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1.
Mayo Clin Proc ; 96(5): 1250-1261, 2021 05.
Artigo em Inglês | MEDLINE | ID: covidwho-1219872

RESUMO

The administration of spike monoclonal antibody treatment to patients with mild to moderate COVID-19 is very challenging. This article summarizes essential components and processes in establishing an effective spike monoclonal antibody infusion program. Rapid identification of a dedicated physical infrastructure was essential to circumvent the logistical challenges of caring for infectious patients while maintaining compliance with regulations and ensuring the safety of our personnel and other patients. Our partnerships and collaborations among multiple different specialties and disciplines enabled contributions from personnel with specific expertise in medicine, nursing, pharmacy, infection prevention and control, electronic health record (EHR) informatics, compliance, legal, medical ethics, engineering, administration, and other critical areas. Clear communication and a culture in which all roles are welcomed at the planning and operational tables are critical to the rapid development and refinement needed to adapt and thrive in providing this time-sensitive beneficial therapy. Our partnerships with leaders and providers outside our institutions, including those who care for underserved populations, have promoted equity in the access of monoclonal antibodies in our regions. Strong support from institutional leadership facilitated expedited action when needed, from a physical, personnel, and system infrastructure standpoint. Our ongoing real-time assessment and monitoring of our clinical program allowed us to improve and optimize our processes to ensure that the needs of our patients with COVID-19 in the outpatient setting are met.


Assuntos
Antivirais/administração & dosagem , COVID-19 , Procedimentos Clínicos , Terapia por Infusões no Domicílio , SARS-CoV-2 , Glicoproteína da Espícula de Coronavírus , Anticorpos Monoclonais/administração & dosagem , COVID-19/epidemiologia , COVID-19/terapia , Protocolos Clínicos , Procedimentos Clínicos/organização & administração , Procedimentos Clínicos/tendências , Eficiência Organizacional , Terapia por Infusões no Domicílio/métodos , Terapia por Infusões no Domicílio/normas , Humanos , Colaboração Intersetorial , Cultura Organizacional , Desenvolvimento de Programas/métodos , SARS-CoV-2/imunologia , SARS-CoV-2/isolamento & purificação , Índice de Gravidade de Doença , Glicoproteína da Espícula de Coronavírus/antagonistas & inibidores , Glicoproteína da Espícula de Coronavírus/imunologia , Estados Unidos/epidemiologia
2.
Mayo Clin Proc ; 96(5): 1250-1261, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33958056

RESUMO

The administration of spike monoclonal antibody treatment to patients with mild to moderate COVID-19 is very challenging. This article summarizes essential components and processes in establishing an effective spike monoclonal antibody infusion program. Rapid identification of a dedicated physical infrastructure was essential to circumvent the logistical challenges of caring for infectious patients while maintaining compliance with regulations and ensuring the safety of our personnel and other patients. Our partnerships and collaborations among multiple different specialties and disciplines enabled contributions from personnel with specific expertise in medicine, nursing, pharmacy, infection prevention and control, electronic health record (EHR) informatics, compliance, legal, medical ethics, engineering, administration, and other critical areas. Clear communication and a culture in which all roles are welcomed at the planning and operational tables are critical to the rapid development and refinement needed to adapt and thrive in providing this time-sensitive beneficial therapy. Our partnerships with leaders and providers outside our institutions, including those who care for underserved populations, have promoted equity in the access of monoclonal antibodies in our regions. Strong support from institutional leadership facilitated expedited action when needed, from a physical, personnel, and system infrastructure standpoint. Our ongoing real-time assessment and monitoring of our clinical program allowed us to improve and optimize our processes to ensure that the needs of our patients with COVID-19 in the outpatient setting are met.


