16 results on '"Sheehan Y"'
Search Results
2. Consensus recommendations on the management of hepatitis C in Australia's prisons
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Winter, RJ, Sheehan, Y, Papaluca, T, Macdonald, GA, Rowland, J, Colman, A, Stoove, M, Lloyd, AR, Thompson, AJ, Winter, RJ, Sheehan, Y, Papaluca, T, Macdonald, GA, Rowland, J, Colman, A, Stoove, M, Lloyd, AR, and Thompson, AJ
- Abstract
INTRODUCTION: Prison settings represent the highest concentration of prevalent hepatitis C cases in Australia due to the high rates of incarceration among people who inject drugs. Highly effective direct-acting antiviral (DAA) therapies for hepatitis C virus (HCV) infection are available to people incarcerated in Australian prisons. However, multiple challenges to health care implementation in the prison sector present barriers to people in prison reliably accessing hepatitis C testing, treatment, and prevention measures. MAIN RECOMMENDATIONS: This Consensus statement highlights important considerations for the management of hepatitis C in Australian prisons. High coverage testing, scale-up of streamlined DAA treatment pathways, improved coverage of opioid agonist therapy, and implementation and evaluation of regulated provision of prison needle and syringe programs to reduce HCV infection and reinfection are needed. CHANGES IN MANAGEMENT AS A RESULT OF THIS STATEMENT: The recommendations set current best practice standards in hepatitis C diagnosis, treatment and prevention in the Australian prison sector based on available evidence. Prison-based health services should strive to simplify and improve efficiency in the provision of the hepatitis C care cascade, including strategies such as universal opt-out testing, point-of-care testing, simplified assessment protocols, and earlier confirmation of cure. Optimising hepatitis C management in prisons is essential to prevent long term adverse outcomes for a marginalised population living with HCV. Scale-up of testing and treatment in prisons will make a major contribution towards Australia's efforts to eliminate hepatitis C as a public health threat by 2030.
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- 2023
3. Understanding hepatitis C virus (HCV) health literacy and educational needs among people in prison to enhance HCV care in prisons.
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Sheehan Y, Cochrane A, Treloar C, Grebely J, Tedla N, Lloyd AR, and Lafferty L
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- Humans, Male, Adult, Australia, Middle Aged, Health Knowledge, Attitudes, Practice, Substance Abuse, Intravenous, Health Literacy, Hepatitis C, Prisoners psychology, Prisons
- Abstract
Background: Hepatitis C virus (HCV) is a significant concern within prison populations. Provision of HCV testing and treatment for people in prison is expanding and a key component of global elimination efforts. Despite growing service availability, several challenges remain in HCV testing and treatment engagement during incarceration. The PIVOT study demonstrated that a 'one-stop-shop' intervention (point-of-care HCV RNA testing, Fibroscan®, nurse-led clinical assessment, and fast-tracked direct-acting antiviral prescription) enhanced HCV testing and treatment at a reception prison in Australia. Utilising Squier et al's Health Literacy Skills Framework, this analysis aimed to understand HCV health literacy and educational needs among people at a reception prison in Australia., Methods: Semi-structured interviews were conducted with twenty-four male PIVOT study participants. Purposive sampling ensured comparable representation of those with: 1) prior HCV testing history (standard pathology / no prior testing), and 2) injecting drug use history (IDU; ever / never)., Results: Varied HCV health literacy levels and educational needs were evident amongst people in prison. Whilst those with multiple incarceration episodes and IDU history (prior knowledge) appeared to have stronger HCV health literacy than those without, substantial gaps in HCV health literacy were evident. Knowledge of HCV transmission risks in prison was high, and most understood the importance of HCV testing and treatment in prison (comprehension), but ability to engage with HCV testing and treatment services, participation in safe injecting behaviours (health-related behaviours), and knowledge of re-infection and re-treatment, within the context of the prison environment, were suboptimal. There was a general desire for increased HCV education in prison., Conclusion: Gaps in HCV health literacy among people in prison were evident, indicating opportunities for improvement. A targeted HCV education program for people in prison, addressing the gaps identified in this analysis, may enhance HCV testing, treatment, and prevention by fostering stronger HCV health literacy among people in prison., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: YS has nothing to disclose. AC and LL have received speaker fees from AbbVie Pty Ltd. CT has received speaker fees from Gilead Sciences. JG is supported by an NHMRC Investigator Grant (1176131), and is a consultant/advisor and has received research grants from AbbVie, Cepheid, Gilead Sciences, Hologic, Indivior, and Merck/MSD. ARL is supported by an NHMRC Practitioner Fellowship (1137587) and has received investigator-initiated research grants from Gilead Sciences and AbbVie Pty Ltd. The contents of the published material are solely the responsibility of the individual authors and do not reflect the views of NHMRC. The Kirby Institute and the Centre for Social Research in Health are funded by the Commonwealth Department of Health and Ageing. The views expressed in this publication do not necessarily represent the position of the Australian Government., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
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- 2024
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4. Development of an evidence-based hepatitis C education program to enhance public health literacy in the Australian prison sector: The Hepatitis in Prisons Education program (HepPEd).
