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1.
Med J (Ft Sam Houst Tex) ; (PB 8-21-01/02/03): 20-21, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33666907

RESUMO

The Installation Management Command (IMCOM) delivers quality base support from the strategic support area, enabling readiness for a globally responsive Army. IMCOM has more than 75 installations, covering more than 13 million acres, in 17 time zones, 12 countries and 58 services. In early March 2020, the COVID-19 pandemic required IMCOM to shift focus in ensuring health protection measures were implemented early and quickly, which relied on medical expertise. The IMCOM Surgeon and the Deputy Surgeon serve as the command's key advisors for all matters related to health care and medical readiness. During the COVID-19 pandemic, the IMCOM Surgeon and the Deputy Surgeon were critical in the consolidation of various information from multiple organizations. They promoted the integration of force health protection principles during COVID-19 operations. All of the military members at IMCOM headquarters (HQ) were considered mission essential while other personnel were identified on a phasing structure in the early stages of the pandemic, which meant civilian personnel were instructed to telework.


Assuntos
/prevenção & controle , Controle de Doenças Transmissíveis/organização & administração , Colaboração Intersetorial , Medicina Militar/organização & administração , /epidemiologia , Gestão de Recursos da Equipe de Assistência à Saúde/organização & administração , Humanos , Parcerias Público-Privadas/organização & administração , Estados Unidos
3.
BMC Infect Dis ; 21(1): 212, 2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33632137

RESUMO

BACKGROUND: Healthcare-associated infections (HAIs) are relevant in developing countries where frequencies can be at least 3 times higher than in developed countries. The purpose of this research was to describe the intervention implemented in intensive care units (ICUs) to reduce HAIs through collaborative project and analyze the variation over 18 months in the incidence density (ID) of the three main HAIs: ventilator associated pneumonia (VAP), central line-associated bloodstream infections (CLABSIs) and catheter-related urinary tract infections (CAUTIs) and also the length of stay and mortality in these ICUs. METHODS: A quasi-experimental study in five public adult clinical-surgical ICUs, to reduce HAIs, through interventions using the BTS-IHI "Improvement Model", during 18 months. In the project, promoted by the Ministry of Health, Brazilian philanthropic hospitals certified for excellence (HE), those mostly private, certified as excellence and exempt from security contributions, regularly trained and monitored public hospitals in diagnostics, data collection and in developing cycles to improve quality and to prevent HAIs (bundles). In the analysis regarding the length of stay, mortality, the IDs of VAP, CLABSIs and CAUTIs over time, a Generalized Estimating Equation (GEE) model was applied for continuous variables, using the constant correlation (exchangeable) between assessments over time. The model estimated the average difference (ß coefficient of the model) of the measures analyzed during two periods: a period in the year 2017 (prior to implementing the project) and in the years 2018 and 2019 (during the project). RESULT: A mean monthly reduction of 0.427 in VAP ID (p = 0.002) with 33.8% decrease at the end of the period and 0.351 in CAUTI ID (p = 0.009) with 45% final decrease. The mean monthly reduction of 0.252 for CLABSIs was not significant (p = 0.068). Length of stay and mortality rates had no significant variation. CONCLUSIONS: Given the success in reducing VAP and CAUTIs in a few months of interventions, the achievement of the collaborative project is evident. This partnership among public hospitals/HE may be applied to other ICUs including countries with fewer resources.


Assuntos
Infecção Hospitalar/prevenção & controle , Hospitais/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Parcerias Público-Privadas/estatística & dados numéricos , Adulto , Brasil/epidemiologia , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/prevenção & controle , Infecção Hospitalar/epidemiologia , Hospitais/normas , Humanos , Incidência , Unidades de Terapia Intensiva/normas , Pneumonia Associada à Ventilação Mecânica/epidemiologia , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Parcerias Público-Privadas/organização & administração , Parcerias Público-Privadas/normas
6.
Epidemiol Serv Saude ; 29(4): e2020499, 2020 09 04.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32901699