Assuntos
Antivirais/administração & dosagem , COVID-19 , Procedimentos Clínicos , Terapia por Infusões no Domicílio , SARS-CoV-2 , Glicoproteína da Espícula de Coronavírus , Anticorpos Monoclonais/administração & dosagem , COVID-19/epidemiologia , COVID-19/terapia , Protocolos Clínicos , Procedimentos Clínicos/organização & administração , Procedimentos Clínicos/tendências , Eficiência Organizacional , Terapia por Infusões no Domicílio/métodos , Terapia por Infusões no Domicílio/normas , Humanos , Colaboração Intersetorial , Cultura Organizacional , Desenvolvimento de Programas/métodos , SARS-CoV-2/imunologia , SARS-CoV-2/isolamento & purificação , Índice de Gravidade de Doença , Glicoproteína da Espícula de Coronavírus/antagonistas & inibidores , Glicoproteína da Espícula de Coronavírus/imunologia , Estados Unidos/epidemiologia
5.
Nurs Adm Q ; 45(2): 152-158, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1078873

RESUMO

This article describes the implementation of an evidence-based mentoring program for new registered nurses (RNs) hired into medical-surgical units in a small community-based hospital during the unfolding of the SARS-Cov2 (COVID-19) pandemic. The hospital's nursing leadership supported the program implementation during the COVID-19 pandemic to provide a broader support system to new RNs to improve nurse retention. During a response to the pandemic, the medical-surgical units faced numerous process changes in a short time, which further reinforced the urgency of an additional support system for the newly hired RNs.


Assuntos
COVID-19/enfermagem , Liderança , Tutoria/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , COVID-19/epidemiologia , Enfermagem Baseada em Evidências/organização & administração , Hospitais Comunitários/organização & administração , Humanos , Satisfação no Emprego , Recursos Humanos de Enfermagem no Hospital/educação , Pandemias , Desenvolvimento de Programas/métodos , Melhoria de Qualidade , SARS-CoV-2
6.
Nurs Outlook ; 69(2): 127-135, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33583605

RESUMO

BACKGROUND: There is a lack of formal guidelines and decision support tools to prevent community-acquired pressure injuries (CAPrIs) in Veterans with spinal cord injury (SCI). PURPOSE: In this article we present our research protocol that describes our plans to create and test a decision support tool to prevent CAPrIs in SCI. METHODS: In Aim 1, we identified mental-models of CAPrI prevention from the perspectives of Veterans (using photovoice, guided tours), and Veterans Health Administration SCI providers (using interviews), and triangulation to compare the two mental-models. This led to a decision support tool developed and validated using Delphi approaches in Aim 2 and will be followed by tool automation and system redesign for pilot implementation in Aim 3. FINDINGS: The nurse-led research protocol provides a map to systematically explore, address and translate research into evidence-based practice. DISCUSSION: Refinement of the protocol will guide future research and implementation.


Assuntos
Assistência Ambulatorial/métodos , Protocolos Clínicos , Técnicas de Apoio para a Decisão , Lesão por Pressão/prevenção & controle , Traumatismos da Medula Espinal/complicações , Assistência Ambulatorial/tendências , Técnica Delfos , Humanos , Desenvolvimento de Programas/métodos , Psicometria/instrumentação , Psicometria/métodos
7.
Nurs Adm Q ; 45(2): 152-158, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33570882

RESUMO

This article describes the implementation of an evidence-based mentoring program for new registered nurses (RNs) hired into medical-surgical units in a small community-based hospital during the unfolding of the SARS-Cov2 (COVID-19) pandemic. The hospital's nursing leadership supported the program implementation during the COVID-19 pandemic to provide a broader support system to new RNs to improve nurse retention. During a response to the pandemic, the medical-surgical units faced numerous process changes in a short time, which further reinforced the urgency of an additional support system for the newly hired RNs.


Assuntos
COVID-19/enfermagem , Liderança , Tutoria/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , COVID-19/epidemiologia , Enfermagem Baseada em Evidências/organização & administração , Hospitais Comunitários/organização & administração , Humanos , Satisfação no Emprego , Recursos Humanos de Enfermagem no Hospital/educação , Pandemias , Desenvolvimento de Programas/métodos , Melhoria de Qualidade , SARS-CoV-2
8.
Medicine (Baltimore) ; 100(1): e23995, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429761

