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Article: Health Care Providers' Perceptions of Quality, Acceptance, and Satisfaction With Telebehavioral Health Services During the COVID-19 Pandemic: Survey-Based Study.

Wright, Jesse / Dewan, Shyam / Hilty, Donald / Dewan, Naakesh A

2020 Volume 7, Issue 12, Page(s) e23245

Abstract: Background: Due to rapidly increasing rates of COVID-19 across the country, system-wide changes were needed to protect the health and safety of health care providers and consumers alike. Technology-based care has received buy-in from all participants, ... ...

Abstract	Background: Due to rapidly increasing rates of COVID-19 across the country, system-wide changes were needed to protect the health and safety of health care providers and consumers alike. Technology-based care has received buy-in from all participants, and the need for technological assistance has been prioritized. Objective: The objective of this study was to determine the initial perceptions and experiences of interprofessional behavioral health providers about shifting from traditional face-to-face care to virtual technologies (telephonic and televideo) during the COVID-19 pandemic. Methods: A survey-based study was performed at a large, integrated medical health care system in West-Central Florida that rapidly implemented primary care provision via telephone and televideo as of March 18, 2020. A 23-item anonymous survey based on a 7-point Likert scale was developed to determine health care providers' perceptions about telephonic and televideo care. The survey took 10 minutes to complete and was administered to 280 professionals between April 27 and May 11, 2020. Results: In all, 170 respondents completed the survey in entirety, among which 78.8% (134/170) of the respondents were female and primarily aged 36-55 years (89/170, 52.4%). A majority of the respondents were outpatient-based providers (159/170, 93.5%), including psychiatrists, therapists, counselors, and advanced practice nurses. Most of them (144/170, 84.7%) had used televideo for less than 1 year; they felt comfortable and satisfied with either telephonic or televideo mode and that they were able to meet the patients' needs. Conclusions: Our survey findings suggest that health care providers valued televideo visits equally or preferred them more than telephonic visits in the domains of quality of care, technology performance, satisfaction of technology, and user acceptance.
Keywords	covid19
Language	English
Publishing date	2020-12-04
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2798262-2
ISSN	2368-7959
ISSN	2368-7959
DOI	10.2196/23245
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Provider Perceptions of Quality, Acceptability, and Satisfaction with Tele-Behavioral Health During the COVID-19 Pandemic

Wright, Jesse / Dewan, Shyam / Hilty, Donald / Dewan, Naakesh

Abstract: BACKGROUND: Due to concerns raised by both providers and consumers, and an ongoing state of emergency, the decision to transition to technology-based care has both pushed and helped health systems to make change. Buy-in has come from all participants of ... ...

Abstract	BACKGROUND: Due to concerns raised by both providers and consumers, and an ongoing state of emergency, the decision to transition to technology-based care has both pushed and helped health systems to make change. Buy-in has come from all participants of care and technological assistance rapidly moved up the priority list. OBJECTIVE: Determine the initial perception of behavioral health providers during a rapid adjustment of care during the COVID-19 pandemic. A large integrated medical healthcare system in West-Central Florida rapidly assessed the views of interprofessional behavioral health providers on their experience shifting to telephone and tele-video technologies. METHODS: A 23-item anonymous survey with Likert questions on a 7-point scale was developed to determine perceptions about both telephonic and tele-video care. The survey took 10 minutes to complete and was conducted April 27, 2020 to May 11, 2020, following care on that started March 18, 2020. RESULTS: Behavioral health professionals (N = 170) were 78.8% female, primarily aged 36-55 (52.4%), and outpatient-based (93.5%) included psychiatrists, therapists, counselors, and advanced practice nurses. Most (84.7%) had used tele-video less than a year and they felt comfortable and satisfied with either mode or felt they met the patients' needs. CONCLUSIONS: Tele-video was valued equally or more than telephone in the domains of quality of care, user experience, satisfaction of technology, and user acceptability.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #922764
Database	COVID19

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Article ; Online: Treating childhood traumatic brain injury with autologous stem cell therapy.

Dewan, Shyam / Schimmel, Samantha / Borlongan, Cesar V

Expert opinion on biological therapy

2018 Volume 18, Issue 5, Page(s) 515–524

Abstract: Introduction: Neonatal traumatic brain injury (TBI) is a significant cause of developmental disorders. Autologous stem cell therapy may enhance neonatal brain plasticity towards repair of the injured neonatal brain.: Areas covered: The endogenous ... ...