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Sheehan Y, Lafferty L, Tedla N, Byrne M, Dawson O, Stewart S, Leber B, Habraken N, and Lloyd AR
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- Humans, Australia, Program Development, Male, Public Health education, Female, Hepatitis C, Chronic prevention & control, Hepatitis C prevention & control, Health Personnel education, Needs Assessment, Health Literacy, Prisons, Health Knowledge, Attitudes, Practice, Health Education, Prisoners psychology
- Abstract
Background: Australia's prisons have a high chronic hepatitis C (HCV) prevalence (8 %). Antiviral therapies and prison-based hepatitis services are available, but only a minority of those eligible are being treated. Improving the HCV public health literacy of the prison sector via targeted education may overcome key barriers to scale-up treatment. This paper describes the: i) HCV public health literacy of the prison setting; ii) barriers and solutions for HCV education and service engagement; iii) HCV education program co-design and development processes; and iv) HepPEd resources., Methods: A national needs assessment was conducted to analyse the HCV public health literacy of the target audience groups in the prisons (healthcare providers; custodial officers; people in prison) to inform development of a prison-specific HCV education program (HepPEd). Structured interviews were conducted with key informants (n = 40). Three National Steering Committees, one for each target group, were convened to co-design and develop HepPEd., Results: Only healthcare providers involved with hepatitis care were considered to have 'good' to 'very good' HCV health literacy (including knowledge, attitudes, and capabilities), with all other groups considered less favourably. Key barriers identified included being time poor (healthcare providers), poor motivation (custodial officers) and stigma (people in prison). Peer education delivery was considered a key facilitator for custodial officers and people in prison. A suite of multi-modal resources addressing the perceived gaps in HCV health literacy was developed, with a broad theme of 'Let's talk about hep C'. Delivery of HepPEd was designed to overcome key barriers and utilise facilitators for each group., Conclusions: Significant gaps in HCV health literacy were perceived amongst the target audience groups. The comprehensive co-design and development processes utilised in HepPEd suggest the program will be well-placed to improve the HCV public health literacy of the prison sector and thereby enhance HCV testing and treatment rates amongst people in prison., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: YS is a co-investigator on investigator-initiated research grants from AbbVie and Gilead Sciences. LL has received speaker fees from AbbVie. ARL has received investigator-initiated research grants from AbbVie, Gilead Sciences, and Sequiris, and is supported by an NHMRC Practitioner Fellowship (1137587). All other authors declare no competing interests., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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5. Challenges and facilitators in repeated bio-behavioural surveys for blood-borne virus infections in Australian prisons.