RESUMO

ABSTRACT: The Chinese government is attaching great importance to the development of ambulatory surgery in order to optimize the healthcare system in China. The study aims to examine the complications and quality indicators of patients who underwent gynecological ambulatory surgery at a tertiary hospital in China.This was a retrospective study of patients who underwent ambulatory surgery between July and September 2019 at the Department of Gynecology of the First Affiliated Hospital of Shandong First Medical University. The patients were followed by phone at 30 days after discharge. The postoperative complications, mortality, unplanned re-operation, delayed discharge, unplanned re-hospitalization, and patient satisfaction were collected. The patients who underwent conventional hysteroscopic resection of uterine lesions during the same period were collected as controls for the economics analysis.A total of 392 patients who underwent ambulatory gynecological surgery were included. Fifteen patients had postoperative complications, and the total complication rate was 3.8% (15/392). Eight (8/392, 2.0%) patients had delayed discharge. There were no unplanned re-operations and deaths. There were two (2/392, 0.5%) cases of unplanned re-hospitalization. At 30 days after discharge, two patients were dissatisfied, and 390 cases were satisfied, for an overall satisfaction rate of 99.5%. Compared with conventional hysteroscopic resection of uterine lesions, ambulatory hysteroscopic surgery had a shorter hospital stay and lower total costs (P < .05) but similar surgery-related costs.Ambulatory gynecological surgery is feasible in China, with an acceptable complication profile and obvious economic and social benefits. Nevertheless, hospital management shall be reinforced.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/métodos , Adulto , Procedimentos Cirúrgicos Ambulatórios/métodos , Procedimentos Cirúrgicos Ambulatórios/normas , Procedimentos Cirúrgicos Ambulatórios/tendências , China/epidemiologia , Estudos de Viabilidade , Feminino , Procedimentos Cirúrgicos em Ginecologia/normas , Procedimentos Cirúrgicos em Ginecologia/tendências , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Desenvolvimento de Programas/métodos , Estudos Retrospectivos
9.
Neurosci Lett ; 746: 135660, 2021 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-33476710

RESUMO

As an integrative discipline, neuroscience can serve as a vehicle for the development of integrative thinking skills and broad-based scientific proficiency in undergraduate students. Undergraduate neuroscience curricula incorporate fundamental concepts from multiple disciplines. Deepening the explicit exploration of these connections in a neuroscience core curriculum has the potential to support more meaningful and successful undergraduate STEM learning for neuroscience students. Curriculum and faculty development activities related to an integrative core curriculum can provide opportunities for faculty across disciplines and departments to advance common goals of inclusive excellence in STEM. These efforts facilitate analysis of the institutional STEM curriculum from the student perspective, and assist in creating an internal locus of accountability for diversity, equity, and inclusion within the institution. Faculty at the College of the Holy Cross have undertaken the collaborative design and implementation of an integrative core curriculum for neuroscience that embraces principles of inclusive pedagogy, emphasizes the connections between neuroscience and other disciplines, and guides students to develop broad proficiency in fundamental STEM concepts and skills.


Assuntos
Currículo/tendências , Neurociências/educação , Neurociências/tendências , Desenvolvimento de Programas/métodos , Estudantes , Universidades/tendências , Escolaridade , Humanos
10.
J Transcult Nurs ; 32(2): 186-190, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33150851

RESUMO

In the midst of the current COVID-19 pandemic, telehealth or the remote delivery of mental health services via videoconferencing technology is experiencing exponential growth in utilization. Telehealth services provide mental healthcare providers the ability to deliver timely assessments, facilitate and leverage scarce resources, and maintain client connections in a time where social distancing is endorsed. The delivery of culturally appropriate psychiatric telehealth services is particularly relevant for diverse ethnic populations along with best practices to promote client-provider engagement and client satisfaction. The aim of this article is to provide an overview of psychiatric telehealth services and its functions and deliver insights into culturally appropriate practice strategies.


Assuntos
Transtornos Mentais/terapia , Desenvolvimento de Programas/métodos , Telemedicina/normas , COVID-19/prevenção & controle , COVID-19/transmissão , Humanos , Transtornos Mentais/psicologia , Quarentena , Telemedicina/métodos
11.
Nurs Outlook ; 69(2): 202-211, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33158560

RESUMO

BACKGROUND: The Department of Veterans Affairs (VA) Quality Scholars (VAQS) program, an interprofessional fellowship that includes pre- and postdoctoral nurses, aims to inspire practice change leaders. Fellows participate in a national curriculum, lead improvement/research teams, and establish professional development plans with expert mentor guidance. PURPOSE: To describe the distinctive elements of the VAQS program, nurse fellow outcomes, and accomplishments of nurse alumni as leaders, researchers, and educators. METHODS: Data were reviewed and aggregated from past and current fellow surveys. FINDINGS: Nurse fellows completed research and improvement projects that benefitted both the VA and the local health systems. Scholarly outcomes include publications, conference presentations, grant submissions, teaching/leading quality improvement, and research initiatives. Graduates transition to positions as nurse scientists, academic faculty, and operational leaders. DISCUSSION: Fellows contribute to the strategic priorities of local and national VA and external health care organizations providing a pipeline of health system expert leaders, educators, and researchers. CONCLUSION: Doctoral nursing fellowship experiences build human capital for enhancing the science of improvement and implementation, interprofessional collaboration, and leadership.


