Enhancing the delivery of comprehensive care for people living with HIV in Canada: insights from citizen panels and a national stakeholder dialogue.

Background: People living with human immunodeficiency virus (HIV) are living longer with health-related disability associated with ageing, including complex conditions. However, health systems in Canada have not adapted to meet these comprehensive care needs.

Methods: We convened three citizen panels and a national stakeholder dialogue.

Patterns of cesarean birth among women living with HIV in Ontario: A cross-sectional, population-level study.

Background: In Canada, as is found globally, women of reproductive age are a growing demographic of persons living with HIV. Combination antiretroviral therapy (cART) treatment enables women living with HIV (WLWH) to become pregnant without perinatal transmission, and they are increasingly planning to become pregnant. Since 2014, Canadian guidelines no longer recommend routine elective cesarean birth (CB) for women who are virally suppressed and receiving cART.

Cohort profile: the LHIV-Manitoba clinical cohort of people living with HIV in Manitoba, Canada.

Purpose: The LHIV-Manitoba cohort was developed as a way to provide a comprehensive source of HIV-related health information in the central Canadian Prairie province of Manitoba. The cohort will provide important information as we aim to better understand local HIV epidemiology and address key knowledge and practice gaps in HIV prevention, treatment and care programming in the province.

Participants: In total, 890 individuals, aged 18 or older and living or receiving HIV care in Manitoba are enrolled in the cohort.

Creating Clinical Cohorts: Challenges Encountered in Two Canadian Provinces.

In 2013, the Living with HIV (LHIV) Innovation team established clinical cohorts of people living with HIV in Manitoba and Newfoundland and Labrador, and they linked the data to provincial health administrative databases. Access to these data enabled researchers to conduct studies across provincial borders; contribute to a national dialogue on HIV health system performance; and give recommendations for evidence-based healthcare, health policy and public health. However, research funding is episodic; maintaining cohorts requires stable funding.

Evolving Toward Shared HIV Care Using the Champlain BASE eConsult Service.

Electronic consultation (eConsultation) is a potential strategy to improve access to specialist expertise and facilitate collaborative care models. The Champlain BASE eConsult service allows for asynchronous communication between primary care providers (PCP) and specialists on a secure, web-based system. HIV experts accessible include HIV physician specialists, HIV pharmacists, and social workers with expertise in HIV.

How the delivery of HIV care in Canada aligns with the Chronic Care Model: A qualitative study.

With the advent of continuous antiretroviral therapy, HIV has become a complex chronic, rather than acute, condition. The Chronic Care Model (CCM) provides an integrated approach to the delivery of care for people with chronic conditions that could therefore be applied to the delivery of care for people living with HIV. Our objective was to assess the alignment of HIV care settings with the CCM.

Canadian HIV Care Settings as Patient-Centered Medical Homes (PCMHs).

Purpose: For people living with HIV (PLWH) using continuous antiretroviral therapy, HIV is now a complex chronic condition often managed in primary care settings. The patient-centered medical home (PCMH) is a model to deliver comprehensive, coordinated, and integrated primary care that promotes collaboration between primary and specialist care and allied services. The study assessed how both Canadian primary and specialist HIV care settings align with the PCMH.

The organizational attributes of HIV care delivery models in Canada: A cross-sectional study.

HIV treatment in Canada has rapidly progressed with the advent of new drug therapies and approaches to care. With this evolution, there is increasing interest in Canada in understanding the current delivery of HIV care, specifically where care is delivered, how, and by whom, to inform the design of care models required to meet the evolving needs of the population. We conducted a cross-sectional survey of Canadian care settings identified as delivering HIV care between June 2015 and January 2016.

Patient activation among people living with HIV: a cross-sectional comparative analysis with people living with diabetes mellitus.

Standardized self-management supports are an integral part of care delivery for many chronic conditions. We used the validated Patient Activation Measure (PAM®) to assess level of engagement for self-management from a sample of 165 people living with HIV (PLWH) and 163 people with diabetes. We conducted multivariable logistic regression to assess associations between demographics and PAM® scores.

Challenges with access to healthcare from the perspective of patients living with HIV: a scoping review & framework synthesis.

Accessing healthcare can be difficult but the barriers multiply for people living with HIV (PLHIV). To improve access and the health of PLHIV, we must consider their perspectives and use them to inform standard practice. A better understanding of the current literature related to healthcare access from the perspective of PLHIV, can help to identify evidence gaps and highlight research priorities and opportunities.

Supported Standing in Boys With Duchenne Muscular Dystrophy.

Purpose: To evaluate the safety, tolerability, and efficacy of supported standing in a small sample of boys with Duchenne muscular dystrophy (DMD).

Methods: Four 12- to 15-year-old boys with DMD engaged in a home-based supported standing program for 6 to 12 months. A single-subject design was employed to examine muscle length.

Consideration of Stimulated Raman Scattering in Yb:Sr(5)(PO(4))(3)F Laser Amplifiers.

