The Adherence Support Gap: The ‘Ideal' Versus ‘Reality’ of Antiretroviral Adherence Support Provided by HIV Health Providers in Clinical Practice

2009 ◽  
Vol 43 (6) ◽  
pp. 1036-1044 ◽  
Author(s):  
Laura Y Park-Wyllie ◽  
Derek Kam ◽  
Ahmed M Bayoumi
Keyword(s):  
Clinical Practice ◽  
Health Providers ◽  
Antiretroviral Adherence ◽  
Adherence Support ◽  
Antiretroviral Adherence Support ◽  
The Ideal

Advancing Racial/Ethnic and Cultural Sensitivity Among PMHNP Students Through Education, Practice, and Experience

2019 ◽  
Vol 25 (6) ◽  
pp. 487-495
Author(s):  
Chase J. Boyer ◽  
Michael J. Rice ◽  
Tanya R. Sorrell ◽  
Alyssa M. Spurling
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Clinical Supervision ◽  
Cultural Sensitivity ◽  
Clinical Training ◽  
Mental Health Providers ◽  
Health Providers ◽  
Education Practice ◽  
Advanced Students ◽  
Racial Ethnic

BACKGROUND: There is an increased need for mental health providers to be more attuned to behavioral health needs of racial/ethnic/cultural minorities and the role of social milieus. AIMS: We prioritized training and assessing racial/ethnic and cultural sensitivity among psychiatric mental health nurse practitioner students throughout coursework, clinical practice, and experiences in underserved settings. METHOD: Prior to beginning clinical coursework, students completed a course on culturally competent care where we measured their ( n = 26) perception of their ability to be racially/ethnically sensitive providers at the beginning and end of the semester, demonstrating significant improvement. During clinical coursework, preceptors measured students’ racially/ethnically and culturally sensitive clinical behaviors with patients. RESULTS: Sensitivity of students in clinical training significantly improved over a semester of clinical supervision. Our results indicated that placements in underserved settings improved students’ racial/ethnic/cultural sensitivity but only among advanced students. At final evaluation, advanced students in underserved settings self-reported significantly higher racial/ethnic and cultural sensitivity than students not in an underserved setting. CONCLUSIONS: Our data suggest that we can produce more racially/ethnically and culturally sensitivity providers through coursework, supervised clinical practice, and experiences in underserved settings. These data are preliminary, and we plan to follow up these results and replicate this work with other cohorts in future semesters.

Noticing in neurology

2019 ◽  
Vol 19 (5) ◽  
pp. 427-430 ◽  
Author(s):  
A J Lees
Keyword(s):  
Clinical Practice ◽  
Clinical Reasoning ◽  
Medical Technology ◽  
Da Vinci ◽  
Leonardo Da Vinci ◽  
The Sun ◽  
Diagnostic Signs ◽  
Specialist Knowledge ◽  
The Brain ◽  
The Ideal

There are three classes of people: those who see, those who see when they are shown, those who do not seeLeonardo da VinciThe three cardinal qualities necessary for the ideal neurologist are observation, the ability to reason backwards inferentially and specialist knowledge. Modern medical technology has greatly increased the ability to diagnose and treat disease but it has also encouraged a benign variant of abulia, which is killing off the art and science of clinical reasoning. Intent gazing at the unfamiliar with old eyes or a long look at the familiar with new eyes offers the neurologist an opportunity to discover hitherto unnoticed diagnostic signs far beyond the resolution of the brain scanner and even the light microscope. While there may be nothing new under the sun, there are plenty of old things that no one has observed, which have the potential to greatly improve clinical practice.

1014 The Majority of Patients With Primary Biliary Cholangitits Do Not Achieve the Ideal Treatment Response in a Real World Clinical Practice

2019 ◽  
Vol 114 (1) ◽  
pp. S584-S584
Author(s):  
Oladuni D. Cummings-John ◽  
Stephenie Geistweidt ◽  
Michael Ritchie ◽  
Candice Angueira ◽  
Toluwalase C. Okubote ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Treatment Response ◽  
Real World ◽  
The Ideal

scholarly journals Tonse Pamodzi: Developing a combination strategy to support adherence to antiretroviral therapy and HIV pre-exposure prophylaxis during pregnancy and breastfeeding

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253280
Author(s):  
Lauren M. Hill ◽  
Friday Saidi ◽  
Kellie Freeborn ◽  
K. Rivet Amico ◽  
Nora E. Rosenberg ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Intervention Development ◽  
Hiv Treatment ◽  
Child Health Services ◽  
Maternal Child Health ◽  
Combination Strategy ◽  
Antiretroviral Adherence ◽  
Treatment And Prevention ◽  
Adherence Support ◽  
Exposure Prophylaxis

