  Proceedings of the Human Factors Society Annual Meeting Vol. 30, No. 10 ( 1986-09), p. 1052-1055
    Details
    In: Proceedings of the Human Factors Society Annual Meeting, SAGE Publications, Vol. 30, No. 10 ( 1986-09), p. 1052-1055
    Abstract: Army National Guard (ARNG) aviators must meet the same aviation training requirements as active Army aviators. During the past 10 years, the training requirements have increased significantly; yet, the amount of time allocated for ARNG aviators to meet the requirements has remained relatively constant. To determine if the aviators need additional allocated training time, a questionnaire survey was conducted. One objective of the survey was to identify the types of obstacles that interfere with the aviators' ability to meet the training requirements. The results indicate that five factors pose major problems to meeting the aviators' continuation training requirements. The factors are an Insufficient Number of Flight Hours, Unavailability of Instructor Pilots, Unavailability of Training Support Areas, Unavailability of Support Equipment, and an Insufficient Amount of Personal Time. The identification of time related obstacles supports the aviators' perceptions that additional training time is needed; however, the identification of obstacles that are not time related suggests that remedial actions, in addition to an increase in training time, can be taken.
    Type of Medium: Online Resource
    ISSN: 0163-5182
    URL: Article
    DOI: 10.1177/154193128603001025
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1986
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  • 10
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    Imaging Techniques for the Evaluation of Glenohumeral Instability
    SAGE Publications ; 2000
    In:  The American Journal of Sports Medicine Vol. 28, No. 3 ( 2000-05), p. 414-434
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 28, No. 3 ( 2000-05), p. 414-434
    Abstract: The ability to image lesions associated with glenohumeral instability has evolved significantly over the past 2 decades. In the past, several imaging techniques ranging from conventional radiography to computerized axial arthrography and, most recently, to magnetic resonance imaging have been used to depict various labral abnormalities. In most instances, conventional radiography remains the initial imaging study for evaluating the patient with persistent shoulder pain and instability. Recently, however, magnetic resonance arthrography has been firmly established as the imaging modality of choice for demonstrating specific soft tissue abnormalities associated with glenohumeral instability. This article will review the role of various imaging modalities including conventional radiography, conventional arthrography, computerized axial arthrography, magnetic resonance imaging, and magnetic resonance arthrography. Emphasis will be placed on the role of magnetic resonance arthrography as it pertains to the lesions associated with glenohumeral instability. A thorough discussion of the appearance of normal anatomic structures, anatomic variations that mimic abnormality, and the various lesions associated with glenohumeral instability will be provided.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/03635465000280032501
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2000
    detail.hit.zdb_id: 2063945-4
    SSG: 31
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