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21.
Christine U. Oramasionwu Terence L. Johnson William A. Zule Jessica Carda-Auten Carol E. Golin 《American journal of public health》2015,105(6):1066-1071
Ongoing injection drug use contributes to the HIV and HCV epidemics in people who inject drugs. In many places, pharmacies are the primary source of sterile syringes for people who inject drugs; thus, pharmacies provide a viable public health service that reduces blood-borne disease transmission.Replacing the supply of high dead space syringes with low dead space syringes could have far-reaching benefits that include further prevention of disease transmission in people who inject drugs and reductions in dosing inaccuracies, medication errors, and medication waste in patients who use syringes.We explored using pharmacies in a structural intervention to increase the uptake of low dead space syringes as part of a comprehensive strategy to reverse these epidemics.There are approximately 1.1 million people living with HIV in the United States.1 Over the past decade, the HIV incidence rate among people who inject drugs (PWID) has decreased; however, PWID remain disproportionately affected by HIV. It is estimated that 8% of new HIV cases in 2010 were among PWID.1 Co-occurring is the HCV epidemic; approximately 2.7 million people are chronically infected with HCV.2 Studies estimate that the prevalence of HCV among PWID ranges from 40% to 90%.3,4 Ongoing injection drug use and injection risk behaviors contribute to both epidemics.Although effective therapies exist, ultimately, preventing the transmission of HIV and HCV is essential to ending these epidemics, particularly in high-risk populations. PWID constitute a vulnerable population that faces numerous economic and personal barriers (e.g., comorbidities) that prevent them from receiving appropriate medical care.5,6 Public health resources and interventions that focus on the prevention of HIV and HCV in PWID are needed.Multiperson use of needles and syringes (i.e., direct sharing) and multiperson use of drug preparation materials (i.e., indirect sharing) are important risk factors for infection acquisition and transmission among PWID.7 An estimated 50% to 80% of PWID acquire HCV infection within the first year of injection drug use.8 Recommended interventions to discourage injection drug use include risk-reduction programs and substance abuse treatment.9 However, because of limited awareness of available programs, lack of access to treatment facilities, need for program referral, and cost of treatment, many PWID are unable to stop injecting drugs.7 A well-known public health measure to reduce the spread of infection is to promote the use of sterile syringes.10 We explored using pharmacies in a structural intervention to help prevent the transmission of HIV and HCV through syringes. 相似文献
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Stoner Marie C. D. Bhushan Nivedita L. Maragh-Bass Allysha C. Mitchell John T. Riggins Linda Walker Maleka LeMasters Katherine Reese Bianka Dearing Aissa Debnam Summer Golin Carol Lightfoot Alexandra F. Pettifor Audrey 《AIDS and behavior》2022,26(5):1672-1683
AIDS and Behavior - Adolescents and young adults (AYA; 13–24 years-old) comprise 22% of new HIV infections in the United States (US), most of whom live in the South. We used the... 相似文献
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In long-term hamster bone marrow cultures, proliferation and differentiation of hemopoietic stem cells occurs for several months without need for hydrocortisone or adherent stromal elements, which are requirements for bone marrow growth in all other species studied. Only the most primitive erythroid progenitors (BFU-E) are produced in the cultures. Following treatment of the cells with erythropoietin, these progenitor cells undergo differentiation into mature hemoglobinized red blood cells. Concomitant addition of erythropoietin (Epo) and prostaglandin-E1 (PGE1) results in the production of large numbers of maturing red blood cells. In cultures stimulated with Epo and PGE1, as many as 70% of the cells are benzidine-positive, while Epo alone stimulated as many as 45% of the cells to become erythroid. Epo and PGE1 do not have any apparent deleterious effect on the continuous hemopoiesis occurring in these cultures. Under identical conditions, syngeneic adherent cell cultures do not produce any erythroid elements. The development of mature red blood cells from primitive erythroid precursors occurs in the presence of Epo alone and without any apparent need for adherent stromal elements. These cultures provide a useful in vitro model for dissecting the positive and negative signals that regulate erythropoiesis. 相似文献
25.
