Evaluation of multi-level barriers and facilitators in a large diabetic retinopathy screening program in federally qualified health centers: a qualitative study.

Background: Recommended annual diabetic retinopathy (DR) screening for people with diabetes has low rates in the USA, especially in underserved populations. Telemedicine DR screening (TDRS) in primary care clinics could expand access and increase adherence. Despite this potential, studies have observed high variability in TDRS rates among clinics and over time, highlighting the need for implementation supports.

Proterometra macrostoma (Trematoda: Azygiidae): location of the redia and emergence path from the snail, Elimia semicarinata (Gastropoda: Pleuroceridae).

The objectives of this study were to describe (1) the osmotic environment and precise location of the Proterometra macrostoma redia in its snail intermediate host, (2) where retraction of the distome body into the cercarial tail occurs, and (3) the subsequent emergence path of the cercaria out of the snail. Snails, Elimia semicarinata , were collected from North Elkhorn Creek in Scott County, Kentucky and screened daily for patent infections. Live rediae were extracted from infected snails in either artificial pond water (APW) or artificial snail water (ASW) and monitored for changes in morphology and movement every hour over 5 hr at 22 C.