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1.
Front Public Health ; 12: 1343546, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38711767

RESUMEN

Introduction: This paper aims to explore the intersection of corporate social responsibility (CSR) and public health within the context of digital platforms. Specifically, the paper explores the impact of digital platforms on the sustainable development practices of enterprises, seeking to comprehend how these platforms influence the implementation of environmental protection policies, resource management, and social responsibility initiatives. Methods: To assess the impact of digital platforms on corporate environmental behavior, we conducted a questionnaire survey targeting employees in private enterprises. This survey aimed to evaluate the relationship between the adoption of digital platforms and the implementation of environmental protection policies and practices. Results: Analysis of the survey responses revealed a significant positive correlation between the use of digital platforms and the environmental protection behavior of enterprises (r=0.523;p<0.001), Moreover, the presence of innovative environmental protection technologies on these platforms was found to positively influence the enforcement of environmental policies, with a calculated impact ratio of (a∗b/c=55.31%). An intermediary analysis highlighted that environmental innovation technology plays a mediating role in this process. Additionally, adjustment analysis showed that enterprises of various sizes and industries respond differently to digital platforms, indicating the need for tailored environmental policies. Discussion: These findings underscore the pivotal role of digital platforms in enhancing CSR efforts and public health by fostering improved environmental practices among corporations. The mediating effect of environmental innovation technologies suggests that digital platforms not only facilitate direct environmental actions but also enhance the efficiency and effectiveness of such initiatives through technological advances. The variability in response by different enterprises points to the importance of customizable strategies in policy formulation. By offering empirical evidence of digital platforms' potential to advance CSR and public health through environmental initiatives, this paper contributes to the ongoing dialogue on sustainable development goals. It provides practical insights for enterprises and policy implications for governments striving to craft more effective environmental policies and strategies.


Asunto(s)
Salud Pública , Responsabilidad Social , Humanos , Encuestas y Cuestionarios , Tecnología Digital , Política Ambiental , Desarrollo Sostenible
2.
Glob Health Action ; 17(1): 2345968, 2024 Dec 31.
Artículo en Inglés | MEDLINE | ID: mdl-38717833

RESUMEN

On 7 December 2022, the State Council of China released 'Measures to Further Optimize the Implementation of the Prevention and Control of the New Coronavirus Epidemic'. The previous three-year dynamic zero epidemic prevention policy was then replaced with a full liberalization policy. On 5 May 2023, the World Health Organization declared that COVID-19 no longer constituted a 'public health emergency of international concern.' However, given the ongoing prevalence of coronavirus, emerging mutations, and the liberalization of restrictions, there are increased risks of vulnerable people contracting new variants. Low vaccination coverage among older people with compromised immune systems, puts them at further risk. The policy shift will increase pressure on already stretched health infrastructure and medical resources. This short article adds to the current debate arguing that the Chinese government should take commensurate preventive measures, including strengthening medical facilities and equipment and targeting ongoing vaccination in older people.


Paper ContextThe COVID-19 pandemic has disproportionately affected older people.This short paper discusses the consequences of China's liberalization policy on the older population.It suggests that the Chinese government should have taken targeted measures to mitigate health risks occurring under the changed circumstances.


Asunto(s)
COVID-19 , Política de Salud , SARS-CoV-2 , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , China/epidemiología , Anciano , Salud Pública , Vacunas contra la COVID-19/administración & dosificación
3.
Am J Public Health ; 114(6): 656, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38718328

Asunto(s)
Salud Pública , Humanos
5.
Nat Commun ; 15(1): 3891, 2024 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-38719858

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic, along with the implementation of public health and social measures (PHSMs), have markedly reshaped infectious disease transmission dynamics. We analysed the impact of PHSMs on 24 notifiable infectious diseases (NIDs) in the Chinese mainland, using time series models to forecast transmission trends without PHSMs or pandemic. Our findings revealed distinct seasonal patterns in NID incidence, with respiratory diseases showing the greatest response to PHSMs, while bloodborne and sexually transmitted diseases responded more moderately. 8 NIDs were identified as susceptible to PHSMs, including hand, foot, and mouth disease, dengue fever, rubella, scarlet fever, pertussis, mumps, malaria, and Japanese encephalitis. The termination of PHSMs did not cause NIDs resurgence immediately, except for pertussis, which experienced its highest peak in December 2023 since January 2008. Our findings highlight the varied impact of PHSMs on different NIDs and the importance of sustainable, long-term strategies, like vaccine development.


