Implementation Outcomes of an Intervention to Improve Myocardial Infarction Care in Tanzania.

Uptake of evidence-based care for acute myocardial infarction (AMI) is limited in Tanzania. To address this, a tailored intervention, the Multicomponent Intervention to Improve Acute Myocardial Infarction Care (MIMIC), was co-designed by an interdisciplinary team. To determine implementation outcomes from a pilot trial of the MIMIC intervention in a Tanzanian emergency department (ED).

Value-Based Care: Lessons for the United Kingdom's National Health Service.

Objectives: The United Kingdom's National Health Service (NHS) is experiencing substantial challenges, including worsening health outcomes, prolonged wait times, workforce dissatisfaction, and financial instability. This commentary aims to identify mechanisms through which the NHS can integrate principles of value-based care (VBC) to enhance system performance and sustainability.

Methods: We conducted a conceptual analysis of global implementations of VBC over the past 2 decades, drawing from experiences in the United States and Europe.

Advancing Health Infrastructure to Address Mental Health Disorders among People Living with HIV in Sub-Saharan Africa.

People living with HIV in sub-Saharan Africa bear a disproportionate burden of mental and behavioral health disorders compared with the general population. Several health care systems throughout the region have made efforts to integrate HIV and mental health care, but these systems have met challenges in long-term sustainability due to limited care continuity and insufficient attention to social determinants of health. In this commentary, we propose evidence-based recommendations for integrating HIV and mental health care that may overcome these barriers.

Acceptability and Feasibility of a Multicomponent Intervention to Improve Acute Myocardial Infarction Care in Northern Tanzania: the MIMIC Pilot Trial.

Background: The Multicomponent Intervention to Improve Acute Myocardial Infarction Care (MIMIC) was developed to increase uptake of evidence-based care for acute myocardial infarction in Tanzania. MIMIC consists of five components: triage cards, pocket cards, an online training module, patient educational pamphlets, and clinical champions. Our aim was to determine the acceptability and feasibility of this intervention among emergency department (ED) providers in Tanzania.

Leveraging Health Policy Solutions to Address Obesity in Rural America.

Rural America faces an alarming obesity crisis, with residents experiencing significantly higher rates of obesity due to socioeconomic disparities, limited access to healthcare, and structural challenges such as food deserts and insufficient healthcare infrastructure. This perspective addresses these pressing issues by proposing targeted, evidence-based interventions to reduce obesity in rural communities. Our recommendations include (1) increasing the number of multidisciplinary healthcare professionals in rural areas through initiatives such as the Rural Medical Scholars Program, the Rural Community Loan Repayment Program, and the Conrad 30 Waiver Program; (2) expanding coverage for essential obesity services via H.

Challenges and Ongoing Actions to Address the Mpox Emergency in Africa.

This review examines key events, challenges, and responses to the mpox public health emergency following the Africa CDC's declaration of a Public Health Emergency of Continental Concern on August 13, 2024. In response to the crisis, over 3.6 million vaccine doses and more than $150 million in funding have been mobilized globally, with contributions from the United States, European Union, and Japan.

Navigating Stigma Against At-Risk Sexual and Gender Minority Populations to End the HIV Epidemic in Sub-Saharan Africa.

In the past year, new laws criminalizing same-sex conduct and the promotion of lesbian, gay, bisexual, transgender, and queer (LGBTQ) rights have emerged as barriers to addressing the HIV epidemic in sub-Saharan Africa (SSA). An augmented approach to addressing HIV within the region's disproportionately affected LGBTQ populations, particularly transgender women and gay, bisexual, and other men who have sex with men (MSM), is imperative for achieving the international goal of ending the HIV epidemic by 2030. In this article, we present recommendations to bolster the continuum of HIV care for MSM and transgender women in SSA.

Direct Primary Care: Financial Analysis and Potential to Reshape the U.S. Healthcare Landscape.

As the United States faces a looming shortage of primary care physicians and escalating rates of clinician burnout, there is a pressing need to explore alternative models of primary care delivery. Direct Primary Care (DPC) is an emerging primary care model in which patients enroll in a membership plan and make direct monthly or yearly payments to a DPC practice for specific primary care services. Although DPC holds the potential to enhance patient care and mitigate clinician burnout, no published studies provide a financial analysis of DPC practices or compare them to traditional fee-for-service (FFS) primary care models.

Multicomponent Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Protocol for a Pilot Implementation Trial.

Background: Although the incidence of acute myocardial infarction (AMI) is rising in sub-Saharan Africa, the uptake of evidence-based care for the diagnosis and treatment of AMI is limited throughout the region. In Tanzania, studies have revealed common misdiagnosis of AMI, infrequent administration of aspirin, and high short-term mortality rates following AMI.

Objective: This study aims to evaluate the implementation and efficacy outcomes of an intervention, the Multicomponent Intervention to Improve Acute Myocardial Infarction Care (MIMIC), which was developed to improve the delivery of evidence-based AMI care in Tanzania.

Culturally Tailored Strategies to Enhance Type 2 Diabetes Care for South Asians in the United States.

South Asian immigrants in the United States face an elevated risk of developing type 2 diabetes (T2DM). This phenomenon has been linked to lifestyle factors and social determinants of health (SDOH) such as high-carbohydrate diet, limited physical activity, and stress from assimilation and other life challenges. Unfortunately, barriers stemming from language discordance, low health literacy, and certain cultural practices can hinder effective clinical management of T2DM among South Asian immigrants.

Characteristics and outcomes of patients with symptomatic chronic myocardial injury in a Tanzanian emergency department: A prospective observational study.

Background: Chronic myocardial injury is a condition defined by stably elevated cardiac biomarkers without acute myocardial ischemia. Although studies from high-income countries have reported that chronic myocardial injury predicts adverse prognosis, there are no published data about the condition in sub-Saharan Africa.

Methods: Between November 2020 and January 2023, adult patients with chest pain or shortness of breath were recruited from an emergency department in Moshi, Tanzania.

Longitudinal ECG changes among adults with HIV in Tanzania: A prospective cohort study.

The prevalence of cardiovascular disease (CVD) is rising among people with HIV (PWH) in sub-Saharan Africa (SSA). Despite the utility of the electrocardiogram (ECG) in screening for CVD, there is limited data regarding longitudinal ECG changes among PWH in SSA. In this study, we aimed to describe ECG changes over a 6-month period in a cohort of PWH in northern Tanzania.