Assuntos
Escolaridade , Bolsas de Estudo/métodos , United States Department of Veterans Affairs/estatística & dados numéricos , Emprego/métodos , Emprego/estatística & dados numéricos , Bolsas de Estudo/tendências , Humanos , Liderança , Desenvolvimento de Programas/métodos , Melhoria de Qualidade/estatística & dados numéricos , Estados Unidos , United States Department of Veterans Affairs/organização & administração
12.
Midwifery ; 92: 102861, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33137546

RESUMO

OBJECTIVES: To explore facilitators and barriers to the implementation of a physiological approach to care during labour and birth in obstetric settings. To explore how facilitators and barriers located at three levels: organisation, professional groups (midwives and obstetricians) and women, interact to influence the implementation of a physiological approach. METHOD: A systematic review of the literature, identified 32 eligible studies from four databases reporting relevant qualitative data. Findings from these studies were thematically synthesised in three phases: line by line coding of findings from primary studies, development of descriptive themes and analytical themes. This review is reported in line with PRISMA guidelines. FINDINGS: At an organisational level, centralisation of care in obstetric units limited time for labouring and professional care to support a physiological labour and birth. Risk management strategies ostensibly designed to promote safety sustained a risk-based approach. At a professional level, important barriers include hierarchical decision-making led by obstetricians, midwifery acquiescence, obstetric and midwifery risk preoccupation, rationalisation of the routine use of clinical intervention and an erosion of midwifery skills and knowledge. At the level of the woman, barriers include a lack of knowledge and reliance on professional decision-making. Facilitators include collaborative working by midwives and obstetricians, a valuing of midwifery autonomy and women's questioning of inappropriate intervention use. KEY CONCLUSIONS: Contrary to evidence-based guidelines that recommend a physiological approach, a risk-based approach informs practices in obstetric units. Primary research has mainly identified barriers to implementing a physiological approach at a professional level, and this has been studied largely from a midwifery perspective. To aid comprehensive investigations of facilitators and barriers and their interactive influences, this review identifies important research gaps for study across all levels: organisation, professionals (midwives and obstetricians) and women. IMPLICATIONS FOR PRACTICE: Risk preoccupations and rationalisation, with negative influences on knowledge and skills in the use of a physiological approach, must prompt reflection and action amongst professional groups. Power imbalances between midwives and obstetricians need to be addressed, drawing on experiences in units where collaborative working and midwifery autonomy is fostered.


Assuntos
Prática Clínica Baseada em Evidências/normas , Fenômenos Reprodutivos Fisiológicos , Atitude do Pessoal de Saúde , Prática Clínica Baseada em Evidências/métodos , Humanos , Tocologia/métodos , Tocologia/normas , Desenvolvimento de Programas/métodos
13.
Midwifery ; 92: 102878, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33161173

RESUMO

OBJECTIVE: To identify factors influencing the OB triage implementation in Iran DESIGN: Qualitative study of conventional content analysis SETTING: A teaching tertiary referral hospital in Ahvaz, Khuzestan, Iran PARTICIPANTS: 37 professional midwives, nurses, gynecologists, and specialists of emergency medicine, and 6 patients MEASUREMENTS AND FINDINGS: Semi-structured interviews were conducted individually and face-to-face. Interviews were audio recorded, transcribed, and analyzed using conventional content analysis. Four overarching categories and nine themes emerged from the content analysis of the interviews and observations. Overarching categories were the guideline, individual, cultural and social context, and organization. The development and structure were themes of the guideline. Knowledge, attitudes, and behaviors were related to the category of individuals. The cultural and social context included cultural and social changes. Implementation and monitoring strategies and executive infrastructure were organizational themes. Participants had differences and similarities in understanding influencing factors. CONCLUSION: The guideline, individual, cultural and social context, and organization were key factors influencing the OB triage implementation in Iran. Some variety was detected between the different occupational groups' perceptions of influencing factors. Providing human resources and training and empowerment of them was the most significant factor influencing, which was acknowledged by almost all participants in all occupational groups. IMPLICATION FOR PRACTICE: Identifying the influencing factors from the perspective of all stakeholders can improve the process of OB triage implementation by eliminating barriers and enhancing facilitators.