RESUMO

This article presents an experience report about integration between public and private health services, health service managers and the academy, for surveillance and control of the COVID-19 epidemic, in the municipality of Tubarão, Santa Catarina, Brazil. The city is home to a university and has a large flow of people from different parts of the country, as well as being one of the first municipalities in the state of Santa Catarina to report cases of community transmission of SARS-CoV-2. The measures adopted included the implementation of the COVID-19 Monitoring Committee, the Municipal Health Emergency Operations Center, and the COVID-19 Contingency Plan. After 100 days of pandemic, 5,979 cases had been reported, 431 (7.2%) had been confirmed, of which five (1.2%) died. Early decisions, such as the immediate suspension of business activities and crowded events, may have reduced the spread of the virus. The partnerships put into place have provided innovation and supported public service management in decision-making based upon scientific evidence.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Relações Interinstitucionais , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Parcerias Público-Privadas/organização & administração , Comitês Consultivos , Brasil/epidemiologia , Comunicação , Infecções por Coronavirus/transmissão , Implementação de Plano de Saúde , Humanos , Pneumonia Viral/transmissão , Vigilância da População/métodos
8.
PLoS One ; 15(6): e0233802, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555648

RESUMO

BACKGROUND: Saudi Arabia is considering increasing the role of the private sector's participation in financing and delivering healthcare services through the adoption of Public-Private Partnerships (PPPs). However, the adoption and successful implementation of PPPs in the Saudi healthcare sector requires careful attention to overcome potential obstacles. OBJECTIVES: This study investigates and identifies potential barriers to the successful implementation of PPPs in the Saudi healthcare sector. METHODS: A pre-tested interviewer-administered questionnaire was used to collect data from 72 respondents over a two-month period. Respondents were asked to rate the degree of influence of potential key barriers using a five-point Likert scale. The collected data was analysed using descriptive and inferential statistics. RESULTS: The evidence showed that the top three barriers, as rated by the respondents, were legal barriers, including delays in receiving approval and permits and law and regulation changes, environmental barriers, including lack of transparency and accountability and technological barriers, including a shortage of professionals qualified to handle PPP projects. CONCLUSIONS: The barriers identified suggested that the government should ensure that PPPs are implemented in a timely manner to ensure that private sector involvement yields the intended benefits. Furthermore, a stable legal and regulatory framework must be established that is properly and easily enforced to avoid confusing stakeholders with too many changes. It is also important to ensure that transparency and accountability measures are strengthened.


Assuntos
Implementação de Plano de Saúde , Parcerias Público-Privadas/organização & administração , Assistência à Saúde/legislação & jurisprudência , Assistência à Saúde/organização & administração , Parcerias Público-Privadas/legislação & jurisprudência , Arábia Saudita
11.
Am J Trop Med Hyg ; 103(3): 947-954, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32458790

RESUMO

Fifteen years of investment in malaria control on Bioko Island, Equatorial Guinea (EG), dramatically reduced malaria-associated morbidity and mortality, but the impact has plateaued. To progress toward elimination, EG is investing in the development of a malaria vaccine. We assessed the unique public-private partnership that has had such a significant impact on malaria on Bioko Island and now added a major effort on malaria vaccine development. As part of a $79M commitment, the EG government (75%) and three American energy companies (25%) have invested since 2012 greater than $55M in the Equatoguinean Malaria Vaccine Initiative (EGMVI) to support clinical development of Sanaria® PfSPZ vaccines (Sanaria Inc., Rockville, MD). In turn, the vaccine development program is building human capital and physical capacity. The EGMVI established regulatory and ethical oversight to ensure compliance with the International Conference on Harmonization and Good Clinical Practices for the first importation of investigational product, ethical approval, and conduct of a clinical trial in Equatoguinean history. The EGMVI has completed three vaccine trials in EG, two vaccine trials in Tanzania, and a malaria incidence study, and initiated preparations for a 2,100-volunteer clinical trial. Personnel are training for advanced degrees abroad and have been trained in Good Clinical Practices and protocol-specific methods. A new facility has established the foundation for a national research institute. Biomedical research and development within this visionary, ambitious public-private partnership is fostering major improvements in EG. The EGMVI plans to use a PfSPZ Vaccine alongside standard malaria control interventions to eliminate Pf malaria from Bioko, becoming a potential model for elimination campaigns elsewhere.


