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Your search keyword '"McIntyre, D"' showing total 266 results
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266 results on '"McIntyre, D"'

1. The Evolution of Clinical Practice and Supervision in the United States

Author

McIntyre, D. John and McIntyre, Christie

Abstract

Clinical practice in teacher education has evolved from an apprenticeship model to one that finds it more intertwined with collaborative arrangements with partnering public schools. We look at how this evolution has had a major impact on the effectiveness of how teachers are prepared in an ever more complex society. We also describe how instructional supervision has been intertwined with clinical practice throughout the decades.

Published
2020

19. Antenatal models of care for women with gestational diabetes mellitus: Vignettes from an international meeting

Author

Sina, M, Cade, TJ, Flack, J, Nolan, CJ, Rajagopal, R, Wong, V, Burcher, L, Barry, A, Gianatti, E, McCarthy, A, McNamara, C, Mickelson, M, Hughes, R, Jones, T, Latino, C, McIntyre, D, Price, S, Simmons, D, Sina, M, Cade, TJ, Flack, J, Nolan, CJ, Rajagopal, R, Wong, V, Burcher, L, Barry, A, Gianatti, E, McCarthy, A, McNamara, C, Mickelson, M, Hughes, R, Jones, T, Latino, C, McIntyre, D, Price, S, and Simmons, D

Abstract

BACKGROUND: Gestational diabetes (GDM) is one of the commonest pregnancy complications and is placing an increasing burden on diabetes and obstetric resources. AIMS: To describe different antenatal models of care that have developed to address the increasing proportion of pregnancies complicated by GDM. MATERIALS AND METHODS: Narrative review with thematic analysis from 15 volunteer antenatal diabetes in pregnancy services from Australia and New Zealand identified through a national diabetes organisation. Main outcomes were approaches to patient education, medical nutrition therapy (MNT), ongoing management and escalation of therapy for women with GDM. RESULTS: All clinics provided at least one group education and one MNT session within 1-2 weeks of GDM diagnosis. Women from culturally and linguistically diverse communities usually required 1:1 education. Ongoing management of women with GDM was through either all women being seen in the GDM clinic, a step-up approach (ongoing management by the primary antenatal team with diabetes team referral if self-blood glucose monitoring (SBGM) or insulin therapy dosage criteria are reached) or step-down approach (ongoing management by the diabetes team with step-down to the primary antenatal team if SBGM criteria are reached). Telehealth was used to reduce the burden of clinic attendance, particularly in rural areas. CONCLUSIONS: Increasing numbers, earlier diagnoses, the need to provide care to women in rural, remote areas, and cultural/language differences, have generated a range of different antenatal models of care, allowed better workload accommodation and probably reduced costs. Randomised controlled trials of different models of care, with associated health economic analyses, are urgently needed.

Published
2020

29. Action to address the household economic burden of non-communicable diseases

Author

Jan, S, Laba, T-L, Essue, BM, Gheorghe, A, Muhunthan, J, Engelgau, M, Mahal, A, Griffiths, U, McIntyre, D, Meng, Q, Nugent, R, and Atun, R

Subjects
Family Characteristics, Financing, Personal, Medically Uninsured, Insurance, Health, National Health Programs, General & Internal Medicine, Humans, Health Expenditures, Noncommunicable Diseases, 11 Medical and Health Sciences
Abstract

The economic burden on households of non-communicable diseases (NCDs), including cardiovascular diseases, cancer, respiratory diseases, and diabetes, poses major challenges to global poverty alleviation efforts. For patients with NCDs, being uninsured is associated with 2-7-fold higher odds of catastrophic levels of out-of-pocket costs; however, the protection offered by health insurance is often incomplete. To enable coverage of the predictable and long-term costs of treatment, national programmes to extend financial protection should be based on schemes that entail compulsory enrolment or be financed through taxation. Priority should be given to eliminating financial barriers to the uptake of and adherence to interventions that are cost-effective and are designed to help the poor. In concert with programmes to strengthen national health systems and governance arrangements, comprehensive financial protection against the growing burden of NCDs is crucial in meeting the UN's Sustainable Development Goals.