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Bah R, Sheehan Y, Li X, Price N, Butler T, Dore GJ, Grebely J, Lloyd AR, and Hajarizadeh B
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Background: Prison-based blood-borne virus (BBV) surveillance is essential for evaluation of prevention and treatment programs for high-risk populations, such as people who inject drugs who are over-represented amongst those incarcerated. Regular triennial surveillance has been in place in Australian prisons for almost two decades, but has been focused to date only on new prison entrants. Recently, the Australian Hepatitis and risk survey in prisons (AusHep study) was established to provide improved surveillance via an expanded bio-behavioural survey representative of all people in prison, including those sentenced and those on remand. This paper aims to identify the challenges and facilitators in conducting bio-behavioural surveys for BBV infections in prison settings., Methods: Randomly selected individuals in 23 prisons, representative of prisons and people in prison (male/female, security classification, rural location, Aboriginal or Torres Strait Islander), were offered point-of-care testing for HIV and hepatitis C (HCV) antibodies, hepatitis B virus surface (HBs) antigen, and HCV RNA (if HCV antibody positive). Data regarding risk behaviours, harm reduction measures, and prior BBV testing and treatment were collected by interview. Data was also collected on the challenges and facilitators encountered during planning and implementation at each participating prison., Results: In the first round, AusHep recruited 1599 participants (98 % participation, 89 % male, median age 35 years, 49 % ever injected drugs). Major implementation challenges included: slow and complex ethics and governance requirements in each jurisdiction, and challenging logistical arrangements and participant access constraints in the prisons. Major facilitators included use of point-of-care testing allowing immediate feedback of results, strong support from jurisdictional stakeholders in correction and public health sectors, flexibility in the timing and detailed planning for each site, and computer tablet-based data collection., Conclusion: The high participation and informative findings indicated clear feasibility of this improved surveillance system. Strong stakeholder engagement and flexibility in logistics facilitated successful implementation of multi-jurisdictional prison-based surveillance., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. BIGGSP 08-APR-2024 10:59 'none', (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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6. Barriers and advocacy needs for hepatitis C services in prisons: Informing the prisons hepatitis C advocacy toolkit.
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Walker SJ, Shrestha LB, Lloyd AR, Dawson O, Sheehan Y, Sheehan J, Maduka NBC, Cabezas J, Akiyama MJ, and Kronfli N
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- Humans, Patient Advocacy, Surveys and Questionnaires, Prisoners, Global Health, Hepatitis C epidemiology, Prisons organization & administration, Health Services Accessibility organization & administration
- Abstract
Background: Carceral settings are a key focus of the 2030 WHO global hepatitis C virus (HCV) elimination goals. Despite this, access to HCV testing and treatment services in prisons remains low globally, limiting opportunities to achieve these goals. Advocacy efforts are needed to address service inequities and mobilise support for enhanced HCV programs in prisons globally. INHSU Prisons, a special interest group of the International Network on Health and Hepatitis in Substance Users (INHSU) is developing a Prisons HCV Advocacy Toolkit to address this need. Here we present findings of a mixed study to inform the development of the Toolkit., Methods: The aim of this study was to inform the development of the Toolkit, including understanding barriers for scaling up prison-based HCV services globally and advocacy needs to address these. An online survey (n = 181) and in-depth interviews (n = 25) were conducted with key stakeholders from countries of different economic status globally. Quantitative data were statistically analysed using R Studio and qualitative data were analysed thematically. The data sets were merged using a convergent design., Results: Key barriers for enhanced prison-based HCV services included lack of political will and action, lack of prison-based healthcare resources, and poor awareness about HCV and the importance of prison-based HCV services. These findings underscore how advocacy efforts are needed to motivate policymakers to prioritise HCV healthcare in prisons and ensure funds are available for services (including diagnostic tools and treatment, healthcare teams to implement services, and systems to measure their success). Advocacy resources to raise the awareness of policy makers, people working in the prison sector, and incarcerated populations were also identified as key to increasing HCV service uptake., Conclusion: The Toolkit has the potential to support advocacy efforts for reaching HCV elimination targets. By understanding the advocacy needs of potential Toolkit end-users, the findings can inform its development and increase its accessibility, acceptability, and uptake for a globally diverse audience., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: This project was supported by an unconditional grant from Gilead Sciences. NK reports research funding from Gilead Sciences, advisory fees from Gilead Sciences, ViiV Healthcare, Merck and Abbvie, and speaker fees from Gilead Sciences, Abbvie and Merck, all outside of the submitted work. ARL has previously received investigator-initiated research grant support from AbbVie and Gilead Sciences., (Copyright © 2024. Published by Elsevier B.V.)
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- 2024
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7. People in community corrections are a population with unmet need for viral hepatitis care.