Assuntos
Trabalho de Parto , Triagem/normas , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Entrevistas como Assunto/métodos , Irã (Geográfico) , Gravidez , Desenvolvimento de Programas/métodos , Pesquisa Qualitativa , Triagem/métodos , Triagem/estatística & dados numéricos
14.
J Nurs Adm ; 51(1): 33-37, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33278199

RESUMO

Mobile supplemental hospitals were an important asset to community response in preparing for the recent pandemic. MED-1 is a Mobile Emergency Department that has adapted and evolved to the changing needs of communities in times of disaster and nondisaster. An overview of the asset (MED-1), the operations, and use is provided to demonstrate how mobile supplemental hospitals can effectively meet a range of healthcare needs. Innovative utilization of MED-1 has secured its future as an effective resource averaging 100 days of deployment per year.


Assuntos
Ambulâncias , Defesa Civil/métodos , Planejamento em Desastres/métodos , Defesa Civil/tendências , Planejamento em Desastres/tendências , Humanos , Desenvolvimento de Programas/métodos
15.
Acad Med ; 96(3): 384-389, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33332906

RESUMO

PROBLEM: The World Health Organization and the World Bank have identified improvement in access to surgical care as an urgent global health challenge and a cost-effective investment in public health. However, trainees in standard U.S. general surgery programs do not have adequate exposure to the procedures, technical skills, and foundational knowledge essential for providing surgical care in resource-limited settings. APPROACH: The Michael E. DeBakey Department of Surgery at Baylor College of Medicine (BCM) created a 7-year global surgery track within its general surgery residency in 2014. Individualized rotations equip residents with the necessary skills, knowledge, and experience to operate in regions with low surgeon density and develop sustainable surgical infrastructures. BCM provides a formal, integrated global surgery curriculum-including 2 years dedicated to global surgery-with surgical specialty rotations in domestic and international settings. Residents tailor their individual experience to the needs of their future clinical practice, region of interest, and surgical specialty. OUTCOMES: There have been 4 major outcomes of the BCM global surgery track: (1) increased exposure for trainees to a broad range of surgeries critical in resource-limited settings, (2) meaningful international partnerships, (3) contributions to global surgery scholarship, and (4) establishment of sustainable global surgery activities. NEXT STEPS: To better facilitate access to safe, timely, and affordable surgical care worldwide, global surgeons should pursue expertise in topics not currently included in U.S. general surgical curricula, such as setting-specific technical skills, capacity building, and organizational collaboration. Future evaluations of the BCM global surgery track will assess the effect of individualized education on trainees' professional identities, clinical practices, academic pursuits, global surgery leadership preparedness, and comfort with technical skills not encompassed in general surgery programs. Increasing availability of quality global surgery training programs would provide a critical next step toward contributing to the delivery of safe surgical care worldwide.


Assuntos
Educação de Pós-Graduação em Medicina/organização & administração , Saúde Global/economia , Especialidades Cirúrgicas/organização & administração , Cirurgiões/provisão & distribuição , Competência Clínica , Análise Custo-Benefício/estatística & dados numéricos , Currículo/normas , Bolsas de Estudo/métodos , Cirurgia Geral/educação , Acesso aos Serviços de Saúde/normas , Humanos , Cooperação Internacional , Internato e Residência , Conhecimento , Desenvolvimento de Programas/métodos , Especialidades Cirúrgicas/estatística & dados numéricos , Estados Unidos/epidemiologia
16.
Am Psychol ; 75(9): 1376-1388, 2020 12.
Artigo em Inglês | MEDLINE | ID: covidwho-1003293

