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Purcell C, McDaid L, Forsyth R, Simpson SA, Elliott L, Bailey JV, Moore L, Mitchell KR. A peer-led, school-based social network intervention for young people in the UK, promoting sexual health via social media and conversations with friends: intervention development and optimisation of STASH. BMC Public Health 2023; 23:675. [PMID: 37041542 PMCID: PMC10088210 DOI: 10.1186/s12889-023-15541-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/23/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND The quality of school-based sex and relationships education (SRE) is variable in the UK. Digitally-based interventions can usefully supplement teacher-delivered lessons and positively impact sexual health knowledge. Designed to address gaps in core SRE knowledge, STASH (Sexually Transmitted infections And Sexual Health) is a peer-led social network intervention adapted from the successful ASSIST (A Stop Smoking in Schools Trial) model, and based on Diffusion of Innovation theory. This paper describes how the STASH intervention was developed and refined. METHODS Drawing on the Six Steps in Quality Intervention Development (6SQuID) framework, we tested a provisional programme theory through three iterative stages -: 1) evidence synthesis; 2) intervention co-production; and 3) adaptation - which incorporated evidence review, stakeholder consultation, and website co-development and piloting with young people, sexual health specialists, and educators. Multi-method results were analysed in a matrix of commonalities and differences. RESULTS Over 21 months, intervention development comprised 20 activities within the three stages. 1) We identified gaps in SRE provision and online resources (e.g. around sexual consent, pleasure, digital literacy), and confirmed critical components including the core ASSIST peer nomination process, the support of schools, and alignment to the national curriculum. We reviewed candidate social media platforms, ruling out all except Facebook on basis of functionality restrictions which precluded their use for our purposes. 2) Drawing on these findings, as well as relevant behaviour change theories and core elements of the ASSIST model, we co-developed new content with young people and other stakeholders, tailored to sexual health and to delivery via closed Facebook groups, as well as face-to-face conversations. 3) A pilot in one school highlighted practical considerations, including around peer nomination, recruitment, awareness raising, and boundaries to message sharing. From this, a revised STASH intervention and programme theory were co-developed with stakeholders. CONCLUSIONS STASH intervention development required extensive adaptation from the ASSIST model. Although labour intensive, our robust co-development approach ensured that an optimised intervention was taken forward for feasibility testing. Evidencing a rigorous approach to operationalising existing intervention development guidance, this paper also highlights the significance of balancing competing stakeholder concerns, resource availability, and an ever-changing landscape for implementation. TRIAL REGISTRATION ISRCTN97369178.
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Affiliation(s)
- Carrie Purcell
- Open University, 10 Drumsheugh Gardens, Edinburgh, EH3 7QJ, UK.
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Lisa McDaid
- Institute for Social Science Research, The University of Queensland, Long Pocket Precinct, 80 Meiers Rd, Indooroopilly, Brisbane, QLD, 4068, Australia
| | - Ross Forsyth
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Clarice Pears Building, Byres Road, Glasgow, G12 8TA, Scotland
| | - Sharon A Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Clarice Pears Building, Byres Road, Glasgow, G12 8TA, Scotland
| | - Lawrie Elliott
- School of Health and Life Sciences, Department of Nursing and Community Health, Glasgow Caledonian University, Room 420 George Moore Building, Cowcaddens Road, Glasgow, G4 OBA, UK
| | - Julia V Bailey
- University College London E-Health Unit, Royal Free Hospital, Upper Third Floor, Rowland Hill Street, London, NW3 2PF, UK
| | - Laurence Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Clarice Pears Building, Byres Road, Glasgow, G12 8TA, Scotland
| | - Kirstin R Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Clarice Pears Building, Byres Road, Glasgow, G12 8TA, Scotland
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Lederer AM, Foster AM, Schmidt N, Gomes GR, Scott G, Watson S, Kissinger PJ. A framework for using real-time evaluative interview feedback for health promotion program and evaluation improvement: The Check It case study. Eval Program Plann 2023; 97:102216. [PMID: 36682139 DOI: 10.1016/j.evalprogplan.2022.102216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/07/2021] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
Formative evaluation is a crucial strategy for health promotion program improvement. Early and ongoing formative evaluation can make a major impact on program outcomes; however, there are few frameworks that provide actual guidance on how programmatic or research teams can systematically perform this kind of important work. In this article we describe the use of an iterative real-time interview feedback framework we developed for Check It, a community-wide chlamydia screening and treatment program for young African American men in New Orleans, Louisiana. The framework considers the diverse and needed perspectives of multiple stakeholders, including participants, interviewers, transcribers, program staff, and lead researchers and/or administrators. Interviews were conducted with N = 15 Check It participants utilizing this approach. Employing the framework led to critical insights that resulted in several vital programmatic and evaluation improvements. Lessons learned, including strengths and challenges of utilizing the framework, are also shared so that this model can be replicated or adapted by program planning and evaluation professionals for other kinds of programs.
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Affiliation(s)
- Alyssa M Lederer
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, 1025 E. 7th Street, Suite 116, Bloomington, IN 47405, USA.
| | - Allison M Foster
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA
| | - Norine Schmidt
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA
| | - Gérard R Gomes
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA
| | - Glenis Scott
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA
| | - Shannon Watson
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA
| | - Patricia J Kissinger
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA
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Richter LM, Monson E, Bye K, Frenzel JE. Design and Assessment of a Pharmacy Student-Delivered Preceptor Development Program. Am J Pharm Educ 2023; 87:ajpe8939. [PMID: 35078766 PMCID: PMC10159611 DOI: 10.5688/ajpe8939] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/18/2022] [Indexed: 05/06/2023]
Abstract
Objective. To design and assess the use of a pharmacy student-delivered preceptor development program.Methods. A student-delivered preceptor development program was developed to ensure all preceptors received documented preceptor development. A menu of discussion topics and associated teaching sheets were created by the school's office of experiential education. On each rotation, advanced pharmacy practice experience (APPE) students led discussions with their preceptors on a topic chosen by the preceptor and submitted documentation of the education. Preceptors answered a survey related to the amount of information and time required for the program, their preference for different formats of preceptor development, one important thing they learned through the program, and future development topics of interest. Students were interviewed regarding their perceptions and use of the program.Results. A novel student-delivered preceptor development program resulted in documentation of preceptor development for all APPE rotations. Seventy-nine preceptors (31% response rate) participated in the survey. In their responses, preceptors generally agreed that they were able to customize their development and incorporate what they learned into practice, and that the program had a convenient format and was valuable for preparing students to be future preceptors. Students reported that the program improved their confidence in communicating with a supervisor and prepared them for precepting.Conclusion. A student-delivered preceptor development program improved documented preceptor development. The program allowed preceptors to customize development opportunities in a convenient format. It was perceived positively by preceptors who would recommend the program to other schools of pharmacy.
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Affiliation(s)
- Lisa M Richter
- North Dakota State University, College of Health Professions, Fargo, North Dakota
| | - Elizabeth Monson
- North Dakota State University, College of Health Professions, Fargo, North Dakota
| | - Katelyn Bye
- North Dakota State University, College of Health Professions, Fargo, North Dakota
| | - Jeanne E Frenzel
- North Dakota State University, College of Health Professions, Fargo, North Dakota
- Editorial Board Member, American Journal of Pharmaceutical Education, Arlington, Virginia
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Barchitta M, Maugeri A, Favara G, Magnano San Lio R, Riela PM, Guarnera L, Battiato S, Agodi A. Development of a Web-App for the Ecological Momentary Assessment of Dietary Habits among College Students: The HEALTHY-UNICT Project. Nutrients 2022; 14:nu14020330. [PMID: 35057511 PMCID: PMC8779738 DOI: 10.3390/nu14020330] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 01/03/2023] Open
Abstract
The transition from adolescence to adulthood is a critical period for the development of healthy behaviors. Yet, it is often characterized by unhealthy food choices. Considering the current pandemic scenario, it is also essential to assess the effects of coronavirus disease-19 (COVID-19) on lifestyles and diet, especially among young people. However, the assessment of dietary habits and their determinants is a complex issue that requires innovative approaches and tools, such as those based on the ecological momentary assessment (EMA). Here, we describe the first phases of the “HEALTHY-UNICT” project, which aimed to develop and validate a web-app for the EMA of dietary data among students from the University of Catania, Italy. The pilot study included 138 students (mean age 24 years, SD = 4.2; 75.4% women), who used the web-app for a week before filling out a food frequency questionnaire with validation purposes. Dietary data obtained through the two tools showed moderate correlations, with the lowest value for butter and margarine and the highest for pizza (Spearman’s correlation coefficients of 0.202 and 0.699, respectively). According to the cross-classification analysis, the percentage of students classified into the same quartile ranged from 36.9% for vegetable oil to 58.1% for pizza. In line with these findings, the weighted-kappa values ranged from 0.15 for vegetable oil to 0.67 for pizza, and most food categories showed values above 0.4. This web-app showed good usability among students, assessed through a 19-item usability scale. Moreover, the web-app also had the potential to evaluate the effect of the COVID-19 pandemic on students’ behaviors and emotions, showing a moderate impact on sedentary activities, level of stress, and depression. These findings, although interesting, might be confirmed by the next phases of the HEALTHY-UNICT project, which aims to characterize lifestyles, dietary habits, and their relationship with anthropometric measures and emotions in a larger sample of students.
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Affiliation(s)
- Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (A.M.); (G.F.); (R.M.S.L.); (A.A.)
- Correspondence:
| | - Andrea Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (A.M.); (G.F.); (R.M.S.L.); (A.A.)
| | - Giuliana Favara
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (A.M.); (G.F.); (R.M.S.L.); (A.A.)
| | - Roberta Magnano San Lio
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (A.M.); (G.F.); (R.M.S.L.); (A.A.)
| | - Paolo Marco Riela
- Department of Mathematics and Informatics, University of Catania, 95123 Catania, Italy; (P.M.R.); (L.G.); (S.B.)
| | - Luca Guarnera
- Department of Mathematics and Informatics, University of Catania, 95123 Catania, Italy; (P.M.R.); (L.G.); (S.B.)
| | - Sebastiano Battiato
- Department of Mathematics and Informatics, University of Catania, 95123 Catania, Italy; (P.M.R.); (L.G.); (S.B.)
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy; (A.M.); (G.F.); (R.M.S.L.); (A.A.)
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Mukhalalati B, Awaisu A, Elshami S, Paravattil B, Zolezzi M, Abu-Hijleh M, Moslih-Almoslih A, Carr A, Bawadi H, Romanowski M, Almahasneh R, Bacha R. Assessment of Educational Needs and Design of a Preceptor Development Program for Health Professional Education Programs in Qatar. J Contin Educ Health Prof 2022; 42:e32-e43. [PMID: 34174045 DOI: 10.1097/ceh.0000000000000353] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Experiential learning is the backbone of many health care professional education programs; however, the quality of learning is profoundly dependent on the skills and experiences of clinical preceptors. This study was conducted at Qatar University Health Cluster (Colleges of Pharmacy, Medicine, and Health Sciences) with the primary objective of identifying the educational needs of preceptors to design and review an educational professional development program. METHODS This study adopted a mixed-methods approach and was conducted in three stages: (1) assessment of preceptor educational needs, (2) designing of the Practice Educators' Academy program, and (3) revision and refinement of the designed program. The needs' assessment was conducted at all the three colleges through a validated survey and focus groups comprising of preceptors, students, and clinical faculty members. The sample included 209 survey respondents and 11 focus group sessions. RESULTS The results yielded five key themes and a variety of individual preferences, which were used to design a five-module face-to-face two-day interactive workshop. For the revision of the designed program, the syllabus was shared purposively with selected scholars and experts in the area of health professions education, and their feedback was collected and critically examined. Furthermore, the refinement of the program was performed on the basis of this feedback, resulting in the revised and representative program being ready for piloting. DISCUSSION A preceptor development program on experiential teaching and learning skills was successfully designed and revised with the needs of the clinical preceptors at its core. Preceptors' skills development can advance health care outcomes by preparing competent health professional graduates.
