Статті в журналах з теми "Rewards and Interventions Advisory Committee"
Щоб переглянути інші типи публікацій з цієї теми, перейдіть за посиланням: Rewards and Interventions Advisory Committee.
Оформте джерело за APA, MLA, Chicago, Harvard та іншими стилями
Ознайомтеся з топ-50 статей у журналах для дослідження на тему "Rewards and Interventions Advisory Committee".
Біля кожної праці в переліку літератури доступна кнопка «Додати до бібліографії». Скористайтеся нею – і ми автоматично оформимо бібліографічне посилання на обрану працю в потрібному вам стилі цитування: APA, MLA, «Гарвард», «Чикаго», «Ванкувер» тощо.
Також ви можете завантажити повний текст наукової публікації у форматі «.pdf» та прочитати онлайн анотацію до роботи, якщо відповідні параметри наявні в метаданих.
Переглядайте статті в журналах для різних дисциплін та оформлюйте правильно вашу бібліографію.
1
Reid, Dorothy, Simon Laplante, Ray Marnoch, Tammy Roberts, Jennifer Noah, Sonja Schmidt, Wanda Beland, and Shana Mohr. "What it takes to support a loved one with FASD." First Peoples Child & Family Review 13, no. 2 (October 26, 2021): 14. http://dx.doi.org/10.7202/1082966ar.
Повний текст джерелаАнотація:
This photovoice project was undertaken by the Family Advisory Committee of the Canada Fetal Alcohol Spectrum Disorder (FASD) Research Network to describe the experiences and the challenges faced by those supporting loved ones with FASD. Photovoice is a method of bringing forth the voice of those who are typically marginalized. It is a process by which people can act as recorders and potential catalysts for social action and change. The Family Advisory Committee chose the photovoice technique to communicate both their experiential knowledge and the research knowledge on both the challenges and rewards in supporting individuals with FASD. This photovoice project highlights several themes that are consistent with the results of caregiver research and provide a glimpse into the experience of those supporting loved ones with FASD. Through this type of knowledge translation the Family Advisory Committee hopes to enhance policy maker and service provider understanding of the necessity of providing support and services not only to the individual with FASD but to those who support them as well.
2
Harris, Lauren, Daniel Gilmore, Anne Longo, and Brittany N. Hand. "Short report: Patterns of US federal autism research funding during 2017–2019." Autism 25, no. 7 (March 25, 2021): 2135–39. http://dx.doi.org/10.1177/13623613211003430.
Повний текст джерелаАнотація:
In 2017, the Interagency Autism Coordinating Committee, a federal advisory panel consisting of autism researchers and community members, recommended that funders of autism research prioritize research projects on: (1) treatments/interventions, (2) evidence-based services, and (3) lifespan issues. We sought to describe research funding since this recommendation was made. We searched the databases of the three largest federal funders of autism research in the United States (National Institutes of Health, Department of Education, and Centers for Disease Control and Prevention) for grants awarded during 2017–2019. We categorized grants as follows: autism screening and diagnosis, biology, risk factors, treatments and interventions, services, lifespan issues, or infrastructure and surveillance. We found that funding patterns remained largely consistent during 2017–2019. Biological research received a relative majority of funding (32.59%), followed by treatments and interventions (22.87%). While given higher funding priority by the Interagency Autism Coordinating Committee’s recent budget recommendation, fewer funds were awarded to research areas like services (5.02%) and lifespan issues (2.51%), indicating a misalignment between funding patterns and the Interagency Autism Coordinating Committee budget recommendation. These findings emphasize the need for autism research funding to align with the Interagency Autism Coordinating Committee budget recommendations to best meet the needs of the autism community, particularly autistic younger, middle-aged, and older adults. Lay abstract In 2017, an advisory board consisting of autism researchers and community members recommended that funders of autism research prioritize research projects on: (1) treatments/interventions, (2) evidence-based services, and (3) lifespan issues. To describe funding in these areas since this recommendation was made, we searched the databases of the three largest federal funders of autism research in the United States. We found that the largest portion of federal funding during 2017–2019 was awarded to research on the biology of autism (32.59%) and treatments and interventions for autism (22.87%). Less funds were awarded to research areas that are high funding priorities by the Interagency Autism Coordinating Committee budget recommendation including services (5.02%) and lifespan issues (2.51%). Our findings emphasize that autism research funding is not consistent with the Interagency Autism Coordinating Committee budget recommendation to increase funding particularly to services and lifespan issues. We recommend that funding patterns should shift to better align with these priorities so that autism research may better serve the needs of the autism community.
3
Wiseman, Patricia, and Kathie Records. "Using Theory to Drive Influenza Related Text Messaging Interventions." International Journal of E-Health and Medical Communications 6, no. 2 (April 2015): 44–58. http://dx.doi.org/10.4018/ijehmc.2015040104.
Повний текст джерелаАнотація:
The Advisory Committee on Immunization Practice recommends all children be vaccinated annually against Influenza. Given the increased use of technology as a strategy to increase immunization coverage, theory-based text messaging may result in higher vaccination rates than traditional vaccine reminders. This article describes the development of theory-based text messages for parents of 5 to 8-year-old children that can be implemented in primary care settings. The development of the text messages was guided by constructs from the Health Belief Model. A pilot study was conducted with community pediatric vaccine health care providers (n = 6), and parents of 5 to 8-year-old children (n = 8) to evaluate the text message content for clarity, internal consistency, and content validity. The evaluation results indicated that our intervention was successful in creating a low cost, theory-based educational intervention that garnered community investment and met the cultural relevance and literacy needs of the priority population.
4
Hua, Martin, Tristan Boonstra, Patrick J. Kelly, Andrew Wilson, Jonathan C. Craig, and Angela C. Webster. "QUALITY OF HEALTH TECHNOLOGY ASSESSMENT REPORTS PREPARED FOR THE MEDICAL SERVICES ADVISORY COMMITTEE." International Journal of Technology Assessment in Health Care 32, no. 4 (2016): 315–23. http://dx.doi.org/10.1017/s0266462316000477.