Published
2018

30. Carbonic anhydrase IX is a pH-stat that sets an acidic tumour extracellular pH in vivo

Author

Lee, S-H, McIntyre, D, Honess, D, Hulikova, A, Pacheco-Torres, J, Cerdán, S, Swietach, P, Harris, AL, Griffiths, JR, Breast Cancer Research Foundation, Worldwide Cancer Research, Royal Society (UK), European Research Council, European Commission, Ministerio de Economía y Competitividad (España), and Cancer Research UK

Subjects
Cancer microenvironment, Proton Magnetic Resonance Spectroscopy, Imidazoles, HCT116 Cells, Cancer metabolism, Article, Cell Hypoxia, Mice, Antigens, Neoplasm, Tumor Microenvironment, Animals, Humans, Lactic Acid, Carbonic Anhydrase IX, Colorectal Neoplasms, Neoplasm Transplantation, Cell Proliferation
Abstract

[Background]: Tumour carbonic anhydrase IX (CAIX), a hypoxia-inducible tumour-associated cell surface enzyme, is thought to acidify the tumour microenvironment by hydrating CO2 to form protons and bicarbonate, but there is no definitive evidence for this in solid tumours in vivo., [Methods]: We used 1H magnetic resonance spectroscopic imaging (MRSI) of the extracellular pH probe imidazolyl succinic acid (ISUCA) to measure and spatially map extracellular pH in HCT116 tumours transfected to express CAIX and empty vector controls in SCID mice. We also measured intracellular pH in situ with 31P MRS and measured lactate in freeze-clamped tumours., [Results]: CAIX-expressing tumours had 0.15 pH-unit lower median extracellular pH than control tumours (pH 6.71 tumour vs pH 6.86 control, P = 0.01). Importantly, CAIX expression imposed an upper limit for tumour extracellular pH at 6.93. Despite the increased lactate concentration in CAIX-expressing tumours, 31P MRS showed no difference in intracellular pH, suggesting that CAIX acidifies only the tumour extracellular space., [Conclusions]: CAIX acidifies the tumour microenvironment, and also provides an extracellular pH control mechanism. We propose that CAIX thus acts as an extracellular pH-stat, maintaining an acidic tumour extracellular pH that is tolerated by cancer cells and favours invasion and metastasis., We are grateful for the support of CRUK (grant number C14303/A17197), the Breast Cancer Research Foundation, the Royal Society, Worldwide Cancer Research and the European Research Council (SURVIVE: 723397). J.P.-T. and S.C. received support from the Spanish Ministry of Economy and Competitiveness SAF2014-23622.

Published
2018

35. Creative Linguistic Impoliteness as aggression in Stanley Kubrick's Full Metal Jacket

Author

Bousfield, DE, McIntyre,, D, Bousfield, DE, and McIntyre,, D

Abstract

Stanley Kubrick’s anti-war film Full Metal Jacket (1987) dramatically represents US Marine Corps basic training during the Vietnam War as both gruelling and brutalising. The brutal, linguistically aggressive and physically intimidating scenes purport to detail the dehumanising process that Marine Corps recruits were put through in preparation for combat during that period. In the film, the recruits are trained by Gunnery Sergeant Hartman, played by the actor R. Lee Ermey, who is himself an ex-Marine Corps drill instructor (1965-1967) and who also served in Vietnam in 1968. As a result of his experience as an instructor, Ermey was given free rein by Kubrick to write his own dialogue for the abusive barrack room and field training scenes in order to lend the drama an air of authenticity. Within the fictional world of the film, the intense training and disciplinary regime ultimately causes one recruit, Private Leonard Lawrence, to crack psychologically. Private Lawrence is nicknamed ‘Gomer Pyle’ by Hartman upon their first meeting, this name being a direct allusion to the hapless character of the same name who was a US Marine recruit in the sitcom Gomer Pyle, U.S.M.C., which ran from 1964-1969 - contemporaneously with the time period in which Full Metal Jacket is set). This insulting allusion is merely the start of a long line of linguistically impolite/aggressive and ultimately physically aggressive interactions which Lawrence/Pyle suffers at the hands of Hartman, both directly and, later in the film as a result of Hartman’s orchestrations, by the other recruits. Under this unrelenting barrage of impoliteness, aggression, and abuse, Lawrence/Pyle eventually shoots Hartman dead before turning his rifle on himself and committing suicide. Thus, the film argues that the dehumanising effect of the basic training, which was ostensibly carried out to toughen up and mentally prepare conscripted recruits for combat in Vietnam, had a profound, brutalising and (potenti