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Affiliation(s)
- Banan Mukhalalati
- Dr. Mukhalalati: Assistant Professor, Clinical Pharmacy and Practice Department, College of Pharmacy, Health Cluster, Qatar University, Doha, Qatar. Prof. Awaisu: Professor, Clinical Pharmacy and Practice Department, College of Pharmacy, Health Cluster, Qatar University, Doha, Qatar. Ms. Elshami: Research Assistant, Clinical Pharmacy and Practice Department, College of Pharmacy, Health Cluster, Qatar University, Doha, Qatar.Dr. Paravattil: Associate Professor, Clinical Pharmacy and Practice Department, College of Pharmacy, Health Cluster, Qatar University, Doha, Qatar.Dr. Zolezzi: Associate Professor, Clinical Pharmacy and Practice Department, College of Pharmacy, Health Cluster, Qatar University, Doha, Qatar.Prof. Abu Hijeh: Department Head of Basic Medical Science, College of Medicine, Health Cluster, Qatar University, Doha, Qatar.Dr. Moslih Al-Moslih: Lecturer of Clinical Education, College of Medicine, Health Cluster, Qatar University, Doha, Qatar.Prof. Carr: Associate Dean for Clinical Education, College of Medicine, Health Cluster, Qatar University, Doha, Qatar.Prof. Bawadi: Section Head of Clinical Education, College of Health Sciences, Health Cluster, Qatar University, Doha, Qatar.Prof. Romanowski: Professor & Coordinator of Graduate Programs, College of Education, Qatar University, Doha, Qatar.Dr. Almahasneh: Associate Professor of Psychological Sciences, College of Education, Qatar University, Doha, Qatar.Dr. Bacha: Research Assistant, Clinical Pharmacy and Practice Department, College of Pharmacy, Health Cluster, Qatar University, Doha, Qatar
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Antoniou T, Mamdani M. Évaluation des solutions fondées sur l’apprentissage machine en santé. CMAJ 2021; 193:E1720-E1724. [PMID: 34750185 PMCID: PMC8584374 DOI: 10.1503/cmaj.210036-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Tony Antoniou
- Centre de recherche et de formation en analytique des soins de santé Li Ka Shing (Antoniou, Mamdani), Réseau hospitalier Unity Health de Toronto; Institut du savoir Li Ka Shing (Antoniou, Mamdani), Réseau hospitalier Unity Health de Toronto; Département de médecine de famille et communautaire (Antoniou), Réseau hospitalier Unity Health deToronto et Université de Toronto; Faculté de médecine Temerty (Mamdani) et Faculté de pharmacie Leslie Dan (Mamdani), Université de Toronto; Institut des politiques, de la gestion et de l'évaluation de la santé (Mamdani), Université de Toronto, Toronto, Ont.
| | - Muhammad Mamdani
- Centre de recherche et de formation en analytique des soins de santé Li Ka Shing (Antoniou, Mamdani), Réseau hospitalier Unity Health de Toronto; Institut du savoir Li Ka Shing (Antoniou, Mamdani), Réseau hospitalier Unity Health de Toronto; Département de médecine de famille et communautaire (Antoniou), Réseau hospitalier Unity Health deToronto et Université de Toronto; Faculté de médecine Temerty (Mamdani) et Faculté de pharmacie Leslie Dan (Mamdani), Université de Toronto; Institut des politiques, de la gestion et de l'évaluation de la santé (Mamdani), Université de Toronto, Toronto, Ont
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Abstract
Family planning (FP) is the domain that enables people to have their desired number of children if any, and the desired spacing of births. FP initiatives are cross-cutting approaches to empower people with human and reproductive rights, lessen child morbidity and pregnancy-related morbidity and mortality, alleviate poverty, slow climate change, provide sustainable economic growth and development, advance education, and voluntarily slow overpopulation. We examine global FP programs: the history, drivers, and indicators to measure impact, policy, and strategy that surrounds human reproduction. We focus on current trends of task-sharing, self-care, digital health solutions, and the ever-changing contexts with our current pandemic of coronavirus disease 2019.
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Abstract
The term "health systems science" (HSS) has recently emerged as a unifying label for competencies in health care delivery and in population and community health. Despite strong evidence that HSS competencies are needed in the current and future health care workforce, heretofore the integration of HSS into medical education has been slow or fragmented-due, in part, to a lack of evidence that these curricula improve education or population outcomes. The recent COVID-19 pandemic and the national reckoning with racial inequities in the United States further highlight the time-sensitive imperative to integrate HSS content across the medical education continuum. While acknowledging challenges, the authors highlight the unique opportunities inherent in an HSS curriculum and present an elaborated curricular framework for incorporating health care delivery and population health into undergraduate medical education. This framework includes competencies previously left out of medical education, increases the scope of faculty development, and allows for evidence of effectiveness beyond traditional learner-centric metrics. The authors apply a widely adopted 6-step approach to curriculum development to address the unique challenges of incorporating HSS. Two examples-of a module on quality improvement (health care delivery) and of an introductory course on health equity (population and community health)-illustrate how the 6-step approach can be used to build HSS curricula. The Supplemental Digital Appendix (at http://links.lww.com/ACADMED/B106) outlines this approach and provides specific examples and resources. Adapting these resources within local environments to build HSS curricula will allow medical educators to ensure future graduates have the expertise and commitment necessary to effect health systems change and to advocate for their communities, while also building the much-needed evidence for such curricula.
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Affiliation(s)
- Mamta K Singh
- M.K. Singh is professor of medicine, Jerome Kowal, MD Designated Professor for Geriatric Health Education, Veterans Affairs Northeast Ohio Healthcare System, and former assistant dean, Health Systems Science, Case Western Reserve University School of Medicine, Cleveland, Ohio; ORCID: https://orcid.org/0000-0001-8235-4272
| | - Heidi L Gullett
- H.L. Gullett is associate professor and Charles Kent Smith, MD and Patricia Hughes Moore, MD Professor in Medical Student Education in Family Medicine, Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, Ohio; ORCID: https://orcid.org/0000-0002-3984-517X
| | - Patricia A Thomas
- P.A. Thomas was, when this was written, professor of medicine, Amasa B. Ford Professor of Geriatrics, and vice dean, Medical Education, Case Western Reserve University School of Medicine, Cleveland, Ohio; she is currently professor of medicine emerita, Johns Hopkins University School of Medicine, Baltimore, Maryland; ORCID: https://orcid.org/0000-0003-4528-9891
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Major ME, Dettling-Ihnenfeldt D, Ramaekers SPJ, Engelbert RHH, van der Schaaf M. Feasibility of a home-based interdisciplinary rehabilitation program for patients with Post-Intensive Care Syndrome: the REACH study. Crit Care 2021; 25:279. [PMID: 34353341 PMCID: PMC8339801 DOI: 10.1186/s13054-021-03709-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Survivors of critical illness experience long-term functional challenges, which are complex, heterogeneous, and multifactorial in nature. Although the importance of rehabilitation interventions after intensive care unit (ICU) discharge is universally recognized, evidence on feasibility and effectiveness of home-based rehabilitation programs is scarce and ambiguous. This study investigates the feasibility of an interdisciplinary rehabilitation program designed for patients with Post-Intensive Care Syndrome (PICS) who are discharged home. METHODS A mixed method, non-randomized, prospective pilot feasibility study was performed with a 6-month follow-up, comparing the intervention (REACH) with usual care. REACH was provided by trained professionals and included a patient-centered, interdisciplinary approach starting directly after hospital discharge. Primary outcomes were patient safety, satisfaction, adherence, referral need and health care usage. Secondary outcomes, measured at 3 timepoints, were functional exercise capacity, self-perceived health status, health-related quality of life (HRQoL), return to work and psychotrauma. Risk of undernutrition was assessed at baseline. RESULTS 43 patients with a median mechanical ventilation duration of 8 (IQR:10) days, were included in the study and 79.1% completed 6-month follow-up. 19 patients received the intervention, 23 received usual care. Groups were similar for gender distribution and ICU length of stay. No adverse events occurred. REACH participants showed higher satisfaction with treatment and reported more allied health professional visits, while the usual care group reported more visits to medical specialists. Qualitative analysis identified positive experiences among REACH-professionals related to providing state-of-the-art interventions and sharing knowledge and expertise within an interprofessional network. Similar recovery was seen between groups on all secondary outcomes, but neither group reached reference values for HRQoL at 6 months. Larger return to work rates were seen in the REACH group. Prevalence of undernutrition at hospital discharge was high in both groups (> 80%), warranting the need for careful tuning of physical therapy and nutritional interventions. CONCLUSIONS This study shows that providing early, home-based rehabilitation interventions for patients with PICS-related symptoms is feasible and perceived positively by patients and professionals. When provided in an interdisciplinary collaborative network state of the art, person-centered interventions can be tailored to individual needs potentially increasing patient satisfaction, adherence, and efficacy. Registered in the Dutch Trial register: NL7792: https://www.trialregister.nl/trial/7792 , registered 7-06-2019.
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Affiliation(s)
- Mel E Major
- European School of Physiotherapy, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands.
| | - Daniela Dettling-Ihnenfeldt
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands
| | - Stephan P J Ramaekers
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands
| | - Raoul H H Engelbert
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands
| | - Marike van der Schaaf
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands
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Zuzelo PR. Choosing Wisely: A Campaign to Promote Conversations Between Clinicians and Providers About Low-Value Care. Holist Nurs Pract 2021; 35:233-235. [PMID: 34115742 DOI: 10.1097/hnp.0000000000000458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Patti Rager Zuzelo
- Doctorate of Nursing Practice (DNP) Program, Advanced Nursing Practice Department, College of Nursing & Health Professions, Drexel University, Philadelphia, Pennsylvania
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Abstract
IMPORTANCE Genomic newborn screening (gNBS) may optimize the health and well-being of children and families. Screening programs are required to be evidence based, acceptable, and beneficial. OBJECTIVES To identify what has been discovered following the reporting of the first gNBS pilot projects and to provide a summary of key points for the design of gNBS. EVIDENCE REVIEW A systematic literature review was performed on April 14, 2021, identifying 36 articles that addressed the following questions: (1) what is the interest in and what would be the uptake of gNBS? (2) what diseases and genes should be included? (3) what is the validity and utility of gNBS? and (4) what are the ethical, legal, and social implications? Articles were only included if they generated new evidence; all opinion pieces were excluded. FINDINGS In the 36 articles included, there was high concordance, except for gene disease inclusion, which was highly variable. Key findings were the need for equitable access, appropriate educational materials, and informed and flexible consent. The process for selecting genes for testing should be transparent and reflect that parents value the certainty of prediction over actionability. Data should be analyzed in a way that minimizes uncertainty and incidental findings. The expansion of traditional newborn screening (tNBS) to identify more life-threatening and treatable diseases needs to be balanced against the complexity of consenting parents of newborns for genomic testing as well as the risk that overall uptake of tNBS may decline. The literature reflected that the right of a child to self-determination should be valued more than the possibility of the whole family benefiting from a newborn genomic test. CONCLUSIONS AND RELEVANCE The findings of this systematic review suggest that implementing gNBS will require a nuanced approach. There are gaps in our knowledge, such as the views of diverse populations, the capabilities of health systems, and health economic implications. It will be essential to rigorously evaluate outcomes and ensure programs can evolve to maximize benefit.