Повний текст джерелаАнотація:
Objectives:The Medical Services Advisory Committee (MSAC) makes recommendations to the Australian Government for funding health technologies under the Medicare Benefits Schedule (MBS). Differences in public, clinical, commercial, and political opinions on health expenditure emphasize the importance of defensible funding decisions. We aimed to evaluate the quality of health technology assessment (HTA) reports over time and among health technologies assessed for MSAC.Main Outcome Measures:A cohort study was performed of HTA reports prepared for MSAC between 1998 and 2013. We measured the quality of HTA reports using reporting guidelines proposed by the European Collaboration for Assessment of Health Interventions. Individual component scores across eleven domains were calculated, and summed for an overall aggregate score. We used linear regression to investigate any change in quality over time and among the types of technologies assessed.Results:We included 110 HTA reports. The safety (80 percent), effectiveness (84 percent), economic (74 percent), and organizational (99 percent) domains were better reported than the psychological, social, and ethical considerations (34 percent). The basic (75 percent), methodological (62 percent), background (82 percent), contextual (46 percent), status quo (54 percent), and technical information (66 percent) that framed each assessment were inconsistently reported. On average, overall quality scores increased by 2 percent (p< 0.001) per year, from approximately 60 percent to 80 percent over the 15-year period, with no significant difference among surgical, diagnostic or other nonpharmaceutical health technologies (p= 0.22).Conclusions:HTA reports prepared for MSAC are a key tool in allocating scarce health resources. The overall quality of these reports has improved, but the reporting of specific domains and subthemes therein could be better addressed.
5
Salami, Bukola, Aloysius Nwabugo Maduforo, Olivia Aiello, Samah Osman, Oserekpamen Favour Omobhude, Kimberly Price, Jo Henderson, Hayley A. Hamilton, Janet Kemei, and Delores V. Mullings. "Factors That Contribute to the Mental Health of Black Youth during COVID-19 Pandemic." Healthcare 12, no. 12 (June 11, 2024): 1174. http://dx.doi.org/10.3390/healthcare12121174.
Повний текст джерелаАнотація:
Background: The mental health of Black youth during the COVID-19 pandemic is potentially influenced by various systemic factors, including racism, socioeconomic disparities, and access to culturally sensitive mental health support. Understanding these influences is essential for developing effective interventions to mitigate mental health disparities. Methods: Our project used a community-based participatory (CBP) research design with an intersectional theoretical perspective. An advisory committee consisting of fourteen Black youth supported all aspects of our project. The research team consisted of experienced Black researchers who also trained six Black youths as research assistants and co-researchers. The co-researchers conducted individual interviews, contributed to data analysis, and mobilized knowledge. Participants were recruited through the advisory committee members and networks of Black youth co-researchers and sent an email invitation to Black community organizations. Forty-eight Black identified were interviewed between the ages of 16 and 30 in Canada. The data was analyzed thematically. We kept a reflexive note throughout all aspects of the project. Results: Participants reported significant challenges with online schooling, including a lack of support and access to resources. Lockdowns exacerbated stress, particularly for those living in toxic living/home environments. Financial burdens, such as food insecurity and precarious employment, were prevalent and exacerbated mental health challenges. Additionally, experiences of anti-Black racism and police brutality during the pandemic heightened stress and anxiety among participants. Conclusions: The findings underscore the complex interplay of systemic factors in shaping the mental health of Black youth during the COVID-19 pandemic. Addressing these disparities requires targeted interventions that address structural inequities and provide culturally competent support to mitigate the impact on mental well-being.
6
Benoit, Britney, Christine Cassidy, Marsha Campbell-Yeo, Doris Gillis, Sara Kirk, S. Meaghan Sim, Michelle LeDrew, et al. "Development of Interventions to Support Provincial Implementation of the Baby-Friendly Initiative: A Study Protocol." Nursing Reports 13, no. 4 (December 13, 2023): 1731–41. http://dx.doi.org/10.3390/nursrep13040143.
Повний текст джерелаАнотація:
Breastfeeding is internationally recognized as the optimal form of infant nutrition. The Baby-Friendly Initiative (BFI) is an evidence-informed program that leads to improved breastfeeding outcomes. Despite the benefits of breastfeeding, Nova Scotia has one of the lowest breastfeeding rates in Canada. Additionally, only two birthing hospitals in the province have BFI designation. We aim to address this gap using a sequential qualitative descriptive design across three phases. In Phase 1, we will identify barriers and facilitators to BFI implementation through individual, semi-structured interviews with 40 health care professionals and 20 parents. An analysis of relevant policy and practice documents will complement these data. In Phase 2, we will develop implementation interventions aimed at addressing the barriers and facilitators identified in Phase 1. An advisory committee of 10–12 administrative, clinical, and parent partners will review these interventions. In Phase 3, the interventions will be reviewed by a panel of 10 experts in BFI implementation through an online survey. Feedback on the revised implementation interventions will then be sought from 20 health system and parent partners through interviews. This work will use implementation science methods to support integrated and sustained implementation of the BFI across hospital/community and rural/urban settings in Nova Scotia. This study was not registered.
7
Capalad, Joselito. "Teaching as a Career: From the Point of View of Millennial Teachers." CGCI International Journal of Administration, Management, Education and Technology 1, no. 1 (January 19, 2024): 28–36. http://dx.doi.org/10.70059/tq6ss407.
Повний текст джерелаАнотація:
This study determined the lived experiences of millennial teachers in the District of Aliaga, Aliaga, Nueva Ecija, during the School Year 2022- 2023. This study formulated guide questions and consulted the thesis advisory committee. Evidence was gathered from 10 millennial teachers born from 1981 to 1998 in Aliaga District, Division of Nueva Ecija. Five participants were already married, one male and four female. Five of the participants are single. There are six Teacher I, three Teacher III, and one Master Teacher I, and three of them have already finished their master's degree, while others have units in their graduate studies. The participants' reasons for choosing teaching as their career were the influence of parents, their love for children, and the inspiration of my past Teacher. Two themes emerged when the participants were asked about their daily routines: lesson planning and getting things ready for the whole day's class. As to the rewards, they all agreed that students learning is the reward they get as teachers. In terms of challenges, they encountered students' behavior, reading, and numeracy. The assistance or support they receive from their school heads is professional development, psychological support, and a positive environment. Cooperation and knowledge sharing emerged as themes regarding their impact on their respective schools.