Published
2018

36. Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Author

Mocroft, A., Lundgren, J. D., Ross, M., Law, M., Reiss, P., Kirk, O., Smith, C., Wentworth, D., Neuhaus, J., Fux, C. A., Moranne, O., Morlat, P., Johnson, M. A., Ryom, L., Powderly, B., Shortman, N., Moecklinghoff, C., Reilly, G., Franquet, X., Sabin, C. A., Phillips, A., Weber, R., Pradier, C., d'Arminio Monforte, A., Dabis, F., El-Sadr, W. M., De Wit, S., Kamara, D., Tverland, J., Mansfeld, M., Nielsen, J., Raben, D., Salbol Brandt, R., Rickenbach, M., Fanti, I., Krum, E., Hillebregt, M., Geffard, S., Sundstrom, A., Delforge, M., Fontas, E., Torres, F., Mcmanus, H., Wright, S., Kjaer, J., Sjol, A., Meidahl, P., Helweg-Larsen, J., Schmidt Iversen, J., Kesselring, A. M., Friis-Moller, N., Kowalska, J., Sabin, C., Bruyand, M., Kamara, D. A., Bower, M., Fatkenheuer, G., Donald, A., Grulich, A., Prins, J. M., Kuijpers, T. W., Scherpbier, H. J., van der Meer, J. T. M., Wit, F. W. M. N., Godfried, M. H., van der Poll, T., Nellen, F. J. B., Geerlings, S. E., van Vugt, M., Pajkrt, D., Bos, J. C., Wiersinga, W. J., van der Valk, M., Goorhuis, A., Hovius, J. W., van Eden, J., Henderiks, A., van Hes, A. M. H., Mutschelknauss, M., Nobel, H. E., Pijnappel, F. J. J., Westerman, A. M., Jurriaans, S., Back, N. K. T., Zaaijer, H. L., Berkhout, B., Cornelissen, M. T. E., Schinkel, C. J., Thomas, X. V., van den Berge, M., Stegeman, A., Baas, S., Hage de Looff, L., Versteeg, D., Pronk, M. J. H., Ammerlaan, H. S. M., Korsten-Vorstermans, E. M. H. M., de Munnik, E. S., Jansz, A. R., Tjhie, J., Wegdam, M. C. A., Deiman, B., Scharnhorst, V., van der Plas, A., Weijsenfeld, A. M., van der Ende, M. E., de Vries-Sluijs, T. E. M. S., C. M. van Gorp, E., Schurink, C. A. M., Nouwen, J. L., Verbon, A., Rijnders, B. J. A., Bax, H. I., Hassing, R. J., van der Feltz, M., Bassant, N., van Beek, J. E. A., Vriesde, M., van Zonneveld, L. M., de Oude-Lubbers, A., van den Berg-Cameron, H. J., Bruinsma-Broekman, F. B., de Groot, J., de Zeeuw- de Man, M., Broekhoven-Kruijne, M. J., Schutten, M., Osterhaus, A. D. M. E., Boucher, C. A. B., Driessen, G. J. A., van Rossum, A. M. C., van der Knaap, L. C., Visser, E., Branger, J., H. M. Duijf-van de Ven C., J., Schippers, E. F., van Nieuwkoop, C., Brimicombe, R. W., van IJperen, J. M., van der Hut, G., Franck, P. F. H., van Eeden, A., Brokking, W., Groot, M., Damen, M., Kwa, I. S., Groeneveld, P. H. P., Bouwhuis, J. W., van den Berg, J. F., van Hulzen, A. G. W., van der Bliek, G. L., Bor, P. C. J., Bloembergen, P., Wolfhagen, M. J. H. M., Ruijs, G. J. H. M., van Lelyveld, S. F. L., Soetekouw, R., Hulshoff, N., van der Prijt, L. M. M., Schoemaker, M., Bermon, N., van der Reijden, W. A., Jansen, R., Herpers, B. L., Veenendaal, D., Kroon, F. P., Arend, S. M., de Boer, M. G. J., Bauer, M. P., Jolink, H., Vollaard, A. M., Dorama, W., Moons, C., Claas, E. C. J., Kroes, A. C. M., den Hollander, J. G., Pogany, K., Kastelijns, M., Smit, J. V., Smit, E., Bezemer, M., van Niekerk, T., Pontesilli, O., Lowe, S. H., Oude