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Affiliation(s)
- Lilian Downie
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Halliday
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Sharon Lewis
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - David J. Amor
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Royal Children’s Hospital, Melbourne, Victoria, Australia
- Victorian Clinical Genetics Services, Melbourne, Victoria, Australia
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Abstract
IMPORTANCE The current program-centric algorithm for the National Resident Matching Program (NRMP) primarily uses the program's ranking of students to determine a match. Concerns that the existing algorithm favors programs over students, recent findings that the program's ranking of applicants is not associated with resident performance, and disruptions of existing screening methods and metrics have prompted reevaluation of the current algorithm relative to a student-centric algorithm, in which student ranking of programs is primary and program ranking of students is secondary. OBJECTIVE To compare program-centric and student-centric algorithms for the NRMP participants. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used randomized computer-generated data reflecting the NRMP match for 2018, 2019, and 2020, capturing more than 50 000 students and more than 4000 programs in 23 specialties, to compare the 2 algorithms. EXPOSURES The same simulated students, programs, and rankings were exposed to the 2 algorithms, running 2300 simulations in the overall analysis and 1000 simulations in each of 23 specialties. MAIN OUTCOMES AND MEASURES The percentage of students who did and did not match, the percentage of students who matched to their top-ranked and top-5-ranked programs, and the program's rank of the last student matched per position were examined. RESULTS The 2 algorithms were not different in percentage of students matched overall (eg, for 2020, program-centric: 59% [95% CI, 57%-61%]; student-centric: 58% [95% CI, 56%-60%]; P = .73). The student-centric algorithm, relative to the program-centric algorithm, matched a significantly higher percentage of students to their first-ranked program (eg, for 2020, 50% [95% CI, 48%-52%] vs 14% [95% CI, 13%-15%]; P < .001) and to their top-5-ranked programs (eg, for 2020, 60% [95% CI, 58%-62%] vs 46% [95% CI, 44%-48%]; P < .001). However, the last position was filled with students who had lower program rankings in the student-centric algorithm vs the program-centric algorithm (2 [95% CI, 1-2] vs 8 [95% CI, 6-10]; P < .001). CONCLUSIONS AND RELEVANCE In this study, the 2 algorithms were not different in the percentage of students matched overall. However, the student-centric algorithm matched a significantly higher percentage of students to their preferred programs. The program-centric algorithm was associated with a lower program's last matched student rank. Further research is needed on the algorithms' associations with cost and time demands in the match, postmatch resident and program performance, and fit with a changing environment.
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Gebreyes M, Mekonnen K, Thorne P, Derseh M, Adie A, Mulema A, Kemal SA, Tamene L, Amede T, Haileslassie A, Gebrekirstos A, Mupangwa WT, Ebrahim M, Alene T, Asfaw A, Dubale W, Yasabu S. Overcoming constraints of scaling: Critical and empirical perspectives on agricultural innovation scaling. PLoS One 2021; 16:e0251958. [PMID: 34043663 PMCID: PMC8158990 DOI: 10.1371/journal.pone.0251958] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/06/2021] [Indexed: 11/18/2022] Open
Abstract
Scaling is a ubiquitous concept in agricultural research in the global south as donors require their research grantees to prove that their results can be scaled to impact upon the livelihoods of a large number of beneficiaries. Recent studies on scaling have brought critical perspectives to the rather technocratic tendencies in the agricultural innovations scaling literature. Drawing on theoretical debates on spatial strategies and practical experience of agricultural innovation scaling in Ethiopia, this paper adds to the current debate on what constitutes scaling and how to overcome critical scaling constraints. The data for the paper came from a qualitative assessment using focus group discussions, key informant interviews, and document analysis on scaling work done in Ethiopia by a USAID-funded research for development project. The paper concludes with four broad lessons for the current understating of agricultural innovation scaling. First, scaling of agricultural innovations requires a balanced focus on technical requirements and associated social dynamics surrounding scaling targets, actors involved and their social relations. Second, appreciating the social dynamics of scaling emphasizes the fact that scaling is more complex than a linear rolling out of innovations towards diffusion. Third, scaling may not be strictly planned; instead, it might be an extension of the innovation generation process that relies heavily on both new and long-term relationships with key partners, trust, and continuous reflection and learning. Fourth, the overall implication of the above three conclusions is that scaling strategies need to be flexible, stepwise, and reflective. Despite the promises of flourishing scaling frameworks, scaling strategies it would appear from the Africa RISING experience that, if real impact is to be achieved, approaches will be required to be flexible enough to manage the social, processual and emergent nature of the practice of scaling.
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Affiliation(s)
- Million Gebreyes
- International Livestock Research Institute (ILRI), Addis Ababa, Ethiopia
- * E-mail:
| | - Kindu Mekonnen
- International Livestock Research Institute (ILRI), Addis Ababa, Ethiopia
| | - Peter Thorne
- International Livestock Research Institute (ILRI), Addis Ababa, Ethiopia
| | - Melkamu Derseh
- International Livestock Research Institute (ILRI), Addis Ababa, Ethiopia
| | - Aberra Adie
- International Livestock Research Institute (ILRI), Addis Ababa, Ethiopia
| | - Annet Mulema
- International Livestock Research Institute (ILRI), Addis Ababa, Ethiopia
| | - Seid Ahmed Kemal
- International Centre for Agricultural Research in the Dry Areas (ICARDA), Rabat, Morocco
| | - Lulseged Tamene
- Alliance for Bioversity International and CIAT (ABC), Addis Ababa, Ethiopia
| | - Tilahun Amede
- International Crop Research Institute for the Semi-Arid Tropics (ICRSAT), Addis Ababa, Ethiopia
| | | | | | | | - Mohammed Ebrahim
- International Livestock Research Institute (ILRI), Addis Ababa, Ethiopia
| | - Temesgen Alene
- International Livestock Research Institute (ILRI), Addis Ababa, Ethiopia
| | - Addisu Asfaw
- International Livestock Research Institute (ILRI), Addis Ababa, Ethiopia
| | - Workneh Dubale
- International Livestock Research Institute (ILRI), Addis Ababa, Ethiopia
| | - Simret Yasabu
- International Livestock Research Institute (ILRI), Addis Ababa, Ethiopia
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Nuzzolese E. iDENTIfyme Informative Campaign: Raising Forensic Dental Identification Awareness in the Community. J Prev Med Public Health 2021; 54:218-219. [PMID: 34092068 PMCID: PMC8190550 DOI: 10.3961/jpmph.21.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 03/25/2021] [Indexed: 11/23/2022] Open
Abstract
The identification of human remains can be performed visually through families and next-of-kin, but it is not advisable to rely only on visual recognition; instead, it is preferable to conduct a forensic comparison of antemortem and postmortem data for primary identifiers (fingerprints, DNA, and dental data). A dental autopsy is particularly valuable in the identification process of skeletonized, carbonized, saponified, and fragmented human remains. The principal challenge in the identification process is the search and collection of antemortem data. To this end, all dental information held on a missing person can represent a precious source of individualizing information that families should share with the police or investigating agencies after reporting a disappearance.
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Affiliation(s)
- Emilio Nuzzolese
- Section of Legal Medicine, Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
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15
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Razonable RR, Aloia NCE, Anderson RJ, Anil G, Arndt LL, Arndt RF, Ausman SE, Bell SJ, Bierle DM, Billings ML, Bishop RK, Cramer CH, Culbertson TL, Dababneh AS, Derr AN, Epps K, Flaker SM, Ganesh R, Gilmer MA, Urena EG, Gulden CR, Haack TL, Hanson SN, Herzog JR, Heyliger A, Hokanson LD, Hopkins LH, Horecki RJ, Krishna BH, Huskins WC, Jackson TA, Johnson RR, Jorgenson B, Kudrna C, Kennedy BD, Klingsporn MK, Kottke B, Larsen JJ, Lessard SR, Lutwick LI, Malone EJ, Matoush JA, Micallef IN, Moehnke DE, Mohamed M, Ness CN, Olson SM, Orenstein R, Palraj R, Patel J, Paulson DJ, Phelan D, Peinovich MT, Ramsey WL, Rau-Kane TJ, Reid KI, Reinschmidt KJ, Seville MT, Skold EC, Smith JM, Speicher LL, Spielman LA, Springer DJ, Sweeten PW, Tempelis JM, Tulledge-Scheitel S, Vergidis P, Whipple DC, Wilker CG, Destro Borgen MJ. A Framework for Outpatient Infusion of Antispike Monoclonal Antibodies to High-Risk Patients with Mild-to-Moderate Coronavirus Disease-19: The Mayo Clinic Model. Mayo Clin Proc 2021; 96:1250-1261. [PMID: 33958056 PMCID: PMC7942148 DOI: 10.1016/j.mayocp.2021.03.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The administration of spike monoclonal antibody treatment to patients with mild to moderate COVID-19 is very challenging. This article summarizes essential components and processes in establishing an effective spike monoclonal antibody infusion program. Rapid identification of a dedicated physical infrastructure was essential to circumvent the logistical challenges of caring for infectious patients while maintaining compliance with regulations and ensuring the safety of our personnel and other patients. Our partnerships and collaborations among multiple different specialties and disciplines enabled contributions from personnel with specific expertise in medicine, nursing, pharmacy, infection prevention and control, electronic health record (EHR) informatics, compliance, legal, medical ethics, engineering, administration, and other critical areas. Clear communication and a culture in which all roles are welcomed at the planning and operational tables are critical to the rapid development and refinement needed to adapt and thrive in providing this time-sensitive beneficial therapy. Our partnerships with leaders and providers outside our institutions, including those who care for underserved populations, have promoted equity in the access of monoclonal antibodies in our regions. Strong support from institutional leadership facilitated expedited action when needed, from a physical, personnel, and system infrastructure standpoint. Our ongoing real-time assessment and monitoring of our clinical program allowed us to improve and optimize our processes to ensure that the needs of our patients with COVID-19 in the outpatient setting are met.