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Winter RJ, Griffin S, Sheehan Y, Nguyen W, Stoové M, Lloyd AR, and Thompson AJ
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To reach World Health Organization elimination targets for hepatitis C, different strategies are needed to reach people who have not yet been diagnosed and treated. In the context of declining treatment initiation rates, innovation in service design and delivery is necessary: testing and treatment needs to be offered to people in non-traditional settings. The community corrections (probation and parole) population is larger than the prison population, which has high prevalence of hepatitis C and-in some countries-established diagnosis and treatment programs. In this Viewpoint we identify a gap in hepatitis C care for people under community correctional supervision, a group who have either never been imprisoned or need continuity of healthcare provided in prison. We propose that offering hepatitis C screening and treatment would benefit this population, and accelerate progress to hepatitis C elimination., Competing Interests: RW has received investigator-initiated funding from Gilead Sciences. YS is a co-investigator on investigator-initiated research grants from Gilead Sciences and AbbVie. MS has received investigator-initiated research grants from Abbvie and Gilead and consultancy from Gilead. AL has received investigator-initiated research grant support from Gilead Sciences and AbbVie. AJT has received consulting fees from Gilead, Abbvie, Roche Diagnostics, Assembly Biosciences, speaker fees from Gilead Sciences, Roche Diagnostics and investigator-initiated grants from Gilead Sciences. All other authors have no conflicts to declare., (© 2024 The Author(s).)
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- 2024
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8. Reply to: " 'One-stop-shop' point-of-care hepatitis C RNA testing intervention in the prison - some issues".
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Sheehan Y, Grebely J, and Lloyd AR
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- Humans, Prisons, Point-of-Care Systems, RNA, Antiviral Agents therapeutic use, Hepacivirus genetics, Prisoners, Hepatitis C diagnosis, Hepatitis C drug therapy, Substance Abuse, Intravenous
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- 2024
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9. A 'one-stop-shop' point-of-care hepatitis C RNA testing intervention to enhance treatment uptake in a reception prison: The PIVOT study.
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Sheehan Y, Cunningham EB, Cochrane A, Byrne M, Brown T, McGrath C, Lafferty L, Tedla N, Dore GJ, Lloyd AR, and Grebely J
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- Humans, Male, Antiviral Agents therapeutic use, Hepacivirus genetics, Point-of-Care Systems, Point-of-Care Testing, Prisons, Prospective Studies, RNA, Hepatitis C diagnosis, Hepatitis C drug therapy, Hepatitis C, Chronic diagnosis, Hepatitis C, Chronic drug therapy, Hepatitis C, Chronic complications, Prisoners, Substance Abuse, Intravenous complications
- Abstract
Background & Aims: Prisons are key venues for scaling-up hepatitis C virus (HCV) testing and treatment. Complex clinical pathways and frequent movements of people in prison remain barriers to HCV care. This study evaluated the impact of a 'one-stop-shop' point-of-care HCV RNA testing intervention on treatment uptake compared with standard of care among people recently incarcerated in Australia., Methods: PIVOT was a prospective, non-concurrent, controlled study comparing HCV treatment uptake during 'standard of care' (n = 239; November 2019-May 2020) and a 'one-stop-shop' intervention (n = 301; June 2020-April 2021) in one reception prison in Australia. The primary endpoint was uptake of direct-acting antiviral treatment at 12 weeks from enrolment. Secondary outcomes included the time taken from enrolment to each stage in the care cascade., Results: A total of 540 male participants were enrolled. Median age (29 vs. 28 years) and history of injecting drug use (48% vs. 42%) were similar between standard of care and intervention phases. Among people diagnosed with current HCV infection (n = 18/63 in the standard of care phase vs. n = 30/298 in the intervention phase), the proportion initiating direct-acting antiviral treatment within 12 weeks from enrolment in the intervention phase was higher (93% [95% CI 0.78-0.99] vs. 22% [95% CI 0.64-0.48]; p <0.001), and the median time to treatment initiation was shorter (6 days [IQR 5-7] vs. 99 days [IQR 57-127]; p <0.001) compared to standard of care., Conclusions: The 'one-stop-shop' intervention enhanced treatment uptake and reduced time to treatment initiation among people recently incarcerated in Australia, thereby overcoming key barriers to treatment scale-up in the prison sector., Impact and Implications: This study provides important insights for policymakers regarding optimal HCV testing and treatment pathways for people newly incarcerated in prisons. The findings will improve health outcomes in people in prison with chronic HCV infection by increasing testing and treatment, thereby reducing infections, liver-related morbidity/mortality, and comorbidities. The findings will change clinical practice, clinical guidelines, and international guidance, and will inform future research and national and regional strategies, in particular regarding point-of-care testing, which is being rapidly scaled-up in various settings globally. The economic impact will likely include health budget savings resulting from reduced negative health outcomes relating to HCV, and health system efficiencies resulting from the introduction of simplified models of care., Clinical Trials Registration: This study is registered at Clinicaltrials.gov (NCT04809246)., (Copyright © 2023. Published by Elsevier B.V.)