8
Finlayson, Marcia, Peter Feys, Ulrik Dalgas, and Daphne Kos. "Intermediate outcomes for clinical trials of multiple sclerosis rehabilitation interventions: Conceptual and practical considerations." Multiple Sclerosis Journal 29, no. 9 (August 2023): 1186–94. http://dx.doi.org/10.1177/13524585231189674.
Повний текст джерелаАнотація:
Background: Rehabilitation is an essential health care service and a critical component of comprehensive multiple sclerosis (MS) care. Objective: As part of a 2-day meeting hosted by the International Advisory Committee on Clinical Trials in MS in December 2022, a panel initiated a discussion on the conceptual and practical issues related to selecting intermediate outcomes for clinical trials of MS rehabilitation interventions. Results: The overarching goal of rehabilitation – optimal functioning – was acknowledged as a complex biopsychosocial phenomenon that varies with patient priorities and environmental context. This complexity means that multiple causal pathways and potential intermediate outcomes must be carefully considered during the design of clinical trials in MS rehabilitation that aim to improve functioning. In addition, practical issues must be considered such as psychometric properties of outcome measures, measure type, and characteristics of the target population, including severity of dysfunction. Conclusion: This article uses the International Classification of Functioning, Disability and Health as a foundation for determining relevant intermediate outcomes for clinical trials of MS rehabilitation interventions.
9
Newcomer, Kim, Andrea Goodman, and David Fenstermacher. "Colorectal Cancer Clinical Trial Summit: Devising solutions and interventions." Journal of Clinical Oncology 41, no. 16_suppl (June 1, 2023): e15603-e15603. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.e15603.
Повний текст джерелаАнотація:
e15603 Background: Only 5% of adult cancer patients enroll in cancer clinical trials; however, approximately 70% are willing to participate. The numerous gaps between patient willingness and trial participation rates suggest that enrollment in clinical trials can be challenging. The Colorectal Cancer Alliance Clinical Trial Think Tank Summit brought together multidisciplinary voices to propose solutions and tailor interventions to increase participation in colorectal cancer (CRC) clinical trials and save lives. Methods: An expert advisory committee supported the planning of the Summit by collating existing knowledge and best practices from across the field. The Alliance collected patient perspectives through interviews and aligned around three critical themes for change in CRC clinical trials. The Summit created a forum for thoughtful and strategic discussions with expert speakers and sessions to explore thematic solutions. Results: The advisory committee’s research activities and discussion identified strategic solutions across the following themes: 1. Marketing & Messaging Trust in Clinical Trials; 2. Fostering Readiness for Community-Based Cancer Research, and 3. Clinical Trial Patient Navigation. There was consensus that cancer patients and the public need to be educated on the importance of clinical trial access and dispel myths about clinical trials. Messaging must be culturally competent, creating quality standards for trial awareness and participation for utilization in a marketing campaign. Summit participants discussed barriers to clinical trial enrollment at the institutional, structural, provider, and patient levels. Collaborations with industry sponsors and partnering with community oncology programs are necessary for designing and conducting research serving the understudied and underserved. Participants identified that navigators are crucial for decentralized clinical trials and are a key element for improving clinical trial efficiency and the patient experience. Developing and launching a centralized clinical trial navigator pilot program is necessary to ensure that navigators are knowledgeable about recruiting CRC clinical trials nationally. Conclusions: Clinical trials are essential to advancing new treatments. To extend clinical research into the community, standardized messaging is needed that dispels myths about clinical trials and highlights positive trial outcomes. By improving our overall messaging, collaboration, education, and access to resources, we can accelerate CRC clinical trial participation to improve outcomes and research answers.
10
Kinlaw, Kathy, Drue H. Barrett, and Robert J. Levine. "Ethical Guidelines in Pandemic Influenza: Recommendations of the Ethics Subcommittee of the Advisory Committee of the Director, Centers for Disease Control and Prevention." Disaster Medicine and Public Health Preparedness 3, S2 (December 2009): S185—S192. http://dx.doi.org/10.1097/dmp.0b013e3181ac194f.
Повний текст джерелаАнотація:
ABSTRACTBecause of the importance of including ethical considerations in planning efforts for pandemic influenza, in February 2005 the Centers for Disease Control and Prevention requested that the Ethics Subcommittee of the Advisory Committee to the Director develop guidance that would serve as a foundation for decision making in preparing for and responding to pandemic influenza. Specifically, the ethics subcommittee was asked to make recommendations regarding ethical considerations relevant to decision making about vaccine and antiviral drug distribution prioritization and development of interventions that would limit individual freedom and create social distancing. The ethics subcommittee identified a number of general ethical considerations including identification of clear goals for pandemic planning, responsibility to maximize preparedness, transparency and public engagement, sound science, commitment to the global community, balancing individual liberty and community interests, diversity in ethical decision making, and commitment to justice. These general ethical considerations are applied to the issues of vaccine and antiviral drug distribution and use of community mitigation interventions. (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S185–S192)
11
Thayabaranathan, Tharshanah, Maarten A. Immink, Susan Hillier, Rene Stolwyk, Nadine E. Andrew, Philip Stevens, Monique F. Kilkenny, et al. "Co-Designing a New Yoga-Based Mindfulness Intervention for Survivors of Stroke: A Formative Evaluation." Neurology International 14, no. 1 (December 21, 2021): 1–10. http://dx.doi.org/10.3390/neurolint14010001.
Повний текст джерелаАнотація:
Movement-based mindfulness interventions (MBI) are complex, multi-component interventions for which the design process is rarely reported. For people with stroke, emerging evidence suggests benefits, but mainstream programs are generally unsuitable. We aimed to describe the processes involved and to conduct a formative evaluation of the development of a novel yoga-based MBI designed for survivors of stroke. We used the Medical Research Council complex interventions framework and principles of co-design. We purposefully approached health professionals and consumers to establish an advisory committee for developing the intervention. Members collaborated and iteratively reviewed the design and content of the program, formatted into a training manual. Four external yoga teachers independently reviewed the program. Formative evaluation included review of multiple data sources and documentation (e.g., formal meeting minutes, focus group discussions, researcher observations). The data were synthesized using inductive thematic analysis. Three broad themes emerged: (a) MBI content and terminology; (b) manual design and readability; and (c) barriers and enablers to deliver the intervention. Various perspectives and feedback on essential components guided finalizing the program. The design phase of a novel yoga-based MBI was strengthened by interdisciplinary, consumer contributions and peer review. The 12-week intervention is ready for testing among survivors of stroke.