Assuntos
Pesquisa Biomédica/organização & administração , Vacinas Antimaláricas/administração & dosagem , Malária Falciparum/epidemiologia , Malária Falciparum/prevenção & controle , Parcerias Público-Privadas/organização & administração , Adolescente , Criança , Pré-Escolar , Erradicação de Doenças/tendências , Guiné Equatorial/epidemiologia , Feminino , Humanos , Mosquiteiros Tratados com Inseticida/provisão & distribução , Ilhas , Malária Falciparum/parasitologia , Malária Falciparum/transmissão , Masculino , Plasmodium falciparum/patogenicidade
13.
PLoS One ; 15(4): e0231737, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32320405

RESUMO

INTRODUCTION: We sought to estimate the prevalence, severity and identify predictors of violence among adolescent girls and young women (AGYW) in informal settlement areas of Nairobi, Kenya, selected for DREAMS (Determined Resilient Empowered AIDS-free, Mentored and Safe) investment. METHODS: Data were collected from 1687 AGYW aged 10-14 years (n = 606) and 15-22 years (n = 1081), randomly selected from a general population census in Korogocho and Viwandani in 2017, as part of an impact evaluation of the "DREAMS" Partnership. For 10-14 year-olds, we measured violence experienced either in the past 6 months or ever using a different set of questions from those used for 15-22 year-olds. Among 15-22 year-olds we measured prevalence of violence, experienced in the past 12 months, using World Health Organization (WHO) definitions for violence typologies. Predictors of violence were identified using multivariable logit models. RESULTS: Among 606 girls aged 10-14 years, about 54% and 7% ever experienced psychological and sexual violence, respectively. About 33%, 16% and 5% experienced psychological, physical and sexual violence in the past 6 months. The 10-14 year old girls who engaged in chores or activities for payment in the past 6 months, or whose family did not have enough food due to lack of money were at a greater risk for violence. Invitation to DREAMS and being a non-Christian were protective. Among 1081 AGYW aged 15-22 years, psychological violence was the most prevalent in the past year (33.1%), followed by physical violence (22.9%), and sexual violence (15.8%). About 7% experienced all three types of violence. Severe physical violence was more prevalent (13.8%) than moderate physical violence (9.2%). Among AGYW aged 15-22 years, being previously married/lived with partner, engaging in employment last month, food insecure were all risk factors for psychological violence. For physical violence, living in Viwandani and being a Muslim were protective; while being previously married or lived with a partner, or sleeping hungry at night during the past 4 weeks were risk factors. The odds of sexual violence were lower among AGYW aged 18-22 years and among Muslims. Engaging in sex and food insecurity increased chances for sexual violence. CONCLUSIONS: Prevalence of recent violence among AGYW is high in this population. This calls for increased effort geared towards addressing drivers of violence as an early entry point of HIV prevention effort in this vulnerable group.


Assuntos
Abastecimento de Alimentos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Abuso Físico/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Adolescente , Criança , Estudos de Coortes , Feminino , Infecções por HIV/epidemiologia , Humanos , Quênia/epidemiologia , Abuso Físico/prevenção & controle , Abuso Físico/psicologia , Prevalência , Parcerias Público-Privadas/organização & administração , Parcerias Público-Privadas/estatística & dados numéricos , Fatores de Risco , População Rural/estatística & dados numéricos , Delitos Sexuais/prevenção & controle , Delitos Sexuais/psicologia , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos , Adulto Jovem
14.
Chin J Traumatol ; 23(3): 152-158, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32278612

RESUMO

PURPOSE: Successful application experiences on public-private partnership (PPP) in different countries, suggest that PPP could be an option in road traffic injury (RTI) prevention. The present study aims at investigating the applicability of PPP policy in RTI prevention in Iran based on the experts' perspectives. METHODS: This is a qualitative study with grounded theory approach which has been conducted in Tabriz University of Medical Sciences, Iran in 2018. The participants were 22 experts in the field of RTIs selected using purposive sampling method. Data were collected by semi-structured interviews and analyzed with content-analysis method. RESULTS: The results were classified under 5 main themes (applicability, scopes and services, challenges, advantages, and strategies) for applying PPP policy and 37 sub-themes. Due to the prevalence of RTIs, the present challenges in public sector, existence of qualified private sector, and successful experiences in other areas, there are opportunities for private sector partnership in prevention of RTIs. Private sector could participate in different scopes and services regarding RTI prevention, including road construction and maintenance, maintenance and provision of vehicles safety and public education. The main challenges including legislation issues, ambiguities in collaboration, political and organizational unsustainability, government's financial hardship and lack of experienced experts in the field of RTI. However, there are significant advantages including high efficiency in program implementation, covering the weaknesses of public sector, effective and efficient management on application of PPP in RTI prevention. The strategies include identifying and prioritizing the assignable activities, identifying the qualified private sector, developing PPP policies and legal frameworks, creating a common language between public and private parties, trying to meet the expectations of the private sector by public sector, developing a comprehensive and sound contract, and cultivating public culture to accept private sector in the field of RTI prevention. CONCLUSION: This study sought to determine whether PPP could be used as strategy to reduce the burden of RTIs in Iran. But it requires a lot of preliminary studies to provide the context and conditions for applying this policy.


