RESUMO
: This article describes the implementation and outcomes of a pediatric clinical education pilot project at a weekend overnight camp for children with special needs. Nine junior-level baccalaureate students participated in the immersion experience. The course skill inventory, an instructor-led postconference, a focus group session, and online forum entries were used to evaluate the experience. The evidence suggests that students gained a wide variety of psychomotor skills and patient-centered care attitudes. Although scheduling was challenging, we concluded the camp clinical was an enlightening and positive experience that offered opportunities not readily available in the hospital setting.
Assuntos
Competência Clínica/normas , Crianças com Deficiência/reabilitação , Bacharelado em Enfermagem/normas , Avaliação Educacional/métodos , Assistência Centrada no Paciente/normas , Preceptoria/normas , Adolescente , Criança , Feminino , Humanos , Masculino , Pesquisa em Educação em Enfermagem , Projetos Piloto , Estudantes de EnfermagemRESUMO
Dengue vaccine development has reached a major milestone with the initiation, in 2010, of the first phase III clinical trial to investigate the Sanofi Pasteur CYD tetravalent dengue vaccine (TDV). The CYD TDV candidate is composed of four recombinant, live, attenuated vaccines (CYD-1-4) based on a yellow fever vaccine 17D (YFV 17D) backbone, each expressing the pre-membrane and envelope genes of one of the four dengue virus serotypes. The vaccine is genetically and phenotypically stable, non-hepatotropic, less neurovirulent than YFV 17D, and does not infect mosquitoes by the oral route. In vitro and in vivo preclinical studies showed that CYD TDV induces controlled stimulation of human dendritic cells, and significant immune responses in monkeys. Scale up and industrialization are being conducted in parallel with preclinical and clinical development to fulfill the needs of phase II/III trials, and to anticipate and facilitate supply and access to vaccine in the countries where the dengue disease burden makes it an urgent public health priority. The vaccine has now been administered to more than 6000 children and adults from dengue endemic and non-endemic areas and no safety concerns have arisen in any of the completed or ongoing trials. A three-dose vaccination regimen induces an immune response against all four serotypes in the large majority of vaccinees. Preexisting flavivirus immunity favors quicker and higher immune responses to CYD TDV, without adversely effecting clinical safety or increasing vaccine viremia. The observed level and nature of the cellular immune responses in humans are consistent with the good safety and immunogenicity profile of the vaccine. Preliminary results of an ongoing, proof-of-concept efficacy and large scale safety study in Thai children are expected by the end of 2012. Here we discuss the different steps and challenges of developing CYD TDV, from research to industrialization, and summarize some of the challenges to the successful introduction of a dengue vaccine into immunization programs.