To eliminate mother-to-child transmission of HIV (EMTCT), scalable strategies to enhance antiretroviral adherence for both antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) are needed as part of integrated HIV and maternal-child health services. We developed Tonse Pamodzi (“all of us together”), an adaptable intervention integrating biomedical and behavioral components to support HIV treatment and prevention. We describe our intervention development process, which comprised formative qualitative research, a review of the literature, and technical input from stakeholders representing the community, health systems, and policymakers. The resulting intervention, described herein, integrates patient-centered counseling and engagement of a patient-selected adherence supporter for pregnant and breastfeeding women initiating ART or PrEP. Patients receiving the intervention engage in Integrated Next Step Counseling (iNSC) sessions delivered by trained counselors to build and maintain adherence skills. Each patient also has the option of selecting an adherence supporter (partner, family member, or friend) who may participate in iNSC sessions and provide adherence support outside of these sessions. This flexible intervention is adaptable not only to ART or PrEP use, but also to the needs and preferences of each woman and the clinical context. If shown to be acceptable and feasible, the Tonse Pamodzi intervention may be an important tool in continuing efforts for EMTCT.

Development of a Teaching Model for Coronal access to the Canine Dentition

1992 ◽  
Vol 9 (4) ◽  
pp. 11-17 ◽  
Author(s):  
Sandra Manfra Marretta ◽  
Gail Golab ◽  
James M.G. Anthony ◽  
Jean Cloran ◽  
Linda Klippert
Keyword(s):  
Clinical Practice ◽  
Access Point ◽  
Dental Student ◽  
Teaching Model ◽  
Canal System ◽  
Cavity Preparation ◽  
Straight Line ◽  
Root Canal System ◽  
The Right ◽  
The Ideal

A dolichocephalic canine skull was utilized to develop a teaching and study model for coronal access cavity preparation of the dentition. The teeth from the right side of the skull were extracted. Each tooth was radiographed in two planes to localize the “ideal” endodontic access point. Barium markers were placed over these points and each tooth was radiographed again to confirm the appropriate location of the marker. Access was created by drilling through the barium marker. Then, K-files were inserted through the access preparation into the root canal system. The teeth were radiographed with the K-files in place to verify straight pathways to the apices. Straight line access to the apex was obtained in all teeth. Creation of this model provides an opportunity for the veterinary dental student to develop and refine skills used in performing endodontic therapy. The model can be utilized by the veterinary dental practitioner in clinical practice.

Australian nurses and device use: the ideal and the real in clinical practice

1998 ◽  
Vol 11 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Dianne Pelletier ◽  
Christine Duffield ◽  
Suzanne Mitten-Lewis ◽  
Sue Nagy ◽  
Jackie Crisp
Keyword(s):  
Clinical Practice ◽  
The Real ◽  
Device Use ◽  
The Ideal

scholarly journals Patch bulging after plaque incision and grafting procedure for Peyronie’s disease. Surgical repair with a collagen fleece

2015 ◽  
Vol 87 (2) ◽  
pp. 173 ◽  
Author(s):  
Andrea Fabiani ◽  
Fabrizio Fioretti ◽  
Alessandra Filosa ◽  
Lucilla Servi ◽  
Gabriele Mammana
Keyword(s):  
Clinical Practice ◽  
Surgical Therapy ◽  
Surgical Repair ◽  
Daily Clinical Practice ◽  
Peyronie’S Disease ◽  
Boston Scientific ◽  
Peyronie's Disease ◽  
Grafting Materials ◽  
Grafting Procedure ◽  
The Ideal

The incision/excision and grafting techniques (PIG) for surgical therapy of Peyronie’s disease (PD) have gained popularity in recent years. Several different graft materials have been used but the ideal graft has yet to be established. The use of grafting materials could cause complications. In the daily clinical practice it will always be more frequent to manage complications arising from their use. We present herein the case of a patch bulging repaired with a ready-to-use collagen fleece (Tachosil®, Takeda, Linz, Austria, Europe) in a 61 years old man subjected to intervention of geometric corporoplasty with Paulo Egydio technique using an acellular collagen material (Xenform® patch, Boston Scientific, Natick, MA, USA) as graft. We also discuss the possible implications of PIG procedure.

Lithium as augmentation for major depressive disorder

2012 ◽  
Vol 2 (1) ◽  
pp. 15-17
Author(s):  
Michelle Geier
Keyword(s):  
Major Depressive Disorder ◽  
Clinical Practice ◽  
Depressive Disorder ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Major Depressive ◽  
Ample Evidence ◽  
Randomized Controlled ◽  
Lithium Augmentation ◽  
The Ideal

Although lithium does not have an FDA approved indication for augmentation of an antidepressant in major depressive disorder, it has been prescribed for this purpose for decades. While a wide variety of medications have been used historically in this capacity, lithium is one of the few agents that has demonstrated efficacy in multiple randomized controlled trials. Although the ideal role for lithium augmentation has yet to be established, there is currently ample evidence to support the clinical practice of adding lithium to conventional antidepressants in pursuit of major depressive disorder remission.

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