of communication during clinical care; diversification of the clinical staff; optimization of the receipt of care and HAART; and enhancement of adherence to treatment. All of the preceding strategies are good ways to reduce the negative impact of HIV infection and AIDS on minorities and to " improve the likelihood that minority patients will engage in care, be satisfied with care, and have posi...

Grounded in a socio-ecological framework, we describe salient health care system and policy factors that influence engagement in human immunodeficiency virus (HIV) clinical care. The discussion emphasizes successful programs and models of service delivery and highlights the limitations of current, fragmented health care system components in supporting effective, efficient, and sustained patient...

INTRODUCTION Laboratory and radiographic studies are often required by psychiatric services prior to admitting emergency patients who are otherwise deemed medically stable. Such testing may represent an unnecessary expense that prolongs emergency department stays without significantly improving care. This study determines the prevalence of such testing and how often it leads to changes in care....

Providing health care in sub-Saharan Africa is a complex problem. Recent reports call for more resources to assist in the prevention and treatment of infectious diseases that affect this population, but policy makers, clinicians, and the public frequently fail to understand that diagnosis is essential to the prevention and treatment of disease. Access to reliable diagnostic testing is severely ...

BACKGROUND Despite considerable international eHealth impetus, there is no guidance on the development of online clinical care pathways. Advances in diagnostics now enable self-testing with home diagnosis, to which comprehensive online clinical care could be linked, facilitating completely self-directed, remote care. We describe a new framework for developing complex online clinical care pathwa...

BACKGROUND Successful point-of-care testing, namely ensuring the completion of the test and treat cycle in the same encounter, has immense potential to reduce diagnostic and treatment delays, and impact patient outcomes. However, having rapid tests is not enough, as many barriers may prevent their successful implementation in point-of-care testing programs. Qualitative research on diagnostic pr...

BACKGROUND Due to the unpredictable burden of pandemic influenza, the best strategy to manage testing, such as rapid or polymerase chain reaction (PCR), and antiviral medications for patients who present with influenza-like illness (ILI) is unknown. METHODOLOGY/PRINCIPAL FINDINGS We developed a set of computer simulation models to evaluate the potential economic value of seven strategies unde...

OBJECTIVE An exploratory study to examine interruptive communication patterns of healthcare staff within an intensive care unit (ICU) during ward rounds. METHODS The study was conducted in a tertiary hospital in Sydney, Australia. Nine participants were observed individually, for a total of 24 h, using the communication observation method (COM). The amount of time spent in conversation, the n...

Objectives. To determine the extent of HIV prevention education and HIV testing delivered to adolescents (ages 13-21); to determine clinician-identified barriers to their own delivery of HIV care to adolescents; and to determine clinicians' awareness of HIV standards of care, rapid testing technology, and common HIV transmission modes. Design. A voluntary, confidential, self-report questionnair...

D iabetic peripheral neuropathy and its late sequelae cost $4 billion annually in the U.S. (1). Improved glycemic control, early detection, and preventive care can prevent or delay adverse outcomes (2–4). An annual foot exam, which may include monofilament testing, is recommended by the American Diabetes Association (5). Unfortunately, neuropathy screening is underutilized in primary care pract...