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2.
Urol Clin North Am ; 48(2): 215-222, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33795055

RESUMEN

The emergence of the COVID-19 pandemic and subsequent public health emergency (PHE) have propelled telemedicine several years into the future. With the rapid adoption of this technology came socioeconomic inequities as minority communities disproportionately have yet to adopt telemedicine. Telemedicine offers solutions to patient access issues that have plagued urology, helping address physician shortages in rural areas and expanding the reach of urologists. The Centers for Medicare & Medicaid Services have adopted changes to expand coverage for telemedicine services. The expectation is that telemedicine will continue to be a mainstay in the health care system with gradual expansion in utilization.


Asunto(s)
/epidemiología , Telemedicina , Urología , Centers for Medicare and Medicaid Services, U.S. , Difusión de Innovaciones , Humanos , Factores Socioeconómicos , Estados Unidos
3.
Front Immunol ; 12: 657711, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33777055

RESUMEN

Background: BNT162b2 and mRNA-1273 are the two recently approved mRNA-based vaccines against COVID-19 which has shown excellent safety and efficacy. Preliminary data about specific and neutralizing antibodies is available covering the first 100 days after vaccination. Methods: We reviewed all the publications regarding the immunologic consequences of BNT162b2 and mRNA-1273 vaccination. A summary of specific antibodies concentration and neutralizing antibodies titers elicited by each vaccine is provided. Results: BNT162b2 and mRNA-1273 displayed a reassuring safety and efficacy profile, with the latter above 94%. They can elicit specific antibodies titers and neutralizing antibodies concentrations that are far superior from those observed among COVID-19 human convalescent serum, across a wide span of age, for at least 100 days after vaccination. Moreover, the vaccine-induced T cellular response is oriented toward a TH1 response and no evidence of vaccine-enhanced disease have been reported. Discussion: BNT162b2 and mRNA-1273 can elicit specific antibodies titers and neutralizing antibodies concentrations above those observed among COVID-19 human convalescent serum in the first 100 days after vaccination. Data about vaccine efficacy in those with previous COVID-19 or immunocompromised is still limited.


Asunto(s)
/uso terapéutico , Inmunización , Inmunogenicidad Vacunal , Vacunas Sintéticas/uso terapéutico , Animales , Anticuerpos Neutralizantes/sangre , Anticuerpos Antivirales/sangre , /inmunología , /efectos adversos , Difusión de Innovaciones , Interacciones Huésped-Patógeno , Humanos , Resultado del Tratamiento , Vacunas Sintéticas/efectos adversos
4.
Cien Saude Colet ; 26(3): 1001-1012, 2021 Mar.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-33729354

RESUMEN

The American response to the pandemic involves a prominent volume of federal resources, especially for developing and acquiring products for internal use, such as diagnostics or vaccines. Investment mechanisms and historical aspects justify this expenditure. Thus, the social construction of nationalism in American society hinders access to health technologies. The review of such aspects shows how the United States (U.S.) secured a large number of potential products, ensuring excessive local production. This unilateral foreign policy has influenced other countries or regional blocs and undermined global cooperation and solidarity, affecting the collective health of several nations.


Asunto(s)
/epidemiología , Salud Global , Cooperación Internacional , Pandemias , /diagnóstico , /estadística & datos numéricos , Costos y Análisis de Costo , Países en Desarrollo , Difusión de Innovaciones , Economía , Recursos en Salud/economía , Recursos en Salud/provisión & distribución , Accesibilidad a los Servicios de Salud , Humanos , Sistemas Políticos , Asignación de Recursos/economía , Asignación de Recursos/métodos , Estados Unidos/epidemiología , United States Dept. of Health and Human Services/economía
5.
Prev Chronic Dis ; 18: E19, 2021 03 04.
Artículo en Inglés | MEDLINE | ID: mdl-33661727

