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\"It is essential to understand the important role of convenient care clinics in healthcare, as the number of individuals seeking care continues to grow.This is a wonderful asset for any advanced practice clinician seeking employment in, or considering starting, a convenient care clinic.\"-- Doody's Book Reviews This is the first comprehensive.

The CCR5 coreceptor may be a therapeutic target to block HIV infection. HIV-1–infected patients who had received previous antiretroviral treatment were enrolled in one of two phase 3, placebo-controlled, double-blind international studies of treatment with maraviroc (a CCR5 antagonist). Maraviroc significantly lowered the HIV-1 viral load and increased the CD4 cell count at 48 weeks. The CCR5 coreceptor may be a therapeutic target to block HIV infection. In two studies, maraviroc (a CCR5 antagonist) significantly lowered the HIV-1 viral load and increased the CD4 cell count at 48 weeks. For the past decade, treatment of human immunodeficiency virus type 1 (HIV-1) has consisted of a multiple-drug regimen targeting one or more of three HIV-1 proteins: reverse transcriptase, protease, and the glycoprotein envelope subunit gp41. 1 Although these antiretroviral combinations are successful in suppressing viral replication and delaying disease progression, drug resistance and toxic effects may occur. 2 – 4 There is therefore a need for better-tolerated, convenient antiretroviral agents with reduced toxicity and activity against multidrug-resistant viruses. Agents with novel mechanisms of action provide options for patients with drug-resistant virus. 4 CC chemokine receptor 5 (CCR5) is an attractive therapeutic target, since people . . .

We previously reported that doctor-patient communication in the cancer context may be suboptimal. We therefore developed measures to assess patient communication preferences and established feasibility of an Internet-based intervention to improve communication. Cancer patients completed an Internet-based survey about communication preferences, with a summary provided to the physician before the consultation. Patients completed a follow-up survey to assess consultation content and satisfaction. Study procedures were feasible, measures exhibited strong internal consistency, and patients expressed satisfaction with the intervention. The Internet offers an opportunity to assess patient preferences and prompt physicians about individual patient informational needs prior to the clinical encounter.

In key subgroups of the HIV-infected patients in the MOTIVATE 1 and MOTIVATE 2 studies, a consistent treatment benefit of maraviroc over placebo was seen at 48 weeks. These subgroups include patients with a low baseline CD4 cell count and a high HIV viral load at screening and those receiving no active background antiretroviral agents. In patients in whom maraviroc failed, the CXCR4-using virus was often present at failure. In key subgroups of HIV-infected patients, a consistent treatment benefit of maraviroc over placebo was seen at 48 weeks. These subgroups include patients with a low baseline CD4 cell count and a high HIV viral load at screening and those receiving no active background antiretroviral agents. The CC chemokine receptor 5 (CCR5) antagonist maraviroc has shown potent antiviral activity in vitro and in vivo against the R5 human immunodeficiency virus type 1 (HIV-1). 1 , 2 As reported by Gulick et al. 3 elsewhere in this issue, treatment with maraviroc plus optimized background therapy was associated with significantly greater virologic and immunologic efficacy and had a similar safety profile, as compared with placebo plus optimized background therapy, in the Maraviroc versus Optimized Therapy in Viremic Antiretroviral Treatment-Experienced Patients (MOTIVATE) 1 and MOTIVATE 2 studies at 48 weeks. Subgroup analyses of data from recent trials evaluating new drugs in patients . . .

We assessed the efficacy and safety of 10-d monotherapy with the orally administered CCR5 antagonist maraviroc in 63 HIV-1-positive individuals prescreened for the absence of CXCR4-using virus. Maximum reduction in viral load occurred at a median of 10–15 d, with a mean reduction of ≥1.6 log 10 copies/ml at all twice daily doses ≥100 mg. These results provide proof of concept that CCR5 antagonism is a viable antiretroviral therapeutic approach.

This is a comprehensive guide to setting up, operating, and practising in a convenient care clinic.

Each quarter, this section of the Philadelphia Social Innovations Journal brings you a selection of recent news reports and other publications featuring topics and trends related to social innovation, disruptive innovation and social entrepreneurship. These “tidbits” offer brief summaries of stories and articles from around the country and the world, and fall under themes such as social media, technology, leadership, “what works,” evolving trends, philanthropy and others. If you come across something you think is worth highlighting here, please send it to Caroline Ridgway at caroline@philasocialinnovations.org.

Each quarter, this section of the Philadelphia Social Innovations Journal brings you a selection of recent news reports and other publications featuring topics and trends related to social innovation, disruptive innovation, and social entrepreneurship. These “tidbits” offer brief summaries of stories and articles from around the country and the world, and fall under themes such as social media, technology, leadership, “what works,” evolving trends, philanthropy, and others. If you come across something you think is worth highlighting here, please send it to Caroline Ridgway at caroline@philasocialinnovations.org.

Each quarter, this section of the Philadelphia Social Innovations Journal brings you a selection of recent news reports and other publications featuring topics and trends related to social innovation, disruptive innovation and social entrepreneurship. These “tidbits” offer brief summaries of stories and articles from around the country and the world, and fall under themes such as social media, technology, leadership, “what works,” evolving trends, philanthropy and others. If you come across something you think is worth highlighting here, please send it to Caroline Ridgway at caroline@philasocialinnovations.org.

Disruptive innovation helps social innovators and entrepreneurs to breathe new life into old ideas. Proven business models, products and services draw value from being reliable, established and consistent. But our needs as consumers and priorities as individuals evolve over time, typically triggering a market response. In some cases, however, a more substantial push is needed to create meaningful change in an industry. Health care is an industry that has, for many Americans, ceased to be practically useful, because of issues related to cost and access. On the other hand, it is a service that we all need; even pediatricians’ children get ear infections on a weekend and would, prior to the advent of retail-based health care, typically wind up in the emergency room.The retail-based convenient care clinic industry meets consumers’ demands because it offers low out-of-pocket cost and high clinical quality relative to its counterparts and because the practitioners work where people shop — a retail clinic can be found within a ten-minute drive of one-third of the U.S. population. Retail care is a disruptive innovation because it successfully reconceptualizes the elements of a well-established system that were failing to meet the needs and expectations of a subset of users. The retail-based clinic movement has taken hold, drawing substantial consumer support and growing quickly. Resolution of our ongoing health care crisis will require similar entrepreneurial creativity and vigor with respect to many other aspects of the system.