Asunto(s)
COVID-19 , Enfermedades Transmisibles , SARS-CoV-2 , Humanos , COVID-19/epidemiología , COVID-19/transmisión , COVID-19/prevención & control , China/epidemiología , Enfermedades Transmisibles/epidemiología , Pandemias/prevención & control , Incidencia , Estaciones del Año , Salud Pública , Control de Enfermedades Transmisibles/métodos
6.
PLoS One ; 19(5): e0303289, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38722891

RESUMEN

Malaria and Human Immunodeficiency Virus infections are among the top 10 causes of death in low income countries. Furthermore, many medicines used in these treatment areas are substandard, which contributes to the high death rate. Using a monitoring system to identify substandard and falsified medicines, the study aims to evaluate the quality of antimalarial and antiretroviral medicines in Sahel countries, assessing site conditions, compliance of medicines with pharmacopoeia tests, formulation equivalence with a reference medicine, and the influence of climate on quality attributes. Ultra Performance Liquid Chromatography methods for eight active pharmaceutical ingredients were validated following the International Conference for Harmonization guideline for its detection and quantification. Quality control consists of visual inspections to detect any misinformation or imperfections and pharmacopeial testing to determine the quality of pharmaceutical products. Medicines which complied with uniformity dosage units and dissolution tests were stored under accelerated conditions for 6 months. Artemether/Lumefantrine and Lopinavir/Ritonavir formulations failed uniformity dosage units and disintegration tests respectively, detecting a total of 28.6% substandard medicines. After 6 months stored under accelerated conditions (40 °C // 75% relative humidity) simulating climatic conditions in Sahel countries, some medicines failed pharmacopeia tests. It demonstrated the influence of these two factors in their quality attributes. This study emphasizes the need of certified quality control laboratories as well as the need for regulatory systems to maintain standards in pharmaceutical manufacturing and distribution in these countries, especially when medicines are transported to rural areas where these climatic conditions are harsher.


Asunto(s)
Antimaláricos , Control de Calidad , Antimaláricos/análisis , Antimaláricos/normas , Humanos , Antirretrovirales/análisis , Salud Pública , Ritonavir/análisis , Ritonavir/uso terapéutico , Administración Oral , Medicamentos de Baja Calidad/análisis , Infecciones por VIH/tratamiento farmacológico , Malaria/tratamiento farmacológico , Lopinavir/análisis , Lopinavir/uso terapéutico
7.
Front Public Health ; 12: 1348718, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38726232

RESUMEN

In recent years, major public health events have had a significant and far-reaching impact on communities. As a response, there has been an increasing interest in enhancing community resilience through innovative ecosystems that involve diverse stakeholders with varying needs and demands. This study investigates the application of innovative ecosystems to improve community resilience in the face of major public health events by utilizing a sequential game approach to balance the interests of government, community, and residents. Subsequently, a comprehensive questionnaire survey was conducted among key stakeholders to ascertain their objectives, requirements and concerns for the innovation ecosystem based on the analysis results of the game model. The reliability and effectiveness of the proposed research method were verified through the analysis and verification of the sequence game model and questionnaire survey results. Finally, according to our analysis results, we propose countermeasures for promoting innovative ecosystems to improve community resilience. The research results indicate that the successful implementation of innovative ecosystems requires consideration of the different needs of stakeholders such as government officials, community members, and residents. Combining these perspectives can effectively promote such systems while enhancing the community's resilience to major public health events.


