Suchergebnisse
Filter
37 Ergebnisse
Sortierung:
Long‐term probability of detecting drug‐resistant HIV in patients starting antiretroviral therapy within the first year of HIV infection
In: Journal of the International AIDS Society, Band 13, Heft S4
ISSN: 1758-2652
7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK
Behaviour and attitudes in HIV (BEAHIV): a national survey study to examine the level of agreement between physicians and patients in symptom reporting
In: Journal of the International AIDS Society, Band 13, Heft S4
ISSN: 1758-2652
7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK
Framework for establishing integrated kidney care programs in low- and middle-income countries
In: Tonelli, M. and Nkunu, V. and Varghese, C. and Abu-Alfa, A.K. and Alrukhaimi, M.N. and Fox, L. and Gill, J. and Harris, D.C.H. and Hou, F.F. and O'Connell, P.J. and Rashid, H.U. and Niang, A. and Ossareh, S. and Tesar, V. and Zakharova, E. and Yang, C.-W. (2020) Framework for establishing integrated kidney care programs in low- and middle-income countries. Kidney International Supplements, 10 (1). e19-e23.
Secular increases in the burden of kidney failure is a major challenge for health systems worldwide, especially in low- and middle-income countries (LMICs) due to growing demand for expensive kidney replacement therapies. In LMICs with limited resources, the priority of providing kidney replacement therapies must be weighed against the prevention and treatment of chronic kidney disease, other kidney disorders such as acute kidney injury, and other noncommunicable diseases, as well as other urgent public health needs. Kidney failure is potentially preventable�not just through primary prevention of risk factors for kidney disease such as hypertension and diabetes, but also by timely management of established chronic kidney disease. Among people with established or incipient kidney failure, there are 3 key treatment strategies�conservative care, kidney transplantation, and dialysis�each of which has its own benefits. Joining up preventive care for people with or at risk for milder forms of chronic kidney disease with all 3 therapies for kidney failure (and developing synergistic links between the different treatment options) is termed �integrated kidney care� and has potential benefits for patients, families, and providers. In addition, because integrated kidney care implicitly considers resource use, it should facilitate a more sustainable approach to managing kidney failure than providing one or more of its components separately. There is currently no agreed framework that LMIC governments can use to establish and/or scale up programs to prevent and treat kidney failure or join up these programs to provide integrated kidney care. This review presents a suggested framework for establishing integrated kidney care programs, focusing on the anticipated needs of policy makers in LMICs. © 2020 International Society of Nephrology
BASE
Defining and delivering resilient ecological networks: nature conservation in England
1.Planning for nature conservation has increasingly emphasised the concepts of resilience and spatial networks. Although the importance of habitat networks for individual species is clear, their significance for long‐term ecological resilience and multi‐species conservation strategies is less established. 2.Referencing spatial network theory, we describe the conceptual basis for defining and assessing a network of wildlife areas that supports species' resilience to multiple forms of perturbations and pressures. We explore actions that could enhance network resilience at a range of scales, based on ecological principles, with reference to four well‐established strategies for intervention in a spatial network ("Better, Bigger, More and Joined") from the influential Making Space for Nature report by Lawton et al. (2010). 3.Building existing theory into useable and scalable approaches applicable to large numbers of species is challenging but tractable. We illustrate the policy context, describe the elements of a long‐term adaptive management plan and provide example actions, metrics and targets for early implementation using England as a case study, where there is an opportunity to include large‐scale ecological planning in a newly launched 25‐year environment plan. 4.Policy implications. The concept of resilient ecological networks has attracted scientific and political support, but there is no consensus on what a resilient network would look like, or how to assess it. Therefore, it is unclear whether existing targets for action will be sufficient to achieve network resilience. We show that the scientific principles to place resilience and network theory at the heart of large‐scale and long‐term environmental planning are established and ready to implement in practice. Delivering a resilient network to support nature recovery is achievable and can be integrated with ongoing conservation actions and targets, by assessing their effectiveness on properties of the entire network. England's 25 Year Environment Plan ...
BASE
FREE ORAL COMMUNICATIONS 1: ALCOHOL AND HEALTH * O1.1 * THE ROLE OF THE NIH IN RESPONSE TO THE GLOBAL BURDEN OF ALCOHOL AND HEALTH: OPPORTUNITIES FOR USA-EUROPEAN COLLABORATION
In: Alcohol and alcoholism: the international journal of the Medical Council on Alcoholism (MCA) and the journal of the European Society for Biomedical Research on Alcoholism (ESBRA), Band 46, Heft Supplement 1, S. i25-i26
ISSN: 1464-3502
Elective surgery cancellations due to the COVID-19 pandemic. Global predictive modelling to inform surgical recovery plans
Background: The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. Methods: A global expert response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian β-regression model was used to estimate 12-week cancellation rates for 190 countries. Elective surgical case-mix data, stratified by specialty and indication (surgery for cancer versus benign disease), were determined. This case mix was applied to country-level surgical volumes. The 12-week cancellation rates were then applied to these figures to calculate the total number of cancelled operations. Results: The best estimate was that 28 404 603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID-19 (2 367 050 operations per week). Most would be operations for benign disease (90·2 per cent, 25 638 922 of 28 404 603). The overall 12-week cancellation rate would be 72·3 per cent. Globally, 81·7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37·7 per cent of cancer operations (2 324 070 of 6 162 311) and 25·4 per cent of elective caesarean sections (441 611 of 1 735 483) would be cancelled or postponed. If countries increased their normal surgical volume by 20 per cent after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from COVID-19 disruption. Conclusion: A very large number of operations will be cancelled or postponed owing to disruption caused by COVID-19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to restore surgical activity safely.
BASE