Lashof, A., Posthouwer, D., Ackens, R. P., Schippers, J., Vergoossen, R., Weijenberg Maes, B., Savelkoul, P. H. M., Loo, I. H., Weijer, S., El Moussaoui, R., Heitmuller, M., Kortmann, W., van Twillert, G., Cohen Stuart, J. W. T., Diederen, B. M. W., Pronk, D., van Truijen-Oud, F. A., Leyten, E. M. S., Gelinck, L. B. S., van Hartingsveld, A., Meerkerk, C., Wildenbeest, G. S., Mutsaers, J. A. E. M., Jansen, C. L., van Vonderen, M. G. A., van Houte, D. P. F., Dijkstra, K., Faber, S., Weel, J., Kootstra, G. J., Delsing, C. E., van der Burg-van de Plas, M., Heins, H., Lucas, E., Brinkman, K., Frissen, P. H. J., Blok, W. L., Schouten, W. E. M., Bosma, A. S., Brouwer, C. J., Geerders, G. F., Hoeksema, K., Kleene, M. J., van der Meche, I. B., Toonen, A. J. M., Wijnands, S., van Ogtrop, M. L., Koopmans, P. P., Keuter, M., van der Ven, A. J. A. M., ter Hofstede, H. J. M., Dofferhoff, A. S. M., van Crevel, R., Albers, M., Bosch, M. E. W., Grintjes-Huisman, K. J. T., Zomer, B. J., Stelma, F. F., Burger, D., Richter, C., van der Berg, J. P., Gisolf, E. H., ter Beest, G., van Bentum, P. H. M., Langebeek, N., Tiemessen, R., Swanink, C. M. A., Veenstra, J., Lettinga, K. D., Spelbrink, M., Sulman, H., Witte, E., Peerbooms, P. G. H., Mulder, J. W., Vrouenraets, S. M. E., Lauw, F. N., van Broekhuizen, M. C., Paap, H., Vlasblom, D. J., Oudmaijer Sanders, E., Smits, P. H. M., Rosingh, A. W., Verhagen, D. W. M., Geilings, J., van Kasteren, M. E. E., Brouwer, A. E., de Kruijf-van de Wiel, B. A. F. M., Kuipers, M., Santegoets, R. M. W. J., van der Ven, B., Marcelis, J. H., G. M. Buiting, A., Kabel, P. J., Bierman, W. F. W., Sprenger, H. G., Scholvinck, E. H., van Assen, S., Wilting, K. R., Stienstra, Y., de Groot-de Jonge, H., van der Meulen, P. A., de Weerd, D. A., Niesters, H. G. M., Riezebos-Brilman, A., van Leer-Buter, C. C., Hoepelman, A. I. M., Schneider, M. M. E., Mudrikova, T., Ellerbroek, P. M., Oosterheert, J. J., Arends, J. E., Barth, R. E., Wassenberg, M. W. M., van Elst-Laurijssen, D. H. M., Laan, L. M., van Oers-Hazelzet, E. E. B., Patist, J., Vervoort, S., Nieuwenhuis, H. E., Frauenfelder, R., Schuurman, R., Verduyn-Lunel, F., Wensing, A. M. J., Peters, E. J. G., van Agtmael, M. A., Perenboom, R. M., Bomers, M., de Vocht, J., Elsenburg, L. J. M., Pettersson, A. M., Vandenbroucke-Grauls, C. M. J. E., Ang, C. W., Geelen, S. P. M., Wolfs, T. F. W., Bont, L. J., Nauta, N., Bezemer, D. O., Gras, L., van Sighem, A. I., Smit, C., Zaheri, S., Kimmel, V., Tong, Y., Lascaris, B., van den Boogaard, R., Hoekstra, P., de Lang, A., Berkhout, M., Grivell, S., Jansen, A., de Groot, L., van den Akker, M., Bergsma, D., Lodewijk, C., Meijering, R., Peeck, B., Raethke, M., Ree, C., Regtop, R., Ruijs, Y., Schoorl, M., Tuijn, E., Veenenberg, L., Woudstra, T., Bakker, Y., de Jong, A., Broekhoven, M., Claessen, E., Rademaker, M. J., Munjishvili, L., Kruijne, E., Tuk, B., Bonnet, F., Dupon, M., Chene, G., Breilh, D., Fleury, H., Malvy, D., Mercie, P., Pellegrin, I., Neau, D., Bouchet, S., Gaborieau, V., Lacoste, D., Tchamgoue, S., Thiebaut, R., Lawson-Ayayi, S., Wittkop, L., Bernard, N., Hessamfar, M., Vandenhende, M. A., Dauchy, F. A., Dutronc, H., Longy-Boursier, M., Duffau, P., Roger