Asunto(s)
Ecosistema , Salud Pública , Humanos , Encuestas y Cuestionarios , Resiliencia Psicológica , Reproducibilidad de los Resultados
8.
PLoS One ; 19(5): e0303382, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38728241

RESUMEN

This study was aimed to explore the association between potential factors including public health and social measures and the number of influenza patients in Thailand between 2014-2021. Secondary data from relevant agencies were collected. Generalized Estimating Equation (GEE) and regression coefficient (ß) were performed at a significance level of 0.05. We found factors associated with number of influenza patients during the time prior to COVID-19 pandemic were monthly income per household (Adjusted ß = -0.02; 95% CI: -0.03, -0.01), population density (Adjusted ß = 1.00; 95% CI: 0.82, 1.18), rainy season (Adjusted ß = 137.15; 95% CI: 86.17, 188.13) and winter time (Adjusted ß = 56.46; 95% CI: 3.21, 109.71). During the time of COVID-19 pandemic, population density (Adjusted ß = 0.20; 95% CI: 0.15, 0.26), rainy season (Adjusted ß = -164.23; 95% CI: -229.93, -98.52), winter time (Adjusted ß = 61.06; 95% CI: 0.71, 121.41), public health control measures (prohibition of entering to into an area with high number of COVID-19 infections (Adjusted ß = -169.34; 95% CI: -233.52, -105.16), and restriction of travelling also reduced the number of influenza patients (Adjusted ß = -66.88; 95% CI: -125.15, -8.62) were associated with number of influenza patients. This study commends strategies in monitoring influenza patients to focus on the areas with low income, high population density, and in specific seasons. Public health and social measures which can be implemented are prohibition of entering to risk-areas (lock down), and restriction of travelling across provinces which their effectiveness in reducing influenza infections.


Asunto(s)
COVID-19 , Gripe Humana , Pandemias , Estaciones del Año , Humanos , Gripe Humana/epidemiología , Tailandia/epidemiología , COVID-19/epidemiología , SARS-CoV-2/aislamiento & purificación , Densidad de Población , Salud Pública
9.
Int J Mol Sci ; 25(9)2024 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38731969

RESUMEN

This review offers a synthesis of the current understanding of the impact of low-dose thallium (Tl) on public health, specifically emphasizing its diverse effects on various populations and organs. The article integrates insights into the cytotoxic effects, genotoxic potential, and molecular mechanisms of thallium in mammalian cells. Thallium, a non-essential heavy metal present in up to 89 different minerals, has garnered attention due to its adverse effects on human health. As technology and metallurgical industries advance, various forms of thallium, including dust, vapor, and wastewater, can contaminate the environment, extending to the surrounding air, water sources, and soil. Moreover, the metal has been identified in beverages, tobacco, and vegetables, highlighting its pervasive presence in a wide array of food sources. Epidemiological findings underscore associations between thallium exposure and critical health aspects such as kidney function, pregnancy outcomes, smoking-related implications, and potential links to autism spectrum disorder. Thallium primarily exerts cellular toxicity on various tissues through mitochondria-mediated oxidative stress and endoplasmic reticulum stress. This synthesis aims to shed light on the intricate web of thallium exposure and its potential implications for public health, emphasizing the need for vigilant consideration of its risks.


Asunto(s)
Salud Pública , Talio , Humanos , Talio/toxicidad , Animales , Exposición a Riesgos Ambientales/efectos adversos , Estrés Oxidativo/efectos de los fármacos
12.
Vestn Oftalmol ; 140(2): 121-124, 2024.
Artículo en Ruso | MEDLINE | ID: mdl-38742508

RESUMEN

This article, composed using literary sources and archival materials, is dedicated to the 155th anniversary of Alexander Grigoryevich Lyutkevich - a prominent Russian ophthalmologist of the late 19th and early 20th centuries (12.09.1867-18.04.1928) and one of the founders of the Voronezh Medical Institute. The paper traces the main stages of his biography, notes his work in rapid-reaction emergency care units, and pays attention to his teaching activities. The importance of Lyutkevich's doctoral dissertation on the treatment of high myopia is emphasized. The article also highlights his important role as editor of the classic textbook "Course of eye diseases" by A.A. Kryukov. In Lyutkevich's public activities, his contribution to the establishment of the Society of Ophthalmologists in Moscow is particularly noteworthy. Lyutkevich's high organizational skills are highlighted, which were clearly manifested in the Yuriev University and in the creation of the medical faculty of the Voronezh University.