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- 2023
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10. Reducing barriers to the hepatitis C care cascade in prison via point-of-care RNA testing: a qualitative exploration of men in prison using an integrated framework.
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Lafferty L, Sheehan Y, Cochrane A, Grebely J, Lloyd AR, and Treloar C
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- Humans, Male, Hepacivirus, Prisons, Point-of-Care Systems, RNA, Prisoners, Hepatitis C diagnosis
- Abstract
Background and Aims: Hepatitis C virus (HCV) is highly prevalent within the prison setting. Although HCV testing and treatment are available within prisons, system barriers can impede progress along the HCV care cascade for those who are incarcerated. The PIVOT intervention used a 'one-stop-shop' model (i.e. point-of-care HCV RNA testing, Fibroscan-based liver disease assessment and treatment) at a reception prison in New South Wales, Australia. This analysis sought to understand the role of point-of-care HCV RNA testing at intake in reducing barriers to the HCV care cascade within the male prison setting., Design and Setting: Qualitative analysis using semi-structured interviews in a reception prison in Australia., Participants: Twenty-four men enrolled in the PIVOT study; all participants had undergone HCV point-of-care testing in the intervention arm., Measurements: Høj's Integrated Framework informed this analysis., Findings: Participants widely expressed the view that point-of-care HCV RNA testing on entry was beneficial for care engagement. Point-of-care testing was perceived as timely (compared with standard pathology) and reduced opportunities for adjudication by correctional officers due to fewer clinic visits for testing and results. Adoption of routine opt-out testing at prison intake was regarded as an important strategy for normalising HCV testing (and likely to increase pathways to treatment uptake) and fostered patient candidacy (i.e. self-perceived eligibility to access care)., Conclusion: Twenty-four men in prison in New South Wales, Australia, who underwent opt-out point-of-care HCV RNA testing on entry into prison, widely supported the programme as a means of overcoming barriers to HCV testing and treatment in the prison setting, as well as providing public health benefits through early detection of HCV infection among people entering into custody., (© 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)
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- 2023
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11. Optimizing point-of-care testing strategies for diagnosis and treatment of hepatitis C virus infection in Australia: a model-based cost-effectiveness analysis.
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Shih STF, Cheng Q, Carson J, Valerio H, Sheehan Y, Gray RT, Cunningham EB, Kwon JA, Lloyd AR, Dore GJ, Wiseman V, and Grebely J
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Background: Timely diagnosis and treatment of hepatitis C virus (HCV) is critical to achieve elimination goals. This study evaluated the cost-effectiveness of point-of-care testing strategies for HCV compared to laboratory-based testing in standard-of-care., Methods: Cost-effectiveness analyses were undertaken from the perspective of Australian Governments as funders by modelling point-of-care testing strategies compared to standard-of-care in needle and syringe programs, drug treatment clinics, and prisons. Point-of-care testing strategies included immediate point-of-care HCV RNA testing and combined point-of-care HCV antibody and reflex RNA testing for HCV antibody positive people (with and without consideration of previous treatment). Sensitivity analyses were performed to investigate the cost per treatment initiation with different testing strategies at different HCV antibody prevalence levels., Findings: The average costs per HCV treatment initiation by point-of-care testing, from A$890 to A$1406, were up to 35% lower compared to standard-of-care ranging from A$1248 to A$1632 depending on settings. The average costs per treatment initiation by point-of-care testing for three settings ranged from A$1080 to A$1406 for RNA, A$960-A$1310 for combined antibody/RNA without treatment history consideration, and A$890-A$1189 for combined antibody/RNA with treatment history consideration. When HCV antibody prevalence was <74%, combined point-of-care HCV antibody and point-of-care RNA testing were the most cost-effective strategies. Modest increases in treatment uptake by 8%-31% were required for immediate point-of-care HCV RNA testing to achieve equivalent cost per