35 research outputs found
Health systems and HIV treatment in sub-Saharan Africa: Matching intervention and program evaluation strategies
No full textObjectives International donors financing the delivery of antiretroviral treatment (ART) in developing countries have recently emphasized their commitment to rigorous evaluation of ART impact on population health. In the same time frame but different contexts, they have announced that they will shift funding from vertically-structured (i.e., disease-specific) interventions to horizontally-structured interventions (i.e., staff, systems and infrastructure that can deliver care for many diseases). We analyze likely effects of the latter shift on the feasibility of impact evaluation. Methods We examine the effect of the shift in intervention strategy on (i) outcome measurement, (ii) cost measurement, (iii) study-design options, and the (iv) technical and (v) political feasibility of program evaluation. Results As intervention structure changes from vertical to horizontal, outcome and cost measurement are likely to become more difficult (because the number of relevant outcomes and costs increases and the sources holding data on these measures become more diverse); study design options become more limited (because it is often impossible to identify a rigorously defined counterfactual in horizontal interventions); the technical feasibility of interventions is reduced (because lag times between intervention and impact increase in length and effect mediating and modifying factors increase in number); and political feasibility of evaluation is decreased (because national policymakers may be reluctant to support the evaluation). Conclusions In the choice of intervention strategy, policymakers need to consider the effect of intervention strategy on impact evaluation. Methodological studies are needed to identify the best approaches to evaluate the population health impact of horizontal interventions.Impact evaluation, health systems, HIV, antiretroviral treatment, Africa
A Mathematical Model for Estimating the Number of Health Workers Required for Universal Antiretroviral Treatment
No full textDespite recent international efforts to increase antiretroviral treatment (ART) coverage, it is estimated that more than 5 million people who need ART in developing countries do not receive such treatment. Shortages of human resources to treat HIV/AIDS (HRHA) are one of the main constraints to scaling up ART. We develop a discrete-time Markovian model to project the numbers of HRHA required to achieve universal ART coverage, taking into account the positive feedback from HRHA numbers to future HRHA need. Feedback occurs because ART is effective in prolonging the lives of HIV-positive people who need treatment, so that an increase in the number of people receiving treatment leads to an increase in the number of people needing it in future periods. We investigate the steady-state behavior of our model and apply it to different regions in the developing world. We find that taking into account the feedback from the current supply of HRHA to the future HRHA need substantially increases the projected numbers of HRHA required to achieve universal ART coverage. We discuss the policy implications of our model.
A Mathematical Model for Estimating the Number of Health Workers Required for Universal Antiretroviral Treatment
No full textDespite recent international efforts to increase antiretroviral treatment (ART) coverage, it is estimated that more than 5 million people who need ART in developing countries do not receive such treatment. Shortages of human resources to treat HIV/AIDS (HRHA) are one of the main constraints to scaling up ART. We develop a discrete-time Markovian model to project the numbers of HRHA required to achieve universal ART coverage, taking into account the positive feedback from HRHA numbers to future HRHA need. Feedback occurs because ART is effective in prolonging the lives of HIVpositive people who need treatment, so that an increase in the number of people receiving treatment leads to an increase in the number of people needing it in future periods. We investigate the steady-state behavior of our model and apply it to different regions in the developing world. We find that taking into account the feedback from the current supply of HRHA to the future HRHA need substantially increases the projected numbers of HRHA required to achieve universal ART coverage. We discuss the policy implications of our model.Mathematical model, health workers, universal antiretroviral treatment
Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study
No full text<p>Background - Although access to life-saving treatment for patients infected with HIV in South Africa has improved substantially since 2004, treating all eligible patients (universal access) remains elusive. As the prices of antiretroviral drugs have dropped over the past years, availability of human resources may now be the most important barrier to achieving universal access to HIV treatment in Africa. We quantify the number of HIV health workers (HHWs) required to be added to the current HIV workforce to achieve universal access to HIV treatment in South Africa, under different eligibility criteria.</p>