Asunto(s)
Oftalmología , Salud Pública , Oftalmología/historia , Humanos , Historia del Siglo XX , Historia del Siglo XIX , Salud Pública/historia , Federación de Rusia , Aniversarios y Eventos Especiales
13.
Health Res Policy Syst ; 22(1): 58, 2024 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-38745326

RESUMEN

BACKGROUND: A key role of public health policy-makers and practitioners is to ensure beneficial interventions are implemented effectively enough to yield improvements in public health. The use of evidence to guide public health decision-making to achieve this is recommended. However, few studies have examined the relative value, as reported by policy-makers and practitioners, of different broad research outcomes (that is, measures of cost, acceptability, and effectiveness). To guide the conduct of research and better inform public health policy and practice, this study aimed at describing the research outcomes that Australian policy-makers and practitioners consider important for their decision-making when selecting: (a) public health interventions; (b) strategies to support their implementation; and (c) to assess the differences in research outcome preferences between policy-makers and practitioners. METHOD: An online value-weighting survey was conducted with Australian public health policy-makers and practitioners working in the field of non-communicable disease prevention. Participants were presented with a list of research outcomes and were asked to select up to five they considered most critical to their decision-making. They then allocated 100 points across these - allocating more points to outcomes perceived as more important. Outcome lists were derived from a review and consolidation of evaluation and outcome frameworks in the fields of public health knowledge translation and implementation. We used descriptive statistics to report relative preferences overall and for policy-makers and practitioners separately. RESULTS: Of the 186 participants; 90 primarily identified as policy-makers and 96 as public health prevention practitioners. Overall, research outcomes of effectiveness, equity, feasibility, and sustainability were identified as the four most important outcomes when considering either interventions or strategies to implement them. Scores were similar for most outcomes between policy-makers and practitioners. CONCLUSION: For Australian policy-makers and practitioners working in the field of non-communicable disease prevention, outcomes related to effectiveness, equity, feasibility, and sustainability appear particularly important to their decisions about the interventions they select and the strategies they employ to implement them. The findings suggest researchers should seek to meet these information needs and prioritize the inclusion of such outcomes in their research and dissemination activities. The extent to which these outcomes are critical to informing the decision of policy-makers and practitioners working in other jurisdictions or contexts warrants further investigation.


Asunto(s)
Personal Administrativo , Política de Salud , Formulación de Políticas , Salud Pública , Humanos , Australia , Estudios Transversales , Toma de Decisiones , Encuestas y Cuestionarios , Enfermedades no Transmisibles/prevención & control , Masculino , Femenino
14.
Arch Iran Med ; 27(5): 272-276, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38690794

RESUMEN

BACKGROUND: Rabies remains a public health problem in middle-income countries like Iran, despite being preventable. This study aimed to evaluate the six-year incidence of animal bites in the southern Caspian Sea region from 2016 to 2022, and focus on estimating the direct costs of animal bite cases using the incidence-based method. METHODS: A multicenter, registry-based study was conducted using surveillance data of animal bites. RESULTS: Of the 40922 cases reported during the study period, 65.9% were male and 34.1% were female. Animal bites were most frequent among individuals over 50 years of age (23.5%), while children under 10 years of age had the lowest frequency of animal bites (2.3%). Animal bites were most common in June. Dogs were responsible for 33277 (81%) cases, cats for 5,624 (13.7%) cases, cows for 1054 (2.5%) cases, and other animals for the remaining cases. During the six-year study period, four deaths due to rabies were reported in the study area. The annual bite incidence rate was 386.3 per 100000 people in northern Iran. The males-to-female ratio was highest in 2019 (M/F ratio=2.4, 95% CI=1.2‒3.4). CONCLUSION: The elderly are at higher risk of animal bites, especially in rural areas. It is important to emphasize the use of protective clothing, washing wounds with soap water and rabies vaccination as initial treatment. Targeted vaccination efforts for eligible animals should be prioritized to minimize unnecessary financial burden. Educating farmers about rabies prevention programs, especially in cases of cow bites, is also important.