Abstract	Introduction: Neonatal traumatic brain injury (TBI) is a significant cause of developmental disorders. Autologous stem cell therapy may enhance neonatal brain plasticity towards repair of the injured neonatal brain. Areas covered: The endogenous neonatal anti-inflammatory response can be enhanced through the delivery of anti-inflammatory agents. Stem cell therapy stands as a robust approach for sequestering the inflammation-induced cell death in the injured brain. Here, we discuss the use of umbilical cord blood cells and bone marrow stromal cells for acute and chronic treatment of experimental neonatal TBI. Autologous stem cell transplantation may dampen neuroinflammation. Clinical translation of this stem cell therapy will require identifying the therapeutic window post-injury and harvesting ample supply of transplantable autologous stem cells. Stem cell banking of cryopreserved cells may allow readily available transplantable cells and circumvent the unpredictable nature of neonatal TBI. Harnessing the anti-inflammatory properties of stem cells is key in combating the progressive neurodegeneration after the initial injury. Expert opinion: Combination treatments, such as with hypothermia, may enhance the therapeutic effects of stem cells. Stem cell therapy has immense potential as a stand-alone or adjunctive therapy for treating neuroinflammation associated with neonatal TBI acutely and for preventing further progression of the injury.
MeSH term(s)	Age of Onset ; Brain Injuries/epidemiology ; Brain Injuries/therapy ; Brain Injuries, Traumatic/epidemiology ; Brain Injuries, Traumatic/therapy ; Child ; Fetal Blood/cytology ; Humans ; Mesenchymal Stem Cells/cytology ; Mesenchymal Stem Cells/physiology ; Stem Cell Transplantation/methods ; Transplantation, Autologous
Language	English
Publishing date	2018-02-15
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. ; Review
ZDB-ID	2052501-1
ISSN	1744-7682 ; 1471-2598
ISSN (online)	1744-7682
ISSN	1471-2598
DOI	10.1080/14712598.2018.1439473
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Article ; Online: Drug treatments that optimize endogenous neurogenesis as a therapeutic option for stroke.

Dewan, Shyam N / Wang, Yun / Yu, Seongjin

Brain circulation

2017 Volume 3, Issue 3, Page(s) 152–155

Abstract: Cell death and neurogenesis have been examined after stroke in the subventricular zone of the adult mammalian brain. New research focuses on the use of drugs to improve the viability of neural progenitor cells in rats after stroke. The aim of the drugs ... ...

Abstract	Cell death and neurogenesis have been examined after stroke in the subventricular zone of the adult mammalian brain. New research focuses on the use of drugs to improve the viability of neural progenitor cells in rats after stroke. The aim of the drugs is to lengthen the timeframe for stroke therapy by targeting the endogenous repair mechanism that follows injury. In this paper, we look at the broad state of stroke therapy to assess the effectiveness of endogenous neurogenesis-enhancing drugs on stroke. This paper is a review article. Referred literature in this paper has been listed in the reference section. The data sets supporting the conclusions of this article are available online by searching various databases, including PubMed. Some original points in this article come from the laboratory practice in our research center and the authors' experiences.
Language	English
Publishing date	2017-10-12
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	2950273-1
ISSN	2455-4626 ; 2394-8108
ISSN (online)	2455-4626
ISSN	2394-8108
DOI	10.4103/bc.bc_20_17
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Article ; Online: Drug treatments that optimize endogenous neurogenesis as a therapeutic option for stroke

Shyam N Dewan / Yun Wang / Seongjin Yu

Brain Circulation, Vol 3, Iss 3, Pp 152-

2017 Volume 155

Abstract	Cell death and neurogenesis have been examined after stroke in the subventricular zone of the adult mammalian brain. New research focuses on the use of drugs to improve the viability of neural progenitor cells in rats after stroke. The aim of the drugs is to lengthen the timeframe for stroke therapy by targeting the endogenous repair mechanism that follows injury. In this paper, we look at the broad state of stroke therapy to assess the effectiveness of endogenous neurogenesis-enhancing drugs on stroke. This paper is a review article. Referred literature in this paper has been listed in the reference section. The data sets supporting the conclusions of this article are available online by searching various databases, including PubMed. Some original points in this article come from the laboratory practice in our research center and the authors' experiences.
Keywords	central nervous system disorders ; endogenous neural progenitor cells ; neurogenesis ; neurogenesis-enhancing drugs ; regenerative medicine ; stroke ; Medical technology ; R855-855.5 ; Diseases of the circulatory (Cardiovascular) system ; RC666-701
Language	English
Publishing date	2017-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Catching the missing million: experiences in enhancing TB & DR-TB detection by providing upfront Xpert MTB/RIF testing for people living with HIV in India.