<p>Methods - We performed a time and motion study in three HIV clinics in a rural, primary care-based HIV treatment program in KwaZulu-Natal, South Africa, to estimate the average time per patient visit for doctors, nurses, and counselors. We estimated the additional number of HHWs needed to achieve universal access to HIV treatment within one year.</p>
<p>Results - For universal access to HIV treatment for all patients with a CD4 cell count of ≤350 cells/μl, an additional 2,200 nurses, 3,800 counselors, and 300 doctors would be required, at additional annual salary cost of 929 million South African rand (ZAR), equivalent to US 400 million).</p>
<p>Conclusions - Universal access to HIV treatment for patients with a CD4 cell count of ≤350 cells/μl in South Africa may be affordable, but the number of HHWs available for HIV treatment will need to be substantially increased. Treatment as prevention strategies will require considerable additional financial and human resources commitments.</p>
Estimating health worker need to provide antiretroviral treatment in the developing world
No full textDespite recent international efforts to increase antiretroviral treatment (ART) coverage, more than 5 million people who need ART in developing countries do not receive such treatment. Shortages of human resources to treat HIV/AIDS (referred to herein as HRHA) are one of the main constraints to further scaling up ART. Planning expansion of ART depends on the ability to predict how many HRHA will be needed in the future. We investigate whether taking into account positive feedback from the current supply of HRHA to future HRHA need substantially alters predictions. This feedback occurs because an increase in the number of HRHA implies an increase in the number of individuals receiving ART and – because ART is a lifelong treatment and is effective in prolonging the lives of HIV-positive people – a rise over time in the number of people requiring ART.Disease, control, global health, HIV/AIDS, Africa.
Identification of beauty and charm quark jets at LHCb
No full textIdentification of jets originating from beauty and charm quarks is important for measuring Standard Model processes and for searching for new physics. The performance of algorithms developed to select b- and c-quark jets is measured using data recorded by LHCb from proton-proton collisions at √s = 7 TeV in 2011 and at √s = 8 TeV in 2012. The efficiency for identifying a b(c) jet is about 65%(25%) with a probability for misidentifying a light-parton jet of 0.3% for jets with transverse momentum p(T) > 20GeV and pseudorapidity 2.2 < η < 4.2. The dependence of the performance on the p(T) and η of the jet is also measured
Promoting hospital-based smoking cessation services at major Swiss hospitals: a before and after study
No full textQUESTIONS UNDER STUDY: Whether a 1-year nationwide, government supported programme is effective in significantly increasing the number of smoking cessation clinics at major Swiss hospitals as well as providing basic training for the staff running them. METHODS: We conducted a baseline evaluation of hospital services for smoking cessation, hypertension, and obesity by web search and telephone contact followed by personal visits between October 2005 and January 2006 of 44 major public hospitals in the 26 cantons of Switzerland; we compared the number of active smoking cessation services and trained personnel between baseline to 1 year after starting the programme including a training workshop for doctors and nurses from all hospitals as well as two further follow-up visits. RESULTS: At base line 9 (21%) hospitals had active smoking cessation services, whereas 43 (98%) and 42 (96%) offered medical services for hypertension and obesity respectively. Hospital directors and heads of Internal Medicine of 43 hospitals were interested in offering some form of help to smokers provided they received outside support, primarily funding to get started or to continue. At two identical workshops, 100 health professionals (27 in Lausanne, 73 in Zurich) were trained for one day. After the programme, 22 (50%) hospitals had an active smoking cessation service staffed with at least 1 trained doctor and 1 nurse. CONCLUSION: A one-year, government-supported national intervention resulted in a substantial increase in the number of hospitals allocating trained staff and offering smoking cessation services to smokers. Compared to the offer for hypertension and obesity this offer is still insufficient
A common origin of complex life cycles in parasitic flatworms: evidence from the complete mitochondrial genome of Microcotyle sebastis (Monogenea : Platyhelminthes)
No full text0000-0002-2718-4001© 2007 Park et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
Financial incentives for return of service in underserved areas: a systematic review
No full textIn many geographical regions, both in developing and in developed countries, the number of health workers is insufficient to achieve population health goals. Financial incentives for return of service are intended to alleviate health worker shortages: A (future) health worker enters into a contract to work for a number of years in an underserved area in exchange for a financial pay-off. The authors of this paper carried out a systematic literature search of PubMed for studies evaluating outcomes of financial-incentive programs published between 1957 and 2007.Disease, control, global health, financial-incentive programs.