Asunto(s)
Mordeduras y Picaduras , Rabia , Irán/epidemiología , Humanos , Rabia/epidemiología , Rabia/prevención & control , Animales , Mordeduras y Picaduras/epidemiología , Masculino , Femenino , Niño , Persona de Mediana Edad , Adolescente , Preescolar , Adulto , Incidencia , Adulto Joven , Perros , Gatos , Anciano , Lactante , Sistema de Registros , Distribución por Edad , Distribución por Sexo , Salud Pública , Anciano de 80 o más Años , Recién Nacido
15.
Cien Saude Colet ; 29(5): e05032023, 2024 May.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-38747767

RESUMEN

The aim of this article is to analyze the serophobic content explicit in the publications published in Digital Social Networks in the context of HIV and AIDS in Brazil. This is a qualitative study of the descriptive exploratory type, based on documents. The data obtained were evaluated using the methodology of documentary analysis through Thematic Content Analysis with the aid of NVivo®12 Plus (Windows). A total of 187 codes were generated, subsequently grouped according to the semantics of the words, originating five thematic categories: #LivingWithHIV, #WeNeedtoTalkAboutIt, #WhatISSEROPHOBIA, #SerophobiaIsACrime, and #NoSerophobia. The results showed the main manifestations of HIV and AIDS-related serophobia on social networks. The shared content discussed the difficulties of living with a disease that has social dimensions; the relevance of talking and disseminating content about HIV and AIDS; the elements that make up the stigmatization process and, consequently, structure serophobia in society; the social and civil rights of people living with HIV; measures to combat serophobia in health institutions; and the implications of serophobia in the field of public health.


O objetivo do artigo é analisar o conteúdo sorofóbico explicitado nas publicações veiculadas nas redes sociais digitais no contexto do HIV e da Aids no Brasil. Trata-se de um estudo qualitativo do tipo exploratório descritivo, de base documental. Os dados obtidos foram avaliados utilizando a metodologia de análise documental por meio da análise de conteúdo temático com auxílio do software NVivo®12 Plus (Windows). Foram gerados 187 códigos, posteriormente agrupados conforme a semântica das palavras, originando cinco categorias temáticas: #VivendoComHIV, #PrecisamosFalarSobreIsso, #OQueÉSOROFOBIA, #SorofobiaéCrime e #SorofobiaNÃO. Os resultados evidenciaram as principais manifestações acerca da sorofobia relacionada ao HIV e à Aids nas redes sociais. O conteúdo compartilhado debateu as dificuldades de viver com uma doença que apresenta dimensões sociais; a relevância de falar e difundir conteúdo sobre o HIV e a Aids; os elementos que compõem o processo de estigmatização e, consequentemente, estruturam a sorofobia na sociedade; os direitos sociais e civis das pessoas vivendo com HIV; as medidas de combate à sorofobia nas instituições de saúde; e as implicações da sorofobia no âmbito da saúde pública.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Estigma Social , Humanos , Brasil , Infecciones por VIH/psicología , Síndrome de Inmunodeficiencia Adquirida/psicología , Red Social , Salud Pública , Investigación Cualitativa
16.
Health Promot Chronic Dis Prev Can ; 44(5): 218-228, 2024 May.
Artículo en Inglés, Francés | MEDLINE | ID: mdl-38748479