12
Reese, Elaine, Jesse Kokaua, Hayley Guiney, Tugce Bakir-Demir, Jimmy McLauchlan, Clair Edgeler, Elizabeth Schaughency, et al. "Kia Tīmata Pai (Best Start): a study protocol for a cluster randomised trial with early childhood teachers to support children’s oral language and self-regulation development." BMJ Open 13, no. 9 (September 2023): e073361. http://dx.doi.org/10.1136/bmjopen-2023-073361.
Повний текст джерелаАнотація:
IntroductionOral language skills are associated with children’s later self-regulation and academic skills; in turn, self-regulation in early childhood predicts successful functioning later in life. The primary objective of this study is to evaluate the separate and combined effectiveness of an oral language intervention (Enhancing Rich Conversations, ENRICH) and a self-regulation intervention (Enhancing Neurocognitive Growth with the Aid of Games and Exercise, ENGAGE) with early childhood teachers and parents for children’s oral language, self-regulation and academic functioning.Methods and analysisThe Kia Tīmata Pai (Best Start) study is a cluster randomised controlled trial with teachers and children in approximately 140 early childhood centres in New Zealand. Centres are randomly assigned to receive either oral language intervention only (ENRICH), self-regulation intervention only (ENGAGE), both interventions (ENRICH+ENGAGE) or an active control condition. Teachers’ and parents’ practices and children’s oral language and self-regulation development are assessed at baseline at age 1.5 years and approximately every 9 months to age 5, and academic performance at age 6. Teacher–child interactions will also be videotaped each year in a subset of the centres. Children’s brain and behaviour development and parent–child interactions will be assessed every 6 months to age 6 years in a subgroup of volunteers.Ethics and disseminationThe Kia Tīmata Pai trial and the two substudies (Video Project; Brain and Behaviour Development) have been approved by the University of Otago Human Ethics Committee (Health; H20/116), and reviewed for cultural responsiveness by: the Ngāi Tahu Research Committee (University of Otago), the Māori Advisory Group (University of Auckland, Liggins Institute) and an internal cultural advisory group. Results will be disseminated in international and national peer-reviewed academic journals and communicated to local, national and international organisations serving early childhood teachers, parents and young children. Data will be available via communication with the corresponding author.Trial registration numberACTRN12621000845831.
13
Galiana-Sánchez, María Eugenia. "The Role of International Organisations in the Development of Public Health Nursing, 1933–1974." Gesnerus 74, no. 2 (November 6, 2017): 188–204. http://dx.doi.org/10.1163/22977953-07402003.
Повний текст джерелаАнотація:
This paper analyses the contribution made by the League of Nations (LoN) and the World Health Organisation (WHO) to the development of public health nursing, and the role of nursing experts working in these and other organisations. The sources consulted included documentation on public health nursing held in the LoN archives and technical reports drawn up by expert committees on nursing and related fields held in the WHO database. In the 1920s, international organisations began seeking to meet the need for public health nurses who could implement community-based interventions, deploying various strategies to achieve this goal over the course of the 20th century. The work of nursing experts on the LoN Hygiene Committee and WHO Advisory Committees underpinned systematic efforts to establish appropriate training in public health nursing and to organise effective nursing services in Europe. The role they played reveals changing attitudes towards the contribution of public health nursing.
14
Haddadi, A., and F. Ravaz. "Historical Approaches to Euthanasia: The Unfinished Story of a Concept." Kutafin Law Review 8, no. 1 (April 30, 2021): 99–114. http://dx.doi.org/10.17803/2313-5395.2021.1.15.099-114.
Повний текст джерелаАнотація:
Various ethics committees in Belgium, Canada, Denmark, Luxembourg, Portugal, and France have made attempts to describe the notion of euthanasia. Opinion No 063 (January 27, 2000) of the National Advisory Committee on Ethics shows that there has been no concensus on the definition of this concept. It is therefore necessary to review historical background of euthanasia from ancient times to modern period to better understand its potential applications in divergent contexts.Studies devoted to euthanasia usually involve two modalities, namely active and passive. The active modality entails the act of deliberately killing a patient with or against their will in order to relieve persistent suffering, while the passive modality deals with the rational valid refusal of life-sustaining medical interventions necessary for the patient's life and health. The goal of this article is to present different historical approaches to euthanasia from two modalities and engage the bioethics community in a discussion on legal, social, and ethical issues of euthanasia all over the world.
15
Hudock, Stephen D., Steven J. Wurzelbacher, Laurence D. Reed, Thomas R. Hales, and Karl V. Siegfried. "A Precursor to Ergonomics Best Practices for the Shipyard Industries." Journal of Ship Production 17, no. 03 (August 1, 2001): 145–50. http://dx.doi.org/10.5957/jsp.2001.17.3.145.
Повний текст джерелаАнотація:
Many of the job processes being performed today in ship construction, repair and recycling yards do not differ significantly from those same processes as performed fifty years ago. The complexity of vessels may have increased dramatically in the past fifty years but many of the job processes have not kept pace with changes in tech-nology. Due in part to the mismatch of technology between work processes and product design, researchers at the National Institute for Occupational Safety and Health (NIOSH), in collaboration with the National Shipbuilding Research Program Advanced Shipbuilding Enterprise (NSRP ASE) and the Maritime Advisory Committee for Occupational Safety and Health (MACOSH), have conducted a series of ergonomic analyses of work processes at a number of domestic shipyards. These analyses have identified specific work processes within the shipyards that have resulted in numerous, severe, or costly musculoskeletal injuries to the shipyard work-force. The mitigation of the occupational risk factors associated with these processes was the focus of targeted ergonomic interventions.
16
Baltussen, Rob, Maarten Jansen, Syeda Shehirbano Akhtar, Leon Bijlmakers, Sergio Torres-Rueda, Muhammad Khalid, Wajeeha Raza, et al. "The Use of Evidence-Informed Deliberative Processes for Designing the Essential Package of Health Services in Pakistan." International Journal of Health Policy and Management 12 (October 24, 2023): 8004. http://dx.doi.org/10.34172/ijhpm.2023.8004.