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Key Words
- cfct, covid-19 frontline care team
- covid-19, coronavirus disease-19
- ehr, electronic health records
- eua, emergency use authorization
- fda, food and drug administration
- hics, healthcare incident command system
- idsa, infectious diseases society of america
- ipac, infection prevention and control
- itc, infusion therapy center
- matrx, monoclonal antibody treatment team
- nih, national institutes of health
- pcct, pediatric covid-19 care team
- sars-cov-2, severe acute respiratory syndrome coronavirus-2
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Affiliation(s)
| | - Nicole C E Aloia
- Administrative Operations, Mayo Clinic Health System, Eau Claire, WI
| | | | - Gokhan Anil
- Department of Obstetrics and Gynecology, Mayo Clinic Health System, Mankato, MN
| | - Lori L Arndt
- Department of Infectious Diseases, Mayo Clinic Health System, Eau Claire, WI
| | - Richard F Arndt
- Department of Pharmacy, Mayo Clinic Health System, Eau Claire, WI
| | - Sara E Ausman
- Department of Pharmacy, Mayo Clinic Health System, Eau Claire, WI
| | - Sarah J Bell
- Department of Nursing, Mayo Clinic, Rochester, MN
| | - Dennis M Bierle
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Marcie L Billings
- Division of Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Rachel K Bishop
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN; Department of Nursing, Mayo Clinic Health System-Franciscan Healthcare, La Crosse, WI
| | - Carl H Cramer
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN; Division of Pediatric Nephrology, Mayo Clinic, Rochester, MN
| | - Tracy L Culbertson
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN; Department of Nursing, Mayo Clinic Health System, Mankato, MN
| | - Ala S Dababneh
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN
| | | | - Kevin Epps
- Department of Pharmacy, Mayo Clinic, Jacksonville, FL
| | - Susan M Flaker
- Department of Pharmacy, Mayo Clinic Health System, Red Wing, MN
| | - Ravindra Ganesh
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Mary A Gilmer
- Department of Pharmacy, Mayo Clinic Health System-Franciscan Healthcare, La Crosse, WI
| | - Eric Gomez Urena
- Division of Infectious Diseases, Mayo Clinic Health System, Mankato, MN
| | | | | | - Sara N Hanson
- Department of Family Medicine, Mayo Clinic Health System, Mankato, MN
| | - Jenna R Herzog
- Administrative Operations, Mayo Clinic Health System, Albert Lea, MN
| | | | | | - Laura H Hopkins
- Department of Nursing, Mayo Clinic Health System, Mankato, MN
| | - Richard J Horecki
- Division of Primary Care Internal Medicine, Mayo Clinic Health System, Eau Claire, WI
| | | | - W Charles Huskins
- Division of Pediatric Infectious Diseases, Mayo Clinic, Rochester, MN
| | - Tammy A Jackson
- Department of Nursing, Mayo Clinic Health System, Eau Claire, WI
| | - Ryan R Johnson
- Department of Administration, Mayo Clinic Health System, Mankato, MN
| | - Betty Jorgenson
- Department of Nursing, Mayo Clinic Health System-Franciscan Healthcare, La Crosse, WI
| | - Cory Kudrna
- Information Technology, Mayo Clinic, Rochester, MN
| | - Brian D Kennedy
- Department of Pharmacy, Mayo Clinic Health System, Lake City, MN
| | - Mary K Klingsporn
- Nursing Education and Professional Development, Mayo Clinic, Rochester, MN
| | - Brian Kottke
- Department of Nursing, Mayo Clinic Health System-Franciscan Healthcare, La Crosse, WI
| | | | - Sarah R Lessard
- Department of Pharmacy, Mayo Clinic Health System-Franciscan Healthcare, La Crosse, WI
| | - Larry I Lutwick
- Department of Infectious Diseases, Mayo Clinic Health System, Eau Claire, WI
| | - Edward J Malone
- Department of Family Medicine, Mayo Clinic Health System-Franciscan Healthcare, La Crosse, WI
| | | | | | | | - Muhanad Mohamed
- Department of Infectious Diseases, Mayo Clinic Health System, Eau Claire, WI
| | | | - Shelly M Olson
- Department of Nursing, Mayo Clinic Health System, Owatonna, MN
| | - Robert Orenstein
- Division of Infectious Diseases, Mayo Clinic Arizona, Phoenix, AZ
| | - Raj Palraj
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN
| | - Janki Patel
- Department of Infectious Diseases, Mayo Clinic Health System, Eau Claire, WI
| | | | - David Phelan
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN
| | | | | | | | - Kevin I Reid
- Department of Dental Specialties, Mayo Clinic, Rochester, MN
| | - Karen J Reinschmidt
- Department of Management Engineering and Consulting, Mayo Clinic, Rochester, MN
| | | | - Erin C Skold
- Legal Department, Mayo Clinic Health System, Eau Claire, WI
| | - Jill M Smith
- Division of Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Leigh L Speicher
- Division of General Internal Medicine, Mayo Clinic Florida, Jacksonville, FL
| | | | | | - Perry W Sweeten
- Department of Pharmacy, Mayo Clinic Health System, Mankato, MN
| | - Jennifer M Tempelis
- Department of Pharmacy, Mayo Clinic Health System-Franciscan Healthcare, La Crosse, WI
| | | | | | - Daniel C Whipple
- Department of Management Engineering and Consulting, Mayo Clinic, Rochester, MN
| | - Caroline G Wilker
- Division of Primary Care Internal Medicine, Mayo Clinic Health System-Franciscan Healthcare, La Crosse, WI
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16
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Krofft K, Stuart W. Implementing a Mentorship Program for New Nurses During a Pandemic. Nurs Adm Q 2021; 45:152-158. [PMID: 33570882 DOI: 10.1097/naq.0000000000000455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article describes the implementation of an evidence-based mentoring program for new registered nurses (RNs) hired into medical-surgical units in a small community-based hospital during the unfolding of the SARS-Cov2 (COVID-19) pandemic. The hospital's nursing leadership supported the program implementation during the COVID-19 pandemic to provide a broader support system to new RNs to improve nurse retention. During a response to the pandemic, the medical-surgical units faced numerous process changes in a short time, which further reinforced the urgency of an additional support system for the newly hired RNs.
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Affiliation(s)
- Karen Krofft
- Nursing Support Services, Genesis Healthcare System, Zanesville, Ohio (Dr Krofft); and College of Nursing, University of South Alabama, Mobile (Dr Stuart)
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17
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Patel KA, Sexton A, Shah M, Hexom B, Gottlieb M. More Than Meets the Eye: Addressing the Role of Telemedicine in Resident Education. Ann Emerg Med 2021; 78:429-433. [PMID: 33781605 DOI: 10.1016/j.annemergmed.2021.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Keya A Patel
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL.
| | - Andrew Sexton
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL
| | - Meeta Shah
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL
| | - Braden Hexom
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL
| | - Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL
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18
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Affiliation(s)
- Jennifer Requejo
- Division of Data, Analytics, Planning and Monitoring, Unicef, New York, New York, USA
| | - Kathleen Strong
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, WHO, Geneva, Switzerland
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19
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Jun J, Sturza M, Maguire S, Waljee J, Smith R, Peahl A. Nurses' Experiences with Implementation of a Postcesarean Birth Opioid-Sparing Protocol. MCN Am J Matern Child Nurs 2021; 46:110-115. [PMID: 33315633 DOI: 10.1097/nmc.0000000000000694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Opioid-sparing protocols have significantly reduced opioid use postcesarean birth through maximizing nonpharmacologic and nonopioid pain management tools. This study explored nurses' experiences with an opioid-sparing protocol at a single institution, where inpatient opioid prescribing was reduced by over half. METHOD Focus groups were used to identify key facilitators and barriers to implementation of the opioid-sparing protocol. The Consolidated Framework for Implementation Research (CFIR) guided data collection and analysis. Focus groups were recorded, transcribed, thematically coded, and analyzed for barriers and facilitators using predetermined CFIR domains. RESULTS Three focus groups of nurses who care for women during postpartum were conducted in March and April 2019. Fourteen nurses participated. They were all women, with an average of 9.3 years (SD = 5.4) of maternity nursing experience. Facilitators of implementation were: 1) high satisfaction with the intervention's efficacy; 2) awareness of opioid harms promoting readiness for opioid-sparing efforts; 3) adequate staffing and the culture of evidence-based practice; and 4) bedside skills in pain management to identify patients' needs. The most significant barrier was a lack of nurse engagement with protocol development and implementation. CLINICAL IMPLICATIONS An increased partnership among the interprofessional team members through all stages of implementation is necessary for the success and sustainability of best patient care practices.
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20
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Ladrón-Arana S, Marín-Fernández B, Orzanco-Garralda R, Tarazona-Martínez I, Escalada-Hernández P. Construction and validation of the CAPA questionnaire of Nutritional Knowledge among Adolescents diagnosed with Feeading and Eting disorders. Actas Esp Psiquiatr 2021; 49:45-56. [PMID: 33686636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 06/12/2023]
Abstract
Feeding and eating disorders represent a serious problem especially in young population. Nutritional education is essential in its treatment and prevention.
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Affiliation(s)
- Sergio Ladrón-Arana
- Mental Health Intermediate-Term Unit Navarre Health Service. Pamplona, Spain
| | | | | | - Ignasi Tarazona-Martínez
- Children-Youth Mental Health and Eating Disorders hospital admission. Hospital Universitari i Politècnic La Fe, Valencia, España
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21
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Davis RW, Sherif YA, Vu MT, Shilstone H, Scott B, Olutoye OO, Hollier L, Nuchtern J, Rosengart TK. Personalized Graduate Medical Education and the Global Surgeon: Training for Resource-Limited Settings. Acad Med 2021; 96:384-389. [PMID: 33332906 DOI: 10.1097/acm.0000000000003898] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PROBLEM The World Health Organization and the World Bank have identified improvement in access to surgical care as an urgent global health challenge and a cost-effective investment in public health. However, trainees in standard U.S. general surgery programs do not have adequate exposure to the procedures, technical skills, and foundational knowledge essential for providing surgical care in resource-limited settings. APPROACH The Michael E. DeBakey Department of Surgery at Baylor College of Medicine (BCM) created a 7-year global surgery track within its general surgery residency in 2014. Individualized rotations equip residents with the necessary skills, knowledge, and experience to operate in regions with low surgeon density and develop sustainable surgical infrastructures. BCM provides a formal, integrated global surgery curriculum-including 2 years dedicated to global surgery-with surgical specialty rotations in domestic and international settings. Residents tailor their individual experience to the needs of their future clinical practice, region of interest, and surgical specialty. OUTCOMES There have been 4 major outcomes of the BCM global surgery track: (1) increased exposure for trainees to a broad range of surgeries critical in resource-limited settings, (2) meaningful international partnerships, (3) contributions to global surgery scholarship, and (4) establishment of sustainable global surgery activities. NEXT STEPS To better facilitate access to safe, timely, and affordable surgical care worldwide, global surgeons should pursue expertise in topics not currently included in U.S. general surgical curricula, such as setting-specific technical skills, capacity building, and organizational collaboration. Future evaluations of the BCM global surgery track will assess the effect of individualized education on trainees' professional identities, clinical practices, academic pursuits, global surgery leadership preparedness, and comfort with technical skills not encompassed in general surgery programs. Increasing availability of quality global surgery training programs would provide a critical next step toward contributing to the delivery of safe surgical care worldwide.
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Affiliation(s)
- Rachel W Davis
- R.W. Davis is a seventh-year resident, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Youmna A Sherif
- Y.A. Sherif is a fourth-year resident, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Megan Thuy Vu
- M.T. Vu is a fifth-year resident, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Holly Shilstone
- H. Shilstone is director of education and alumni affairs, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Bradford Scott
- B. Scott is professor and vice chair for education, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Oluyinka O Olutoye
- O.O. Olutoye is professor of pediatric surgery, Department of Surgery, The Ohio State University College of Medicine, and surgeon-in-chief, Nationwide Children's Hospital, Columbus, Ohio
| | - Larry Hollier
- L. Hollier Jr is professor of surgery and chief, Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and surgeon-in-chief, Texas Children's Hospital, Houston, Texas
| | - Jed Nuchtern
- J. Nuchtern is professor of pediatric surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Chief of Global Surgery, Texas Children's Hospital, Houston, Texas
| | - Todd K Rosengart
- T.K. Rosengart is professor and chair, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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22
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Affiliation(s)
- Mary Jo Satusky
- Mary Jo Satusky, BSN, RN, ONC, Nurse Educator, National Association of Orthopaedic Nurses, Chicago, IL
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23
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Basu AC, Hill AS, Isaacs AK, Mondoux MA, Mruczek REB, Narita T. Integrative STEM education for undergraduate neuroscience: Design and implementation. Neurosci Lett 2021; 746:135660. [PMID: 33476710 DOI: 10.1016/j.neulet.2021.135660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/15/2020] [Accepted: 01/05/2021] [Indexed: 11/18/2022]
Abstract
As an integrative discipline, neuroscience can serve as a vehicle for the development of integrative thinking skills and broad-based scientific proficiency in undergraduate students. Undergraduate neuroscience curricula incorporate fundamental concepts from multiple disciplines. Deepening the explicit exploration of these connections in a neuroscience core curriculum has the potential to support more meaningful and successful undergraduate STEM learning for neuroscience students. Curriculum and faculty development activities related to an integrative core curriculum can provide opportunities for faculty across disciplines and departments to advance common goals of inclusive excellence in STEM. These efforts facilitate analysis of the institutional STEM curriculum from the student perspective, and assist in creating an internal locus of accountability for diversity, equity, and inclusion within the institution. Faculty at the College of the Holy Cross have undertaken the collaborative design and implementation of an integrative core curriculum for neuroscience that embraces principles of inclusive pedagogy, emphasizes the connections between neuroscience and other disciplines, and guides students to develop broad proficiency in fundamental STEM concepts and skills.