RESUMEN

INTRODUCTION: Communication is vital for effective and precise public health practice. The limited formal educational opportunities in health communication render professional development opportunities especially important. Competencies for public health communication describe the integrated knowledge, values, skills and behaviours required for practitioner and organizational performance. Many countries consider communication a core public health competency and use communication competencies in workforce planning and development. METHODS: We conducted an environmental scan and content analysis to determine the availability of public health communication professional development opportunities in Canada and the extent to which they support communication-related core competencies. Three relevant competency frameworks were used to assess the degree to which professional development offerings supported communication competency development. RESULTS: Overall, 45 professional development offerings were included: 16 "formalized offerings" (training opportunities such as courses, webinars, certificate programs) and 29 "materials and tools" (resources such as toolkits, guidebooks). The formalized offerings addressed 25% to 100% of the communication competencies, and the materials and tools addressed 67% to 100%. Addressing misinformation and disinformation, using current technology and communicating with diverse populations are areas in need of improved professional development. CONCLUSION: There is a significant gap in public health communication formalized offerings in Canada and many of the materials and tools are outdated. Public health communication professional development offerings lack coordination and do not provide comprehensive coverage across the communication competencies, limiting their utility to strengthen the public health workforce. More, and more comprehensive, professional development offerings are needed.


Asunto(s)
Competencia Profesional , Humanos , Canadá , Competencia Profesional/normas , Comunicación en Salud/normas , Comunicación en Salud/métodos , Salud Pública/normas , Salud Pública/educación , Desarrollo de Personal/organización & administración , Desarrollo de Personal/métodos , Comunicación
17.
J Prim Care Community Health ; 15: 21501319241253547, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38742616

RESUMEN

More than 50 million Americans suffer from chronic pain, costing our society an estimated 565 to 635 billion dollars annually. Its complexity and training deficits in healthcare providers result in many patients receiving ineffective care. Large health inequities also exist in access to effective pain care for vulnerable populations. The traumatic history of indigenous people and people of color in regards to the experience of pain care perpetuates a lack of trust in the healthcare system, causing many to hesitate to seek medical treatment for painful events and conditions. Other vulnerable populations include those with sickle cell disease or fibromyalgia, whose experience of pain has not been well-understood. There are both barriers to care and stigma for patients with pain, including those taking prescribed doses of long-term opioids, those with known substance use disorder, and those with mental health diagnoses. The suffering of patients with pain can be "invisible" to the clinician, and to one's community at large. Pain can affect all people; but those most vulnerable to not getting effective care may continue to suffer in silence because their voices are not heard. Since 1973, pain societies around the globe have worked tirelessly to bring clinicians together to advance pain and opioid education, research, and patient care. These improvements consist of pain education, integrative treatment, and the understanding that a therapeutic alliance is critical to effective pain management. Pain education for both pre and post-licensure health professionals has increased substantially over the last decade. In addition, integrative and interdisciplinary approaches for clinical pain management are now considered best practices in pain care for patients with moderate to severe pain in addition to the development of a strong therapeutic alliance.


Asunto(s)
Dolor Crónico , Humanos , Dolor Crónico/tratamiento farmacológico , Dolor Crónico/terapia , Manejo del Dolor/métodos , Analgésicos Opioides/uso terapéutico , Estados Unidos , Salud Pública , Accesibilidad a los Servicios de Salud , Disparidades en Atención de Salud , Poblaciones Vulnerables
20.
CJEM ; 26(5): 349-358, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38704790

