A5066087520- Tuberculosis Research and Epidemiology
- HIV/AIDS Research and Interventions
- Mobile Health and mHealth Applications
- Digital Mental Health Interventions
- Pneumocystis jirovecii pneumonia detection and treatment
- Patient Satisfaction in Healthcare
- Health Literacy and Information Accessibility
- Surgical Simulation and Training
- Healthcare Operations and Scheduling Optimization
- ICT in Developing Communities
- Health Policy Implementation Science
- Simulation-Based Education in Healthcare
- HIV/AIDS Impact and Responses
- Radiology practices and education
- Innovative Human-Technology Interaction
- Hospital Admissions and Outcomes
- Patient-Provider Communication in Healthcare
- Child and Adolescent Health
- Celiac Disease Research and Management
- Quality and Safety in Healthcare
- Histiocytic Disorders and Treatments
- Child Abuse and Trauma
- Atherosclerosis and Cardiovascular Diseases
- Psychiatric care and mental health services
- Hate Speech and Cyberbullying Detection
University of California, San Francisco
2018-2024
San Francisco General Hospital
2020-2024
Black Country Healthcare NHS Foundation Trust
2023
Black Country Partnership NHS Foundation Trust
2023
Penn State Milton S. Hershey Medical Center
2023
Coventry and Warwickshire Partnership NHS Trust
2022
Children's National
2022
Health Foundation
2016-2020
Imperial College Healthcare NHS Trust
2020
St Mary's Hospital
2020
Background Adherence to and completion of tuberculosis (TB) treatment remain problematic in many high-burden countries. 99DOTS is a low-cost digital adherence technology that could increase TB completion. Methods findings We conducted pragmatic stepped-wedge cluster-randomized trial including all adults treated for drug-susceptible pulmonary at 18 health facilities across Uganda over 8 months (1 December 2018–31 July 2019). Facilities were randomized switch from routine (control period)...
Abstract Background Extreme disparities in access, experience, and outcomes highlight the need to transform how pregnancy care is designed delivered United States, especially for low-income individuals people of color. Methods We used human-centered design (HCD) understand challenges facing Medicaid-insured pregnant interventions address these challenges. The HCD method has three phases: Inspiration, Ideation, Implementation. This study focused on first second. In Inspiration phase we...
Background Expanding access to shorter regimens for tuberculosis (TB) prevention, such as once-weekly isoniazid and rifapentine taken 3 months (3HP), is critical reducing global TB burden among people living with HIV (PLHIV). Our coprimary hypotheses were that high levels of acceptance completion 3HP could be achieved delivery strategies optimized overcome well-contextualized barriers would highest when PLHIV provided an informed choice between strategies. Methods findings In a pragmatic,...
Historically, medical trainees were educated in the hospital on real patients. Over last decade, there has been a shift to practicing skills through simulations with mannequins or patient actors. Virtual reality (VR), and particular, use of 360-degree video audio (cineVR), is next-generation advancement simulation that novel applications augment clinical skill practice, empathy building, team training. In this paper, we describe methods design develop cineVR education curriculum for trauma...
Third-year medical student, Penn State College of Medicine, Hershey, Pennsylvania; ORCID: https://orcid.org/0000-0002-8312-9197 https://orcid.org/0000-0002-1479-3588 Associate professor, Departments General Surgery and Humanities, Health Milton S. Hershey Medical Center, email: [email protected]; https://orcid.org/0000-0003-3975-3897 First published online Acknowledgements: The authors wish to thank their colleagues, Xhoni Pashaj Diba Atar, for contributing insight expertise in engineering...
99DOTS is a low-cost digital adherence technology that allows people with tuberculosis (TB) to self-report treatment adherence. There are limited data on its implementation, feasibility, and acceptability from sub-Saharan Africa. We conducted longitudinal analysis cross-sectional surveys nested within stepped-wedge randomized trial at 18 health facilities in Uganda between December 2018 January 2020. The assessed implementation of key components 99DOTS-based intervention, including...
This study aims to assess the impact of a virtual reality trainer in improving percutaneous renal access skills urological trainees.A total 36 urology trainees participated this prospective study. Initially, they were taken through exercise gaining lower pole calyceal system and introducing guidewire down ureter. Trainees' performance was then assessed by reality-derived parameters simulator at baseline after 2 h training.Participants who underwent training with demonstrated significant...