Повний текст джерелаАнотація:
Background: The Disease Control Priorities 3 (DCP3) project provides long-term support to Pakistan in the development and implementation of its universal health coverage essential package of health services (UHC-EPHS). This paper reports on the priority setting process used in the design of the EPHS during the period 2019-2020, employing the framework of evidence-informed deliberative processes (EDPs), a tool for priority setting with the explicit aim of optimising the legitimacy of decision-making in the development of health benefit packages. Methods: We planned the six steps of the framework during two workshops in the Netherlands with participants from all DCP3 Pakistan partners (October 2019 and February 2020), who implemented these at the country level in Pakistan in 2019 and 2020. Following implementation, we conducted a semi-structured online survey to collect the views of participants in the UHC benefit package design about the prioritisation process. Results: The key steps in the EDP framework were the installation of advisory committees (involving more than 150 members in several Technical Working Groups [TWGs] and a National Advisory Committee [NAC]), definition of decision criteria (effectiveness, cost-effectiveness, avoidable burden of disease, equity, financial risk protection, budget impact, socio-economic impact and feasibility), selection of interventions for evaluation (a total of 170), and assessment and appraisal (across the three dimensions of the UHC cube) of these interventions. Survey respondents were generally positive across several aspects of the priority setting process. Conclusion: Despite several challenges, including a partial disruption because of the COVID-19 pandemic, implementation of the priority setting process may have improved the legitimacy of decision-making by involving stakeholders through participation with deliberation, and being evidence-informed and transparent. Important lessons were learned that can be beneficial for other countries designing their own health benefit package such as on the options and limitations of broad stakeholder involvement.
17
Risling, Tracie, Courtney Carlberg, Iman Kassam, Tyler Moss, Patricia Janssen, Steve Iduye, and Gillian Strudwick. "Supporting population mental health and wellness during the COVID-19 pandemic in Canada: protocol for a sequential mixed-method study." BMJ Open 11, no. 11 (November 2021): e052259. http://dx.doi.org/10.1136/bmjopen-2021-052259.
Повний текст джерелаАнотація:
IntroductionThe global COVID-19 pandemic has reported to have a negative impact on the mental health and well-being of individuals around the world. Mental health system infrastructure, primarily developed to support individuals through in-person care, struggled to meet rising demand for services even prior to COVID-19. With public health guidelines requiring the use of physical distancing during the pandemic, digital mental health supports may be one way to address the needs of the population. Despite this, barriers exist in promoting and supporting access to existing and emerging digital resources. Text messaging may address some of these barriers, extending the potential reach of these digital interventions across divides that may separate some vulnerable or disadvantaged groups from essential mental health supports. Building on an existing knowledge synthesis project identifying key digital resources for improved mental health, this research will establish low-tech connections to assess need and better match access to services for those who need it most. The aim of this study is to codesign a customised two-way texting service to explore need and better align access to mental health supports for Canadians located in Saskatchewan during the COVID-19 pandemic.Methods and analysisThis study will be completed in Saskatchewan, Canada. For this project, the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will be used to support three phases of a sequential mixed-method study. An advisory committee of Saskatchewan residents will guide this work with the study team. A 10-week service will be launched to connect individuals with appropriately suited digital mental health interventions through the use of text messaging. In phase 1, implementation and prototyping will be conducted with collaborative codesign for key elements related to features of an enrolment survey and initial messaging content. Phase 2 will focus on advancing the effectiveness of the service using quantitative user data. In phase 3, an embedding approach will be used to integrate both qualitative and quantitative data collected to understand the overall acceptability, satisfaction and perceived benefit of the text messaging service. Thematic analysis and descriptive statistics will be used as analytic methods.Ethics and disseminationThis study has received approval from the Research Ethics Board at the University of Saskatchewan. A knowledge dissemination plan has been developed that includes traditional academic approaches such as conference presentations, and academic publications, as well as mainstream approaches such as social media, radio and dissemination through the advisory committee.
18
Ingram, Jenny, Debbie Johnson, Sarah Johnson, Heather A. O'Mahen, David Kessler, Hazel Taylor, Roslyn Law, et al. "Protocol for a feasibility randomised trial of low-intensity interventions for antenatal depression: ADAGIO trial comparing interpersonal counselling with cognitive behavioural therapy." BMJ Open 9, no. 8 (August 2019): e032649. http://dx.doi.org/10.1136/bmjopen-2019-032649.
Повний текст джерелаАнотація:
IntroductionOne in eight women suffer from depression during pregnancy. Currently, low-intensity brief treatment based on cognitive behavioural therapy (CBT) is the only talking treatment widely available in the National Health Service (NHS) for mild and moderate depression. CBT involves identifying and changing unhelpful negative thoughts and behaviours to improve mood. Mothers in our patient advisory groups requested greater treatment choice. Interpersonal counselling (IPC) is a low-intensity version of interpersonal therapy. It may have important advantages during pregnancy over CBT because it targets relationship problems, changes in role and previous losses (eg, miscarriage). We aim to compare CBT and IPC for pregnant women with depression in a feasibility study.Methods and analysisA two-arm non-blinded randomised feasibility study of 60 women will be conducted in two UK localities. Women with depression will be identified through midwife clinics and ultrasound scanning appointments and randomised to receive six sessions of IPC or CBT. In every other way, these women will receive usual care. Women thought to have severe depression will be referred for more intensive treatment. After 12 weeks, we will measure women’s mood, well-being, relationship satisfaction and use of healthcare. Women, their partners and staff providing treatments will be interviewed to understand whether IPC is an acceptable approach and whether changes should be introduced before applying to run a larger trial.Several groups of patients with depression during pregnancy have contributed to our study design. A patient advisory group will meet and advise us during the study.Ethics and disseminationStudy results will inform the design of a larger multicentre randomised controlled trial (RCT). Our findings will be shared through public engagement events, papers and reports to organisations within the NHS. National Research Ethics Service Committee approved the study protocol.Trial registration numberISRCTN11513120.
19
Shivakumar, Latha, Christine B. Weldon, Ali McBride, Igor Puzanov, Joanne Riemer, Matthew R. Zibelman, and Leigh Boehmer. "Identifying strategies to address obstacles to optimal integration of cancer immunotherapies in the community." Journal of Clinical Oncology 38, no. 5_suppl (February 10, 2020): 96. http://dx.doi.org/10.1200/jco.2020.38.5_suppl.96.
