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1.
Hist Philos Life Sci ; 42(4): 53, 2020 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-33141370

RESUMO

The SARS-CoV-2 pandemic constituted a crisis situation in which science was very far from Kitcher's ideal of well-ordered science. I suggest that this could and should have been different. Kitcher's ideal should play a role in assessing the allocation of research resources in future crisis situations, as it provides a way to balance highly divergent interests and incorporate the common good into decision-making processes on research.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Projetos de Pesquisa , Pesquisa/organização & administração , Betacoronavirus/fisiologia , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia
4.
Ann Glob Health ; 86(1): 104, 2020 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-32874935

RESUMO

Despite predictions that the number of deaths in Africa due to COVID-19 will reach 10 million, overall, the continent has reported relatively few cases compared to the rest of the world. Many African countries have been successful in containing initial outbreaks by rapidly using evidence-based interventions through implementation strategies adapted from other countries' COVID-19 response as well as from prior epidemics. However, it is unclear whether these interventions will lead to long-term and complete success in stopping COVID-19 spread. Implementation research is a tool that can be used by countries to learn how to identify and understand contextual factors impacting COVID-19 prevention and control and select evidence-based interventions and strategies known to reduce spread of the virus. We identify seven key contextual factors that are facilitators or barriers to implementation of these interventions, and several strategies that can be leveraged if the factor is present or ones to strengthen if weak to improve implementation. These factors are: a culture of accountability, national coordination, financial stability of the population, culture of innovation, culture and capacity for research, health systems strength, and cross-border economies. Implementation science methods can serve to develop knowledge at a country and regional level on how to identify, utilize, and address these and other contextual factors, and inform relevant evidence-based interventions and implementation strategies. This approach can support African countries' ability to address key challenges as they arise, both in fighting COVID-19 and future health systems challenges.


Assuntos
Controle de Doenças Transmissíveis , Infecções por Coronavirus , Prática Clínica Baseada em Evidências , Pandemias , Pneumonia Viral , Pesquisa/organização & administração , Organizações de Assistência Responsáveis , África/epidemiologia , Betacoronavirus/isolamento & purificação , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Difusão de Inovações , Transmissão de Doença Infecciosa/prevenção & controle , Prática Clínica Baseada em Evidências/métodos , Prática Clínica Baseada em Evidências/normas , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Fatores Socioeconômicos
5.
Transl Behav Med ; 10(4): 827-834, 2020 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-32885815

RESUMO

The COVID-19 pandemic has slowed research progress, with particularly disruptive effects on investigations of addressing urgent public health challenges, such as chronic pain. The National Institutes of Health (NIH) Department of Defense (DoD) Department of Veterans Affairs (VA) Pain Management Collaboratory (PMC) supports 11 large-scale, multisite, embedded pragmatic clinical trials (PCTs) in military and veteran health systems. The PMC rapidly developed and enacted a plan to address key issues in response to the COVID-19 pandemic. The PMC tracked and collaborated in developing plans for addressing COVID-19 impacts across multiple domains and characterized the impact of COVID-19 on PCT operations, including delays in recruitment and revisions of study protocols. A harmonized participant questionnaire will facilitate later meta-analyses and cross-study comparisons of the impact of COVID-19 across all 11 PCTs. The pandemic has affected intervention delivery, outcomes, regulatory and ethics issues, participant recruitment, and study design. The PMC took concrete steps to ensure scientific rigor while encouraging flexibility in the PCTs, while paying close attention to minimizing the burden on research participants, investigators, and clinical care teams. Sudden changes in the delivery of pain management interventions will probably alter treatment effects measured via PMC PCTs. Through the use of harmonized instruments and surveys, we are capturing these changes and plan to monitor the impact on research practices, as well as on health outcomes. Analyses of patient-reported measures over time will inform potential relationships between chronic pain, mental health, and various socioeconomic stressors common among Americans during the COVID-19 pandemic.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus , Saúde Mental/tendências , Manejo da Dor , Pandemias , Pneumonia Viral , Pesquisa , Betacoronavirus , Dor Crônica/epidemiologia , Dor Crônica/psicologia , Dor Crônica/terapia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , National Institutes of Health (U.S.) , Manejo da Dor/ética , Manejo da Dor/métodos , Manejo da Dor/tendências , Pandemias/prevenção & controle , Seleção de Pacientes , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pesquisa/organização & administração , Pesquisa/tendências , Fatores Socioeconômicos , Estados Unidos/epidemiologia , United States Department of Veterans Affairs
11.
BMC Public Health ; 20(Suppl 2): 1058, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787895

RESUMO

BACKGROUND: Thoughtful and equitable engagement with international partners is key to successful research. STRIPE, a consortium of 8 academic and research institutions across the globe whose objective is to map, synthesize, and disseminate lessons learned from polio eradication, conducted a process evaluation of this partnership during the project's first year which focused on knowledge mapping activities. METHODS: The STRIPE consortium is led by Johns Hopkins University (JHU) in partnership with 6 universities and 1 research consultancy organization in polio free, at-risk, and endemic countries. In December 2018 JHU team members submitted written reflections on their experiences (n = 9). We held calls with each consortium member to solicit additional feedback (n = 7). To establish the partnership evaluation criteria we conducted preliminary analyses based on Blackstock's framework evaluating participatory research. In April 2019, an in-person consortium meeting was held; one member from each institution was asked to join a process evaluation working group. This group reviewed the preliminary criteria, adding, subtracting, and combining as needed; the final evaluation criteria were applied to STRIPE's research process and partnership and illustrative examples were provided. RESULTS: Twelve evaluation criteria were defined and applied by each member of the consortium to their experience in the project. These included access to resources, expectation setting, organizational context, external context, quality of information, relationship building, transparency, motivation, scheduling, adaptation, communication and engagement, and capacity building. For each criteria members of the working group reflected on general and context-specific challenges and potential strategies to overcome them. Teams suggested providing more time for recruitment, training, reflection, pre-testing. and financing to alleviate resource constraints. Given the large scope of the project, competing priorities, and shifting demands the working group also suggested a minimum of one full-time project coordinator in each setting to manage resources. CONCLUSION: Successful management of multi-country, multicentered implementation research requires comprehensive communication tools (which to our knowledge do not exist yet or are not readily available), expectation setting, and institutional support. Capacity building activities that address human resource needs for both individuals and their institutions should be incorporated into early project planning.


