Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-8 (of 8 Records) |
Query Trace: Dumitru C[original query] |
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Updated Federal Recommendations for HIV Prevention With Adults and Adolescents With HIV in The United States: The Pivotal Role of Nurses
Dumitru G , Irwin K , Tailor A . J Assoc Nurses AIDS Care 2017 28 (1) 8-18 In December 2014, the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration (HRSA), the National Institutes of Health, the Association of Nurses in AIDS Care (ANAC), and four other nongovernmental organizations issued the Recommendations for HIV Prevention with Adults and Adolescents with HIV in the United States (CDC et al., 2014a). The guideline includes recommendations on provision and delivery of services for HIV prevention, care, and treatment to people living with HIV (PLWH) to succeed in reaching and advancing the National HIV/AIDS Strategy (NHAS) prevention and care goals and objectives, including: avert new cases of HIV infection, increase the proportion of PLWH who are aware of their infection, and reduce HIV-related illnesses, death, and health disparities (The White House Office of National AIDS Policy, 2015). The 2014 guideline updates and further expands the 2003 federal Recommendations for Incorporating HIV Prevention into the Medical Care of Persons Living with HIV for clinicians (CDC, 2003) and includes recommendations for a broad spectrum of clinicians, nonclinical prevention providers, health departments, and HIV planning groups. The guideline focuses on strategies to reduce onward HIV transmission because these strategies were more effective and cost-effective than strategies to reduce the general risk of HIV acquisition; topics covered in the guideline reflect new evidence about interventions that can prevent HIV transmission from PLWH (CDC et al., 2014a). The full list of recommendations in the main guideline and three different summaries of recommendations for three main audiences aim to meet the needs of a broad range of clinical and nonclinical providers. |
Evaluating the evidence for more frequent than annual HIV screening of gay, bisexual, and other men who have sex with men in the United States: Results from a systematic review and CDC Expert Consultation
DiNenno EA , Prejean J , Delaney KP , Bowles K , Martin T , Tailor A , Dumitru G , Mullins MM , Hutchinson A , Lansky A . Public Health Rep 2017 133 (1) 33354917738769 The Centers for Disease Control and Prevention (CDC) recommended in 2006 that sexually active gay, bisexual, and other men who have sex with men (MSM) be screened for human immunodeficiency virus (HIV) at least annually. A workgroup comprising CDC and external experts conducted a systematic review of the literature, including benefits, harms, acceptability, and feasibility of annual versus more frequent screening among MSM, to determine whether evidence was sufficient to change the current recommendation. Four consultations with managers of public and nonprofit HIV testing programs, clinics, and mathematical modeling experts were conducted to provide input on the programmatic and scientific evidence. Mathematical models predicted that more frequent than annual screening of MSM could prevent some new HIV infections and would be more cost-effective than annual screening, but this evidence was considered insufficient due to study design. Evidence supports CDC's current recommendation that sexually active MSM be screened at least annually. However, some MSM might benefit from more frequent screening. Future research should evaluate which MSM subpopulations would benefit most from more frequent HIV screening. |
Recommendations for HIV screening of gay, bisexual, and other men who have sex with men - United States, 2017
DiNenno EA , Prejean J , Irwin K , Delaney KP , Bowles K , Martin T , Tailor A , Dumitru G , Mullins MM , Hutchinson AB , Lansky A . MMWR Morb Mortal Wkly Rep 2017 66 (31) 830-832 CDC's 2006 recommendations for human immunodeficiency virus (HIV) testing state that all persons aged 13-64 years should be screened for HIV at least once, and that persons at higher risk for HIV infection, including sexually active gay, bisexual, and other men who have sex with men (MSM), should be rescreened at least annually (1). Authors of reports published since 2006, including CDC (2), suggested that MSM, a group that is at highest risk for HIV infection, might benefit from being screened more frequently than once each year. In 2013, the U.S. Preventive Services Task Force (USPSTF) found insufficient evidence to specify an HIV rescreening interval but recommended annual screening for MSM as a reasonable approach (3). However, some HIV providers have begun to offer more frequent screening, such as once every 3 or 6 months, to some MSM. A CDC work group conducted a systematic literature review and held four expert consultations to review programmatic experience to determine whether there was sufficient evidence to change the 2006 CDC recommendation (i.e., at least annual HIV screening of MSM in clinical settings). The CDC work group concluded that the evidence remains insufficient to recommend screening more frequently than at least once each year. CDC continues to recommend that clinicians screen asymptomatic sexually active MSM at least annually. Each clinician can consider the benefits of offering more frequent screening (e.g., once every 3 or 6 months) to individual MSM at increased risk for acquiring HIV infection, weighing their patients' individual risk factors, local HIV epidemiology, and local testing policies. |