Повний текст джерелаАнотація:
96 Background: Evolving indications for immuno-oncology (IO) therapies in cancer pose a significant challenge to community clinicians around the practical issues that must be addressed to implement these therapies safely and effectively. The Association of Community Cancer Centers (ACCC) initiated a quality improvement (QI) research study to assess the impact of educational interventions targeting the multidisciplinary cancer care team on evidence-based integration of IO therapy. Methods: The QI study collected baseline data from 100 patients initiating IO therapy between Dec 2017-Apr 2018 at two community cancer centers on co-morbidities, immune-related adverse events (irAEs), laboratory tests, ER visits and hospitalizations, patient education, and adherence. The advisory committee analyzed this data to identify practice gaps and designed educational interventions to address these gaps. After clinicians at both centers completed the educational interventions, data was collected from 100 patients initiating IO therapy between Jan 2019-Apr2019 and compared using Fisher’s exact test. We also conducted staff surveys before and after participating in the interventions. Results: Offering ACCC-created IO wallet cards to patients was a recommended intervention but only one site adopted this. The site that used the wallet cards had a statistically significant reduction in hospitalization rates compared to the other site (38% vs 70%, p = 0.0024). Respondents to the practice surveys reported an increase in handing out patient education materials following participation in the interventions. They also reported an improved understanding of strategies to manage patients with co-morbidities, management of irAEs, patient education and engagement, interprofessional communication, and coordination with non-oncology specialists. Conclusions: Community cancer center directed educational interventions are feasible and may improve clinician understanding, comfort, and attitudes with the integration of emerging IO agents. Administering wallet cards to patients at the beginning of IO therapy may decrease the risk of hospitalization and warrants further investigation in larger studies.
20
Singh, Ankita. "Probing the Minority Conundrum: Sardar Patel and Minorities in India." RESEARCH REVIEW International Journal of Multidisciplinary 7, no. 4 (April 15, 2022): 64–81. http://dx.doi.org/10.31305/rrijm.2022.v07.i04.009.
Повний текст джерелаАнотація:
Indian Constitution is a progressive document based on liberal ethos of equality and freedom. Secularism, as imbibed in the document gives freedom of religious practices and believes and even propagation to people of all faith. This is also considered as the fundamental characteristic of the Indian Constitution which cannot be altered. Given the image of Vallabhai Patel it looks astounding to find out that he was the head of the advisory committee on minorities in the constituent assembly which proposed special protection to minorities in particular. This chapter is an attempt to understand the depth of the contribution of Patel in shaping the minority rights in India and establishing secular polity. The chapter is divided in two major parts; one is dealing with the theoretical basis on which the minority questions are generally seen. This also deals with the peculiar provisions in the legal and political setups which makes India a secular polity. Second is examining the role and interventions of Patel in the constituent assembly on the issue.
21
Yang, Xiaochen, Omar Galárraga, Wangnan Cao, Haoxiang Lin, Fei Cao, and Chun Chang. "Financial incentive interventions for smoking cessation among Chinese smokers: study protocol for a cluster randomised controlled trial." BMJ Open 14, no. 4 (April 2024): e080344. http://dx.doi.org/10.1136/bmjopen-2023-080344.
Повний текст джерелаАнотація:
IntroductionThere is an urgent issue to relieve the burdens caused by tobacco use through feasible and effective smoking cessation interventions, particularly in a middle-income country with less accessible smoking cessation services and high demand for quitting smoking. Financial incentives have shown effective in changing health behaviours, thus needing to test its portability to a wider implementation and effectiveness of increasing smoking cessation rates.Methods and analysisThis is a three-arm cluster randomised controlled trial. 462 eligible participants will be assigned to 2 financial incentive groups—rewards or deposits, or the control group. All participants including those in the control group will receive text messages to help quitting smoking developed by the US National Cancer Institute over a 3-month intervention period. In addition to text messages, reward group participants will be rewarded with CNY200 and CNY400 (CNY100 approximately US$15) for sustained smoking abstinence at 1 month and 3 months follow-up assessments; participants in the deposit group will accumulate CNY200 and CNY600 in the deposit accounts after verified smoking abstinence at 1 month and 3 months follow-up assessments, and all the deposits will be given at once right after the 3-month follow-up visit. The primary outcome is biochemically verified smoking abstinence rate sustained for 6 months after enrolment.Ethics and disseminationThis trial protocol has been approved by the Ethics Committee of Peking University Health Science Centre (date: 23 February 2023; ethical approval number: IRB00001052-22172). Results and findings of this trial will be disseminated in peer-reviewed journals and professional conferences.Trial registration numberChiCTR-IOR-2300069631.
22
Duffy, Thomas, Natalie Gil, Benzeer Siddique, Stephen Duffy, Andrew Prentice, Sarah Marshall, Natasha K. Djedovic, et al. "Comparing the effectiveness and cost-effectiveness of text-message reminders and telephone patient navigation to improve the uptake of faecal immunochemical test screening among non-responders in London: a randomised controlled trial protocol." BMJ Open 14, no. 6 (June 2024): e079482. http://dx.doi.org/10.1136/bmjopen-2023-079482.
