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2.
Proc Natl Acad Sci U S A ; 118(6)2021 02 09.
Artículo en Inglés | MEDLINE | ID: mdl-33531366

RESUMEN

With more time being spent on caregiving responsibilities during the COVID-19 pandemic, female scientists' productivity dropped. When female scientists conduct research, identity factors are better incorporated in research content. In order to mitigate damage to the research enterprise, funding agencies can play a role by putting in place gender equity policies that support all applicants and ensure research quality. A national health research funder implemented gender policy changes that included extending deadlines and factoring sex and gender into COVID-19 grant requirements. Following these changes, the funder received more applications from female scientists, awarded a greater proportion of grants to female compared to male scientists, and received and funded more grant applications that considered sex and gender in the content of COVID-19 research. Further work is urgently required to address inequities associated with identity characteristics beyond gender.


Asunto(s)
/epidemiología , Equidad de Género , Políticas , Investigadores/estadística & datos numéricos , Distinciones y Premios , Investigación Biomédica/economía , Investigación Biomédica/organización & administración , Eficiencia , Femenino , Organización de la Financiación/estadística & datos numéricos , Humanos , Masculino , Pandemias , Investigadores/economía , Factores Sexuales
5.
PLoS One ; 16(1): e0243211, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33434197

RESUMEN

BACKGROUND: The Health Resources and Services Administration (HRSA), Federal Office of Rural Health Policy (FORHP) funded the Evidence-Based Tele-Emergency Network Grant Program (EB TNGP) to serve the dual purpose of providing telehealth services in rural emergency departments (teleED) and systematically collecting data to inform the telehealth evidence base. This provided a unique opportunity to examine trends across multiple teleED networks and examine heterogeneity in processes and outcomes. METHOD AND FINDINGS: Six health systems received funding from HRSA under the EB TNGP to implement teleED services and they did so to 65 hospitals (91% rural) in 11 states. Three of the grantees provided teleED services to a general patient population while the remaining three grantees provided teleED services to specialized patient populations (i.e., stroke, behavioral health, critically ill children). Over a 26-month period (November 1, 2015 -December 31, 2017), each grantee submitted patient-level data for all their teleED encounters on a uniform set of measures to the data coordinating center. The six grantees reported a total of 4,324 teleED visits and 99.86% were technically successful. The teleED patients were predominantly adult, White, not Latinx, and covered by Medicare or private insurance. Across grantees, 7% of teleED patients needed resuscitation services, 58% were rated as emergent, and 30% were rated as urgent. Across grantees, 44.2% of teleED patients were transferred to another inpatient facility, 26.0% had a routine discharge, and 24.5% were admitted to the local inpatient facility. For the three grantees who served a general patient population, the most frequent presenting complaints for which teleED was activated were chest pain (25.7%), injury or trauma (17.1%), stroke symptoms (9.9%), mental/behavioral health (9.8%), and cardiac arrest (9.5%). The teleED consultation began before the local clinician exam in 37.8% of patients for the grantees who served a general patient population, but in only 1.9% of patients for the grantees who provided specialized services. CONCLUSIONS: Grantees used teleED services for a representative rural population with urgent or emergent symptoms largely resulting in transfer to a distant hospital or inpatient admission locally. TeleED was often available as the first point of contact before a local provider examination. This finding points to the important role of teleED in improving access for rural ED patients.


Asunto(s)
Servicio de Urgencia en Hospital , Medicina Basada en la Evidencia , Organización de la Financiación , Servicios de Salud Rural , Telemedicina , United States Health Resources and Services Administration , Adolescente , Adulto , Anciano , Niño , Preescolar , Estudios de Cohortes , Femenino , Hospitales Rurales , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Alta del Paciente , Índice de Severidad de la Enfermedad , Factores de Tiempo , Estados Unidos , Adulto Joven
11.
Lancet Glob Health ; 9(2): e181-e188, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33482139