Universal motorcycle helmet laws to reduce injuries: A Community Guide Systematic Review
Peng Y , Vaidya N , Finnie R , Reynolds J , Dumitru C , Njie G , Elder R , Ivers R , Sakashita C , Shults RA , Sleet DA , Compton RP . Am J Prev Med 2017 52 (6) 820-832 CONTEXT: Motorcycle crashes account for a disproportionate number of motor vehicle deaths and injuries in the U.S. Motorcycle helmet use can lead to an estimated 42% reduction in risk for fatal injuries and a 69% reduction in risk for head injuries. However, helmet use in the U.S. has been declining and was at 60% in 2013. The current review examines the effectiveness of motorcycle helmet laws in increasing helmet use and reducing motorcycle-related deaths and injuries. EVIDENCE ACQUISITION: Databases relevant to health or transportation were searched from database inception to August 2012. Reference lists of reviews, reports, and gray literature were also searched. Analysis of the data was completed in 2014. EVIDENCE SYNTHESIS: A total of 60 U.S. studies qualified for inclusion in the review. Implementing universal helmet laws increased helmet use (median, 47 percentage points); reduced total deaths (median, -32%) and deaths per registered motorcycle (median, -29%); and reduced total injuries (median, -32%) and injuries per registered motorcycle (median, -24%). Repealing universal helmet laws decreased helmet use (median, -39 percentage points); increased total deaths (median, 42%) and deaths per registered motorcycle (median, 24%); and increased total injuries (median, 41%) and injuries per registered motorcycle (median, 8%). CONCLUSIONS: Universal helmet laws are effective in increasing motorcycle helmet use and reducing deaths and injuries. These laws are effective for motorcyclists of all ages, including younger operators and passengers who would have already been covered by partial helmet laws. Repealing universal helmet laws decreased helmet use and increased deaths and injuries. |
Public health interventions for asthma: an umbrella review, 1990-2010
Labre MP , Herman EJ , Dumitru GG , Valenzuela KA , Cechman CL . Am J Prev Med 2012 42 (4) 403-10 CONTEXT: Asthma is a chronic respiratory disease increasingly prevalent in the U.S., particularly among children and certain minority groups. This umbrella review sought to assess and summarize existing systematic reviews of asthma-related interventions that might be carried out or supported by state or community asthma control programs, and to identify gaps in knowledge. EVIDENCE ACQUISITION: Eleven databases were searched through September 2010, using terms related to four concepts: asthma, review, intervention, and NOT medication. Reviews of the effectiveness of medications, medical procedures, complementary and alternative medicine, psychological interventions, family therapy, and nutrients or nutritional supplements were excluded. Two coders screened each record and extracted data from the included reviews. EVIDENCE SYNTHESIS: Data analysis was conducted from May to December 2010. Of 42 included reviews, 19 assessed the effectiveness of education and/or self-management, nine the reduction of indoor triggers, nine interventions to improve the provision of health care, and five examined other interventions. Several reviews found consistent evidence of effectiveness for self-management education, and one review determined that comprehensive home-based interventions including the reduction of multiple indoor asthma triggers are effective for children. Other reviews found limited or insufficient evidence because of study limitations. CONCLUSIONS: State or community asthma control programs should prioritize (1) implementing interventions for which the present review found evidence of effectiveness and (2) evaluating promising interventions that have not yet been adequately assessed. |
Recommendations from the Task Force on Community Preventive Services to decrease asthma morbidity through home-based, multi-trigger, multicomponent interventions
Task Force on Community Preventive Services , Dumitru GG . Am J Prev Med 2011 41 S1-4 Asthma, a common chronic respiratory disease and major source of morbidity in the U.S., affects more than 20 million Americans, can substantially reduce quality of life, and has more than doubled in prevalence since 1980.1 Asthma is also a major cause of hospital use1 and results in very high direct and indirect costs (over $32.7 billion in healthcare costs spent annually when adjusted to 2007 U.S. dollars).2 In 2001, asthma was ranked the 25th leading cause of disability-adjusted life-years (DALYs) lost worldwide3 and is a leading cause of school absences for U.S. children.4 | Asthma is inextricably linked with the home environment and occupant health. Conditions in the home environment must be addressed to treat asthma adequately.5, 6 | The recommendations presented below are based on findings from the accompanying systematic review of home-based, multi-trigger, multicomponent environmental interventions to reduce asthma morbidity, published in this supplement.7 The findings on economic efficiency are from a systematic review of economic evaluations of such interventions, also in this supplement.8 |
Economic value of home-based, multi-trigger, multicomponent interventions with an environmental focus for reducing asthma morbidity: a Community Guide systematic review