Повний текст джерелаАнотація:
IntroductionParticipation in bowel cancer screening is lower in regions where there is high ethnic diversity and/or socioeconomic deprivation. Interventions, such as text message reminders and patient navigation (PN), have the potential to increase participation in these areas. As such, there is interest in the comparative effectiveness of these interventions to increase bowel cancer screening participation, as well as their relative cost-effectiveness.Methods and analysisThis study will use a three-arm randomised controlled trial design to compare the effectiveness and cost-effectiveness of text message reminders and PN to increase the uptake of bowel cancer screening in London. Participants will be individuals who have not returned a completed faecal immunochemical test kit within 13 weeks of receiving a routine invitation from the London bowel cancer screening hub. Participants will be randomised (in a 1:1:1 ratio) to receive either (1) usual care (ie, ‘no intervention’), (2) a text message reminder at 13 weeks, followed by repeated text message reminders at 15, 17 and 19 weeks (in the event of non-response) or (3) a text message reminder at 13 weeks, followed by PN telephone calls at 15, 17 and 19 weeks in the event of non-response. The primary endpoint will be participation in bowel cancer screening, defined as ‘the return of a completed kit by week 24’. Statistical analysis will use multivariate logistic regression and will incorporate pairwise comparisons of all three groups, adjusted for multiple testing.Ethics and disseminationApprovals to conduct the research have been obtained from University College London’s Joint Research Office (Ref: 150666), the Screening Research, Innovation and Development Advisory Committee (‘RIDAC’, Ref: 2223 014 BCSP Kerrison), the Health Research Authority (Ref: 22/WM/0212) and the Confidentiality Advisory Group (Ref: 22/CAG/0140). Results will be conveyed to stakeholders, notably those managing the screening programme and published in peer-reviewed journals/presented at academic conferences.Trial registration numberISRCTN17245519
23
Whelan, Jillian, Joshua Hayward, Melanie Nichols, Andrew D. Brown, Liliana Orellana, Victoria Brown, Denise Becker, et al. "Reflexive Evidence and Systems interventions to Prevention Obesity and Non-communicable Disease (RESPOND): protocol and baseline outcomes for a stepped-wedge cluster-randomised prevention trial." BMJ Open 12, no. 9 (September 2022): e057187. http://dx.doi.org/10.1136/bmjopen-2021-057187.
Повний текст джерелаАнотація:
IntroductionSystems science methodologies have been used in attempts to address the complex and dynamic causes of childhood obesity with varied results. This paper presents a protocol for the Reflexive Evidence and Systems interventions to Prevention Obesity and Non-communicable Disease (RESPOND) trial. RESPOND represents a significant advance on previous approaches by identifying and operationalising a clear systems methodology and building skills and knowledge in the design and implementation of this approach among community stakeholders.Methods and analysisRESPOND is a 4-year cluster-randomised stepped-wedge trial in 10 local government areas in Victoria, Australia. The intervention comprises four stages: catalyse and set up, monitoring, community engagement and implementation. The trial will be evaluated for individuals, community settings and context, cost-effectiveness, and systems and implementation processes. Individual-level data including weight status, diet and activity behaviours will be collected every 2 years from school children in grades 2, 4 and 6 using an opt-out consent process. Community-level data will include knowledge and engagement, collaboration networks, economic costs and shifts in mental models aligned with systems training. Baseline prevalence data were collected between March and June 2019 among >3700 children from 91 primary schools.Ethics and disseminationEthics approval: Deakin University Human Research Ethics Committee (HREC 2018-381) or Deakin University’s Faculty of Health Ethics Advisory Committee (HEAG-H_2019-1; HEAG-H 37_2019; HEAG-H 173_2018; HEAG-H 12_2019); Victorian Government Department of Education and Training (2019_003943); Catholic Archdiocese of Melbourne (Catholic Education Melbourne, 2019-0872) and Diocese of Sandhurst (24 May 2019). The results of RESPOND, including primary and secondary outcomes, and emerging studies developed throughout the intervention, will be published in the academic literature, presented at national and international conferences, community newsletters, newspapers, infographics and relevant social media.Trial registration numberACTRN12618001986268p.
24
Fennessy, Paul, and Richard King. "VP40 Robotic Surgery: From Health Technology Assessment To State Health Policy." International Journal of Technology Assessment in Health Care 34, S1 (2018): 169. http://dx.doi.org/10.1017/s0266462318003525.
Повний текст джерелаАнотація:
Introduction:The aging population means more men are diagnosed with prostate cancer, resulting in greater demand for treatment. Robot-assisted radical prostatectomy (RARP) claims to offer additional benefits to patients and providers. The independent Victorian Health Technology Program Advisory Committee assessed safety, clinical effectiveness and cost effectiveness evidence and financial impact to inform policy, access and reimbursement decision-making by state government policy makers and public hospital providers.Methods:Public and private hospital activity and costs for 2008–09 to 2012–13 from the Victorian Admitted Episodes Database (VAED) and the Victorian Cost Data Collection (VCDC) were identified. Data were extracted and reviewed based on (i) DRGs M01A and B, (ii) primary diagnostic code C61 (ICD-10-AM), and (iii) Australian Classification of Health Interventions procedure codes for open (ORP), laparoscopic (LRP) and RARP, supplemented by Victorian Prostate Cancer Clinical Registry data. English language Health Technology Assessments (HTAs)/systematic reviews published January 2009 to January 2015 were identified and analysed with comparative clinical outcomes data for RARP vs. ORP and RARP vs. LRP analysed. Not all reported the same data and most outcomes data presented were odds ratios and risk ratios.Results:RARP offers patients a shorter length of stay (LOS) compared with ORP or LRP, but the procedure takes longer to perform. While RARP has similar safety and clinical effectiveness profiles compared with ORP and LRP, published data do not unequivocally demonstrate that RARP is superior to ORP or LRP in terms of clinical outcomes. RARP is more expensive than ORP and LRP. The cost differential increases when capital costs are taken into account. Cost offsets from a reduced LOS are insufficient to justify the higher cost.Conclusions:Since RARP produces similar clinical outcomes to ORP and LRP but at a higher cost, the Victorian Health Technology Program Advisory Committee considered the case for public sector support of RARP is weak and provided two recommendations: (i) State Government resources are not used to procure RARP capital equipment; (ii) public hospitals can refer patients to a RARP provider, provided costs are negotiated prior to patient transfer and fully covered by the referring hospital.
25
Garbi, Madalina. "National Institute for Health and Care Excellence clinical guidelines development principles and processes." Heart 107, no. 12 (February 23, 2021): 949–53. http://dx.doi.org/10.1136/heartjnl-2020-318661.
Повний текст джерелаАнотація:
Clinical guidelines are developed by professional societies and also, in England, by an independent non-departmental public body, the National Institute for Health and Care Excellence (NICE). Similarities and differences between these guidelines should be viewed in the context of different objectives, responsibilities and roles of guideline developers. This review describes the NICE clinical guidelines development principles and processes with the aim to provide the reader an informed perspective on the recommendations made. NICE clinical guidelines are developed by an appointed independent advisory committee comprising healthcare professionals as well as lay members, supported by a professional team comprising project managers, information specialists, systematic reviewers and health economists. Furthermore, registered stakeholders comprising organisations that have an interest in the guideline topic, or represent people whose practice or care may be directly affected by the guideline, are consulted on the draft scope and draft guidelines. NICE selects a limited number of high impact questions to be answered by the review of evidence, rather than cover a certain topic exhaustively as the clinical guidelines developed by professional societies may do. NICE clinical guidelines recommendations reflect both the clinical effectiveness and the cost-effectiveness of interventions.
