Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 9 de 9
Filtrar
1.
JAMA ; 331(5): 444-445, 2024 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-38319338
2.
BMC Health Serv Res ; 22(1): 736, 2022 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-35655276

RESUMO

BACKGROUND: This article reports an evaluation of the Immunization Training Challenge Hackathons (ITCH), invented by The Geneva Learning Foundation (TGLF) for national and sub-national immunization staff who strive to develop the knowledge and capacity of others to improve immunization program performance. ITCH, a fully-digital program focused on networked collaborative problem-solving between peers, provided an "opt-in" activity for learners in the Teach to Reach (T2R) Accelerator Program designed to improve training effectiveness in the immunization sphere. METHODS: Conducted by a team from the University of Georgia, this mixed method evaluation consisted of thematic analysis of recorded sessions and open-ended comments; and statistical analyses of application and follow-up survey data. The evaluation focused on what was learned and how ITCH participants implemented what they learned. Key stakeholder interviews provided supplemental data about program intent and results. ITCH consisted of 17 30-min sessions held in 2020, in English and French, with 581 participating at least once out of 1,454 enrolled in the overall program. Challenge owners and respondents came from 15 African and Asian countries and spanned different roles with differing scope. RESULTS: Over 85% [n = 154] of survey respondents [n = 181, a 31% response rate] indicated they were able to implement what they learned from the ITCH sessions. A majority [n = 139, 76.7%] reported finding the sessions useful. Issues with poor connectivity and the timing of the live meetings impeded some in their ability to participate, a problem compounded by consequences of the pandemic. The ITCH process constituted of learning or coming to consciousness simultaneously of four types of learning - participants realizing how much they could learn from each other (peer learning), experiencing the power of defying distance to solve problems together (remote learning), and feeling a growing sense of belonging to a community (social learning), emergent across country borders and health system levels (networked learning). CONCLUSIONS: Based on evaluation findings, it was concluded that ITCH demonstrated an effective scalable, informal, non-didactic, experience-led, fast-paced, peer learning design. A focus on community engagement and developing brokering skills was recommended.


Assuntos
Imunização , Saúde Pública , Humanos , Programas de Imunização , Grupo Associado , Resolução de Problemas
3.
J Public Health Manag Pract ; 17(4): 350-3, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21617411

RESUMO

We describe and assess how the College of Public Health at the University of Georgia, established in 2005, has developed formal institutional mechanisms to facilitate community-university partnerships that serve the needs of communities and the university. The College developed these partnerships as part of its founding; therefore, the University of Georgia model may serve as an important model for other new public health programs. One important lesson is the need to develop financial and organizational mechanisms that ensure stability over time. Equally important is attention to how community needs can be addressed by faculty and students in academically appropriate ways. The integration of these 2 lessons ensures that the academic mission is fulfilled at the same time that community needs are addressed. Together, these lessons suggest that multiple formal strategies are warranted in the development of academically appropriate and sustainable university-community partnerships.


Assuntos
Relações Comunidade-Instituição/economia , Necessidades e Demandas de Serviços de Saúde , Saúde Pública/educação , Serviços de Saúde Comunitária , Georgia , Universidades
4.
Am J Obstet Gynecol ; 196(3): 198-205, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17346522

RESUMO

OBJECTIVE: The purpose of this study was to compare free beta and intact human chorionic gonadotropin in first trimester screening with pregnancy-associated plasma protein-A and nuchal translucency. STUDY DESIGN: A Monte Carlo simulation trial was conducted based on a literature review of the PUBMED database (1966 to November 2005). RESULTS: In younger patients (< 35 years), detection of Down syndrome increased by 4, 5, 6, and 7 percentage points when free beta was added to pregnancy-associated plasma protein-A and nuchal translucency compared with 0, 0, 2, and 4 percentage points for intact human chorionic gonadotropin at 9-12 weeks' gestation, respectively. In advanced maternal age patients (> or = 35), inclusion of free beta-human chorionic gonadotropin reduced the false-positive rate by 2.5, 3.1, 3.8, and 4.4 percentage points compared with 0.1, 0.3, 1.0, and 2.2 percentage points for intact human chorionic gonadotropin at 9-12 weeks, respectively. CONCLUSION: The results of our analysis suggest that in a first-trimester Down syndrome screening protocol free beta-human chorionic gonadotropin achieves higher sensitivity and lower false-positive results than intact human chorionic gonadotropin . Moreover, intact human chorionic gonadotropin does not add substantially to screening performance until the end of the first trimester.


Assuntos
Gonadotropina Coriônica Humana Subunidade beta/sangue , Gonadotropina Coriônica/sangue , Síndrome de Down/diagnóstico , Proteína Plasmática A Associada à Gravidez/análise , Biomarcadores/sangue , Protocolos Clínicos , Feminino , Humanos , Gravidez , Primeiro Trimestre da Gravidez
6.
Semin Perinatol ; 29(6): 364-6, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16533648

RESUMO

Screening and diagnostic testing are sequentially-oriented procedures for progressively analyzing risk. Screening is broadly based and aimed at identifying those at high risk of a disease or condition. Diagnostic testing is designed to more definitively answer the question of whether or not a person has a disease or condition. Understanding the differences among four key measures of evaluation for tests (sensitivity, specificity, positive predictive value and negative predictive value) are necessary for proper utilization of screening tests.