Nurmagambetov TA , Barnett SB , Jacob V , Chattopadhyay SK , Hopkins DP , Crocker DD , Dumitru GG , Kinyota S . Am J Prev Med 2011 41 S33-47 CONTEXT: A recent systematic review of home-based, multi-trigger, multicomponent interventions with an environmental focus showed their effectiveness in reducing asthma morbidity among children and adolescents. These interventions included home visits by trained personnel to assess the level of and reduce adverse effects of indoor environmental pollutants, and educate households with an asthma client to reduce exposure to asthma triggers. The purpose of the present review is to identify economic values of these interventions and present ranges for the main economic outcomes (e.g., program costs, benefit-cost ratios, and incremental cost-effectiveness ratios). EVIDENCE ACQUISITION: Using methods previously developed for Guide to Community Preventive Services economic reviews, a systematic review was conducted to evaluate the economic efficiency of home-based, multi-trigger, multicomponent interventions with an environmental focus to improve asthma-related morbidity outcomes. A total of 1551 studies were identified in the search period (1950 to June 2008), and 13 studies were included in this review. Program costs are reported for all included studies; cost-benefit results for three; and cost-effectiveness results for another three. Information on program cost was provided with varying degrees of completeness: six of the studies did not provide a list of components included in their program cost description (limited cost information), three studies provided a list of program cost components but not a cost per component (partial cost information), and four studies provided both a list of program cost components and costs per component (satisfactory cost information). EVIDENCE SYNTHESIS: Program costs per participant per year ranged from $231-$14,858 (in 2007 U.S.$). The major factors affecting program cost, in addition to completeness, were the level of intensity of environmental remediation (minor, moderate, or major), type of educational component (environmental education or self-management), the professional status of the home visitor, and the frequency of visits by the home visitor. Benefit-cost ratios ranged from 5.3-14.0, implying that for every dollar spent on the intervention, the monetary value of the resulting benefits, such as averted medical costs or averted productivity losses, was $5.30-$14.00 (in 2007 U.S.$). The range in incremental cost-effectiveness ratios was $12-$57 (in 2007 U.S.$) per asthma symptom-free day, which means that these interventions achieved each additional symptom-free day for net costs varying from $12-$57. CONCLUSIONS: The benefits from home-based, multi-trigger, multicomponent interventions with an environmental focus can match or even exceed their program costs. Based on cost-benefit and cost-effectiveness studies, the results of this review show that these programs provide a good value for dollars spent on the interventions. |
Effectiveness of home-based, multi-trigger, multicomponent interventions with an environmental focus for reducing asthma morbidity: a Community Guide systematic review
Crocker DD , Kinyota S , Dumitru GG , Ligon CB , Herman EJ , Ferdinands JM , Hopkins DP , Lawrence BM , Sipe TA . Am J Prev Med 2011 41 S5-S32 CONTEXT: Asthma exacerbations are commonly triggered by exposure to allergens and irritants within the home. The purpose of this review was to evaluate evidence that interventions that target reducing these triggers through home visits may be beneficial in improving asthma outcomes. The interventions involve home visits by trained personnel to conduct two or more components that address asthma triggers in the home. Intervention components focus on reducing exposures to a range of asthma triggers (allergens and irritants) through environmental assessment, education, and remediation. EVIDENCE ACQUISITION: Using methods previously developed for the Guide to Community Preventive Services, a systematic review was conducted to evaluate the evidence on effectiveness of home-based, multi-trigger, multicomponent interventions with an environmental focus to improve asthma-related morbidity outcomes. The literature search identified over 10,800 citations. Of these, 23 studies met intervention and quality criteria for inclusion in the final analysis. EVIDENCE SYNTHESIS: In the 20 studies targeting children and adolescents, the number of days with asthma symptoms (symptom-days) was reduced by 0.8 days per 2 weeks, which is equivalent to 21.0 symptom-days per year (range of values: reduction of 0.6 to 2.3 days per year); school days missed were reduced by 12.3 days per year (range of values: reduction of 3.4 to 31.2 days per year); and the number of asthma acute care visits were reduced by 0.57 visits per year (interquartile interval: reduction of 0.33 to 1.71 visits per year). Only three studies reported outcomes among adults with asthma, finding inconsistent results. CONCLUSIONS: Home-based, multi-trigger, multicomponent interventions with an environmental focus are effective in improving overall quality of life and productivity in children and adolescents with asthma. The effectiveness of these interventions in adults is inconclusive due to the small number of studies and inconsistent results. Additional studies are needed to (1) evaluate the effectiveness of these interventions in adults and (2) determine the individual contributions of the various intervention components. |
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