Schmeltz, J., Pistone, T., Receveur, M. C., Cazanave, C., Ochoa, A., Vareil, M. O., Pellegrin, J. L., Viallard, J. F., Greib, C., Lazaro, E., Lafon, M. E., Reigadas, S., Trimoulet, P., Molimard, M., Titier, K., Moreau, J. F., Haramburu, F., Miremont-Salame, G., Dupont, A., Gerard, Y., Caunegre, L., Andre, K., Bonnal, F., Farbos, S., Gemain, M. C., Ceccaldi, J., De Witte, S., Courtault, C., Monlun, E., Lataste, P., Meraud, J. P., Chossat, I., Blaizeau, M. J., Conte, V., Decoin, M., Delaune, J., Delveaux, S., Diarra, F., D'Ivernois, C., Frosch, A., Hannapier, C., Lenaud, E., Leleux, O., Le Marec, F., Leray, J., Louis, I., Palmer, G., Pougetoux, A., Sicard, X., Touchard, D., Uwamaliya-Nziyumvira, B., Petoumenos, K., Bendall, C., Moore, R., Edwards, S., Watson, K., Roth, N., Nicholson, J., Bloch, M., Franic, T., Baker, D., Vale, R., Carr, A., Cooper, D., Chuah, J., Ngieng, M., Nolan, D., Skett, J., Calvo, G., Mateu, S., Domingo, P., Sambeat, M. A., Gatell, J., Del Cacho, E., Cadafalch, J., Fuster, M., Codina, C., Sirera, G., Vaque, A., Clumeck, N., Necsoi, C., Gennotte, A. F., Gerard, M., Kabeya, K., Konopnicki, D., Libois, A., Martin, C., Payen, M. C., Semaille, P., Van Laethem, Y., Neaton, J., Bartsch, G., Thompson, G., Luskin-Hawk, R., Telzak, E., Abrams, D. I., Cohn, D., Markowitz, N., Arduino, R., Mushatt, D., Friedland, G., Perez, G., Tedaldi, E., Fisher, E., Gordin, F., Crane, L. R., Sampson, J., Baxter, J., Cozzi-Lepri, A., Grint, D., Podlekareva, D., Peters, L., Reekie, J., Fischer, A. H., Losso, M., Elias, C., Vetter, N., Zangerle, R., Karpov, I., Vassilenko, A., Mitsura, V. M., Suetnov, O., Colebunders, R., Vandekerckhove, L., Hadziosmanovic, V., Kostov, K., Begovac, J., Machala, L., Jilich, D., Sedlacek, D., Kronborg, G., Benfield, T., Larsen, M., Gerstoft, J., Katzenstein, T., Hansen, A. -B. E., Skinhoj, P., Pedersen, C., Ostergaard, L., Zilmer, K., Smidt, J., Ristola, M., Katlama, C., Viard, J. -P., Girard, P. -M., Livrozet, J. M., Vanhems, P., Rockstroh, J., Schmidt, R., van Lunzen, J., Degen, O., Stellbrink, H. J., Staszewski, S., Bickel, M., Kosmidis, J., Gargalianos, P., Xylomenos, G., Perdios, J., Panos, G., Filandras, A., Karabatsaki, E., Sambatakou, H., Banhegyi, D., Mulcahy, F., Yust, I., Turner, D., Burke, M., Pollack, S., Hassoun, G., Maayan, S., Vella, S., Esposito, R., Mazeu, I., Mussini, C., Arici, C., Pristera, R., Mazzotta, F., Gabbuti, A., Vullo, V., Lichtner, M., Chirianni, A., Montesarchio, E., Gargiulo, M., Antonucci, G., Testa, A., Narciso, P., Vlassi, C., Zaccarelli, M., Lazzarin, A., Castagna, A., Gianotti, N., Galli, M., Ridolfo, A., Rozentale, B., Zeltina, I., Chaplinskas, S., Hemmer, R., Staub, T., Ormaasen, V., Maeland, A., Bruun, J., Knysz, B., Gasiorowski, J., Horban, A., Bakowska, E., Grzeszczuk, A., Flisiak, R., Boron-Kaczmarska, A., Pynka, M., Parczewski, M., Beniowski, M., Mularska, E., Trocha, H., Jablonowska, E., Malolepsza, E., Wojcik, K., Antunes, F