Assuntos
Programas de Rastreamento , Síndrome de Imunodeficiência Adquirida/diagnóstico , Técnicas e Procedimentos Diagnósticos , Reações Falso-Positivas , Feminino , Doenças Genéticas Inatas/diagnóstico , Predisposição Genética para Doença , Infecções por HIV/diagnóstico , Humanos , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Idade Materna , Gravidez , Diagnóstico Pré-Natal , Fatores de Risco , Sensibilidade e Especificidade , Estatística como Assunto
7.
J Extra Corpor Technol ; 36(2): 145-8, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15334754

RESUMO

Subsequent to cardiac surgery with cardiopulmonary bypass (CPB), patients are at risk of postoperative bleeding caused by acquired defects associated with the procedure. As such, many patients receive prophylactic blood product transfusion. The effectiveness of measuring platelet function using a near-patient platelet function analyzer for the purpose of regulating platelet transfusion and potentially modulating other blood products including fresh frozen plasma (FFP) and cryoprecipitate (CRYO) transfusion was evaluated prospectively in patients undergoing CPB. A 6-month prospective study was designed that encompassed all CPB patients at Aultman Hospital (Canton, OH) during 2001. Each patient was assessed postoperatively for platelet count and function using a point-of-care analyzer. Data were used to help determine whether a platelet transfusion would be administered. Transfusion of CRYO and FFP was also recorded. The data were then compared to the retrospective same 6-month period in the preceding year for the purpose of determining the value of this system in guiding transfusion triage. There were 1770 platelet packs transfused during the study period, representing a 34% reduction in platelet usage. Platelet transfusions were reduced by 51% (5.75 in 2001 vs. 11.75 in 2000) per patient. CRYO/FFP usage was also substantially reduced. During the study period, the patient caseload had increased by 72 (310 vs. 238). Monitoring platelet count and function as a result of CPB and administering an appropriate transfusion protocol can positively impact transfusion outcome.


Assuntos
Ponte Cardiopulmonar , Contagem de Plaquetas/instrumentação , Transfusão de Plaquetas , Sistemas Automatizados de Assistência Junto ao Leito , Hemorragia Pós-Operatória/prevenção & controle , Autoanálise/instrumentação , Bioensaio , Ponte Cardiopulmonar/efeitos adversos , Humanos , Cuidados Pós-Operatórios/instrumentação , Estudos Prospectivos , Fatores de Risco , Fatores de Tempo
8.
Clin Biochem ; 37(6): 481-8, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15183296

RESUMO

OBJECTIVES: Elevated plasma lipoprotein(a) [Lp(a)] is a significant risk factor for vascular disease. Standardization of Lp(a) mass measurement is complicated by the heterogeneity of apolipoprotein(a) [apo(a)]. We investigated whether Lp(a) cholesterol measurement, which is not influenced by apo(a) size, is a viable alternative to measuring Lp(a) mass. DESIGN AND METHODS: Plasma Lp(a) cholesterol was measured electrophoretically, with and without ultracentrifugation, and results were compared to each other and to immunoturbidimetrically measured Lp(a) mass in 470 subjects. RESULTS: Ultracentrifuged and whole plasma Lp(a) cholesterol levels demonstrated high correlation (R = 0.964). All samples with detectable (>/=2.0 mg/dl) Lp(a) cholesterol had Lp(a) mass >30 mg/dl (the clinically relevant cutpoint), while 59 samples with Lp(a) mass >30 mg/dl did not have detectable Lp(a) cholesterol. CONCLUSIONS: Lp(a) cholesterol can be measured in whole plasma without interference from VLDL lipoproteins. The relative clinical merits of measuring Lp(a) cholesterol vs. Lp(a) mass or both in combination deserves investigation.


Assuntos
Colesterol/sangue , Eletroforese em Gel de Ágar , Lipoproteína(a)/sangue , Nefelometria e Turbidimetria , Ultracentrifugação , Western Blotting , Estudos de Viabilidade , Humanos , Minnesota , Valores de Referência , Análise de Regressão , Fatores de Risco , Doenças Vasculares/sangue
9.
Diabetes Technol Ther ; 5(4): 695-702, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14511424

RESUMO

Current diabetes management requires the collection of a large volume of data by the patient for analysis by his or her provider. There are numerous practical and technical barriers to doing this effectively and efficiently. In addition, the calculation of the correct insulin dose is complex because it requires considering anticipated carbohydrate consumption and exercise in addition to the current blood glucose level. A Diabetes Management and Communication System (DMCS) has been developed using a Compaq iPAQ Pocket PC with a Sprint PCS wireless AirCard. This system circumvents the problem of multiple proprietary programs for each brand of meter and permits the accurate determination of the proper insulin dose. Privacy is maintained by using only the iPAQ serial number as the patient identifier with access to the website protected by unique patient and provider passwords. The iPAQ was programmed with formulas that included: insulin sensitivity factor, current glucose level, amount of carbohydrates, appropriate carbohydrate:insulin ratio for that meal, and duration/intensity of exercise. Once the information is entered, an insulin dose is calculated, although an alternative dose can be selected. The data are downloaded to http://www.HealthSentry.net, where they are displayed in both tabular and graphic form. The patient may view the glucose data in both tabular and graphic form on the iPAQ. Thus a DMCS has been developed to assist patients and providers in improving glycemic control. A proof-of-concept study is underway to determine the effectiveness of the DMCS in patients with Type 1 diabetes mellitus who are currently using insulin pumps.


Assuntos
Glicemia/análise , Diabetes Mellitus/terapia , Software , Automação , Carboidratos da Dieta , District of Columbia , Monitoramento Ambiental/métodos , Humanos , Insulina/sangue , Medicina Militar/métodos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...