Fc gamma receptor II (CD32) on malignant B cells influences modulation induced by anti-CD19 monoclonal antibody 总被引:1,自引:1,他引:1
Vervoordeldonk SF; Merle PA; van Leeuwen EF; van der Schoot CE; von dem Borne AE; Slaper-Cortenbach IC 《Blood》1994,83(6):1632-1639
Antigenic modulation is one of many factors determining the effectiveness of monoclonal antibody (MoAb)-mediated therapy. To select the isotype of a CD19 MoAb most suitable for radioimmunotherapy of patients with B-cell malignancies, we studied the influence of MoAb isotype on modulation, after binding of the MoAb to different cell-line cells. The CD19-IgG1 MoAb was found to induce modulation of CD19 antigens on Daudi cell line cells more rapidly than did its IgG2a switch variant. We provide evidence that this difference in modulation rate is caused by the expression of Fc gamma receptor II (Fc gamma RII) on these cells. Experiments aimed at elucidating the mechanism of Fc gamma RII involvement in modulation induction by CD19-IgG1 showed that Fc gamma RII did not comodulate with CD19 MoAbs. However, cocrosslinking of CD19 and Fc gamma RII with CD19-IgG1 MoAb resulted in enhanced calcium mobilization in Daudi cells. This increased signal induction accompanies the enhanced capping and subsequent modulation of CD19 antigens. Because Fc gamma RII is expressed in varying densities on malignant B cells in all differentiation stages, our results have implications for the MoAb isotype most suitable for use in MoAb-based therapy of patients with B-cell malignancies. 相似文献
26.
What effect does increasing inpatient time have on outpatient-oriented internist satisfaction? 下载免费PDF全文
Saint S Zemencuk JK Hayward RA Golin CE Konrad TR Linzer M;SGIM Career Satisfaction Group 《Journal of general internal medicine》2003,18(9):725-729
OBJECTIVE: Because career satisfaction among general internists is relatively low, we sought to understand the impact on satisfaction of general internists managing patients both in and outside of the hospital. Using data from a national survey, we asked, “Among outpatient-oriented general internists (i.e., internists who spend less than 50% of their clinical time caring for inpatients), what effect does time spent in the hospital have on physician satisfaction, stress, and burnout?” DESIGN/PARTICIPANTS: The Physician Worklife Study, in which 5,704 physicians in primary and specialty nonsurgical care selected from the American Medical Association’s Masterfile were surveyed (adjusted response rate=52%), was used. Our analyses focused on clinically active outpatient-oriented general internists (N=339). MEASUREMENTS AND MAIN RESULTS: We constructed multivariate linear models to test for statistically significant associations between the amount of time spent seeing inpatients and physician satisfaction as measured by several satisfaction scales. Even after controlling for total hours worked and other possible confounding variables, we found that increased time working in the hospital was significantly associated with decreases in satisfaction with administration, specialty, autonomy, and personal time, and significantly associated with an increase in life stress. There was also a significant association between increased time spent in the hospital and burnout. CONCLUSIONS: Our findings imply that there may be a tension between the practice of inpatient and outpatient medicine by general internists, and suggest that fewer hospital duties may increase career satisfaction for outpatient-oriented internists. Although additional studies are warranted in order to better understand why these relationships exist, our data suggest that the hospitalist model of inpatient care might be one approach to alleviate stress and improve satisfaction for many general internists. 相似文献
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David L. Rosen Catherine A. Grodensky Anna R. Miller Carol E. Golin Marisa E. Domino Wizdom Powell David A. Wohl 《Journal of urban health》2018,95(2):149-158
In 2011, North Carolina (NC) created a program to facilitate Medicaid enrollment for state prisoners experiencing community inpatient hospitalization during their incarceration. The program, which has been described as a model for prison systems nationwide, has saved the NC prison system approximately $10 million annually in hospitalization costs and has potential to increase prisoners’ access to Medicaid benefits as they return to their communities. This study aims to describe the history of NC’s Prison-Based Medicaid Enrollment Assistance Program (PBMEAP), its structure and processes, and program personnel’s perspectives on the challenges and facilitators of program implementation. We conducted semi-structured interviews and a focus group with PBMEAP personnel including two administrative leaders, two “Medicaid Facilitators,” and ten social workers. Seven major findings emerged: 1) state legislation was required to bring the program into existence; 2) the legislation was prompted by projected cost savings; 3) program development required close collaboration between the prison system and state Medicaid office; 4) technology and data sharing played key roles in identifying inmates who previously qualified for Medicaid and would likely qualify if hospitalized; 5) a small number of new staff were sufficient to make the program scalable; 6) inmates generally cooperated in filling out Medicaid applications, and their cooperation was encouraged when social workers explained possible benefits of receiving Medicaid after release; and 7) the most prominent program challenges centered around interaction with county Departments of Social Services, which were responsible for processing applications. Our findings could be instructive to both Medicaid non-expansion and expansion states that have either implemented similar programs or are considering implementing prison Medicaid enrollment programs in the future. 相似文献
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MJ Hwang A Bhangu CE Webster DM Bowley MX Gannon SS Karandikar 《Annals of the Royal College of Surgeons of England》2014,96(5):343-347