Assuntos
Saúde Global , Relações Interinstitucionais , Cooperação Internacional , Pesquisa/organização & administração , Erradicação de Doenças , Humanos , Poliomielite/prevenção & controle , Estados Unidos
12.
BMC Public Health ; 20(Suppl 2): 1176, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787949

RESUMO

BACKGROUND: Lessons from polio eradication efforts and the Global Polio Eradication Initiative (GPEI) are useful for improving health service delivery and outcomes globally. The Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) is a multi-phase project which aims to map, package and disseminate knowledge from polio eradication initiatives as academic and training programs. This paper discusses initial findings from the knowledge mapping around polio eradication activities across a multi-country context. METHODS: The knowledge mapping phase (January 2018 - December 2019) encompassed four research activities (scoping review, survey, key informant interviews (KIIs), health system analyses). This paper utilized a sequential mixed method design combining data from the survey and KIIs. The survey included individuals involved in polio eradication between 1988 and 2019, and described the contexts, implementation strategies, intended and unintended outcomes of polio eradication activities across levels. KIIs were conducted among a nested sample in seven countries (Afghanistan, Bangladesh, the Democratic Republic of Congo, Ethiopia, India, Indonesia, Nigeria) and at the global level to further explore these domains. RESULTS: The survey generated 3955 unique responses, mainly sub-national actors representing experience in over 74 countries; 194 KIIs were conducted. External factors including social, political, and economic factors were the most frequently cited barriers to eradication, followed by the process of implementing activities, including program execution, planning, monitoring, and stakeholder engagement. Key informants described common strategies for addressing these barriers, e.g. generating political will, engaging communities, capacity-building in planning and measurement, and adapting delivery strategies. The polio program positively affected health systems by investing in system structures and governance, however, long-term effects have been mixed as some countries have struggled to institutionalize program assets. CONCLUSION: Understanding the implementing context is critical for identifying threats and opportunities to global health programs. Common implementation strategies emerged across countries; however, these strategies were only effective where organizational and individual capacity were sufficient, and where strategies were appropriately tailored to the sociopolitical context. To maximize gains, readiness assessments at different levels should predate future global health programs and initiatives should consider system integration earlier to ensure program institutionalization and minimize system distortions.


Assuntos
Difusão de Inovações , Erradicação de Doenças , Saúde Global , Poliomielite/prevenção & controle , Pesquisa/organização & administração , Humanos , Inquéritos e Questionários
15.
Drug Discov Today ; 25(9): 1604-1613, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32679173

RESUMO

Here, we explore the dynamics of the response of the scientific community to several epidemics, including Coronavirus Disease 2019 (COVID-19), as assessed by the numbers of clinical trials, publications, and level of research funding over time. All six prior epidemics studied [bird flu, severe acute respiratory syndrome (SARS), swine flu, Middle East Respiratory Syndrome (MERS), Ebola, and Zika] were characterized by an initial spike of research response that flattened shortly thereafter. Unfortunately, no antiviral medications have been discovered to date as treatments for any of these diseases. By contrast, the HIV/AIDS pandemic has garnered consistent research investment since it began and resulted in drugs being developed within 7 years of its start date, with many more to follow. We argue that, to develop effective treatments for COVID-19 and be prepared for future epidemics, long-term, consistent investment in antiviral research is needed.


Assuntos
Antivirais/farmacologia , Infecções por Coronavirus , Desenvolvimento de Medicamentos , Epidemias , Pandemias , Pneumonia Viral , Pesquisa , Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Desenvolvimento de Medicamentos/métodos , Desenvolvimento de Medicamentos/organização & administração , Epidemias/história , Epidemias/prevenção & controle , História do Século XX , História do Século XXI , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pesquisa/organização & administração , Pesquisa/normas
18.
Am J Pharm Educ ; 84(6): ajpe8158, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32665729

RESUMO

The novel coronavirus identified in 2019 (COVID-19) pandemic has impacted pharmacy graduate and postgraduate education. This crisis has resulted in a cosmic shift in the administration of these programs to ensure core values are sustained. Adjustments may be needed at a minimum to ensure that postgraduate trainees complete program requirements while maintaining safety. Moving forward, additional issues may arise that will need to be addressed such as admissions and program onboarding, acclimating students to new training environments, and managing inadequate resources for distance education, distance practice, and remote versus in-person research opportunities.


Assuntos
Infecções por Coronavirus/epidemiologia , Educação de Pós-Graduação/organização & administração , Educação em Farmácia/organização & administração , Pneumonia Viral/epidemiologia , Betacoronavirus , Educação a Distância , Educação de Pós-Graduação/normas , Educação em Farmácia/normas , Humanos , Relações Interprofissionais , Pandemias , Equipe de Assistência ao Paciente/organização & administração , Residências em Farmácia/organização & administração , Pesquisa/organização & administração , Critérios de Admissão Escolar , Ensino/organização & administração , Telemedicina/organização & administração
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