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Affiliation(s)
- Alo C Basu
- Department of Psychology, College of the Holy Cross, 1 College Street, Worcester, MA, 01610, USA.
| | - Alexis S Hill
- Department of Biology, College of the Holy Cross, 1 College Street, Worcester, MA, 01610, USA.
| | - André K Isaacs
- Department of Chemistry, College of the Holy Cross, 1 College Street, Worcester, MA, 01610, USA.
| | - Michelle A Mondoux
- Department of Biology, College of the Holy Cross, 1 College Street, Worcester, MA, 01610, USA.
| | - Ryan E B Mruczek
- Department of Psychology, College of the Holy Cross, 1 College Street, Worcester, MA, 01610, USA.
| | - Tomohiko Narita
- Department of Physics, College of the Holy Cross, 1 College Street, Worcester, MA, 01610, USA.
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Yan L, Rong F, Gao M, Chen G, Su Y, Xing L, Xu M. Complications and feasibility analysis of ambulatory surgery for gynecological diseases in China. Medicine (Baltimore) 2021; 100:e23995. [PMID: 33429761 PMCID: PMC7793318 DOI: 10.1097/md.0000000000023995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/25/2020] [Indexed: 11/26/2022] Open
Abstract
The Chinese government is attaching great importance to the development of ambulatory surgery in order to optimize the healthcare system in China. The study aims to examine the complications and quality indicators of patients who underwent gynecological ambulatory surgery at a tertiary hospital in China.This was a retrospective study of patients who underwent ambulatory surgery between July and September 2019 at the Department of Gynecology of the First Affiliated Hospital of Shandong First Medical University. The patients were followed by phone at 30 days after discharge. The postoperative complications, mortality, unplanned re-operation, delayed discharge, unplanned re-hospitalization, and patient satisfaction were collected. The patients who underwent conventional hysteroscopic resection of uterine lesions during the same period were collected as controls for the economics analysis.A total of 392 patients who underwent ambulatory gynecological surgery were included. Fifteen patients had postoperative complications, and the total complication rate was 3.8% (15/392). Eight (8/392, 2.0%) patients had delayed discharge. There were no unplanned re-operations and deaths. There were two (2/392, 0.5%) cases of unplanned re-hospitalization. At 30 days after discharge, two patients were dissatisfied, and 390 cases were satisfied, for an overall satisfaction rate of 99.5%. Compared with conventional hysteroscopic resection of uterine lesions, ambulatory hysteroscopic surgery had a shorter hospital stay and lower total costs (P < .05) but similar surgery-related costs.Ambulatory gynecological surgery is feasible in China, with an acceptable complication profile and obvious economic and social benefits. Nevertheless, hospital management shall be reinforced.
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Affiliation(s)
- Li Yan
- Department of Obstetrics and Gynecology
| | | | | | | | | | | | - Min Xu
- Administrative Department, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
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Dale E, Conigrave KM, Kelly PJ, Ivers R, Clapham K, Lee KSK. A Delphi yarn: applying Indigenous knowledges to enhance the cultural utility of SMART Recovery Australia. Addict Sci Clin Pract 2021; 16:2. [PMID: 33407873 PMCID: PMC7787604 DOI: 10.1186/s13722-020-00212-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mutual support groups are a popular treatment for substance use and other addictive behaviours. However, little is known about the cultural utility of these programmes for Indigenous peoples. METHODS A three-round Delphi study, utilising Indigenous research yarning methods was conducted to: (1) Obtain expert opinion regarding the cultural utility of an Indigenous SMART Recovery handbook; (2) Gain consensus on areas within the SMART Recovery programme that require cultural modification and; (3) Seek advice on how modifications could be implemented in future programme design and delivery. The panellists were 11 culturally, geographically, and professionally diverse Indigenous Australian health and wellbeing experts. A group consensus level of 80% was set prior to each survey round. RESULTS There was 100% participant retention across all three Delphi rounds. The panel reached consensus on five key programme modifications (composition of a separate facilitator and group member handbook; culturally appropriate language, terminology, and literacy level; culturally meaningful programme activities; supplementary storytelling resources; and customisation for diverse community contexts). The panel also developed a series of practical implementation strategies to guide SMART Recovery through a modification process. CONCLUSION The findings highlight the importance of involving Indigenous peoples in the design, delivery and validation of mainstream mutual support programmes. Indigenous-led programme modifications could help improve accessibility and usefulness of mutual support groups for Indigenous peoples worldwide. This study is an example of how Indigenous research methods can be used alongside the Delphi technique. This approach demonstrated a way that Indigenous peoples from culturally and geographically diverse locations can participate in research anonymously, autonomously and without added burden on personal, community or professional obligations.
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Affiliation(s)
- Elizabeth Dale
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia.
- School of Psychology, University of Wollongong, Wollongong, NSW, 2500, Australia.
| | - Katherine M Conigrave
- Royal Prince Alfred Hospital, Drug Health Services, Camperdown, NSW, Australia
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Camperdown, NSW, Australia
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- School of Psychology, University of Wollongong, Wollongong, NSW, 2500, Australia
| | - Rowena Ivers
- Gradute School of Medicine, The University of Wollongong, Wollongong, NSW, Australia
- Illawarra Aboriginal Medical Service, Wollongong, NSW, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, Faculty of Business, University of Wollongong, Wollongong, NSW, Australia
| | - K S Kylie Lee
- Royal Prince Alfred Hospital, Drug Health Services, Camperdown, NSW, Australia
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia
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Abstract
BACKGROUND Demanding working conditions in medical practice pressurise the well-being of physicians across all career stages, likely harming patients and healthcare systems. Structural solutions to harmful working conditions are necessary as well as interventions to support physicians in contemporary practice. We report on developing and piloting a team-based program for physicians to improve their working conditions and well-being. APPROACH Program development steps involved: a preparatory phase, needs assessment, and program design. The program consisted of (1) a feedback tool addressing working conditions and well-being, and an intervention including (2a) a facilitated team dialogue and (2b) a team training on communication and collaborative job crafting. In the program's pilot, 377 physicians from 48 teams in 14 Dutch hospitals used the feedback tool. Four teams participated in the team dialogue. Two teams performed the team training. EVALUATION Physicians indicated that the program was a useful format to gain insight into their working conditions and well-being, and possibly to improve their well-being collaboratively. REFLECTION We provide seven critical reflections on developing and piloting our program, accompanied by recommendations for developing well-being interventions. Our development approach, program components, and recommendations may support physicians and other healthcare professionals in demanding work environments.
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Affiliation(s)
- Maarten P M Debets
- Research Group Professional Performance and Compassionate Care, Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - Kiki M J M H Lombarts
- Research Group Professional Performance and Compassionate Care, Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Renée A Scheepers
- Research Group Professional Performance and Compassionate Care, Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Research Group Socio-Medical Sciences, Erasmus School of Health Policy and Management, Erasmus University of Rotterdam, Rotterdam, The Netherlands
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Lewis V, Baldwin CD, Morahan PS, Thorndyke LE, Gusic ME. Leadership Development Projects: Bidirectional Impact on Faculty and Institutions. J Contin Educ Health Prof 2021; 41:75-81. [PMID: 33433127 DOI: 10.1097/ceh.0000000000000329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The Hedwig von Ameringen Executive Leadership in Academic Medicine program (ELAM) is a national professional development program for women that includes institutional action projects (IAPs). Although benefits of ELAM participation are well documented, the value of the IAPs has not been specifically evaluated. We explored the experience of ELAM Fellows and leaders from one institution to elucidate how institutional factors influence project implementation and outcomes. METHODS Fellows and deans participated in semistructured interviews. We analyzed the transcripts qualitatively to develop themes and describe factors that influenced IAP implementation and outcomes. We used the New World Kirkpatrick Model, an updated version of the widely used Kirkpatrick model of educational program evaluation, as a framework to elucidate how participants applied their leadership learning through project work, and to analyze early results of projects that indicated institutional impact. RESULTS Project work had bidirectional impact on the fellows in the program and on the institution itself. Project enablers included: focusing projects on institutional priorities, obtaining sustainable support, and navigating institutional complexity. Leading indicators of institutional outcomes included contributions to institutional leadership and culture, and mutual enhancement of the reputation of the fellow and of the institution. DISCUSSION By examining enablers and barriers for institutionally based projects conducted in a national leadership development program, we identified the drivers that facilitated application of leadership learning. Leading indicators of project outcomes reflected bidirectional impact on fellows and the institution, demonstrating outcomes at the highest levels of the New World Kirkpatrick Model.
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Affiliation(s)
- Vivian Lewis
- Dr. Vivian Lewis: Professor Emerita of Obstetrics and Gynecology and University Director of Ombuds Programming and Development, University of Rochester, Rochester, NY. Dr. Constance D. Baldwin: Professor of Pediatrics, University of Rochester Medical Center, Rochester, NY. Dr. Page S. Morahan: Professor Emerita, and Founding Director, Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program for Women, Drexel University College of Medicine, Philadelphia, PA. Dr. Luanne E. Thorndyke: Professor of Clinical Medicine, Department of Medicine and Executive Vice Dean, Keck School of Medicine, University of Southern California, Los Angeles, CA. Dr. Maryellen E. Gusic: Senior Advisor for Educational Affairs and Professor of Medical Education and Pediatrics, Center for Medical Education Research and Scholarly Innovation, Office of Medical Education and Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA
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Neely R, Haynes K, Miller G. Development of a Mobile Hospital for Disaster Relief. J Nurs Adm 2021; 51:33-37. [PMID: 33278199 DOI: 10.1097/nna.0000000000000963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mobile supplemental hospitals were an important asset to community response in preparing for the recent pandemic. MED-1 is a Mobile Emergency Department that has adapted and evolved to the changing needs of communities in times of disaster and nondisaster. An overview of the asset (MED-1), the operations, and use is provided to demonstrate how mobile supplemental hospitals can effectively meet a range of healthcare needs. Innovative utilization of MED-1 has secured its future as an effective resource averaging 100 days of deployment per year.
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Affiliation(s)
- Robyn Neely
- Author Affiliations: Associate Vice President/Chief Nurse Executive (Ms Neely), Atrium Health; Manager of Operations (Ms Haynes); and Director of Clinical Services (Mr Miller), Mobile Medicine, Charlotte, North Carolina
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Austin JP, Baskerville M, Bumsted T, Haedinger L, Nonas S, Pohoata E, Rogers M, Spickerman M, Thuillier P, Mitchell SH. Development and evaluation of a simulation-based transition to clerkship course. Perspect Med Educ 2020; 9:379-384. [PMID: 32458381 PMCID: PMC7718359 DOI: 10.1007/s40037-020-00590-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
BACKGROUND Transition to clerkship courses bridge the curricular gap between preclinical and clinical medical education. However, despite the use of simulation-based teaching techniques in other aspects of medical training, these techniques have not been adequately described in transition courses. We describe the development, structure and evaluation of a simulation-based transition to clerkship course. APPROACH Beginning in 2012, our institution embarked upon an extensive curricular transformation geared toward competency-based education. As part of this effort, a group of 12 educators designed, developed and implemented a simulation-based transition course. The course curriculum involved seven goals, centered around the 13 Association of American Medical Colleges Core Entrustable Professional Activities for entering residency. Instructional techniques included high-fidelity simulation, and small and large group didactics. Student competency was determined through a simulation-based inpatient-outpatient objective structured clinical examination, with real-time feedback and remediation. The effectiveness of the course was assessed through a mixed methods approach involving pre- and post-course surveys and a focus group. EVALUATION Of 166 students, 152 (91.6%) completed both pre- and post-course surveys, and nine students participated in the focus group. Students reported significant improvements in 21 out of 22 course objectives. Qualitative analysis revealed three key themes: learning environment, faculty engagement and collegiality. The main challenge to executing the course was procuring adequate faculty, material and facility resources. REFLECTION This simulation-based, resource-heavy transition course achieved its educational objectives and provided a safe, supportive learning environment for practicing and refining clinical skills.