The stimulated Raman-scattering (SRS) gain coefficient has been measured quantitatively for the first time to our knowledge in Yb:Sr(5)(PO(4))(3)F to be 1.23 ? 0.12 cm/GW at 1053 nm.

Gain saturation measurements of ytterbium-doped Sr5(PO4)3 F.

We report on the experimental measurement of the saturated gain of Yb(3+):Sr(5)(PO(4))(3)F at the 1047-nm laser line as a function of pump fluence and probe energy. The emission line was accurately modeled as a single homogeneous extraction, yielding values of 6.2 x 10(-20) cm(2) for the emission cross section and 3.

4.0-4.5-mum lasing of Fe:ZnSe below 180 K, a new mid-infrared laser material.

Lasing of Fe:ZnSe is demonstrated, for the first time to the authors' knowledge, for temperatures ranging from 15 to 180 K. The output wavelength of the Fe:ZnSe laser was observed to tune with temperature from 3.98mum at 15 K to 4.

Three-level Q-switched laser operation of ytterbium-doped Sr(5)(PO(4))(3)F at 985 nm.

Ytterbium-doped Sr(5)(PO(4))(3)F was successfully lased at 985 nm in quasi-cw mode with a slope efficiency of 74% and an absorbed threshold energy of 18 mJ. Q-switched slope efficiencies of 21% were obtained with a maximum energy of 9.4 mJ in 8.

Precision spectral sculpting for narrow-band amplification of broadband frequency-modulated pulses.

Amplification of broadband frequency-modulated (FM) pulses in high-efficiency materials such as ytterbium-doped strontium fluorapatite results in significant gain narrowing, leading to reduced on-target bandwidths for beam smoothing and to conversion from frequency modulation to amplitude modulation (AM). To compensate for these effects, we have applied precision spectral sculpting, requiring both amplitude and phase shaping, to the amplification of broadband FM pulses in narrow-band gain media. We have demonstrated sculpting for centerline small-signal gains of 10(4), producing amplified pulses that have both sufficient bandwidths for on-target beam smoothing and temporal profiles that have no potentially damaging AM.

Trimethylaminuria is caused by mutations of the FMO3 gene in a North American cohort.

Trimethylaminuria (TMAuria) (McKusick 602079) first described in 1970 is an autosomal recessive condition caused by a partial or total incapacity to catalyze the N-oxygenation of the odorous compound trimethylamine (TMA). The result is a severe body odor and associated psychosocial conditions. This inborn error of metabolism, previously thought to be rare, is now being increasingly detected in severe and milder presentations.

Mutations of the flavin-containing monooxygenase gene (FMO3) cause trimethylaminuria, a defect in detoxication.

Individuals with the recessive condition trimethylaminuria exhibit variation in metabolic detoxication of xenobiotics by hepatic flavin-containing monooxygenases. We show here that mutations in the human flavin-containing monooxygenase isoform 3 gene ( FMO3 ) impair N -oxygenation of xenobiotics and are responsible for the trimethylaminuria phenotype. Three disease-causing mutations in nine Australian-born probands have been identified which share a particular polymorphic haplotype.

Comparisons of nuclear-encoded small-subunit ribosomal RNAs reveal the evolutionary position of the Glaucocystophyta.

The Glaucocystophyta (e.g., Cyanophora paradoxa) form a morphologically distinct group of photosynthetic protists that is primarily distinguished by its cyanelles (= plastids).

ALGAE CONTAINING CHLOROPHYLLS a + c ARE PARAPHYLETIC: MOLECULAR EVOLUTIONARY ANALYSIS OF THE CHROMOPHYTA.

Sequence comparisons of small subunit ribosomal RNA coding regions from 12 chlorophylls a + c-containing algae were used to infer phylogenetic relationships within the Chromophyta. Three chromophyte lines of descent, delineated by the Bacillariophyceae, the Phaeophyceae/Xanthophyceae, and the Chrysophyceae/Eustigmatophyceae/Synurophyceae are members of a complex evolutionary assemblage, which also includes representatives of the Oomycota ("lower" fungi). Maximum parsimony and distance matrix methods demonstrate a common evolutionary history for these lineages but their relative branching order could not be determined.

Harmonic conversion of large-aperture 1.05-microm laser beams for inertial-confinement fusion research.

To provide high-energy, high-power beams at short wavelengths for inertial-confinement fusion experiments, we routinely convert the 1.05-microm output of the Nova, Nd:phosphate-glass, laser system to its second- or third-harmonic wavelength. We describe the design and performance of the 3 x 3 arrays of potassium dihydrogen phosphate crystal plates used for type-II-type-II phase-matched harmonic conversion of the Nova 0.

Power, energy, and temporal performance of the Nova laser facility with recent improvements to the amplifier system.

High-powered glass-laser systems with multiple beams, frequency-conversion capabilities, and pulseshaping flexibility have made numerous contributions to the understanding of inertial confinement fusion and related laser-plasma interactions. The Nova laser at Lawrence Livermore National Laboratory is the largest such laser facility. We have made improvements to the Nova amplifier system that permit increased power and energy output.