treatment initiation compared to standard-of-care., Interpretation: Point-of-care testing is more cost-effective than standard of care for populations at risk of HCV. Testing strategies combining point-of-care HCV antibody and RNA testing are likely to be cost-effective in most settings., Funding: National Health and Medical Research Council., Competing Interests: R.T.G. has received funding for his research from WHO and has provided non-funded project advice to Gilead and ViiV. Y.S. is a co-investigator on investigator-initiated research grants from AbbVie and Gilead Sciences. A.R.L. has received investigator-initiated research grants from AbbVie, Gilead Sciences, and Sequiris. G.J.D. is a consultant/advisor and has received research grants from Abbvie, Abbot Diagnostics, Gilead Sciences, Bristol Myers Squibb, Cepheid, GlaxoSmithKline, Merck, Janssen and Roche. J.G. is a consultant/advisor and has received research grants from AbbVie, Biolytical, Camurus, Cepheid, Gilead Sciences, Hologic, Indivor, and Merck/MSD and has received honoraria from AbbVie, Cepheid, Gilead Sciences, and Merck. No input into this work was provided by any of the above listed organisations or institutions. All other authors have no conflicts of interest to declare., (© 2023 The Author(s).)
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- 2023
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12. Consensus recommendations on the management of hepatitis C in Australia's prisons.
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Winter RJ, Sheehan Y, Papaluca T, Macdonald GA, Rowland J, Colman A, Stoove M, Lloyd AR, and Thompson AJ
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- Humans, Prisons, Hepacivirus, Antiviral Agents therapeutic use, Australia epidemiology, Prisoners, Hepatitis C, Chronic drug therapy, Substance Abuse, Intravenous epidemiology, Hepatitis C diagnosis, Hepatitis C drug therapy, Hepatitis C epidemiology
- Abstract
Introduction: Prison settings represent the highest concentration of prevalent hepatitis C cases in Australia due to the high rates of incarceration among people who inject drugs. Highly effective direct-acting antiviral (DAA) therapies for hepatitis C virus (HCV) infection are available to people incarcerated in Australian prisons. However, multiple challenges to health care implementation in the prison sector present barriers to people in prison reliably accessing hepatitis C testing, treatment, and prevention measures., Main Recommendations: This Consensus statement highlights important considerations for the management of hepatitis C in Australian prisons. High coverage testing, scale-up of streamlined DAA treatment pathways, improved coverage of opioid agonist therapy, and implementation and evaluation of regulated provision of prison needle and syringe programs to reduce HCV infection and reinfection are needed., Changes in Management as a Result of This Statement: The recommendations set current best practice standards in hepatitis C diagnosis, treatment and prevention in the Australian prison sector based on available evidence. Prison-based health services should strive to simplify and improve efficiency in the provision of the hepatitis C care cascade, including strategies such as universal opt-out testing, point-of-care testing, simplified assessment protocols, and earlier confirmation of cure. Optimising hepatitis C management in prisons is essential to prevent long term adverse outcomes for a marginalised population living with HCV. Scale-up of testing and treatment in prisons will make a major contribution towards Australia's efforts to eliminate hepatitis C as a public health threat by 2030., (© 2023 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.)
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- 2023
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13. The role of low-income and middle-income country prisons in eliminating hepatitis C.
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Akiyama MJ, Kronfli N, Cabezas J, Sheehan Y, Scheibe A, Brahni T, Naik K, Mashabela P, Chan P, Luhmann N, and Lloyd AR
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- Humans, Income, Poverty, Hepatitis C epidemiology, Hepatitis C prevention & control, Prisons
- Abstract
Competing Interests: ARL reports investigator-initiated research grants from AbbVie, Gilead Sciences, and Sequiris. NK reports consulting fees from AbbVie, Gilead Sciences, ViiV Healthcare, and Merck Canada; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AbbVie and Gilead Sciences. YS is a co-investigator on investigator-initiated research grants from AbbVie and Gilead Sciences. All other authors declare no competing interests.
