A5004078173- HIV-related health complications and treatments
- Healthcare Systems and Reforms
- Global Maternal and Child Health
- Patient Satisfaction in Healthcare
- Cardiovascular Disease and Adiposity
- Healthcare Policy and Management
- Primary Care and Health Outcomes
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Telemedicine and Telehealth Implementation
- Emergency and Acute Care Studies
- Global Health and Epidemiology
- Chronic Disease Management Strategies
- Infective Endocarditis Diagnosis and Management
- HIV/AIDS Research and Interventions
- HIV/AIDS Impact and Responses
- Patient-Provider Communication in Healthcare
- Mobile Health and mHealth Applications
- Healthcare Quality and Management
- Genetic factors in colorectal cancer
- Facilities and Workplace Management
- Cardiac tumors and thrombi
- Stuttering Research and Treatment
- Gestational Diabetes Research and Management
- Gastrointestinal disorders and treatments
- Psoriasis: Treatment and Pathogenesis
Harvard University
2009-2024
Brigham and Women's Hospital
2015-2023
Ariadne Diagnostics (United States)
2019-2023
Servicio Canario de la Salud
2023
Massachusetts General Hospital
2015-2021
Lemuel Shattuck Hospital
2019-2021
Makerere University
2021
Center for Global Health
2015
Johns Hopkins University
2014
Johns Hopkins Bayview Medical Center
2014
Osteopontin (Opn) contributes to diverse biological processes that include immune responses, vascularization, and bone formation. Until recently, studies describing the activities of Opn have focused on cytokine-like properties secreted protein. Here, we show alternative translation a single mRNA species generates intracellular isoform. Utilization 5' canonical start site protein includes an N-terminal signal sequence allowing targeting secretory vesicles cytokine secretion, whereas usage...
The city of Daegu, South Korea, had the first large outbreak Covid-19 outside China. Despite facing similar challenges as other cities — shortages personal protective equipment, inpatient beds, and health care workers rate infections among in Daegu remained lower than rates experienced by its counterparts. Health system leaders public officials mobilized a regional reorganization along with several hospital-level interventions that concentrated resources relieved shortages, ultimately...
Abstract HIV-associated changes in intestinal microbiota are believed to be important drivers of disease progression. However, the majority studies have focused on populations high-income countries rather than developing regions where HIV burden is greatest. To better understand impact fecal globally, we compare microbial community individuals U.S., Uganda, and Botswana. We identify significant bacterial taxa alterations with both treated untreated infection a high degree uniqueness each...
Asthma is an increasing global health burden, especially in the western world. Public interventions are sought to lessen its prevalence or severity, and diet nutrition have been identified as potential factors. With rapid changes being one of hallmarks westernization, may play a key role affecting complex genetics developmental pathophysiology asthma. The present review investigates hypotheses about hygiene, antioxidants, lipids other nutrients, food types dietary patterns, breastfeeding,...
Background. Human immunodeficiency virus (HIV) infection and associated immune activation predict the risk of cardiovascular disease in resource-rich areas. Less is known about these relationships sub-Saharan Africa. Methods. Beginning 2005, we enrolled subjects southwestern Uganda into a cohort at time antiretroviral therapy (ART) initiation. Multiple measures were assessed before 6 months after ART 2013, participants aged >40 years underwent metabolic profiling, including measurement...
Abstract Background Among those with injection drug use-associated infective endocarditis (IDU-IE), against medical advice (AMA) discharge is common and linked to adverse outcomes. Understanding trends, risk factors, timing needed reduce IDU-IE AMA discharges. Methods We identified individuals ages 18–64 International Classification of Diseases, 9thRevision, diagnosis codes for (IE) in the National Inpatient Sample, a representative sample United States hospitalizations from January 2010...
► Continuity is a critical but often neglected function of high-quality primary care and has three core domains: relational, informational managerial continuity.► Improving continuity feasible in low-income middle-income country health systems by using comprehensive empanelment or community-based follow-up programmes to improve retention care.► must receive more attention, measurement improvement efforts, order achieve equitable, for all.
Background Patients with opioid use disorder (OUD) who are hospitalized for serious infections requiring prolonged intravenous antibiotics may face barriers to discharge, which could prolong hospital length of stay (LOS) and increase financial burden. We investigated differences in LOS, discharge disposition, charges between hospitalizations patients without OUD. Methods findings utilized the 2016 National Inpatient Sample—a nationally representative database all discharges from US acute...
State decisions to expand Medicaid eligibility were particularly consequential for federally qualified health centers (FQHCs), which serve 30 million low-income patients across the US. The longer-term association of expansion with outcomes at FQHCs is unknown. To assess 5-year uninsurance rates and hypertension diabetes outcome measures by race ethnicity in a nationally representative population FQHCs. Using difference-in-differences analysis retrospective cohort from universe US FQHCs,...