RESUMO

In today's world of global migration and urbanization, millions of children are separated from parents. Their mental health and future competences as citizens depend on the quality of care from foster parents and group home staff in nonparental care settings. Caregivers are challenged by poor work conditions, too many children, and a lack of knowledge about care for traumatized children. How can our profession match this challenge by upscaling interventions? Digital designs for applications of psychology are growing, recently accelerated by the COVID-19 crisis. From 2008, the author developed a blended learning intervention. In partnerships with nongovernmental organizations and government agencies, care recommendations from an international network of researchers are transformed into start-up seminars for staff, followed by a 6-month online classroom education. Students learn and practice how to train local caregiver groups in attachment-based care, using training sessions developed in local languages, adjusted to culture. At present, the author's Fairstart Foundation educated 500 staff from partners in 26 countries, who have trained the caregivers of some 40,000 children. The theoretical, logistic and technical steps from research to daily caregiver-child practices are described, to inspire discussions of how online designs and international partnerships may benefit underserved populations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Cuidadores/educação , Cuidado da Criança , Criança Abandonada , Educação à Distância , Cuidados no Lar de Adoção , Lares para Grupos , Desenvolvimento de Programas , Trauma Psicológico/enfermagem , Capacitação de Professores , Adulto , COVID-19 , Criança , Cuidado da Criança/métodos , Cuidado da Criança/organização & administração , Cuidado da Criança/normas , Cuidado da Criança/estatística & dados numéricos , Criança Abandonada/estatística & dados numéricos , Educação à Distância/métodos , Educação à Distância/organização & administração , Educação à Distância/estatística & dados numéricos , Cuidados no Lar de Adoção/métodos , Cuidados no Lar de Adoção/organização & administração , Cuidados no Lar de Adoção/estatística & dados numéricos , Lares para Grupos/organização & administração , Lares para Grupos/estatística & dados numéricos , Humanos , Cooperação Internacional , Colaboração Intersetorial , Desenvolvimento de Programas/métodos , Desenvolvimento de Programas/normas , Desenvolvimento de Programas/estatística & dados numéricos , Capacitação de Professores/métodos , Capacitação de Professores/organização & administração , Capacitação de Professores/estatística & dados numéricos
17.
Am Psychol ; 75(9): 1376-1388, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33382320

RESUMO

In today's world of global migration and urbanization, millions of children are separated from parents. Their mental health and future competences as citizens depend on the quality of care from foster parents and group home staff in nonparental care settings. Caregivers are challenged by poor work conditions, too many children, and a lack of knowledge about care for traumatized children. How can our profession match this challenge by upscaling interventions? Digital designs for applications of psychology are growing, recently accelerated by the COVID-19 crisis. From 2008, the author developed a blended learning intervention. In partnerships with nongovernmental organizations and government agencies, care recommendations from an international network of researchers are transformed into start-up seminars for staff, followed by a 6-month online classroom education. Students learn and practice how to train local caregiver groups in attachment-based care, using training sessions developed in local languages, adjusted to culture. At present, the author's Fairstart Foundation educated 500 staff from partners in 26 countries, who have trained the caregivers of some 40,000 children. The theoretical, logistic and technical steps from research to daily caregiver-child practices are described, to inspire discussions of how online designs and international partnerships may benefit underserved populations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Cuidadores/educação , Cuidado da Criança , Criança Abandonada , Educação à Distância , Cuidados no Lar de Adoção , Lares para Grupos , Desenvolvimento de Programas , Trauma Psicológico/enfermagem , Capacitação de Professores , Adulto , COVID-19 , Criança , Cuidado da Criança/métodos , Cuidado da Criança/organização & administração , Cuidado da Criança/normas , Cuidado da Criança/estatística & dados numéricos , Criança Abandonada/estatística & dados numéricos , Educação à Distância/métodos , Educação à Distância/organização & administração , Educação à Distância/estatística & dados numéricos , Cuidados no Lar de Adoção/métodos , Cuidados no Lar de Adoção/organização & administração , Cuidados no Lar de Adoção/estatística & dados numéricos , Lares para Grupos/organização & administração , Lares para Grupos/estatística & dados numéricos , Humanos , Cooperação Internacional , Colaboração Intersetorial , Desenvolvimento de Programas/métodos , Desenvolvimento de Programas/normas , Desenvolvimento de Programas/estatística & dados numéricos , Capacitação de Professores/métodos , Capacitação de Professores/organização & administração , Capacitação de Professores/estatística & dados numéricos
18.
Med J Aust ; 213 Suppl 10: S3-S31, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33190287