., Doroana, M., Caldeira, L., Mansinho, K., Maltez, F., Duiculescu, D., Rakhmanova, A., Zakharova, N., Buzunova, S., Jevtovic, D., Mokras, M., Stanekova, D., Tomazic, J., Gonzalez-Lahoz, J., Soriano, V., Labarga, P., Medrano, J., Moreno, S., Rodriguez, J. M., Clotet, B., Jou, A., Paredes, R., Tural, C., Puig, J., Bravo, I., Miro, J. M., Gutierrez, M., Mateo, G., Karlsson, A., Flamholc, L., Ledergerber, B., Francioli, P., Cavassini, M., Hirschel, B., Boffi, E., Furrer, H., Battegay, M., Elzi, L., Kravchenko, E., Chentsova, N., Frolov, V., Kutsyna, G., Servitskiy, S., Krasnov, M., Barton, S., Johnson, A. M., Mercey, D., Murphy, M., Weber, J., Scullard, G., Fisher, M., Leen, C., Morfeldt, L., Thulin, G., Akerlund, B., Koppel, K., Hakangard, C., Moroni, M., Angarano, G., Antinori, A., Armignacco, O., Castelli, F., Cauda, Roberto, Di Perri, G., Iardino, R., Ippolito, G., Perno, C. F., von Schloesser, F., Viale, P., Ceccherini-Silberstein, F., Girardi, E., Lo Caputo, S., Puoti, M., Andreoni, M., Ammassari, A., Balotta, C., Bonora, S., Borderi, M., Capobianchi, R., Ceccherini- Silberstein, F., Cingolani, A., Cinque, P., De Luca, A., Di Biagio, A., Gori, A., Guaraldi, G., Lapadula, G., Madeddu, G., Maggiolo, F., Marchetti, G., Marcotullio, S., Monno, L., Quiros Roldan, E., Rusconi, S., Cicconi, P., Formenti, T., Galli, L., Lorenzini, P., Giacometti, A., Costantini, A., Santoro, C., Suardi, C., Vanino, E., Verucchi, G., Minardi, C., Quirino, T., Abeli, C., Manconi, P. E., Piano, P., Vecchiet, J., Falasca, K., Sighinolfi, L., Segala, D., Cassola, G., Viscoli, G., Alessandrini, A., Piscopo, R., Mazzarello, G., Mastroianni, C., Belvisi, V., Bonfanti, P., Caramma, I., Castelli, A. P., Rizzardini, G., Ridolfo, A. L., Piolini, R., Salpietro, S., Carenzi, L., Moioli, M. C., Puzzolante, C., Abrescia, N., Guida, M. G., Onofrio, M., Baldelli, F., Francisci, D., Parruti, G., Ursini, T., Magnani, G., Ursitti, M. A., D'Avino, A., Gallo, L., Nicastri, E., Acinapura, R., Capozzi, M., Libertone, R., Tebano, G., Cattelan, A., Mura, M. S., Caramello, P., Orofino, G. C., Sciandra, M., Pellizzer, G., Manfrin, V., Dollet, K., Caissotti, C., Dellamonica, P., Roger, P. M., Bernard, E., Cua, E., De Salvador-Guillouet, F., Durant, J., Ferrando, S., Dunais, B., Mondain-Miton, V., Perbost, I., Prouvost-Keller, B., Pugliese, P., Naqvi, A., Pillet, S., Risso, K., Aubert, V., Barth, J., Bernasconi, E., Boni, J., Bucher, H. C., Burton-Jeangros, C., Calmy, A., Egger, M., Fehr, J., Fellay, J., Gorgievski, M., Gunthard, H., Haerry, D., Hasse, B., Hirsch, H. 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J., Barber, T. J., Brook, M. G., Care, C. D., Chadwick, D. R., Chikohora, M., Churchill, D. R., Cornforth, D., Dockrell, D. H., Easterbrook, P. J., Fox, P. A., Gomez, P. A., Gompels, M. M., Harris, G. M., Herman, S., Jackson, A. G. A., Jebakumar, S. P. R., Kinghorn, G. R., Kuldanek, K. A., Larbalestier, N., Lumsden, M., Maher, T., Mantell, J., Muromba, L., Orkin, C. M., Palfreeman, A. J., Peters, B. S., Peto, T. E. A., Portsmouth, S. D., Rajamanoharan