RESUMEN

BACKGROUND: The Global Fund to Fight AIDS, Tuberculosis and Malaria is a robust vertical global health programme. The extent to which vertical programmes financially support health security has not been investigated. We, therefore, endeavoured to quantify the extent to which the budgets of this vertical programme support health security. We believe this is a crucial area of work as the global community works to combine resources for COVID-19 response and future pandemic preparedness. METHODS: We examined budgets for work in Kenya, Uganda, Vietnam, Democratic Republic of the Congo, Guatemala, Guinea, India, Indonesia, Nigeria, and Sierra Leone from January, 2014 to December, 2020. These ten countries were selected because of the robustness of investments and the availability of data. Using the International Health Regulations Joint External Evaluation (JEE) tool as a framework, we mapped budget line items to health security capacities. Two researchers independently reviewed each budget and mapped items to the JEE. Budgets were then jointly reviewed until a consensus was reached regarding if an item supported health security directly, indirectly, or not at all. The budgets for the study countries were inputted into a single Microsoft Excel spreadsheet and line items that mapped to JEE indicators were scaled up to their respective JEE capacity. Descriptive analyses were then done to determine the total amount of money budgeted for activities that support health security, how much was budgeted for each JEE capacity, and how much of the support was direct or indirect. FINDINGS: The research team reviewed 37 budgets. Budgets totalled US$6 927 284 966, and $2 562 063 054 (37·0%) of this mapped to JEE capacities. $1 330 942 712 (19·2%) mapped directly to JEE capacities and $1 231 120 342 (17·8%) mapped indirectly to JEE capacities. Laboratory systems, antimicrobial resistance, and the deployment of medical countermeasures and personnel received the most overall budgetary support; laboratory systems, antimicrobial resistance, and workforce development received the greatest amount of direct budgetary support. INTERPRETATION: Over one-third of the Global Fund's work also supports health security and the organisation has budgeted more than $2 500 000 000 for activities that support health security in ten countries since 2014. Although these funds were not budgeted specifically for health security purposes, recognising how vertical programmes can synergistically support other global health efforts has important implications for policy related to health systems strengthening. FUNDING: Resolve to Save Lives: An Initiative of Vital Strategies.


Asunto(s)
Organización de la Financiación/economía , Salud Global/economía , Cooperación Internacional , Presupuestos , /prevención & control , Países en Desarrollo , Programas de Gobierno/economía , Humanos , Pandemias/prevención & control , Estados Unidos
13.
Health Res Policy Syst ; 19(1): 5, 2021 Jan 18.
Artículo en Inglés | MEDLINE | ID: mdl-33461564

RESUMEN

The COVID-19 pandemic has created urgent demand around the world for knowledge generation about a novel coronavirus, its transmission, and control, putting academic institutions at the frontline of politics. While many academic institutions are well poised to conduct research, there are well-documented barriers for these institutions, particularly in low- and middle-income countries (LMICs), to further conduct strategic synthesis and dissemination to promote knowledge utilization among policy-makers. These systemic barriers to knowledge translation (KT) pose significant challenges for academic institutions seeking to take advantage of unprecedented policy windows to inform evidence-based decision-making. Global health funding organizations should prioritize the support of academic institutions' activities along the KT pathway, including both knowledge generation and strategic dissemination, to improve knowledge uptake for decision-making to improve health. Institutional capacity-building initiatives for KT have the potential to profoundly impact responses to this and future pandemics.


Asunto(s)
Creación de Capacidad , Países en Desarrollo , Salud Global , Política de Salud , Pandemias , Investigación en Medicina Traslacional , Planificación en Desastres , Práctica Clínica Basada en la Evidencia , Organización de la Financiación , Humanos , Conocimiento , Formulación de Políticas , Apoyo a la Investigación como Asunto , Instituciones Académicas , Investigación en Medicina Traslacional/economía
15.
PLoS One ; 15(12): e0243973, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33370337