RESUMEN

INTRODUCTION: Communication networks among professionals can be pathways for accelerating the diffusion of innovations if some local health departments (LHDs) drive the spread of knowledge. Such a network could prove valuable during public health emergencies such as the novel coronavirus disease 2019 (COVID-19) pandemic. Our objective was to determine whether LHDs in the United States were tied together in an informal network to share information and advice about innovative community health practices, programs, and policies. METHODS: In January and February 2020, we conducted an online survey of 2,303 senior LHD leaders to ask several questions about their sources of advice. We asked respondents to rank up to 3 other LHDs whose practices informed their work on new public health programs, evidence-based practices, and policies intended to improve community health. We used a social network analysis program to assess answers. RESULTS: A total of 329 LHDs responded. An emergent network appeared to operate nationally among 740 LHDs. Eleven LHDs were repeatedly nominated by peers as sources of advice or examples (ie, opinion leaders), and 24 acted as relational bridges to hold these emergent networks together (ie, boundary spanners). Although 2 LHDs played both roles, most LHDs we surveyed performed neither of these roles. CONCLUSION: Opinion leading and boundary spanning health departments can be accessed to increase the likelihood of affecting the rate of interest in and adoption of innovations. Decision makers involved in disseminating new public health practices, programs, or policies may find our results useful both for emergencies and for practice-as-usual.


Asunto(s)
Práctica Clínica Basada en la Evidencia/normas , Sistemas de Información en Salud , Difusión de la Información/métodos , Sistemas de Información/organización & administración , /epidemiología , Comunicación , Difusión de Innovaciones , Sistemas de Información en Salud/organización & administración , Sistemas de Información en Salud/tendencias , Conocimientos, Actitudes y Práctica en Salud , Humanos , Bases del Conocimiento , Mejoramiento de la Calidad , Estados Unidos/epidemiología
6.
Front Public Health ; 9: 640598, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33681137

RESUMEN

Developing countries struggle to provide high-quality, equitable care to all. Challenges of resource allocation frequently lead to ethical concerns of healthcare inequity. To tackle this, such developing nations continually need to implement healthcare innovation, coupled with capacity building to ensure new strategies continue to be developed and executed. The COVID-19 pandemic has made significant demands of healthcare systems across the world-to provide equitable healthcare to all, to ensure public health principles are followed, to find novel solutions for previously unencountered healthcare challenges, and to rapidly develop new therapeutics and vaccines for COVID-19. Countries worldwide have struggled to accomplish these demands, especially the latter two, considering that few nations had long-standing systems in place to ensure processes for innovation were on-going before the pandemic struck. The crisis represents a critical juncture to plan for a future. This future needs to incorporate a vision for the implementation of healthcare innovation, coupled with capacity building to ensure new strategies continue to be developed and executed. In this paper, the case of the massive Indian healthcare system is utilized to describe how it could implement this vision. An inclusive, ethically-resilient framework has been broadly laid out for healthcare innovation in the future, thereby ensuring success in both the short- and the long-term.


Asunto(s)
Prestación de Atención de Salud , Planificación en Salud , Innovación Organizacional , Creación de Capacidad , Difusión de Innovaciones , Política de Salud , Humanos , India , Aprendizaje Automático , Salud Pública , Calidad de la Atención de Salud
7.
J Nurs Educ ; 60(3): 172-176, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33657237

RESUMEN

BACKGROUND: The nature of a nurse's job is changing dramatically. Nurses are assuming expanded roles for a broad range of patients in community-based care. Nurse educators have a responsibility to teach nursing students about the needs of patients and families in the home care setting. METHOD: To describe how the creation of a home care video series and a medication reconciliation simulation scenario were used as a teaching strategy in a simulation center. RESULTS: The teaching strategy supported senior-level nursing students' understanding of the complexity of home care nursing and the nurse's role and responsibilities in care coordination, care transitions, and interprofessional practice. CONCLUSION: The home care video scenario was received favorably by nursing students. Additional simulation video scenarios are needed that address the health disparities among underrepresented and vulnerable groups. There is potential to offer the simulation in a virtual-online format during the COVID-19 pandemic and social distancing mandates. [J Nurs Educ. 2021;60(3):172-176.].