, S., Ronan, A., Schwenk, A., Slinn, M. A., Stroud, C. J., Thomas, R. C., Wansbrough-Jones, M. H., Whiles, H. J., White, D. J., Williams, E., Williams, I. G., Acosta, E. A., Adamski, A., Antoniskis, D., Aragon, D. R., Barnett, B. J., Baroni, C., Barron, M., Baxter, J. D., Beers, D., Beilke, M., Bemenderfer, D., Bernard, A., Besch, C. L., Bessesen, M. T., Bethel, J. T., Blue, S., Blum, J. D., Boarden, S., Bolan, R. K., Borgman, J. B., Brar, I., Braxton, B. K., Bredeek, U. F., Brennan, R., Britt, D. E., Bulgin-Coleman, D., Bullock, D. E., Campbell, B., Caras, S., Carroll, J., Casey, K. K., Chiang, F., Cindrich, R. B., Clark, C., Cohen, C., Coley, J., Condoluci, D. V., Contreras, R., Corser, J., Cozzolino, J., Daley, L., Dandridge, D., D'Antuono, V., Darcourt Rizo Patron, J. G., Dehovitz, J. A., Dejesus, E., Desjardin, J., Dietrich, C., Dolce, E., Erickson, D., Faber, L. L., Falbo, J., Farrough, M. J., Farthing, C. F., Ferrell-Gonzalez, P., Flynn, H., Frank, M., Freeman, K. F., French, N., Fujita, N., Gahagan, L., Gilson, I., Goetz, M. B., Goodwin, E., Guity, C. K., Gulick, P., Gunderson, E. R., Hale, C. M., Hannah, K., Henderson, H., Hennessey, K., Henry, W. K., Higgins, D. T., Hodder, S. L., Horowitz, H. W., Howe-Pittman, M., Hubbard, J., Hudson, R., Hunter, H., Hutelmyer, C., Insignares, M. T., Jackson, L., Jenny, L., Johnson, D. L., Johnson, G., Johnson, J., Kaatz, J., Kaczmarski, J., Kagan, S., Kantor, C., Kempner, T., Kieckhaus, K., Kimmel, N., Klaus, B. M., Koeppe, J. R., Koirala, J., Kopka, J., Kostman, J. R., Kozal, M. J., Kumar, A., Lampiris, H., Lamprecht, C., Lattanzi, K. M., Lee, J., Leggett, J., Long, C., Loquere, A., Loveless, K., Lucasti, C. J., Macveigh, M., Makohon, L. H., Markowitz, N. P., Marks, C., Martorell, C., Mcfeaters, E., Mcgee, B., Mcintyre, D. M., Mcmanus, E., Melecio, L. G., Melton, D., Mercado, S., Merrifield, E., Mieras, J. A., Mogyoros, M., Moran, F. M., Murphy, K., Mutic, S., Nadeem, I., Nadler, J. P., Ognjan, A., O'Hearn, M., O'Keefe, K., Okhuysen, P. C., Oldfield, E., Olson, D., Orenstein, R., Ortiz, R., Parpart, F., Pastore-Lange, V., Paul, S., Pavlatos, A., Pearce, D. D., Pelz, R., Peterson, S., Pitrak, D., Powers, S. L., Pujet, H. C., Raaum, J. W., Ravishankar, J., Reeder, J., Reilly, N. A., Reyelt, C., Riddell, J., Rimland, D., Robinson, M. L., Rodriguez, A. E., Rodriguez-Barradas, M. C., Rodriguez Derouen, V., Rosmarin, C., Rossen, W. L., Rouff, J. R., Sampson, J. H., Sands, M., Savini, C., Schrader, S., Schulte, M. M., Scott, R., Seedhom, H., Sension, M., Sheble-Hall, A., Shuter, J., Slater, L. N., Slotten, R., Smith, M., Snap, S., States, D. M., Stringer, G., Summers, K. K., Swanson, K., Sweeton, I. B., Szabo, S., Telzak, E. E., Thompson, M. A., Thompson, S., Ting Hong Bong, C., Vaccaro, A., Vasco, L. M., Vecino, I., Verlinghieri, G. K., Visnegarwala, F., Wade, B. H., Weis, S. E., Weise, J. A., Weissman, S., Wilkin, A. M., Witter, J. H., Wojtusic, L., Wright, T. J., Yeh, V., Young, B., Zeana, C., Zeh, J., Savio, E., Vacarezza, M., and Cauda R. (ORCID:0000-0002-1498-4229)

