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Garfein RS, Collins K, Muñoz F, Moser K, Cerecer-Callu P, Raab F, Rios P, Flick A, Zúñiga ML, Cuevas-Mota J, Liang K, Rangel G, Burgos JL, Rodwell TC, Patrick K. Feasibility of tuberculosis treatment monitoring by video directly observed therapy: a binational pilot study. Int J Tuberc Lung Dis 2016; 19:1057-64. [PMID: 26260824 DOI: 10.5588/ijtld.14.0923] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although directly observed therapy (DOT) is recommended worldwide for monitoring anti-tuberculosis treatment, transportation and personnel requirements limit its use. OBJECTIVE To evaluate the feasibility and acceptability of 'video DOT' (VDOT), which allows patients to record and transmit medication ingestion via videos watched remotely by health care providers to document adherence. METHODS We conducted a single-arm trial among tuberculosis (TB) patients in San Diego, California, USA, (n = 43) and Tijuana, Mexico (n = 9) to represent high- and low-resource settings. Pre-/post-treatment interviews assessed participant characteristics and experiences. Adherence was defined as the proportion of observed doses to expected doses. RESULTS The mean age was 37 years (range 18-86), 50% were male, and 88% were non-Caucasian. The mean duration of VDOT use was 5.5 months (range 1-11). Adherence was similar in San Diego (93%) and Tijuana (96%). Compared to time on in-person DOT, 92% preferred VDOT, 81% thought VDOT was more confidential, 89% never/rarely had problems recording videos, and 100% would recommend VDOT to others. Seven (13%) participants were returned to in-person DOT and six (12%) additional participants had their phones lost, broken or stolen. CONCLUSIONS VDOT was feasible and acceptable, with high adherence in both high- and low-resource settings. Efficacy and cost-effectiveness studies are needed.
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Affiliation(s)
- R S Garfein
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA
| | - K Collins
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA
| | - F Muñoz
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA
| | - K Moser
- San Diego County Health and Human Services Agency, San Diego, California, USA
| | - P Cerecer-Callu
- Instituto de Servicios de Salud, Tijuana, Baja California, México
| | - F Raab
- Department of Preventive Medicine and Public Health, University of California, San Diego, La Jolla, USA
| | - P Rios
- Qualcomm Institute, University of California, San Diego, La Jolla, USA
| | - A Flick
- Qualcomm Institute, University of California, San Diego, La Jolla, USA
| | - M L Zúñiga
- School of Social Work, San Diego State University, San Diego, California, USA
| | - J Cuevas-Mota
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA
| | - K Liang
- San Diego County Health and Human Services Agency, San Diego, California, USA
| | - G Rangel
- Comision de Salud Fronteriza, Sección México-Secretaria de Salud, Tijuana, Baja California, México
| | - J L Burgos
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA
| | - T C Rodwell
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA
| | - K Patrick
- Department of Preventive Medicine and Public Health, University of California, San Diego, La Jolla, USA; Qualcomm Institute, University of California, San Diego, La Jolla, USA
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Cortes M, Flick A, Barone MA, Amatya R, Pollack AE, Otero-Flores J, Juarez C, McMullen S. Results of a pilot study of the time to azoospermia after vasectomy in Mexico City. Contraception 1997; 56:215-22. [PMID: 9408702 DOI: 10.1016/s0010-7824(97)00138-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In a joint pilot study by Family Health International (FHI), AVSC International, and the Instituto Mexicano del Seguro Social (IMSS), information was gathered on the determinants of azoospermia following vasectomy on 38 healthy men who chose vasectomy for contraception. The time and number of ejaculations associated with loss of sperm motility and loss of sperm eosin vital staining were also evaluated. "Azoospermia" was defined on the basis of two consecutive azoospermic semen samples collected at least 3 days apart. The single decrement life table method was used to calculate weekly gross cumulative life table rates for the time to azoospermia, zero motility, and zero viability. The Kaplan-Meier method was used to calculate the product-limit estimates of the cumulative rates for the total number of ejaculations to azoospermia, 0% motility and 0% viability. The median time to azoospermia was 10 weeks and at the end of week 20, the life table rate (+/- standard error) was 93.0 (+/- 6.30) weeks/100 men. The median number of ejaculations to azoospermia was between 25 and 30, and the cumulative rate (+/- standard error) at 60 ejaculations reached 94.5 (+/- 5.16)/100 men.
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Affiliation(s)
- M Cortes
- Instituto Mexicano del Seguro Social (IMSS), México City, México
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Abstract
Small groups lasting eight sessions each and aimed at improving patient's interpersonal problem-solving skills were conducted for a total of 41 hospitalized psychiatric patients. Forty control patients received the same pre and posttests but notraining. Twenty-three patients participated in play-reading groups without problem-solving training (placebo condition). Three separate 3 by 2 repeated measures analyses of variance showed that hospitalization alone improved the patient's functioning on the criterion test of problem-solving, but the problem-solving training groups advanced the improvement significantly. More disturbed patients made only slightly greater gains than less disturbed ones. The hospital stay was significantly shorter for the experimental and the placebo groups than for the control sample.
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