Asunto(s)
Difusión de Innovaciones , Educación en Enfermería/organización & administración , Cuidados de Enfermería en el Hogar/educación , Entrenamiento Simulado/métodos , Educación a Distancia , Humanos , Aprendizaje , Investigación en Educación de Enfermería , Investigación en Evaluación de Enfermería , Estudiantes de Enfermería/psicología , Estados Unidos/epidemiología , Grabación de Cinta de Video
8.
Ciênc. Saúde Colet ; 26(3): 1001-1012, mar. 2021. tab, graf
Artículo en Portugués | LILACS | ID: biblio-1153847

RESUMEN

Resumo A resposta americana à pandemia envolve um proeminente volume de recursos federais, em especial destinados ao desenvolvimento e aquisição de produtos no uso interno, como diagnósticos ou vacinas. As justificativas para esse desembolso se baseiam em mecanismos de investimentos e aspectos históricos. Assim, a construção social do nacionalismo na formação na sociedade americana prejudica o acesso a tecnologias em saúde. A revisão desses aspectos demonstra como os Estados Unidos (EUA) garantiram compra de grande quantitativo de produtos em potencial, inclusive assegurando excessiva produção local. Essa política externa unilateral tem influenciado outros países ou blocos regionais e prejudicado a cooperação e a solidariedade global com impacto na saúde coletiva de diversas nações.


Abstract The American response to the pandemic involves a prominent volume of federal resources, especially for developing and acquiring products for internal use, such as diagnostics or vaccines. Investment mechanisms and historical aspects justify this expenditure. Thus, the social construction of nationalism in American society hinders access to health technologies. The review of such aspects shows how the United States (U.S.) secured a large number of potential products, ensuring excessive local production. This unilateral foreign policy has influenced other countries or regional blocs and undermined global cooperation and solidarity, affecting the collective health of several nations.


Asunto(s)
Humanos , Salud Global , Infecciones por Coronavirus/epidemiología , Pandemias , Cooperación Internacional , Sistemas Políticos , Estados Unidos/epidemiología , United States Dept. of Health and Human Services/economía , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Costos y Análisis de Costo , Asignación de Recursos/economía , Asignación de Recursos/métodos , Países en Desarrollo , Difusión de Innovaciones , Economía , Recursos en Salud/economía , Recursos en Salud/provisión & distribución , Accesibilidad a los Servicios de Salud
9.
Health Aff (Millwood) ; 40(3): 400-409, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33539184

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic response brought forth major changes in innovation policy. This article takes stock of the key features of the COVID-19 innovation system-the network of public and private actors influencing the development and diffusion of technologies to combat the pandemic. Before the pandemic, biomedical research and development policy consisted largely of "push" funding from the public sector in support of basic research and "pull" incentives from patents to motivate private companies to invest in clinical trials and develop drugs and vaccines. In contrast, during the pandemic, public funding shifted its focus to late-stage product development and manufacturing. Procurement agreements with governments replaced traditional pull incentives from patents for the major private companies. Nonpatent barriers to competition may also have incentivized innovation. The challenges to ensuring diffusion have gained in prominence during the pandemic, though it is unclear what role patents will play in pricing and access. Some aspects of this approach to biomedical innovation may be unique to crises, but others could provide lessons for policy beyond the pandemic.


Asunto(s)
Investigación Biomédica/economía , Difusión de Innovaciones , Desarrollo de Medicamentos/economía , Asociación entre el Sector Público-Privado , Humanos
10.
12.
JMIR Public Health Surveill ; 7(2): e25935, 2021 02 09.
Artículo en Inglés | MEDLINE | ID: mdl-33503001

RESUMEN

The emergence of COVID-19 spurred the formation of myriad teams to tackle every conceivable aspect of the virus and thwart its spread. Enabled by global digital connectedness, collaboration has become a constant theme throughout the pandemic, resulting in the expedition of the scientific process (including vaccine development), rapid consolidation of global outbreak data and statistics, and experimentation with novel partnerships. To document the evolution of these collaborative efforts, the authors collected illustrative examples as the pandemic unfolded, supplemented with publications from the JMIR COVID-19 Special Issue. Over 60 projects rooted in collaboration are categorized into five main themes: knowledge dissemination, data propagation, crowdsourcing, artificial intelligence, and hardware design and development. They highlight the numerous ways that citizens, industry professionals, researchers, and academics have come together worldwide to consolidate information and produce products to combat the COVID-19 pandemic. Initially, researchers and citizen scientists scrambled to access quality data within an overwhelming quantity of information. As global curated data sets emerged, derivative works such as visualizations or models were developed that depended on consistent data and would fail when there were unanticipated changes. Crowdsourcing was used to collect and analyze data, aid in contact tracing, and produce personal protective equipment by sharing open designs for 3D printing. An international consortium of entrepreneurs and researchers created a ventilator based on an open-source design. A coalition of nongovernmental organizations and governmental organizations, led by the White House Office of Science and Technology Policy, created a shared open resource of over 200,000 research publications about COVID-19 and subsequently offered cash prizes for the best solutions to 17 key questions involving artificial intelligence. A thread of collaboration weaved throughout the pandemic response, which will shape future efforts. Novel partnerships will cross boundaries to create better processes, products, and solutions to consequential societal challenges.