Abstract

Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with ≥3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR ≤ 60 ml/min/1.73 m2. Poisson regression was used to develop a risk score, externally validated on two independent cohorts. In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7–6.7; median follow-up 6.1 y, range 0.3–9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was −2 (interquartile range –4 to 2). There was a 1:393 chance of developing CKD in the next 5 y in the low risk group (risk score < 0, 33 events), rising to 1:47 and 1:6 in the medium (risk score 0–4, 103 events) and high risk groups (risk score ≥ 5, 505 events)

Published
2015

37. General practitioners and national health insurance results of a national survey

Author

BLECHER, M, JACOBS, T, McIntyre, D, Health Economics Unit, and Faculty of Health Sciences

Subjects
Public health, Questionnaire, education, Medico general, République Sud Africaine, Modification, Homme, Santé publique, South Africa(Republic), Système santé, General practitioner, Seguro enfermedad, Assurance maladie, Afrique, Health insurance, Attitude, Sistema salud, Africa, Health system, Médecin généraliste, Modificación, Evaluation, Human
Abstract

OBJECTIVE: To determine the attitudes of South African general practitioners (GPs) to national health insurance (NHI), social health insurance (SHI) and other related health system reforms. DESIGN: A national survey using postal questionnaires and telephonic follow-up of non-responders. SETTING: GPs throughout South Africa. PARTICIPANTS: Four hundred and forty-three GPs were randomly selected from a national sampling frame of 6,781 GPs. MAIN OUTCOME MEASURES: Acceptance of NHI and GP preferences with regard to financing, provision, benefits, coverage and the role of GPs. MAIN RESULTS: A response rate of 82.1% was achieved. Sixty-two per cent of GPs approved of the introduction of some form of social or NHI in South Africa, while 24.1% disapproved. Approval rose to 81.6% if GPs were to maintain their independent status, e.g. own premises and working hours, to 75% if additional private top-up insurance was allowed, and to 79.9% if payment was by fee-for-service. Seventy per cent of GPs in the study stated that they had the capacity to treat more patients. The most important reason given for approving of NHI was to make health care more equitable and accessible to the majority of South Africans. A high proportion of GPs approved of increasing the level of interaction between GPs and district health authorities. CONCLUSIONS: Most GPs approved of some form of social or NHI system, provided that the system did not significantly threaten their professional autonomy or economic and financial situation.

Published
2017
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