RESUMEN

PURPOSE: We utilized quality improvement (QI) approaches to increase emergency department (ED) provider engagement with research participant enrollment during the opioid crisis and coronavirus disease (COVID-19) pandemic. The context of this work is the Evaluating Microdosing in the Emergency Department (EMED) study, a randomized trial offering buprenorphine/naloxone to ED patients through randomization to standard or microdosing induction. Engaging providers is crucial for participant recruitment to our study. Anticipating challenges sustaining long-term engagement after a 63% decline in provider referrals four months into enrollments, we applied Plan-Do-Study-Act (PDSA) cycles to develop and implement an engagement strategy to increase and sustain provider engagement by 50% from baseline within 9 months. METHODS: Our engagement strategy was centered on Coffee Carts rounds: 5-min study-related educational presentations for providers on shift; and a secondary initiative, a Suboxone Champions program, to engage interested providers as study-related peer educators. We used provider referrals to our team as a proxy for study engagement and report the percent change in mean weekly referrals across two PDSA cycles relative to our established referral baseline. RESULTS: A QI approach afforded real-time review of interventions based on research and provider priorities, increasing engagement via mean weekly provider referrals by 14.5% and 49% across two PDSA cycles relative to baseline, respectively. CONCLUSIONS: Our Coffee Carts and Suboxone Champions program are efficient, low-barrier, educational initiatives to convey study-related information to providers. This work supported our efforts to maximally engage providers, minimize burden, and provide life-saving buprenorphine/naloxone to patients at risk of fatal overdose.


RéSUMé: BUT: Nous avons utilisé des approches d'amélioration de la qualité (AQ) pour accroître l'engagement des fournisseurs des services d'urgence (SU) avec l'inscription des participants à la recherche pendant la crise des opioïdes et la pandémie de maladie à coronavirus (COVID-19). Le contexte de ce travail est l'étude Evaluating Microdosing in the Emergency Department (EMED), un essai randomisé offrant de la buprénorphine/naloxone aux patients aux urgences par randomisation à l'induction standard ou au microdosage. L'engagement des fournisseurs est crucial pour le recrutement des participants à notre étude. En anticipant les difficultés à maintenir un engagement à long terme après une baisse de 63 % des recommandations de fournisseurs quatre mois après les inscriptions, nous avons appliqué le Plan-Do-Study-Act (PDSA) cycles d'élaboration et de mise en œuvre d'une stratégie d'engagement visant à accroître et à maintenir l'engagement des fournisseurs de 50 % par rapport au niveau de référence dans les neuf mois. MéTHODES: Notre stratégie de mobilisation était axée sur les tournées de Coffee Carts : des présentations éducatives de cinq minutes sur l'étude pour les fournisseurs sur le quart de travail; et une initiative secondaire, un programme Suboxone Champions, pour mobiliser les fournisseurs intéressés en tant que pairs éducateurs liés à l'étude. Nous avons utilisé les recommandations des fournisseurs à notre équipe comme indicateur de la participation à l'étude et nous avons signalé le pourcentage de changement dans les recommandations hebdomadaires moyennes pour deux cycles PDSA par rapport à notre base de référence établie. RéSULTATS: Une approche d'AQ a permis d'examiner en temps réel les interventions en fonction des priorités de la recherche et des fournisseurs, ce qui a augmenté l'engagement par l'intermédiaire des recommandations hebdomadaires moyennes des fournisseurs de 14,5 % et de 49 % au cours de deux cycles de PDSA par rapport au niveau de référence, respectivement. CONCLUSION: Notre programme Coffee Carts and Suboxone Champions est une initiative éducative efficace et peu contraignante qui permet de transmettre aux fournisseurs des renseignements sur les études. Ce travail a appuyé nos efforts visant à mobiliser au maximum les fournisseurs, à réduire au minimum le fardeau et à fournir de la buprénorphine/naloxone vitale aux patients à risque de surdose mortelle.


Asunto(s)
COVID-19 , Servicio de Urgencia en Hospital , Sobredosis de Opiáceos , Mejoramiento de la Calidad , Humanos , COVID-19/epidemiología , Sobredosis de Opiáceos/epidemiología , Naloxona/uso terapéutico , Naloxona/administración & dosificación , Selección de Paciente , Antagonistas de Narcóticos/uso terapéutico , Antagonistas de Narcóticos/administración & dosificación , Salud Pública , Pandemias , SARS-CoV-2 , Masculino , Femenino , Buprenorfina/uso terapéutico
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