Asunto(s)
/prevención & control , Conducta Cooperativa , Difusión de Innovaciones , Pandemias/prevención & control , /epidemiología , Humanos
14.
Methods Mol Biol ; 2261: 481-488, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33421009

RESUMEN

The Western blot is widely used in the study of protein biochemistry, but it is notoriously labor-intensive, and it is limited in its reproducibility and quantification, among many other challenges. By contrast, capillary-based protein separation and immunodetection, known as Simple Western™, overcomes many of the challenges associated with the traditional Western blot, and it is quickly gaining traction as a replacement for traditional Western blot analysis. The advantages that capillary-based immunoassay offers include ease of use, automation, reproducibility, quantification, and even built-in total protein normalization. In this chapter, we describe protocols for the two basic types of capillary-based immunodetection assays, one by molecular weight separation and the other by charge separation. In both methods, protein samples are separated in the capillary followed seamlessly by immunodetection with chemiluminescent or fluorescent antibodies for highly sensitive and specific detection of target proteins.


Asunto(s)
Western Blotting/tendencias , Técnica del Anticuerpo Fluorescente/tendencias , Inmunoensayo/tendencias , Proteínas/análisis , Animales , Difusión de Innovaciones , Predicción , Glicosilación , Humanos , Peso Molecular
16.
MAbs ; 13(1): 1860476, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33459118

RESUMEN

In this 12th annual installment of the Antibodies to Watch article series, we discuss key events in antibody therapeutics development that occurred in 2020 and forecast events that might occur in 2021. The coronavirus disease 2019 (COVID-19) pandemic posed an array of challenges and opportunities to the healthcare system in 2020, and it will continue to do so in 2021. Remarkably, by late November 2020, two anti-SARS-CoV antibody products, bamlanivimab and the casirivimab and imdevimab cocktail, were authorized for emergency use by the US Food and Drug Administration (FDA) and the repurposed antibodies levilimab and itolizumab had been registered for emergency use as treatments for COVID-19 in Russia and India, respectively. Despite the pandemic, 10 antibody therapeutics had been granted the first approval in the US or EU in 2020, as of November, and 2 more (tanezumab and margetuximab) may be granted approvals in December 2020.* In addition, prolgolimab and olokizumab had been granted first approvals in Russia and cetuximab saratolacan sodium was first approved in Japan. The number of approvals in 2021 may set a record, as marketing applications for 16 investigational antibody therapeutics are already undergoing regulatory review by either the FDA or the European Medicines Agency. Of these 16 mAbs, 11 are possible treatments for non-cancer indications and 5 are potential treatments for cancer. Based on the information publicly available as of November 2020, 44 antibody therapeutics are in late-stage clinical studies for non-cancer indications, including 6 for COVID-19, and marketing applications for at least 6 (leronlimab, tezepelumab, faricimab, ligelizumab, garetosmab, and fasinumab) are planned in 2021. In addition, 44 antibody therapeutics are in late-stage clinical studies for cancer indications. Of these 44, marketing application submissions for 13 may be submitted by the end of 2021. *Note added in proof on key events announced during December 1-21, 2020: margetuximab-cmkb and ansuvimab-zykl were approved by FDA on December 16 and 21, 2020, respectively; biologics license applications were submitted for ublituximab and amivantamab.


Asunto(s)
Anticuerpos/uso terapéutico , Antivirales/uso terapéutico , Desarrollo de Medicamentos/tendencias , Descubrimiento de Drogas/tendencias , Reposicionamiento de Medicamentos/tendencias , /efectos de los fármacos , Animales , Anticuerpos/efectos adversos , Antivirales/efectos adversos , /virología , Difusión de Innovaciones , Aprobación de Drogas , Predicción , Interacciones Huésped-Patógeno , Humanos , /inmunología
18.
Br J Radiol ; 94(1117): 20200613, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33090919