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Affiliation(s)
- Jared P Austin
- Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA.
| | - Mark Baskerville
- Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Tracy Bumsted
- School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Leslie Haedinger
- School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Stephanie Nonas
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Eugen Pohoata
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Meghan Rogers
- School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Megan Spickerman
- School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Philippe Thuillier
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
| | - Suzanne H Mitchell
- Departments of Behavioral Neuroscience, Psychiatry and the Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
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Tinker EC, Garrison MM, Ward TM. Development of the Sleep Health in Preschoolers (SHIP) intervention: Integrating a theoretical framework for a family-centered intervention to promote healthy sleep. Fam Syst Health 2020; 38:406-417. [PMID: 33591782 DOI: 10.1037/fsh0000546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The purpose of this paper is to describe the development and design of a theoretically derived, family centered, and home-delivered health behavior change intervention to address behavioral sleep problems in young children, including modifications responsive to pilot study experiences. Sleep Health in Preschoolers (SHIP) is an intervention grounded in Bandura's Social Cognitive Theory and Bronfenbrenner's Socioecological framework that integrates an individualized, stepwise approach to include self-management skills and the inherent and dynamic interactions between individual child, parent, and family level factors and diverse socioecologic factors. SHIP is a personalized, tailored intervention that partners with parents to provide knowledge, motivation, and skills for setting and achieving goals, adapting to setbacks, and problem-solving in an iterative fashion to improve their child's sleep. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Vilanova-Sánchez A, Choueiki J, Smith CA, Callicot S, Frischer JS, Levitt MA. Creating a collaborative program for the care of children with colorectal and pelvic problems. Semin Pediatr Surg 2020; 29:150985. [PMID: 33288133 DOI: 10.1016/j.sempedsurg.2020.150985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The treatment of patients with colorectal disorders and their associated urologic, gynecologic, gastrointestinal, spinal, and orthopedic anomalies requires care from various medical and surgical specialties over the course of their lifetime. This is ideally handled by a collaborative center which facilitates the assessment and development of a long-term patient care plan among multiple specialties which can enhance the quality of care, improve communication among different specialties, and improve patient satisfaction and outcomes. We describe the process, as well as lessons learned in developing such a center.
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Scanderbeg DJ, Yashar C, Ouhib Z, Jhingran A, Einck J. Development, implementation, and associated challenges of a new HDR brachytherapy program. Brachytherapy 2020; 19:874-880. [PMID: 32950407 PMCID: PMC7495265 DOI: 10.1016/j.brachy.2020.08.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/20/2020] [Accepted: 08/27/2020] [Indexed: 12/24/2022]
Abstract
Developing any new radiation oncology program requires planning and analysis of the current state of the facility and its capacity to take on another program. Staff must consider a large number of factors to establish a feasible, safe, and sustainable program. We present a simple and generic outline that lays out the process for developing and implementing a new HDR brachytherapy program in any setting, but with particular emphasis on challenges associated with starting the program in a limited resource setting. The sections include feasibility of a program, starting cases, machine and equipment selection, and quality and safety.
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Affiliation(s)
- Daniel J Scanderbeg
- Radiation Medicine and Applied Sciences, University of California, San Diego, CA.
| | - Catheryn Yashar
- Radiation Medicine and Applied Sciences, University of California, San Diego, CA
| | - Zoubir Ouhib
- Radiation Oncology, Lynn Regional Cancer Center, Delray Beach, FL
| | - Anuja Jhingran
- Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - John Einck
- Radiation Medicine and Applied Sciences, University of California, San Diego, CA
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Shadowen NL, Guerra NG, Beveridge R, McCoy EK. A resilient research approach: Using community-based participatory action research in a rural area of India. J Community Psychol 2020; 48:2491-2503. [PMID: 32906204 DOI: 10.1002/jcop.22429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 06/11/2023]
Abstract
This community-based participatory action research (CBPAR) study describes a method for evaluating an after-school resilience-focused intervention in a low-resource rural area of southern India. Communities Rising, a locally developed resilience and academic program, was evaluated in a cross-continent collaboration between a research team at a U.S. university and the local community. The CBPAR literature highlights the importance of cultural considerations, community considerations, and community participation in the research process. The present case study describes the CBPAR research process and considerations at every phase of the research project, providing a road map of how community engagement can strengthen research, empower the community, and provide valuable knowledge. This study was conducted in three phases that focused on inclusion of local voices in the development both of the resilience program and the evaluation data collection process. Youth surveyors were particularly key to the research process. Data on participant demographics, satisfaction with the program, and qualitative contributions are also provided. Strengths and limitations of this study process in a rural community are discussed.
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Affiliation(s)
- Noel L Shadowen
- Department of Psychological and Brain Sciences, Center for Training, Evaluation, & Community Collaboration (C-TECC), Newark, Delaware, USA
| | - Nancy G Guerra
- Department of Psychological Science, School of Social Ecology, Social & Behavioral Sciences, University of California, Irvine, California, USA
| | - Ryan Beveridge
- Department of Psychological and Brain Sciences, Center for Training, Evaluation, & Community Collaboration (C-TECC), Newark, Delaware, USA
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Levy N, Zucco L, Ehrlichman RJ, Hirschberg RE, Hutton Johnson S, Yaffe MB, Ramachandran SK, Bose S, Leibowitz A. Development of Rapid Response Capabilities in a Large COVID-19 Alternate Care Site Using Failure Modes and Effect Analysis with In Situ Simulation. Anesthesiology 2020; 133:985-996. [PMID: 32773686 PMCID: PMC7434018 DOI: 10.1097/aln.0000000000003521] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/23/2020] [Indexed: 12/15/2022]
Abstract
Preparedness measures for the anticipated surge of coronavirus disease 2019 (COVID-19) cases within eastern Massachusetts included the establishment of alternate care sites (field hospitals). Boston Hope hospital was set up within the Boston Convention and Exhibition Center to provide low-acuity care for COVID-19 patients and to support local healthcare systems. However, early recognition of the need to provide higher levels of care, or critical care for the potential deterioration of patients recovering from COVID-19, prompted the development of a hybrid acute care-intensive care unit. We describe our experience of implementing rapid response capabilities of this innovative ad hoc unit. Combining quality improvement tools for hazards detection and testing through in situ simulation successfully identified several operational hurdles. Through rapid continuous analysis and iterative change, we implemented appropriate mitigation strategies and established rapid response and rescue capabilities. This study provides a framework for future planning of high-acuity services within a unique field hospital setting.
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Binello N, Garrasi C, Canale E, Sancipriano V, Audisio K, Nicolì V, Airola C, Nocera L, Vitale C, Perotto M. Building a Covid-19 unit in a state of emergency: a cross-generational working model. Healthcare delivery lessons from the pandemic. Eur Rev Med Pharmacol Sci 2020; 24:10205-10207. [PMID: 33090429 DOI: 10.26355/eurrev_202010_23242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- N Binello
- COVID-19 Isolation Unit - General Medicine, Michele and Pietro Ferrero Hospital, Verduno, Italy.
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Hayward B, Sinclair S, Martin-Babin M, Villa L, Madell D. Creating Health Literate Consumer Resources: Insights from a Professional Development Program. Health Lit Res Pract 2020; 4:e185-e189. [PMID: 32929518 PMCID: PMC7490146 DOI: 10.3928/24748307-20200806-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 08/26/2019] [Indexed: 11/20/2022] Open
Abstract
The Rauemi Atawhai (RA) Program, delivered at Counties Manukau Health by Health Literacy New Zealand (Limited), is a professional development program that aims to develop the capability in health care professionals to recognize and develop health literate, culturally competent health education resources and systems. Local evaluation of this program explored participant learning and barriers to becoming a health literate organization. We found that program participants consolidated their understanding or built a more comprehensive understanding of health literacy. Further, they gained new skills to assist them in developing future consumer resources. However, within the evaluation period, the RA Program had limited influence on the design and refinement of systems for developing, reviewing, disseminating, and evaluating consumer resources for their service, as well as approaches for engaging patients and family in design and review. Significant organizational action is needed to support these changes. Opportunities for leaders and managers to participate in capability building and discussions to create conditions (e.g., resource and authorization) for change in the environments in which staff work are needed. [HLRP: Health Literacy Research and Practice. 2020;4(3):e185-e189.].
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Pressfield L, Campa M, Ramstrom K, Kabadi S, Lopez C. Translating Theory into Practice: Lessons Learned from Developing a Program Model to Foster Resiliency in Expectant and Parenting Youth. Matern Child Health J 2020; 24:132-140. [PMID: 32065336 PMCID: PMC7497358 DOI: 10.1007/s10995-020-02890-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE This paper describes the approach used to develop the Adolescent Family Life Program (AFLP) Positive Youth Development (PYD) Model within the structure of an existing state government-run program. DESCRIPTION The California Department of Public Health, Maternal, Child and Adolescent Health (CDPH/MCAH) Division undertook an innovative approach to develop a program model to help expectant and parenting youth build resilience. CDPH/MCAH started by assessing existing program efforts and theory to develop and test new strategies in the field, structure a program model, and build toward broader expansion and sustainability. CDPH/MCAH engaged local organizations from across the state, their staff and enrolled youth, experts, and evaluators in an iterative program development process to standardize an effective model that could be replicated and evaluated. ASSESSMENT Key lessons for program developers and administrators are to ensure adequate staffing with diverse expertise related to the topic and content to support the multiple components of program development and implementation, evaluation, and training; identify the guiding theory and framework early and link them with clearly articulated core components to ensure the final model reflects the intended purpose and is structured to support implementation; engage implementation staff on the ground and focus early and often on processes for supporting people through change. CONCLUSION The lessons learned can guide others working with existing programs to develop standardized program models or translate new science and theory into practice.
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Affiliation(s)
- Lissa Pressfield
- California Department of Public Health, Maternal, Child and Adolescent Health Division, PO Box 997377, MS 0510, Sacramento, CA, 95899, USA.
| | - Mary Campa
- California Department of Public Health, Maternal, Child and Adolescent Health Division, PO Box 997377, MS 0510, Sacramento, CA, 95899, USA
| | - Karen Ramstrom
- Shasta County Health and Human Services Agency, 2650 Breslaur Way, Redding, CA, 96001, USA
| | - Sangi Kabadi
- California Department of Public Health, Maternal, Child and Adolescent Health Division, PO Box 997377, MS 0510, Sacramento, CA, 95899, USA
| | - Catherine Lopez
- California Department of Public Health, Women, Infants and Children (WIC) Division, 3901 Lennane Drive, Sacramento, CA, 95834, USA
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Batastini AB, Jones ACT, Lester ME, Davis RM. Initiation of a multidisciplinary telemental health clinic for rural justice-involved populations: Rationale, recommendations, and lessons learned. J Community Psychol 2020; 48:2156-2173. [PMID: 32779794 DOI: 10.1002/jcop.22424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/11/2020] [Accepted: 07/19/2020] [Indexed: 05/16/2023]
Abstract
Videoconferencing technology (VCT) is rapidly increasing in the mental healthcare industry and is becoming an attractive option to reach justice-involved populations. This paper first highlights the need for alternative service delivery solutions and reviews current literature on the use of VCT for correctional clients. We then outline the specific timeline, procedures, and barriers associated with the initiation of a virtual, multidisciplinary telemental health clinic for jailed and community-released offenders in a rural Mississippi county aimed at reducing criminogenic and psychiatric risks. Finally, we summarize generalizable recommendations for establishing community partnerships, developing structural and logistical processes, and delivering VCT while accounting for unique client factors and integrating evidence-based intervention strategies. We hope other community leaders will feel empowered to initiate similar programs that address needs within in their own jurisdictions.