Raizada, Neeraj / Sachdeva, Kuldeep Singh / Sreenivas, Achuthan / Kulsange, Shubhangi / Gupta, Radhey Shyam / Thakur, Rahul / Dewan, Puneet / Boehme, Catharina / Paramsivan, Chinnambedu Nainarappan

PloS one

2015 Volume 10, Issue 2, Page(s) e0116721

Abstract: Background: A critical challenge in providing TB care to People Living with HIV (PLHIV) is establishing an accurate bacteriological diagnosis. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these ... ...

Abstract	Background: A critical challenge in providing TB care to People Living with HIV (PLHIV) is establishing an accurate bacteriological diagnosis. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents results from PLHIV taking part in a large demonstration study across India wherein upfront Xpert MTB/RIF testing was offered to all presumptive PTB cases in public health facilities. Method: The study covered a population of 8.8 million across 18 sub-district level tuberculosis units (TU), with one Xpert MTB/RIF platform established at each TU. All HIV-infected patients suspected of TB (both TB and Drug Resistant TB (DR-TB)) accessing public health facilities in study area were prospectively enrolled and provided upfront Xpert MTB/RIF testing. Result: 2,787 HIV-infected presumptive pulmonary TB cases were enrolled and 867 (31.1%, 95% Confidence Interval (CI) 29.4‒32.8) HIV-infected TB cases were diagnosed under the study. Overall 27.6% (CI 25.9-29.3) of HIV-infected presumptive PTB cases were positive by Xpert MTB/RIF, compared with 12.9% (CI 11.6-14.1) who had positive sputum smears. Upfront Xpert MTB/RIF testing of presumptive PTB and DR-TB cases resulted in diagnosis of 73 (9.5%, CI 7.6‒11.8) and 16 (11.2%, CI 6.7‒17.1) rifampicin resistance cases, respectively. Positive predictive value (PPV) for rifampicin resistance detection was high 97.7% (CI 89.3‒99.8), with no significant difference with or without prior history of TB treatment. Conclusion: The study results strongly demonstrate limitations of using smear microscopy for TB diagnosis in PLHIV, leading to low TB and DR-TB detection which can potentially lead to either delayed or sub-optimal TB treatment. Our findings demonstrate the usefulness and feasibility of addressing this diagnostic gap with upfront of Xpert MTB/RIF testing, leading to overall strengthening of care and support package for PLHIV.
MeSH term(s)	Drug Resistance, Bacterial ; Female ; HIV Infections/epidemiology ; Humans ; India/epidemiology ; Male ; Rifampin ; Tuberculosis, Multidrug-Resistant/epidemiology ; Tuberculosis, Pulmonary/epidemiology
Chemical Substances	Rifampin (VJT6J7R4TR)
Language	English
Publishing date	2015-02-06
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0116721
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The Potential Impact of Up-Front Drug Sensitivity Testing on India's Epidemic of Multi-Drug Resistant Tuberculosis.

Sachdeva, Kuldeep Singh / Raizada, Neeraj / Gupta, Radhey Shyam / Nair, Sreenivas Achuthan / Denkinger, Claudia / Paramasivan, Chinnambedu Nainarappan / Kulsange, Shubhangi / Thakur, Rahul / Dewan, Puneet / Boehme, Catharina / Arinaminpathy, Nimalan

PloS one

2015 Volume 10, Issue 7, Page(s) e0131438

Abstract: Background: In India as elsewhere, multi-drug resistance (MDR) poses a serious challenge in the control of tuberculosis (TB). The End TB strategy, recently approved by the world health assembly, aims to reduce TB deaths by 95% and new cases by 90% ... ...