RESUMEN

OBJECTIVE: The improvement of radiotherapy depends largely on the implementation of innovations, of which effectivity varies widely. The aim of this study is to develop a prediction model for successful innovation implementation in radiotherapy to improve effective management of innovation projects. METHODS: A literature review was performed to identify success factors for innovation implementation. Subsequently, in two large academic radiotherapy centres in the Netherlands, an inventory was made of all innovation projects executed between 2011 and 2017. Semi-structured interviews were performed to record the presence/absence of the success factors found in the review for each project. Successful implementation was defined as timely implementation, yes/no. Cross-tables, Χ2 tests, t-tests and Benjamin-Hochberg correction were used for analysing the data. A multivariate logistic regression technique was used to build a prediction model. RESULTS: From the 163 identified innovation projects, only 54% were successfully implemented. We found 31 success factors in literature of which 14 were significantly related to successful implementation in the innovation projects in our study. The prediction model contained the following determinants: (1) sufficient and competent employees, (2) complexity, (3) understanding/awareness of the project goals and process by employees, (4) feasibility and desirability. The area Under the curve (AUC) of the prediction model was 0.86 (0.8-0.92, 95% CI). CONCLUSION: A prediction model was developed for successful implementation of innovation in radiotherapy. ADVANCES IN KNOWLEDGE: This prediction model is the first of its kind and, after external validation, could be widely applicable to predict the timely implementation of radiotherapy innovations.


Asunto(s)
Difusión de Innovaciones , Innovación Organizacional , Oncología por Radiación/métodos , Oncología por Radiación/organización & administración , Humanos , Modelos Organizacionales , Países Bajos
19.
J Stroke Cerebrovasc Dis ; 30(3): 105556, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33360252

RESUMEN

OBJECTIVES/BACKGROUND: Medical therapy is the first line of treatment for intracranial atherosclerotic disease (ICAD). Percutaneous transluminal angioplasty and stenting (PTAS) are mainly considered for those patients with severe stenosis and recurrent events despite aggressive medical therapy. In this review, we discuss the application of PTAS as a treatment option for ICAD and its future prospect. MATERIALS AND METHODS: We did the literature review of the key articles and guidelines to elaborate on the role of PTAS in the management of ICAD based on the current data and expert opinion. We searched PubMed, Google Scholar, and Scopus up to August 2020, and included articles published only in the English language. RESULTS: Since the publication of the results from SAMMPRIS and VISSIT trials, stenting is no longer recommended for secondary stroke prevention in patients with symptomatic ICAD. However, recent clinical studies on intracranial stenting for a subgroup of ICAD patients have shown promising results, likely due to better patient selection and continued advancement of endovascular techniques. CONCLUSION: There exists a lack of consensus regarding the best endovascular treatment approach (e.g., angioplasty alone or balloon mounted stent vs. self-expanding stent with or without prior angioplasty) or management of in-stent restenosis. Another area of clinical controversy relates to the ideal use and duration of antiplatelet therapy.


Asunto(s)
Angioplastia de Balón , Arteriosclerosis Intracraneal/terapia , /terapia , Angioplastia de Balón/efectos adversos , Angioplastia de Balón/instrumentación , Ensayos Clínicos como Asunto , Difusión de Innovaciones , Medicina Basada en la Evidencia , Humanos , Arteriosclerosis Intracraneal/diagnóstico por imagen , Arteriosclerosis Intracraneal/fisiopatología , /fisiopatología , Inhibidores de Agregación Plaquetaria/uso terapéutico , Diseño de Prótesis , Factores de Riesgo , Stents , Resultado del Tratamiento
20.
Trans R Soc Trop Med Hyg ; 115(3): 205-207, 2021 03 06.
Artículo en Inglés | MEDLINE | ID: mdl-33367883

RESUMEN

Countries have seen substantial disruptions to usual health services related to coronavirus disease 2019 and these are likely to have immediate and long-term indirect effects on many disease control programmes, including neglected tropical diseases (NTDs). The pandemic has highlighted the usefulness of mathematical modelling to understand the impacts of these disruptions and future control measures on progress towards 2030 NTD goals. The pandemic also provides an opportunity, and a practical necessity, to transform NTD programmes through innovation.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles/organización & administración , Difusión de Innovaciones , Enfermedades Desatendidas/epidemiología , Enfermedades Desatendidas/prevención & control , Medicina Tropical , Humanos , Pandemias , Organización Mundial de la Salud
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