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- 2022
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14. "That was quick, simple, and easy": Patient perceptions of acceptability of point-of-care hepatitis C RNA testing at a reception prison.
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Lafferty L, Cochrane A, Sheehan Y, Treloar C, Grebely J, and Lloyd AR
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- Humans, Male, Phobic Disorders, Point-of-Care Systems, Point-of-Care Testing, Prisons, RNA, Hepatitis C diagnosis, Prisoners
- Abstract
Introduction: Current diagnostic pathways require multiple healthcare provider visits and lead to a drop-off in the hepatitis C virus (HCV) testing and treatment care cascade. In prison settings, frequent transitioning between prisons and the community further reduces uptake of testing and treatment. The PIVOT study evaluated a 'one-stop-shop' intervention integrating point-of-care HCV RNA testing, Fibroscan®-based liver disease assessment, and treatment prescription at a reception prison in Australia. This qualitative sub-study was undertaken to assess patient acceptability of point-of-care HCV RNA testing in the reception prison setting., Methods: Twenty-four men in prison enrolled in the PIVOT study participated in semi-structured interviews; all of whom had undergone point-of-care HCV RNA testing in the PIVOT study. Patients were purposefully selected to ensure comparable representation of people with and without a history of injecting drug use and people with and without prior HCV testing experience (standard venepuncture). Sekhon's Theoretical Framework of Acceptability, consisting of seven components (affective attitude, burden, ethicality, intervention coherence, opportunity cost, perceived effectiveness, and self-efficacy), informed this qualitative analysis., Results: Acceptability of fingerstick point-of-care HCV RNA testing was evident across four components: affective attitude, burden, self-efficacy, and perceived effectiveness. Patients described point-of-care testing as "quick and easy" (affective attitude), while swift results were viewed as alleviating anxiety associated with long wait times for standard pathology (burden). Patients averse to venepuncture (e.g., fear of needles or poor vein health) found the fingerstick method accessible, thereby enabling participation in HCV screening (self-efficacy). Participants attributed confidence in test results predominantly due to trust in the healthcare system or trust in the personnel administering the test (perceived effectiveness)., Conclusion: People entering custody perceive fingerstick HCV RNA point-of-care testing to be an acceptable method and preferred this method to standard HCV testing via venepuncture. In light of these findings, prison health authorities should consider the role of opt-out point-of-care HCV RNA testing upon prison entry., Competing Interests: Declarations of Interest LL has nothing to declare. AC has nothing to declare. YS has nothing to declare. JG is a consultant/advisor and has received research grants from Abbvie, Cepheid, Gilead Sciences, Hologic, Indivior, and Merck/MSD. CT has received speaker fees from AbbVie and Gilead Sciences. ARL has received investigator-initiated research support from Gilead and Abbvie., (Copyright © 2021 Elsevier B.V. All rights reserved.)
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- 2022
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15. Hepatitis C elimination among people incarcerated in prisons: challenges and recommendations for action within a health systems framework.
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Akiyama MJ, Kronfli N, Cabezas J, Sheehan Y, Thurairajah PH, Lines R, and Lloyd AR
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- Disease Eradication organization & administration, Harm Reduction, Health Policy, Health Services Accessibility, Hepatitis C diagnosis, Hepatitis C therapy, Humans, International Cooperation, Politics, Social Determinants of Health, Social Stigma, Disease Eradication methods, Hepatitis C prevention & control, Prisoners, Prisons
- Abstract
Hepatitis C virus (HCV) is a global public health problem in correctional settings. The International Network on Health and Hepatitis in Substance Users-Prisons Network is a special interest group committed to advancing scientific knowledge exchange and advocacy for HCV prevention and care in correctional settings. In this Review, we highlight seven priority areas and best practices for improving HCV care in correctional settings: changing political will, ensuring access to HCV diagnosis and testing, promoting optimal models of HCV care and treatment, improving surveillance and monitoring of the HCV care cascade, reducing stigma and tackling the social determinants of health inequalities, implementing HCV prevention and harm reduction programmes, and advancing prison-based research., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
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- 2021
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16. Phonics training for English-speaking poor readers.