BackgroundThe coronavirus disease 2019 pandemic has presented an enormous challenge to healthcare providers worldwide. The appropriate use of personal protective equipment (PPE) been essential ensure staff and patient safety. 'PPE Helper Programme' was developed at a large London hospital group counteract suboptimal PPE practice. Based on behaviour change model capability, opportunity motivation (COM-B), the programme provided support, advice education ward staff.AimEvaluation...
Background Digital adherence technologies have been widely promoted as a means to improve tuberculosis medication adherence. However, uptake of these has suboptimal by both patients and health workers. Not surprisingly, studies not demonstrated significant improvement in treatment outcomes. Objective This study aimed optimize well-known digital technology, 99DOTS, for end user needs Uganda. We describe the findings ideation phase human-centered design methodology adapt 99DOTS according set...
From preventing cholera and diarrhea by reducing exposure to human waste, transmission of COVID-19 through handwashing, water, sanitation hygiene (WASH) can save lives. Numerous global health initiatives have been created combat the spread infectious diseases. However, according Sanitation Hygiene Fund, “decades under investment in made this sector weakest link our efforts achieve [Sustainable Development Goals (SDGs)].” There appear be various reasons for lag attention to, funding toward,...
Recently, a 3-month (12-dose) regimen of weekly isoniazid and rifapentine (3HP) was recommended by the World Health Organization for prevention tuberculosis (TB) among people living with HIV (PLHIV) on common antiretroviral therapy regimens. The best approach to delivering 3HP PLHIV remains uncertain.
Violence is a public health problem. Hospital-based violence intervention programs such as the San Francisco Wraparound Project (WAP) have been shown to reduce future violent injury. The WAP model employs culturally competent case managers who recruit and enroll violently injured patients clients. Client acceptance of variable, program success depends on streamlined, timely communication access resources. High rates smartphone usage in populations are at risk for reinjury create an...
To use a mixed methods approach to investigate the patient waiting experience for medically underserved population at an outpatient surgical clinic.We used lean methodology perform 96 time-tracked observations of journey in clinic, documenting duration activities from arrival departure. We also human-centered design (HCD) and analyze 43 semi-structured interviews understand patients' unmet needs.Patients spent average 68.5% their total clinic visit be seen. While was 95.8 minutes, over...
Background Scaling up shorter regimens for tuberculosis (TB) prevention such as once weekly isoniazid–rifapentine (3HP) taken 3 months is a key priority achieving targets set forth in the World Health Organization’s (WHO) END TB Strategy. However, there are few data on 3HP patient acceptance and completion context of routine HIV care sub-Saharan Africa. Methods findings The Options Trial pragmatic, parallel type effectiveness–implementation randomized trial comparing optimized strategies...
Introduction Low-cost digital adherence technologies (DATs) such as 99DOTS have emerged an alternative to directly observed therapy (DOT), the current standard for tuberculosis (TB) treatment supervision. However, there are limited data support DAT scale-up. The ‘DOT DAT’ trial aims evaluate effectiveness and implementation of a 99DOTS-based TB supervision strategy. Methods analysis This is pragmatic, stepped-wedge cluster randomised trial, with hybrid type 2 effectiveness-implementation...
Three months of isoniazid-rifapentine (3HP) is being scaled up for tuberculosis (TB) preventive treatment (TPT) among people living with HIV (PLHIV) in high-burden settings. More evidence needed to identify factors influencing successful 3HP delivery. We conducted a qualitative assessment delivery nested within the Options Trial, which compared three optimized strategies delivering 3HP: facilitated directly observed therapy (DOT), self-administered (SAT), and patient choice between DOT SAT...
Abstract 99DOTS is a low-cost digital adherence technology that allows people with tuberculosis (TB) to self-report treatment adherence. There are limited data on its implementation, feasibility, and acceptability from sub-Saharan Africa. We conducted longitudinal analysis cross-sectional surveys nested within stepped-wedge randomized trial at 18 health facilities in Uganda between December 2018 January 2020. The assessed implementation of key components 99DOTS-based intervention, including...