Assuntos
Lesões Acidentais/prevenção & controle , Acidentes de Trânsito/prevenção & controle , Prova Pericial , Parcerias Público-Privadas , Adulto , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Parcerias Público-Privadas/organização & administração , Pesquisa Qualitativa
19.
Lancet Infect Dis ; 20(2): e54-e62, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31753765

RESUMO

In this Personal View, we critically examine the wider context of international efforts to stimulate commercial antibiotic research and development via public-private initiatives. Despite these efforts, antibiotics remain a global resource without an international support structure that is commensurate to the risks from antibiotic-resistant infections and the long-term nature of required solutions. To protect this resource, we propose a two-pronged antibiotic research and development strategy based on a short-term strengthening of incentives (such as market entry rewards) to maximise the delivery of existing opportunities in the pipeline, and on a concurrent medium-term to long-term establishment of a global, publicly funded antibiotic research and development institute. Designed sustainably to deliver novel and first-in-class antibiotics targeting key human health gaps, the institute and its staff would become a global resource that, unlike the private pharmaceutical sector, would be managed as an open science platform. Our model of internationalised public research and development would maximise scientific synergy and cross-fertilisation, minimise replication of effort, acquire and preserve existing know-how, and ensure equitable and sustainable access to novel and effective antibiotics. Its genuinely global focus would also help counteract tendencies to equate donor with global health priorities. Our proposal is not radical. Historical precedent and developments in other research areas show that sustained international funding of publicly owned research can hasten the delivery of critically needed drugs and lower barriers to access.


Assuntos
Antibacterianos/isolamento & purificação , Desenvolvimento de Medicamentos/organização & administração , Descoberta de Drogas/organização & administração , Cooperação Internacional , Pesquisa/organização & administração , Saúde Global , Humanos , Motivação , Parcerias Público-Privadas/organização & administração
20.
Nurs Res ; 69(1): 51-61, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31609899

RESUMO

BACKGROUND: As federal research funding focuses more on academic/community collaborations to address health inequities, it is important to understand characteristics of these partnerships and how they work to achieve health equity outcomes. OBJECTIVES: This study built on previous National Institutes of Health-funded research to (a) describe partnership characteristics and processes of federally funded, community-based participatory research (CBPR) or community-engaged research projects; (b) explore characteristics of these projects by stage of funding; and (c) build on previous understanding of partnership promising practices. METHODS: Between fall 2016 and spring 2017, we completed a cross-sectional analysis and principal component analysis of online survey data from key informants of federally funded CBPR and community-engaged research projects. Respondents for 179 projects (53% response rate) described project characteristics (e.g., type of partner, stage of partnership, and population) and the use of promising practices (e.g., stewardship, advisory board roles, training topics) by stage of partnership. RESULTS: Projects involved community, healthcare, and government partners, with 49% of respondents reporting their project was in the early stage of funding. More projects focused on Black/African American populations, whereas principal investigators were mostly White. The more established a partnership (e.g., with multiple projects), the more likely it employed the promising practices of stewardship (i.e., community safeguards for approval), community advisory boards, and training on values and power. CONCLUSIONS: Community engagement is a developmental process with differences between early-stage and established CBPR partnerships. Engaging in active reflection and adopting promising partnering practices are important for CBPR partnerships working to improve health equity. The data provided in this study provide key indicators for reflection.


Assuntos
Pesquisa Biomédica/métodos , Pesquisa Participativa Baseada na Comunidade/organização & administração , Comportamento Cooperativo , Equidade em Saúde , Parcerias Público-Privadas/organização & administração , Pesquisadores/psicologia , Identificação Social , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados Unidos
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