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Affiliation(s)
- Ashley B Batastini
- School of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
- Center for Telehealth, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ashley C T Jones
- School of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Michael E Lester
- School of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Riley M Davis
- School of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
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Wyse JJ, Ono SS, Kabat M, True G. Supporting family caregivers of Veterans: Participant perceptions of a federally-mandated caregiver support program. Healthc (Amst) 2020; 8:100441. [PMID: 32919580 PMCID: PMC8054832 DOI: 10.1016/j.hjdsi.2020.100441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/23/2020] [Accepted: 05/26/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To understand patients' and caregivers' experiences with and perceptions of a federally-mandated program within the Department of Veterans Affairs (VA) that provides educational and monetary support to family caregivers of post-9/11 Veterans. METHODS Twenty-six Veterans and their family caregivers were recruited to participate in individual and dyadic interviews. Interviews lasted between 60 and 90 min and took place between August 2016 and July 2018 in Oregon and Louisiana. Interviews were recorded, transcribed and coded by multiple team members. Recurrent themes and categories were identified through close examination of coded text and comparison within and across transcripts. RESULTS Three main themes emerged in the data: 1) appreciation of the caregiver program for validating and compensating family caregiver work; 2) perception that some caregiving activities are less visible, and thus go unrecognized and uncompensated; 3) concern about loss of benefits. CONCLUSIONS Implications and policy recommendations for programs to support family caregivers, both within the VA and in the context of the broader national movement to support family caregivers, are discussed.
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Affiliation(s)
- Jessica J Wyse
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, USA; Oregon Health & Science University-Portland State University School of Public Health, USA.
| | - Sarah S Ono
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, USA; Department of Family Medicine, Oregon Health & Science University, USA
| | - Margaret Kabat
- Atlas Research, Former National Director, Caregiver Support Program, US Department of Veterans Affairs, USA
| | - Gala True
- South Central Mental Illness Research, Education, and Clinical Center, Southeast Louisiana Veterans Health Care System, USA; Section of Population and Community Medicine, LSU School of Medicine, USA
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Dundin A, Siegert C, Miller D, Ouchi K, Lakin JR, Bernacki R, Sciacca K. A Pivot to Palliative: An Interdisciplinary Program Development in Preparation for a Coronavirus Patient Surge in the Emergency Department. J Emerg Nurs 2020; 46:760-767.e1. [PMID: 33023790 PMCID: PMC7442908 DOI: 10.1016/j.jen.2020.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 11/21/2022]
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Smigelsky MA, Nieuwsma JA, Meador K, Vega RJ, Henderson B, Jackson GL. Dynamic Diffusion Network: Advancing moral injury care and suicide prevention using an innovative model. Healthc (Amst) 2020; 8:100440. [PMID: 32919579 PMCID: PMC7405892 DOI: 10.1016/j.hjdsi.2020.100440] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/24/2020] [Accepted: 05/23/2020] [Indexed: 11/19/2022]
Abstract
Healthcare providers across a wide variety of settings face a common challenge: the need to provide real time care for complex problems that are not adequately addressed by existing protocols. In response to these intervention gaps, frontline providers may utilize existing evidence to develop new approaches that are tailored to specific problems. It is imperative that such approaches undergo some form of evaluation, ensuring quality control while permitting ongoing adaptation and refinement. “Dynamic diffusion” is an innovative approach to intervention improvement and dissemination whereby care practices are delivered and continuously evaluated under real-world conditions as part of a structured network experience. This “dynamic diffusion network” (DDN) promotes cross-pollination of ideas and shared learning to generate relatively rapid improvements in care. The pilot Mental Health and Chaplaincy DDN was developed to advance suicide prevention efforts and moral injury care practices being conducted by 13 chaplain-mental health professional teams across the Veterans Health Administration. Lessons learned from the pilot DDN include the importance of the following: geographic and cultural diversity among innovation collaborators to ensure the broadest possible relevance of solutions; leadership support to facilitate engagement of frontline providers in quality improvement efforts; and participation in a community of practice to motivate providers and offer opportunities for direct collaboration and cross-pollination of ideas.
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Affiliation(s)
- Melissa A Smigelsky
- Mental Health and Chaplaincy, Department of Veterans Affairs, Durham, NC, USA; Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, USA.
| | - Jason A Nieuwsma
- Mental Health and Chaplaincy, Department of Veterans Affairs, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Keith Meador
- Mental Health and Chaplaincy, Department of Veterans Affairs, Durham, NC, USA; Departments of Psychiatry and Health Policy, Center for Biomedical Ethics and Society, Vanderbilt Divinity School, Vanderbilt University, Nashville, TN, USA
| | - Ryan J Vega
- VHA Innovation Ecosystem/Diffusion of Excellence, Department of Veterans Affairs, Washington, DC, USA
| | - Blake Henderson
- VHA Innovation Ecosystem/Diffusion of Excellence, Department of Veterans Affairs, Washington, DC, USA
| | - George L Jackson
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, USA; Department of Population Health Sciences and Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA
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Abstract
Mentorship may offer protégés numerous benefits including improved self-esteem, increased interest in research, and/or enhanced productivity. Without proper planning, reflection, and evaluation, however, mentorship programs may result in undesirable consequences. In this paper we describe a mentorship program designed to improve psychosocial support and professional development for residents, that while initially successful, was terminated due to perceptions of inequity that led to strife among residents and ultimately created a toxic learning climate. Leader-member exchange theory provides a lens through which to view our program's failure and to offer some potential solutions to mitigate such challenges for other programs. Leader-member exchange theory focuses on the importance of relationships, communication, and awareness of biases to optimize interactions between dyads such as a mentor and a protégé. We highlight opportunities during the stranger, acquaintance, and mature partnership phases that could have helped to save a residency mentorship program.
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Affiliation(s)
- Jessica L Bunin
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Holly S Meyer
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Steven J Durning
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Kerr H, Widger K, Cullen-Dean G, Price J, O’Halloran P. "Transition from children's to adult services for adolescents/young adults with life-limiting conditions: developing realist programme theory through an international comparison". BMC Palliat Care 2020; 19:115. [PMID: 32731863 PMCID: PMC7393825 DOI: 10.1186/s12904-020-00620-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 07/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Managing transition of adolescents/young adults with life-limiting conditions from children's to adult services has become a global health and social care issue. Suboptimal transitions from children's to adult services can lead to measurable adverse outcomes. Interventions are emerging but there is little theory to guide service developments aimed at improving transition. The Transition to Adult Services for Young Adults with Life-limiting conditions (TAYSL study) included development of the TASYL Transition Theory, which describes eight interventions which can help prepare services and adolescents/young adults with life-limiting conditions for a successful transition. We aimed to assess the usefulness of the TASYL Transition Theory in a Canadian context to identify interventions, mechanisms and contextual factors associated with a successful transition from children's to adult services for adolescents/young adults; and to discover new theoretical elements that might modify the TASYL Theory. METHODS A cross-sectional survey focused on organisational approaches to transition was distributed to three organisations providing services to adolescents with life-limiting conditions in Toronto, Canada. This data was mapped to the TASYL Transition Theory to identify corresponding and new theoretical elements. RESULTS Invitations were sent to 411 potentially eligible health care professionals with 56 responses from across the three participating sites. The results validated three of the eight interventions: early start to the transition process; developing adolescent/young adult autonomy; and the role of parents/carers; with partial support for the remaining five. One new intervention was identified: effective communication between healthcare professionals and the adolescent/young adult and their parents/carers. There was also support for contextual factors including those related to staff knowledge and attitudes, and a lack of time to provide transition services centred on the adolescent/young adult. Some mechanisms were supported, including the adolescent/young adult gaining confidence in relationships with service providers and in decision-making. CONCLUSIONS The Transition Theory travelled well between Ireland and Toronto, indicating its potential to guide both service development and research in different contexts. Future research could include studies with adult service providers; qualitative work to further explicate mechanisms and contextual factors; and use the theory prospectively to develop and test new or modified interventions to improve transition.
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Affiliation(s)
- Helen Kerr
- School of Nursing and Midwifery, Queen’s University Belfast, Medical Biology Centre, Lisburn Road, Belfast, BT9 7BL Northern Ireland
| | - Kimberley Widger
- University of Toronto, Lawrence S Bloomberg John Hopkins University Baetjer Memorial Library, The Hopsital for Sick Children, Toronto, Canada
| | | | - Jayne Price
- Faculty of Health, Social Care and Education, Kingston and St George’s University, London, UK
| | - Peter O’Halloran
- School of Nursing and Midwifery, Queen’s University Belfast, Medical Biology Centre, Lisburn Road, Belfast, BT9 7BL Northern Ireland
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D'haenens F, Helsloot K, Lauwaert K, Agache L, de Velde GV, De Frène V, Embo M, Vermeulen J, Beeckman K, Fobelets M. Towards an integrated perinatal care pathway for vulnerable women: The development and validation of quality indicators. Midwifery 2020; 89:102794. [PMID: 32668387 DOI: 10.1016/j.midw.2020.102794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/30/2020] [Accepted: 07/07/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Development and validation of a set of quality indicators for vulnerable women during the perinatal period. DESIGN A three-phase method was used. Phase 1 consisted of a literature review to identify publications for the development of care domains and potential QIs, as well as a quality assessment by the research team. In phase 2 an expert panel assessed the set of concept QIs in a modified three-round Delphi survey. Finally, semi-structured interviews with vulnerable women were conducted as a final quality assessment of a set of indicators (phase 3). Ethical approval was obtained from the ethics committee of the University Hospital Brussels and from the Ethics Committees of all the participating hospitals. SETTING The Flemish Region and the Brussels Capital Region in Belgium. PARTICIPANTS Healthcare and social care professionals (n = 40) with expertise in the field of perinatal care provision for vulnerable families. Vulnerable women (n = 11) who gave birth in one of the participating hospitals. FINDINGS The literature review resulted in a set of 49 potential quality indicators in five care domains: access to healthcare, assessment and screening, informal support, formal support and continuity of care. After assessment by the expert panel and vulnerable women, a final set of 21 quality indicators in five care domains was identified. First of all, organisation of care must involve an integrated multidisciplinary approach taking account of financial, administrative and social barriers (care domain 1: access to healthcare). Second, qualitative care includes the timely initiation of care, a general screening of the various aspects of vulnerability (biological, psychological, social and cognitive) and a risk assessment for all women (care domain 2: assessment and screening). Vulnerable women benefit from intensive formal and informal support taking account of individual needs and strengths (care domain 3: formal support; care domain 4: informal support). Finally, continuity of care needs to be guaranteed in line with vulnerable woman's individual needs (care domain 5: continuity of care). KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Implementing quality indicators in existing and new care pathways offers an evidence-based approach facilitating an integrated view promoting a healthy start for woman and child. These quality indicators can assist healthcare providers, organisations and governmental agencies to improve the quality of perinatal care for vulnerable women.