The aim of this study is to evaluate Breast Imaging Reporting and Data Systems (BI-RADS) 4A/B subcategory risk estimates for ductal carcinoma in situ (DCIS) invasive cancer (IC), determining whether changing the proposed cutoffs a higher biopsy threshold could safely increase cancer-to-biopsy yields while minimizing false-positive biopsies. A prospective clinical trial was performed BI-RADS 4 lesions from women seen clinic between January 2006 March 2007. An experienced radiologist...
Preventable cardiovascular disease (CVD) risk factors are responsible for the majority of CVD-related deaths, and increasingly recognized as a cause morbidity mortality HIV-infected persons taking antiretroviral therapy (ART). Simplified tools such American Heart Association's ideal health (iCVH) construct may identify prognosticate CVD in resource-limited settings. No studies have evaluated iCVH metrics sub-Saharan Africa or among adults. Thus, central aim this study was to compare levels...
Primary health care is a critical foundation of high-quality systems. Health facility management has been studied in high-income countries, but there are significant measurement gaps about and primary performance low middle-income countries. A evaluation tool (PRIME-Tool) was initially piloted Ghana where better associated with higher on select outcomes such as essential drug availability, trust providers, ease following provider's advice, overall patient-reported quality rating. In this...
Introduction Person-centredness, including patient experience and satisfaction, is a foundational element of quality care. Evidence indicates that poor satisfaction are drivers underutilisation healthcare services, which in turn major driver avoidable mortality. However, there limited information about care at the population level, particularly low-income middle-income countries. Methods A multistage cluster sample design was used to obtain nationally representative women reproductive age...
<h3>Importance</h3> Recent reports have highlighted that expanding access to health care is ineffective at meeting the goal of universal coverage if offered does not meet a minimum level quality. Health facilities nearest patient's homes are perceived offer inadequate or inappropriate frequently bypassed in favor more distant private tertiary-level hospital higher-quality care. <h3>Objective</h3> To estimate frequency with which women Ghana bypass primary facility and describe patient...
Person-centeredness is a foundation of high-quality health systems but poorly measured in low- and middle-income countries (LMICs). We piloted an online survey four LMICs to identify the prevalence correlates excellent patient-reported quality care (QOC).The aims this study were investigate examine people's overall ratings relation their experiences seeking respective as well individual-, provider- facility-level predictors.We administered cross-sectional using Random Domain Intercept...
HIV infection is associated with arterial stiffness, but no studies have assessed this relationship in sub-Saharan Africa. We enrolled 205 participants over 40 years old Uganda: 105 on antiretroviral therapy for a median of 7 years, and random sample 100 age sex-matched HIV-uninfected controls from the clinic catchment area. The prevalence stiffness (ankle brachial index > 1.2) was 33%, 18%, 19% 2% HIV+ men, HIV– women, women. In multivariable models adjusted cardiovascular risk factors,...
Background Although ≈70% of the world's population people living with HIV reside in sub-Saharan Africa, there are minimal prospective data on contributions infection to atherosclerosis region. Methods and Results We conducted a observational cohort study antiretroviral therapy >40 years age rural Uganda, along population-based comparators not infected HIV. collected cardiovascular disease risk factors carotid ultrasound measurements annually. fitted linear mixed effects models, adjusted for...
This cohort study investigates the dispensation of COVID-19 vaccination at federally qualified health centers in US and whether vaccine has been distributed equitably to people different races ethnicities.
This cohort study assesses visit rates before and after telehealth expansion to assess whether availability at federally qualified health centers is associated with for patients mental diagnoses.
The utility and validity of cardiovascular diseases (CVD) risk scores are not well studied in sub-Saharan Africa. We compared correlated CVD with carotid intima media thickness (c-IMT) among HIV-infected uninfected people Uganda.We first calculated using the (1) Framingham laboratory-based score; (2) nonlaboratory score (FRS-BMI); (3) Reynolds (4) American College Cardiology Heart Association (5) Data collection on Adverse Effects Anti-HIV Drugs score. then absolute categories across each...
Since the 1990s, following similar reforms to its general politico-administrative systems, Uganda has decentralized public healthcare system by shifting decision-making power away from central Ministry of Health and towards more distal administrative levels. Previous research used decision space-the autonomy demonstrated entities in an hierarchy-to measure overall health decentralization. This study aimed determine how reported managers Ugandan facilities (de facto space) differs that which...
Background Antiretroviral therapy (ART) has led to diminishing AIDS-related mortality but a concomitant increase in non-communicable diseases (NCDs) for people with HIV (PWH). Whereas physical activity (PA) been shown help prevent NCDs and NCD outcomes other settings, there are few data on PA its correlates among PWH high-endemic settings. We aimed compare by serostatus rural Uganda. Methods analysed from the UGANDAC study, an observational cohort including ambulatory care Mbarara, Uganda,...