Abstract	Background: In India as elsewhere, multi-drug resistance (MDR) poses a serious challenge in the control of tuberculosis (TB). The End TB strategy, recently approved by the world health assembly, aims to reduce TB deaths by 95% and new cases by 90% between 2015 and 2035. A key pillar of this approach is early diagnosis of tuberculosis, including use of higher-sensitivity diagnostic testing and universal rapid drug susceptibility testing (DST). Despite limitations of current laboratory assays, universal access to rapid DST could become more feasible with the advent of new and emerging technologies. Here we use a mathematical model of TB transmission, calibrated to the TB epidemic in India, to explore the potential impact of a major national scale-up of rapid DST. To inform key parameters in a clinical setting, we take GeneXpert as an example of a technology that could enable such scale-up. We draw from a recent multi-centric demonstration study conducted in India that involved upfront Xpert MTB/RIF testing of all TB suspects. Results: We find that widespread, public-sector deployment of high-sensitivity diagnostic testing and universal DST appropriately linked with treatment could substantially impact MDR-TB in India. Achieving 75% access over 3 years amongst all cases being diagnosed for TB in the public sector alone could avert over 180,000 cases of MDR-TB (95% CI 44187 - 317077 cases) between 2015 and 2025. Sufficiently wide deployment of Xpert could, moreover, turn an increasing MDR epidemic into a diminishing one. Synergistic effects were observed with assumptions of simultaneously improving MDR-TB treatment outcomes. Our results illustrate the potential impact of new and emerging technologies that enable widespread, timely DST, and the important effect that universal rapid DST in the public sector can have on the MDR-TB epidemic in India.
MeSH term(s)	Antitubercular Agents/therapeutic use ; Epidemics/prevention & control ; Humans ; Incidence ; India/epidemiology ; Microbial Sensitivity Tests ; Models, Theoretical ; Prevalence ; Tuberculosis, Multidrug-Resistant/diagnosis ; Tuberculosis, Multidrug-Resistant/drug therapy ; Tuberculosis, Multidrug-Resistant/epidemiology ; Tuberculosis, Multidrug-Resistant/microbiology ; Tuberculosis, Multidrug-Resistant/prevention & control ; Tuberculosis, Multidrug-Resistant/transmission
Chemical Substances	Antitubercular Agents
Language	English
Publishing date	2015-07-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0131438
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Book ; Online: Catching the missing million

Raizada, Neeraj / Sreenivas, Achuthan / Paramsivan, Chinnambedu Nainarappan / Boehme, Catharina / Kulsange, Shubhangi / Thakur, Rahul / Gupta, Radhey Shyam / Dewan, Puneet / Sachdeva, Kuldeep Singh

experiences in enhancing TB & DR-TB detection by providing upfront Xpert MTB/RIF testing for people living with HIV in India

2015

Abstract: Research Support, U.S. Gov't, Non-P.H.S. ... Journal Article ... Multicenter Study ...

Abstract	Research Support, U.S. Gov't, Non-P.H.S. Journal Article Multicenter Study A critical challenge in providing TB care to People Living with HIV (PLHIV) is establishing an accurate bacteriological diagnosis. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents results from PLHIV taking part in a large demonstration study across India wherein upfront Xpert MTB/RIF testing was offered to all presumptive PTB cases in public health facilities.The study covered a population of 8.8 million across 18 sub-district level tuberculosis units (TU), with one Xpert MTB/RIF platform established at each TU. All HIV-infected patients suspected of TB (both TB and Drug Resistant TB (DR-TB)) accessing public health facilities in study area were prospectively enrolled and provided upfront Xpert MTB/RIF testing.2,787 HIV-infected presumptive pulmonary TB cases were enrolled and 867 (31.1%, 95% Confidence Interval (CI) 29.4‒32.8) HIV-infected TB cases were diagnosed under the study. Overall 27.6% (CI 25.9-29.3) of HIV-infected presumptive PTB cases were positive by Xpert MTB/RIF, compared with 12.9% (CI 11.6-14.1) who had positive sputum smears. Upfront Xpert MTB/RIF testing of presumptive PTB and DR-TB cases resulted in diagnosis of 73 (9.5%, CI 7.6‒11.8) and 16 (11.2%, CI 6.7‒17.1) rifampicin resistance cases, respectively. Positive predictive value (PPV) for rifampicin resistance detection was high 97.7% (CI 89.3‒99.8), with no significant difference with or without prior history of TB treatment.The study results strongly demonstrate limitations of using smear microscopy for TB diagnosis in PLHIV, leading to low TB and DR-TB detection which can potentially lead to either delayed or sub-optimal TB treatment. Our findings demonstrate the usefulness and feasibility of addressing this diagnostic gap with upfront of Xpert MTB/RIF testing, leading to overall strengthening of care and support package for PLHIV.
Language	English
Publishing date	2015-02-06
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Catching the missing million

Neeraj Raizada / Kuldeep Singh Sachdeva / Achuthan Sreenivas / Shubhangi Kulsange / Radhey Shyam Gupta / Rahul Thakur / Puneet Dewan / Catharina Boehme / Chinnambedu Nainarappan Paramsivan

PLoS ONE, Vol 10, Iss 2, p e

experiences in enhancing TB & DR-TB detection by providing upfront Xpert MTB/RIF testing for people living with HIV in India.

