This study shows evidence of sustained improvements in HIV care processes and treatment outcomes for an estimated population of 2296 HIV patients in 17 BC sites. Overall success points to opportunities for other high-income countries seeking to improve HIV health outcomes.

Objective: Many contemporary acute care facilities lack safe and effective clinical handover practices resulting in patient transitions that are vulnerable to discontinuities in care, medical errors, and adverse patient safety events. This article is intended to supplement existing handover improvement literature by providing practical guidance for leaders and managers who are seeking to improve the safety and the effectiveness of clinical handovers in the acute care setting.Methods: A 4-stage change model has been applied to guide the application of strategies for handover improvement. Change management and quality improvement principles, as well as concepts drawn from safety science and high-reliability organizations, were applied to inform strategies.Results: A model for handover improvement respecting handover complexity is presented. Strategies targeted to stages of change include the following:1. Enhancing awareness of handover problems and opportunities with the support of strategic directions, accountability, end user involvement, and problem complexity recognition. 2. Identifying solutions by applying and adapting best practices in local contexts. 3. Implementing locally adapted best practices supported by communication, documentation, and training. 4. Institutionalizing practice changes through integration, monitoring, and active dissemination. Finally, continued evaluation at every stage is essential.Conclusions: Although gaps in handover process and function knowledge remain, efforts to improve handover safety and effectiveness are still possible. Continued evaluation is critical in building this understanding and to ensure that practice changes lead to improvements in patient safety, organizational effectiveness, and patient and provider satisfaction. Through handover knowledge building, fundamental changes in handover policies and practices may be possible.

Cells regulate their volume in response to changes in the osmolarity of both their extracellular and their intracellular environments. We investigated the ability of the human airway epithelial cell line Calu-3 to respond to changes in extracellular osmolarity. Although switching Calu-3 cells from an isosmotic to a hyperosmotic environment resulted in cell shrinkage, there was no compensatory mechanism for the cells to return to their original volume. In contrast, switching to a hyposmotic environment resulted in an initial cell swelling response, followed by a regulatory volume decrease (RVD). Pharmacologic studies demonstrate that the voltage-activated K+ channels Kv4.1 and (or) Kv4.3 play a crucial role in mediating this RVD response, and we demonstrated expression of these channel types at the mRNA and protein levels. Furthermore, inhibition of the large- and intermediate-conductance Ca2+-activated K+ channels KCa1.1 (maxi-K) and KCa3.1 (hIK) also implicated these channels as playing a role in volume recovery in Calu-3 cells. This report describes the nature of volume regulation in the widely used model cell line Calu-3.

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Objectives: Behavioral conditions contribute to poor clinical outcomes and are not routinely addressed in medical settings in Viet Nam. Few studies focus on the level of integrated care in clinics, the provider ratings of the prevalence of behavioral conditions, the need for a behavioral health consultant (BHC), and patient health risk assessments (HRAs) in Viet Nam. To fill these research gaps, this study aims to explore the level of behavioral health integration in primary care clinics, the provider perceived prevalence of behavioral problems, the need for an expert behavioral health consultant on the primary care team, and the health risks for patients in Viet Nam. Methodology: This study collected first-hand survey data from two healthcare sites, 41 service providers, and 199 patients in Hanoi, Viet Nam. Regression analyses were conducted to examine the relationship between HRA behavioral conditions and each of the biometric health risk factors. Results:The healthcare site and provider survey results showed low levels of integrated health services, provider perceptions of the moderate prevalence of common behavioral conditions, and the need for a BHC to assist in care. In addition, the patient's HRA results showed an elevated risk of sleep apnea, fruit and vegetable intake, tobacco, alcohol use for men, and poor health literacy. Conclusion: The level of integrated care services is low in Viet Nam, the need for the providers to have a BHC to assist in treatment is moderate, and the patients reported elevated health risks in several areas. The findings demonstrated a pressing need for the development of integrated behavioral health care services in Viet Nam.