Measurements of prompt charm production cross-sections in collisions at = 13 TeV
No full textProduction cross-sections of prompt charm mesons are measured with the first data from collisions at the LHC at a centre-of-mass energy of . The data sample corresponds to an integrated luminosity of collected by the LHCb experiment. The production cross-sections of , , , and mesons are measured in bins of charm meson transverse momentum, , and rapidity, , and cover the range and . The inclusive cross-sections for the four mesons, including charge conjugation, within the range of are found to be \begin{align*} \begin{array}{lcr} \sigma(pp \to D^{0} X) &=& 2460 \pm \phantom{1}3 \pm 130\,\mu\mathrm{b} \\ \sigma(pp \to D^{+} X) &=& 1000 \pm \phantom{1}3 \pm 110\,\mu\mathrm{b} \\ \sigma(pp \to D_{s}^{+} X) &=& 460 \pm 13 \pm 100\,\mu\mathrm{b} \\ \sigma(pp \to D^{*+} X) &=& 880 \pm \phantom{1}5 \pm 140\,\mu\mathrm{b} \end{array} \end{align*} where the uncertainties are due to statistical and systematic uncertainties, respectively.Production cross-sections of prompt charm mesons are measured with the first data from collisions at the LHC at a centre-of-mass energy of . The data sample corresponds to an integrated luminosity of collected by the LHCb experiment. The production cross-sections of , , , and mesons are measured in bins of charm meson transverse momentum, , and rapidity, , and cover the range and . The inclusive cross-sections for the four mesons, including charge conjugation, within the range of are found to be \begin{align*} \begin{array}{lcr} \sigma(pp \to D^{0} X) &=& 2460 \pm \phantom{1}3 \pm 130\,\mu\mathrm{b} \\ \sigma(pp \to D^{+} X) &=& 1000 \pm \phantom{1}3 \pm 110\,\mu\mathrm{b} \\ \sigma(pp \to D_{s}^{+} X) &=& 460 \pm 13 \pm 100\,\mu\mathrm{b} \\ \sigma(pp \to D^{*+} X) &=& 880 \pm \phantom{1}5 \pm 140\,\mu\mathrm{b} \end{array} \end{align*} where the uncertainties are due to statistical and systematic uncertainties, respectively.Production cross-sections of prompt charm mesons are measured with the first data from pp collisions at the LHC at a centre-of-mass energy of 13 TeV. The data sample corresponds to an integrated luminosity of 4.98 ± 0.19 pb collected by the LHCb experiment. The production cross-sections of D, D, D , and D mesons are measured in bins of charm meson transverse momentum, p, and rapidity, y, and cover the range 0 < p < 15GeV/c and 2.0 < y < 4.5. The inclusive cross-sections for the four mesons, including charge conjugation, within the range of 1 < p < 8 GeV/c are found to be \begin{array}{l}\sigma \left( pp\to {D}^0X\right)=2460\pm 3\pm 130\,\upmu \mathrm{b}\hfill \\ {}\sigma \left( pp\to {D}^{+}X\right)=1000\pm 3\pm 110\,\upmu \mathrm{b}\hfill \\ {}\sigma \left( pp\to {D}_s^{+}X\right)=460\pm 13\pm 100\,\upmu \mathrm{b}\hfill \\ {}\sigma \left( pp\to {D}^{\ast +}X\right)=880\pm 5\pm 140\,\upmu \mathrm{b}\hfill \end{array} where the uncertainties are due to statistical and systematic uncertainties, respectively.Production cross-sections of prompt charm mesons are measured with the first data from collisions at the LHC at a centre-of-mass energy of . The data sample corresponds to an integrated luminosity of collected by the LHCb experiment. The production cross-sections of , , , and mesons are measured in bins of charm meson transverse momentum, , and rapidity, , and cover the range and . The inclusive cross-sections for the four mesons, including charge conjugation, within the range of are found to be \begin{equation} \sigma(pp \to D^{0} X) = 2072 \pm 2 \pm 124\,\mu\mathrm{b}\\ \sigma(pp \to D^{+} X) = 834 \pm 2 \pm \phantom{1}78\,\mu\mathrm{b}\\ \sigma(pp \to D_{s}^{+} X) = 353 \pm 9 \pm \phantom{1}76\,\mu\mathrm{b}\\ \sigma(pp \to D^{*+} X) = 784 \pm 4 \pm \phantom{1}87\,\mu\mathrm{b} \end{equation} where the uncertainties are due to statistical and systematic uncertainties, respectively