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McArthur G, Sheehan Y, Badcock NA, Francis DA, Wang HC, Kohnen S, Banales E, Anandakumar T, Marinus E, and Castles A
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- Adolescent, Adult, Australia, Canada, Child, Female, Humans, Language, Male, Randomized Controlled Trials as Topic, Socioeconomic Factors, United Kingdom, United States, Comprehension, Dyslexia rehabilitation, Phonation physiology, Phonetics, Reading
- Abstract
Background: The reading skills of 16% of children fall below the mean range for their age, and 5% of children have significant and severe reading problems. Phonics training is one of the most common reading treatments used with poor readers, particularly children., Objectives: To measure the effect of phonics training and explore the impact of various factors, such as training duration and training group size, that might moderate the effect of phonics training on literacy-related skills in English-speaking poor readers., Search Methods: We searched CENTRAL, MEDLINE, Embase, 12 other databases, and three trials registers up to May 2018. We also searched reference lists of included studies and contacted experts in the field to identify additional studies., Selection Criteria: We included studies that used randomisation, quasi-randomisation, or minimisation to allocate participants to a phonics intervention group (phonics training only or phonics training plus one other literacy-related skill) or a control group (no training or non-literacy training). Participants were English-speaking poor readers with word reading one standard deviation below the appropriate level for their age (children, adolescents, and adults) or one grade or year below the appropriate level (children only), for no known reason. Participants had no known comorbid developmental disorder, or physical, neurological, or emotional problem., Data Collection and Analysis: We used standard methodological procedures expected by Cochrane., Main Results: We included 14 studies with 923 participants in this review. Studies took place in Australia, Canada, the UK, and the USA. Six of the 14 included studies were funded by government agencies and one was funded by a university grant. The rest were funded by charitable foundations or trusts. Each study compared phonics training alone, or in conjunction with one other reading-related skill, to either no training (i.e. treatment as usual) or alterative training (e.g. maths). Participants were English-speaking children or adolescents, of low and middle socioeconomic status, whose reading was one year, one grade, or one standard deviation below the level expected for their age or grade for no known reason. Phonics training varied between studies in intensity (up to four hours per week), duration (up to seven months), training group size (individual and small groups), and delivery (human and computer). We measured the effect of phonics training on seven primary outcomes (mixed/regular word reading accuracy, non-word reading accuracy, irregular word reading accuracy, mixed/regular word reading fluency, non-word reading fluency, reading comprehension, and spelling). We judged all studies to be at low risk of bias for most risk criteria, and used the GRADE approach to assess the quality of the evidence.There was low-quality evidence that phonics training may have improved poor readers' accuracy for reading real and novel words that follow the letter-sound rules (standardised mean difference (SMD) 0.51, 95% confidence interval (CI) 0.13 to 0.90; 11 studies, 701 participants), and their accuracy for reading words that did not follow these rules (SMD 0.67, 95% CI 0.26 to 1.07; 10 studies, 682 participants). There was moderate-quality evidence that phonics training probably improved English-speaking poor readers' fluency for reading words that followed the letter-sounds rules (SMD 0.45, 95% CI 0.19 to 0.72; 4 studies, 224 participants), and non-word reading fluency (SMD 0.39, 95% CI 0.10 to 0.68; 3 studies, 188 participants), as well as their accuracy for reading words that did not follow these rules (SMD 0.84, 95% CI 0.30 to 1.39; 4 studies, 294 participants). In addition, there was low-quality evidence that phonics training may have improved poor readers' spelling (SMD 0.47, 95% CI -0.07 to 1.01; 3 studies, 158 participants), but only slightly improve their reading comprehension (SMD 0.28, 95% CI -0.07 to 0.62; 5 studies, 343 participants)., Authors' Conclusions: Phonics training appears to be effective for improving literacy-related skills, particularly reading fluency of words and non-words, and accuracy of reading irregular words. More studies are needed to improve the precision of outcomes, including word and non-word reading accuracy, reading comprehension, spelling, letter-sound knowledge, and phonological output. More data are also needed to determine if phonics training in English-speaking poor readers is moderated by factors such as training type, intensity, duration, group size, or administrator.
- Published
- 2018
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