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1.
The healthcare of people with HIV is transitioning from specialty care to the primary healthcare (PHC) system. However, many of the performance indicators used to measure the quality of HIV care pre-date this transition. The goal of this work was to examine how existing HIV care performance indicators measure the comprehensive and longitudinal care offered in a PHC setting. A scoping review consisting of peer-reviewed and grey literature searches was performed. Two reviewers evaluated study eligibility and indicators in documents meeting inclusion criteria were extracted into a database. Indicators were matched to a PHC performance measurement framework to determine their applicability for evaluating quality of care in the PHC setting. The literature search identified 221 publications, of which 47 met inclusion criteria. 1184 indicators were extracted and removal of duplicates left 558 unique indicators. A majority of the 558 indicators fell under the ‘secondary prevention’ (12%) and ‘care of chronic conditions’ (33%) domains when indicators were matched to the PHC performance framework. Despite the imbalance, nearly all performance domains in the PHC framework were populated by at least one indicator with significant concentrations in domains such as patient-provider relationship, patient satisfaction, population and community characteristics, and access to care. Existing performance frameworks for the care of people with HIV provide a comprehensive set of indicators that align well with a PHC performance framework. Nonetheless, some important elements of care, such as patient-reported outcomes, are poorly covered by existing indicators. Advancing our understanding of how the experience of care for people with HIV is impacted by changes in health services delivery, specifically more care within the PHC system, will require performance indicators to capture this aspect of HIV care. 相似文献
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Data on embryonic and larval development times (D) of Calanus species are analysed using Blehrádek's temperature (T) function, D = a (T – )b, with b = – 2.05 as in previous studies. Among these species, for embryonic duration varies directly with temperatures in their geographical ranges and a is related to egg diameter. Using and b from embryonic durations, the fitted values of a for older stages are related to body sizes. Roughly estimated nucleus numbers in single adult females of C. finmarchicus, glacialis and hyperboreus were similar at 72 000, 85 000, and 96 000 respectively. Genome sizes (2C) of adult females are ca. 13 pg DNA in C. finmarchicus and pacificus, ca. 17 pg in C. sinicus, ca. 21 pg in C. helgolandicus and marshallae, and ca. 25 pg in C. glacialis and hyperboreus. These correspond roughly to body sizes and temperature-corrected development rates, quite precisely so in the sibling pair C. finmarchicus and C. glacialis, suggesting that, given similar nucleus numbers, there is nucleotypic control of whole-organism characteristics. 相似文献
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Naive and chronically infected CBA mice were challenged percutaneously with cercariae and biopsied at varying times thereafter to provide skin samples for light and electron microscopy. The epidermis and dermis doubled in thickness in both groups; this change occurred within 3 h in immune mice and by 48 h in controls. Immune skin showed a 5-fold increase in total thickness by 72 h. Primary reaction sites were characterised by neutrophil infiltrates but in immune mice, eosinophils replaced neutrophils by day 2. Granulocytic micro-abscesses formed in the epidermis in both naive and immune skin; they entrapped cast cercarial tails and schistosomula and were eventually sloughed from the skin surface. An early loss of challenge parasites may occur in this way. Not all penetrated schistosomula completed transformation by developing the double outer membrane and these may constitute additional casualties. Schistosomula in immune but not naive skin were invested by a surface coat; this is suggested to represent an antigen/antibody complex. Significant numbers of larvae in immune skins were associated with intact granulocytes or free eosinophil granules and dead, infiltrated parasites occurred in the dermis. Such individuals may account for the additional attrition recorded in immune mice. Mast cells became associated with granulocytes in both groups of animals; they degranulated by simple exocytosis in naive skin but compound exocytosis in immune skin. 相似文献
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After the administration of the anticancer drug cis-dichlorodiammine platinum II (cisplatin) to male rats, the Pt in the soluble fraction of the kidney is isolated, by gel filtration, in association with a high molecular weight component and a low molecular weight fraction. At 24 h, Pt is also recovered in a metallothionein-like fraction which elutes from Sephadex G-50 with a lower apparent molecular weight than endogenous (Cu, Zn)-thionein or Cd-thionein isolated from the kidneys of Cd2+-treated rats. None of these low molecular weight metal-binding fractions binds to Octyl Sepharose CL-4B. On DE-52 ion exchange chromatography, Cd-thionein is resolved into two isometallothioneins whereas the low molecular weight Pt-binding fraction is only partially purified and contains at least six components which elute at higher gradient concentrations than metallothionein. Pretreatment with Cd2+ which stimulates the synthesis of renal and hepatic metallothionein has no effect on the uptake and subcellular distribution of Pt in the liver and kidneys. Cisplatin treatment reduces the concentration of Cu and Zn in the renal metallothionein and other soluble protein fractions in the kidney. When administered to Cd2+-pretreated rats, cisplatin promotes the loss of Zn from the soluble protein fractions but causes the redistribution of Cd from the metallothionein to the high molecular weight fraction and fails to inhibit the Cd2+-induced accumulation of Cu in the kidneys and the binding of Cu to the soluble protein fractions. It is suggested that metallothionein probably does not have a significant role in the renal metabolism of Pt following the administration of cisplatin to rats. 相似文献
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Schistosoma mansoni: schistosomulicidal activity of macrophages isolated from liver granulomas of infected mice 总被引:2,自引:0,他引:2
Mice infected with Schistosoma mansoni develop T cell-mediated granulomatous reactions around disseminated parasite eggs. In this study, granuloma-derived leucocytes have been examined for schistosomulicidal capacity by the use of in vitro cytotoxicity assays. Adherent macrophages, that were shown by electron microscopy to exhibit no gross morphological abnormalities, were unable to mediate significant mortality in the absence of serum factors. When cocultured with immune serum and complement, however, these cells killed +/- 26% of the larvae at a cell:target ratio of 5000:1. In contrast, granuloma-derived cell populations that were enriched for eosinophils (50-70% eosinophil content) showed only minimal cytotoxic potential. This may be related to observed structural changes in the eosinophil lysosomal granules, or perhaps to blocking of the cell-surface receptors by immune complexes. It is concluded that granuloma macrophages, activated by egg antigen-sensitised T lymphocytes, may serve as effector cells in immunity to schistosomules. 相似文献
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The synergistic effects of potential amino donors were studied in the assay of CTP synthetase in extracts of Chinese hamster fibroblasts. We found that L-glutamine was not effective as the sole amino donor, but combinations of L-glutamine with NH4HCO3, L-arginine or potassium phosphate did result in the conversion of UTP to CTP. L-arginine or potassium phosphate were also not effective when used alone, and NH4HCO3 was only slightly effective. Our studies demonstrate that the individual synergistic combinations were not additive; multiple combinations of components decreased rather than increased the formation of CTP. The synergistic combinations of L-glutamine with either NH4HCO3 or L-arginine had an absolute requirement for ATP; when ATP and PEP were absent no conversion of UTP to CTP occurred. The presence of GTP in a reaction mixture slightly increased the formation of CTP when L-glutamine and NH4HCO3 were used and substantially increased CTP formation when L-glutamine and L-arginine were used. De novo CTP synthesis was greatly reduced when nonradioactive CTP was added to an assay mixture, suggesting feedback inhibition. A TLC procedure has been developed that allows for the direct separation of UTP and CTP without requiring prior conversion to the mononucleotide or nucleoside level. 相似文献
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