2015 Volume 0116721

Abstract: A critical challenge in providing TB care to People Living with HIV (PLHIV) is establishing an accurate bacteriological diagnosis. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This ...

Abstract	A critical challenge in providing TB care to People Living with HIV (PLHIV) is establishing an accurate bacteriological diagnosis. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents results from PLHIV taking part in a large demonstration study across India wherein upfront Xpert MTB/RIF testing was offered to all presumptive PTB cases in public health facilities.The study covered a population of 8.8 million across 18 sub-district level tuberculosis units (TU), with one Xpert MTB/RIF platform established at each TU. All HIV-infected patients suspected of TB (both TB and Drug Resistant TB (DR-TB)) accessing public health facilities in study area were prospectively enrolled and provided upfront Xpert MTB/RIF testing.2,787 HIV-infected presumptive pulmonary TB cases were enrolled and 867 (31.1%, 95% Confidence Interval (CI) 29.4‒32.8) HIV-infected TB cases were diagnosed under the study. Overall 27.6% (CI 25.9-29.3) of HIV-infected presumptive PTB cases were positive by Xpert MTB/RIF, compared with 12.9% (CI 11.6-14.1) who had positive sputum smears. Upfront Xpert MTB/RIF testing of presumptive PTB and DR-TB cases resulted in diagnosis of 73 (9.5%, CI 7.6‒11.8) and 16 (11.2%, CI 6.7‒17.1) rifampicin resistance cases, respectively. Positive predictive value (PPV) for rifampicin resistance detection was high 97.7% (CI 89.3‒99.8), with no significant difference with or without prior history of TB treatment.The study results strongly demonstrate limitations of using smear microscopy for TB diagnosis in PLHIV, leading to low TB and DR-TB detection which can potentially lead to either delayed or sub-optimal TB treatment. Our findings demonstrate the usefulness and feasibility of addressing this diagnostic gap with upfront of Xpert MTB/RIF testing, leading to overall strengthening of care and support package for PLHIV.
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Potential Impact of Up-Front Drug Sensitivity Testing on India's Epidemic of Multi-Drug Resistant Tuberculosis.

Kuldeep Singh Sachdeva / Neeraj Raizada / Radhey Shyam Gupta / Sreenivas Achuthan Nair / Claudia Denkinger / Chinnambedu Nainarappan Paramasivan / Shubhangi Kulsange / Rahul Thakur / Puneet Dewan / Catharina Boehme / Nimalan Arinaminpathy

PLoS ONE, Vol 10, Iss 7, p e

2015 Volume 0131438

Abstract: In India as elsewhere, multi-drug resistance (MDR) poses a serious challenge in the control of tuberculosis (TB). The End TB strategy, recently approved by the world health assembly, aims to reduce TB deaths by 95% and new cases by 90% between 2015 and ... ...

Abstract	In India as elsewhere, multi-drug resistance (MDR) poses a serious challenge in the control of tuberculosis (TB). The End TB strategy, recently approved by the world health assembly, aims to reduce TB deaths by 95% and new cases by 90% between 2015 and 2035. A key pillar of this approach is early diagnosis of tuberculosis, including use of higher-sensitivity diagnostic testing and universal rapid drug susceptibility testing (DST). Despite limitations of current laboratory assays, universal access to rapid DST could become more feasible with the advent of new and emerging technologies. Here we use a mathematical model of TB transmission, calibrated to the TB epidemic in India, to explore the potential impact of a major national scale-up of rapid DST. To inform key parameters in a clinical setting, we take GeneXpert as an example of a technology that could enable such scale-up. We draw from a recent multi-centric demonstration study conducted in India that involved upfront Xpert MTB/RIF testing of all TB suspects.We find that widespread, public-sector deployment of high-sensitivity diagnostic testing and universal DST appropriately linked with treatment could substantially impact MDR-TB in India. Achieving 75% access over 3 years amongst all cases being diagnosed for TB in the public sector alone could avert over 180,000 cases of MDR-TB (95% CI 44187 - 317077 cases) between 2015 and 2025. Sufficiently wide deployment of Xpert could, moreover, turn an increasing MDR epidemic into a diminishing one. Synergistic effects were observed with assumptions of simultaneously improving MDR-TB treatment outcomes. Our results illustrate the potential impact of new and emerging technologies that enable widespread, timely DST, and the important effect that universal rapid DST in the public sector can have on the MDR-TB epidemic in India.
Keywords	Medicine ; R ; Science ; Q
Subject code	306
Language	English
Publishing date	2015-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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