RESUMEN

Grant writing is an essential skill to develop for academic and other career success but providing individual feedback to large numbers of trainees is challenging. In 2014, we launched the Stanford Biosciences Grant Writing Academy to support graduate students and postdocs in writing research proposals. Its core program is a multi-week Proposal Bootcamp designed to increase the feedback writers receive as they develop and refine their proposals. The Proposal Bootcamp consisted of two-hour weekly meetings that included mini lectures and peer review. Bootcamp participants also attended faculty review workshops to obtain faculty feedback. Postdoctoral trainees were trained and hired as course teaching assistants and facilitated weekly meetings and review workshops. Over the last six years, the annual Bootcamp has provided 525 doctoral students and postdocs with multi-level feedback (peer and faculty). Proposals from Bootcamp participants were almost twice as likely to be funded than proposals from non-Bootcamp trainees. Overall, this structured program provided opportunities for feedback from multiple peer and faculty reviewers, increased the participants' confidence in developing and submitting research proposals, while accommodating a large number of participants.


Asunto(s)
Investigación Biomédica/educación , Organización de la Financiación , Escritura , Adulto , Educación Continua/métodos , Femenino , Humanos , Masculino , Tutoría/métodos , Revisión por Pares , Autoeficacia
17.
Adv Physiol Educ ; 44(4): 741-743, 2020 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-33205997

RESUMEN

The COVID--19 pandemic has impacted undergraduate and graduate student research. With the uncertainty right now, it is a challenge for faculty to offer clear guidance for how students can proceed with their research and capstone projects. In this brief editorial, we offer suggestions for moving student research forward during the COVID-19 pandemic.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Investigadores , Investigación , Estudiantes , Simulación por Computador , Minería de Datos , Organización de la Financiación , Humanos , Metaanálisis como Asunto , Cambio Social , Revisiones Sistemáticas como Asunto
20.
PLoS One ; 15(8): e0237519, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32810162

RESUMEN

INTRODUCTION: Microfinance is a widely promoted developmental initiative to provide poor women with affordable financial services for poverty alleviation. One popular adaption in South Asia is the Self-Help Group (SHG) model that India adopted in 2011 as part of a federal poverty alleviation program and as a secondary approach of integrating health literacy services for rural women. However, the evidence is limited on who joins and continues in SHG programs. This paper examines the determinants of membership and staying members (outcomes) in an integrated microfinance and health literacy program from one of India's poorest and most populated states, Uttar Pradesh across a range of explanatory variables related to economic, socio-demographic and area-level characteristics. METHOD: Using secondary survey data from the Uttar Pradesh Community Mobilization project comprising of 15,300 women from SHGs and Non-SHG households in rural India, we performed multivariate logistic and hurdle negative binomial regression analyses to model SHG membership and duration. RESULTS: While in general poor women are more likely to be SHG members based on an income threshold limit (government-sponsored BPL cards), women from poorest households are more likely to become members, but less likely to stay members, when further classified using asset-based wealth quintiles. Additionally, poorer households compared to the marginally poor are less likely to become SHG members when borrowing for any reason, including health reasons. Only women from moderately poor households are more likely to continue as members if borrowing for health and non-income-generating reasons. The study found that an increasing number of previous pregnancies is associated with a higher membership likelihood in contrast to another study from India reporting a negative association. CONCLUSION: The study supports the view that microfinance programs need to examine their inclusion and retention strategies in favour of poorest household using multidimensional indicators that can capture poverty in its myriad forms.


Asunto(s)
Participación de la Comunidad/estadística & datos numéricos , Organización de la Financiación/estadística & datos numéricos , Accesibilidad a los Servicios de Salud , Servicios de Salud Materno-Infantil , Grupos de Autoayuda/organización & administración , Adolescente , Adulto , Composición Familiar , Femenino , Organización de la Financiación/organización & administración , Alfabetización en Salud/economía , Alfabetización en Salud/organización & administración , Promoción de la Salud , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Renta/estadística & datos numéricos , India/epidemiología , Recién Nacido , Servicios de Salud Materno-Infantil/economía , Servicios de Salud Materno-Infantil/organización & administración , Servicios de Salud Materno-Infantil/provisión & distribución , Persona de Mediana Edad , Pobreza/economía , Pobreza/estadística & datos numéricos , Embarazo , Población Rural/estadística & datos numéricos , Grupos de Autoayuda/estadística & datos numéricos , Encuestas y Cuestionarios , Factores de Tiempo , Adulto Joven
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