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Affiliation(s)
- Florence D'haenens
- Midwifery Department, Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Belgium.
| | - Kaat Helsloot
- Midwifery Department, Artevelde University of Applied Sciences, Ghent, Belgium.
| | - Karen Lauwaert
- Midwifery Department, Artevelde University of Applied Sciences, Ghent, Belgium.
| | - Lien Agache
- Social Care Department, Artevelde University of Applied Sciences, Ghent, Belgium.
| | - Griet Van de Velde
- Midwifery Department, Artevelde University of Applied Sciences, Ghent, Belgium; Midwifery Department, Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Belgium.
| | - Veerle De Frène
- Midwifery Department, Artevelde University of Applied Sciences, Ghent, Belgium.
| | - Mieke Embo
- Midwifery Department, Artevelde University of Applied Sciences, Ghent, Belgium.
| | - Joeri Vermeulen
- Midwifery Department, Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Belgium; Department of Public Health, Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Belgium.
| | - Katrien Beeckman
- University Hospital Brussels, Nursing and Midwifery Research Unit, Belgium; Vrije Universiteit Brussel (VUB), Nursing and Midwifery Research Unit, Faculty of Medicine and Pharmacy & Universitair Ziekenhuis Brussel, Belgium; Verpleeg- en vroedkunde, Centre for Research and Innovation in Care, Midwifery Research Education and Policymaking (MIDREP), Universiteit Antwerpen, Belgium.
| | - Maaike Fobelets
- Department of Public Health, Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Belgium; Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Belgium.
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Bacon E, Budney G, Bondy J, Kahn MG, McCormick EV, Steiner JF, Tabano D, Waxmonsky JA, Zucker R, Davidson AJ. Developing a Regional Distributed Data Network for Surveillance of Chronic Health Conditions: The Colorado Health Observation Regional Data Service. J Public Health Manag Pract 2020; 25:498-507. [PMID: 31348165 PMCID: PMC6286241 DOI: 10.1097/phh.0000000000000810] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Electronic health records (EHRs) provide an alternative to traditional public health surveillance surveys and administrative data for measuring the prevalence and impact of chronic health conditions in populations. As the infrastructure for secondary use of EHR data improves, many stakeholders are poised to benefit from data partnerships for regional access to information. Electronic health records can be transformed into a common data model that facilitates data sharing across multiple organizations and allows data to be used for surveillance. The Colorado Health Observation Regional Data Service, a regional distributed data network, has assembled diverse data partnerships, flexible infrastructure, and transparent governance practices to better understand the health of communities through EHR-based, public health surveillance. This article describes attributes of regional distributed data networks using EHR data and the history and design of Colorado Health Observation Regional Data Service as an emerging public health surveillance tool for chronic health conditions. Colorado Health Observation Regional Data Service and our experience may serve as a model for other regions interested in similar surveillance efforts. While benefits from EHR-based surveillance are described, a number of technology, partnership, and value proposition challenges remain.
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Affiliation(s)
- Emily Bacon
- Department of Sociology and Population Program, Institute of Behavioral Science, University of Colorado Boulder, Boulder, Colorado (Ms Bacon); Denver Public Health, Denver Health, Denver, Colorado (Mr Budney, Ms McCormick, and Dr Davidson); Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Denver, Colorado (Ms Bondy); Department of Pediatrics, University of Colorado Denver Anschutz Medical Campus, Denver, Colorado (Dr Kahn); Kaiser Permanente Colorado Institute for Health Research, Denver, Colorado (Dr Steiner); Kaiser Permanente Colorado Institute for Health Research, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado (Mr Tabano); Jefferson Center for Mental Health, Department of Family Medicine, University of Colorado Medical Anschutz Campus, Aurora, Colorado (Dr Waxmonsky); and University of Colorado Anschutz Medical Campus, Aurora, Colorado (Ms Zucker)
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Lemon SC, Goins KV, Sreedhara M, Arcaya M, Aytur SA, Heinrich K, Kerner B, Lyn R, Maddock JE, Riessman R, Schmid TL. Developing Core Capabilities for Local Health Departments to Engage in Land Use and Transportation Decision Making for Active Transportation. J Public Health Manag Pract 2020; 25:464-471. [PMID: 31348161 PMCID: PMC6684222 DOI: 10.1097/phh.0000000000000948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To develop a core set of capabilities and tasks for local health departments (LHDs) to engage in land use and transportation policy processes that promote active transportation. DESIGN We conducted a 3-phase modified Delphi study from 2015 to 2017. SETTING We recruited a multidisciplinary national expert panel for key informant interviews by telephone and completion of a 2-step online validation process. PARTICIPANTS The panel consisted of 58 individuals with expertise in local transportation and policy processes, as well as experience in cross-sector collaboration with public health. Participants represented the disciplines of land use planning, transportation/public works, public health, municipal administration, and active transportation advocacy at the state and local levels. MAIN OUTCOME MEASURES Key informant interviews elicited initial capabilities and tasks. An online survey solicited rankings of impact and feasibility for capabilities and ratings of importance for associated tasks. Feasibility rankings were used to categorize capabilities according to required resources. Results were presented via second online survey for final input. RESULTS Ten capabilities were categorized according to required resources. Fewest resources were as follows: (1) collaborate with public officials; (2) serve on land use or transportation board; and (3) review plans, policies, and projects. Moderate resources were as follows: (4) outreach to the community; (5) educate policy makers; (6) participate in plan and policy development; and (7) participate in project development and design review. Most resources were as follows: (8) participate in data and assessment activities; (9) fund dedicated staffing; and (10) provide funding support. CONCLUSIONS These actionable capabilities can guide planning efforts for LHDs of all resource levels.
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Affiliation(s)
- Stephenie C. Lemon
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Karin Valentine Goins
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Meera Sreedhara
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Mariana Arcaya
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Semra A. Aytur
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Katie Heinrich
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Bridget Kerner
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Rodney Lyn
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Jay E. Maddock
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Robin Riessman
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Thomas L. Schmid
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
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Sy A, Marriott J, Tannis C, Demment M, McIntosh S, Hadley J, Albert P, Buenconsejo-Lum L, Dye T. A Rapid Assessment Procedure to Develop A Non-Communicable Disease Prevention Pilot Health Communications Project Using E- and M-Health Communications in Pohnpei State, Federated States of Micronesia. Hawaii J Health Soc Welf 2020; 79:58-63. [PMID: 32596680 PMCID: PMC7311940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Pohnpei State of the Federated States of Micronesia, located in the Northwestern Pacific Ocean, has limited health research infrastructure; chronic non-communicable diseases (NCD) such as diabetes, heart disease, and cancer are a concern. Over 73% of Pohnpei's population is overweight or obese. E- and m- (mobile) health interventions are becoming more popular in low and middle income countries. A Rapid Assessment Procedure was conducted for formative research to identify the enabling factors and challenges related to health communication and technology in Pohnpei to address NCD prevention. Thirty-seven local stakeholders were identified through snowball sampling for interviews and group discussions about e-health readiness and NCD priorities, held in local settings. Interviews were audio recorded, with field notes taken. Data were iteratively coded using DEDOOSE. Diabetes emerged as the most serious NCD issue because both the health system and local community are having to deal with the complications and consequences. Stakeholders recommended that prevention should be integrated with diabetes treatment. Local health workers' teaching evidence-based diabetes prevention and other health promotion education were through handheld (mobile devices) was identified. The ability to readily access evidence-based health education materials and modules is compatible with community approaches providing tailored, individual and small group education and social support. This approach may serve as a key component of local NCD prevention communications initiatives integral to prevent diabetes and its complications as remote Small Island Nations face burgeoning NCD epidemics and dramatic shifts in diet and activity.
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Affiliation(s)
- Angela Sy
- John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (AS, LB-L)
| | - Jahron Marriott
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY (JM,TD)
| | - Candace Tannis
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY (CT)
| | - Margaret Demment
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY (MD)
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY (SM)
| | - Johnny Hadley
- Pohnpei State Cancer Control Program, Pohnpei, Federated States of Micronesia (JH, PA)
| | - Pertina Albert
- Pohnpei State Cancer Control Program, Pohnpei, Federated States of Micronesia (JH, PA)
| | - Lee Buenconsejo-Lum
- John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (AS, LB-L)
| | - Timothy Dye
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY (JM,TD)
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49
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Debs-Ivall S, Kerr E, Lemire-Rodger G. The Development and Implementation of a Model of Nursing Clinical Practice: A Journey. Nurs Leadersh (Tor Ont) 2020; 33:38-43. [PMID: 32573403 DOI: 10.12927/cjnl.2020.26239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The Ottawa Hospital (TOH) is a large academic health sciences centre that employs over 4,300 nurses. TOH came into existence in 1998 with the provincially mandated merger of five academic and community hospitals. In addition to the challenges of merging competitive cultures and differing work processes, patient care was carried out at the different campuses through diverse delivery models. This proved to be problematic in the program management model adopted by the amalgamated organization.
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Affiliation(s)
- Salma Debs-Ivall
- Director, Debs-Ivall Consulting Inc., Former Project Manager, New Knowledge and Innovations, The Ottawa Hospital, Ottawa, ON
| | - Evelyn Kerr
- Former Director (Retired), Nursing Clinical Practice, The Ottawa Hospital, Ottawa, ON
| | - Ginette Lemire-Rodger
- Former Senior Vice President (Retired), Professional Practice and Chief Nursing Executive, The Ottawa Hospital, Ottawa, ON
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50
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Judge JL, Cazares VA, Thompson Z, Skidmore LA. Development of low-cost cardiac and skeletal muscle laboratory activities to teach physiology concepts and the scientific method. Adv Physiol Educ 2020; 44:181-187. [PMID: 32243218 PMCID: PMC7410070 DOI: 10.1152/advan.00149.2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/13/2020] [Accepted: 03/09/2020] [Indexed: 06/11/2023]
Abstract
Anatomy and Physiology courses taught at community colleges tend to focus laboratory hours primarily on anatomy as opposed to physiology. However, research demonstrates that, when instructors utilize active learning approaches (such as in laboratory settings) where students participate in their own learning, students have improved outcomes, such as higher test scores and better retention of material. To provide community college students with opportunities for active learning in physiology, we developed two laboratory exercises to engage students in cardiac and skeletal muscle physiology. We utilized low-cost SpikerBox devices to measure electrical activity during cardiac (electrocardiogram) and skeletal muscle (electromyogram) contraction. Laboratory activities were employed in Anatomy and Physiology courses at two community colleges in southeast Michigan. A 2-h laboratory period was structured with a 20-min slide presentation covering background material on the subject and experiments to examine the effects of environmental variables on nervous system control of cardiac and skeletal muscle contraction. Students were asked to provide hypotheses and proposed mechanisms, complete a results section, and provide conclusions for the experiments based on their results. Our laboratory exercises improved student learning in physiology and knowledge of the scientific method and were well-received by community college students enrolled in Anatomy and Physiology. Our results demonstrate that the use of a SpikerBox for cardiac and skeletal muscle physiology concepts is a low-cost and effective approach to integrate physiology activities into an Anatomy and Physiology course.
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Affiliation(s)
- Jennifer L Judge
- Institutional Research and Academic Career Development Award Program, University of Michigan, Ann Arbor, Michigan
| | - Victor A Cazares
- Institutional Research and Academic Career Development Award Program, University of Michigan, Ann Arbor, Michigan
| | - Zoe Thompson
- Institutional Research and Academic Career Development Award Program, University of Michigan, Ann Arbor, Michigan
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