RESUMO

■The RHD Endgame Strategy: the blueprint to eliminate rheumatic heart disease in Australia by 2031 (the Endgame Strategy) is the blueprint to eliminate rheumatic heart disease (RHD) in Australia by 2031. Aboriginal and Torres Strait Islander people live with one of the highest per capita burdens of RHD in the world. ■The Endgame Strategy synthesises information compiled across the 5-year lifespan of the End Rheumatic Heart Disease Centre of Research Excellence (END RHD CRE). Data and results from priority research projects across several disciplines of research complemented literature reviews, systematic reviews and narrative reviews. Further, the experiences of those working in acute rheumatic fever (ARF) and RHD control and those living with RHD to provide the technical evidence for eliminating RHD in Australia were included. ■The lived experience of RHD is a critical factor in health outcomes. All future strategies to address ARF and RHD must prioritise Aboriginal and Torres Strait Islander people's knowledge, perspectives and experiences and develop co-designed approaches to RHD elimination. The environmental, economic, social and political context of RHD in Australia is inexorably linked to ending the disease. ■Statistical modelling undertaken in 2019 looked at the economic and health impacts of implementing an indicative strategy to eliminate RHD by 2031. Beginning in 2019, the strategy would include: reducing household crowding, improving hygiene infrastructure, strengthening primary health care and improving secondary prophylaxis. It was estimated that the strategy would prevent 663 deaths and save the health care system $188 million. ■The Endgame Strategy provides the evidence for a new approach to RHD elimination. It proposes an implementation framework of five priority action areas. These focus on strategies to prevent new cases of ARF and RHD early in the causal pathway from Streptococcus pyogenes exposure to ARF, and strategies that address the critical systems and structural changes needed to support a comprehensive RHD elimination strategy.


Assuntos
Desenvolvimento de Programas/métodos , Febre Reumática/prevenção & controle , Cardiopatia Reumática/prevenção & controle , Adolescente , Adulto , Austrália/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Sistema de Registros , Febre Reumática/complicações , Febre Reumática/epidemiologia , Cardiopatia Reumática/epidemiologia , Cardiopatia Reumática/etiologia , Prevenção Secundária , Streptococcus pyogenes , Adulto Jovem
19.
BMJ Open Qual ; 9(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33028654

RESUMO

BACKGROUND: Depression, which is a serious medical illness, is prevalent worldwide and it negatively impacts the adolescent lifestyle. Adolescent depression is associated with adverse emotional and functional outcomes and suboptimal physical health. Over the last decade, it has been found that approximately 9% of teenagers meet the criteria for depression at any given time, and one in five teenagers have a history of depression during adolescence. Ninety per cent of paediatricians believe that recognition of child and adolescent depression is their responsibility; however, it has been reported that 46% lacked confidence that they could recognise depression. METHODS: In this study, adolescents between 12 and 17 years of age were screened during their well-child visits using the Patient Health Questionnaire Modified for Adolescents. A score of 10 or higher warrants a referral to a social worker and psychiatrist. The goals of this quality improvement project were to implement a standardised questionnaire and to improve the screening, diagnosis and treatment of depression in children from 12 to 17 years of age. RESULTS: It was found that the adolescent depression screening rate significantly improved within 6 months of implementing this quality improvement project. The screening rate improved to 50% by mid-cycle (Plan-Do-Study-Act (PDSA) cycle 3) and up to 70% at the end of the 6-month period (PDSA cycle 5). Improvement was noted among all providers, across all age groups, and in both male and female patients by the end of the study period. CONCLUSION: Standardised screening tests with a scoring system help providers to identify and monitor depression symptoms using a common language, especially in the outpatient clinical setting where the patient may be seen by different providers.


Assuntos
Comportamento do Adolescente/psicologia , Depressão/diagnóstico , Programas de Rastreamento/normas , Questionário de Saúde do Paciente/estatística & dados numéricos , Adolescente , Criança , Depressão/psicologia , Feminino , Hospitais Federais/organização & administração , Hospitais Federais/estatística & dados numéricos , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Desenvolvimento de Programas/métodos , Inquéritos e Questionários , Estados Unidos
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