26
Cho, Yoo Mi, and Kyoung Suk Lee. "Mediating Effects of Diet Quality between Meal Frequency and Cardiometabolic Risk among Korean Adults: Data from the 7th Korea National Health and Nutrition Examination Survey (KNHNES)." Journal of Korean Critical Care Nursing 16, no. 2 (June 30, 2023): 67–80. http://dx.doi.org/10.34250/jkccn.2023.16.2.67.
Повний текст джерелаАнотація:
Purpose : The 2020 Dietary Guidelines Advisory Committee specifically noted that meal frequency is associated with risks for cardiovascular disease, type 2 diabetes, and all-cause mortality, although the current evidence on meal frequency is conflicting. As meal frequency itself is affected by various factors, the aim of the study was not only to examine its relationships with cardiometabolic risk but also to identify the mediating effects of dietary quality.Methods : This study used a descriptive correlational design. In all 8,141 healthy adults participated in the study. Measurements included meal frequency, cardiometabolic risk, and diet quality. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient analysis, and process macro bootstrapping model 4.Results : The meal frequency was 3.52±0.61 times per day, the risk of cardiovascular metabolic diseases was 0.01±0.61 points, and the diet quality was 62.08±13.87 points. In mediation analysis, the effect of meal frequency on cardiometabolic risk score was completely mediated by diet quality.Conclusion : Improved diet quality in healthy adults should be considered when designing meal frequency interventions aimed at reducing their cardiometabolic risk, as the effect of meal frequency support on cardiometabolic risk was found to be mediated by diet quality.
27
Wright-Hughes, Alexandra, Rebecca Walwyn, Judy M. Wright, Amanda Farrin, Peter Fonagy, Dennis Ougrin, Daniel Stahl, and David Cottrell. "Reducing Self-harm in Adolescents. An individual participant data meta-analysis (RISA-IPD): systematic review protocol." BMJ Open 11, no. 5 (May 2021): e049255. http://dx.doi.org/10.1136/bmjopen-2021-049255.
Повний текст джерелаАнотація:
IntroductionUp to 10% of adolescents report self-harm in the previous year. Non-fatal repetition is common (18% in 1 year), death from any cause shows a fourfold and suicide a 10-fold excess. Despite the scale of the problem, there is insufficient evidence for effective interventions for self-harm. Those who self-harm do so for a variety of different reasons. Different treatments may be more effective for subgroups of adolescents; however, little is known about which subgroups are appropriate for further study. This protocol outlines a systematic review and individual participant data meta-analysis (IPD-MA) to identify subgroups of adolescents for which therapeutic interventions for self-harm show some evidence of benefit.Methods and analysisA systematic literature search was conducted in August 2019 (including Cochrane Library, Embase, trial registers and other databases). An update search is planned. Study selection will identify randomised controlled trials examining interventions to reduce self-harm in adolescents who have self-harmed and presented to services. Identified research teams will be invited to contribute data and form a collaborative group. Two-stage IPD-MA will be used to evaluate effectiveness of different therapeutic interventions compared with any active or non-active control on repetition of self-harm, general psychopathology, depression, suicidal ideation, quality of life and death. Subgroup analyses will identify adolescent subgroups in whom different therapeutic interventions may be more effective. Meta-regression will explore moderating study and intervention effects. Sensitivity analyses will incorporate aggregate data from studies lacking IPD and test the robustness of results to methods for handling missing data, within-study clustering, non-adherence and study quality.Ethics and disseminationEthical approval is provided by the University of Leeds, Faculty of Medicine and Health Ethics Committee (18-098). Outcomes will inform research recommendations and will be disseminated internationally through the collaborative group, a service user advisory group, open-access peer-reviewed publication and conference presentations.PROSPERO registration numberCRD42019152119.
28
Bakkacha, Ouiam, Geoffrey L. Uy, Ibrahim Aldoss, Matthew C. Foster, David A. Sallman, Kendra L. Sweet, David A. Rizzieri, et al. "Improvement in Cytokine Release Syndrome Management for the Treatment of AML Patients with Flotetuzumab, a CD123 x CD3 Bispecific Dart® Molecule for T-Cell Redirected Therapy." Blood 134, Supplement_1 (November 13, 2019): 5144. http://dx.doi.org/10.1182/blood-2019-127138.
Повний текст джерелаАнотація:
Background: Cytokine release syndrome (CRS) management in acute myeloid leukemia (AML) patients treated with flotetuzumab, an investigational CD123xCD3 bispecific DART® molecule for T cell redirected therapy. CRS is a hallmark of T cell activating therapy and can be correlated with efficacy, specifically, with CAR-T cells(1). Identification of patients at risk for high grade CRS will help guide CRS management. Flotetuzumab (MGD006) is anovel CD123xCD3 bispecific DART® molecule in Phase 1/2 testing in patients with relapsed/ refractory AML. Several strategies have been successfully employed to mitigate CRS severity, some have been previously reported (2, 3). Here we report on further refinement of CRS management and subsequent investigation of potentiel predictive biomarkers of severity. Methods: The recommended phase 2 dose (RP2D) of flotetuzumab is 500ng/kg/d CIV. Week 1 comprises a step-wise lead-in dose (LID) (1-step: 100 ng/kg/day days 1-4; 2-step: 30ng/kg/d for 3days, 100ng/kg/d for 4days, or multi-step (MS) LID at 30, 60, 100, 200, 300, 400 and 500 ng/kg/day each for 24 hours) in order to improve flotetuzumab tolerability. Tocilizumab usage recommended early in CRS management. The relationships between immune cells (T-cell subsets, monocytes) and tumor burden (percent CD123+ AML blasts, CD123 expression) were further interrogated as potential determinants of CRS. Results: 50 patients have been treated at the RP2D. While almost all patients experienced IRR/CRS events, the majority of these patients experienced IRR/CRS that were mild-moderate in severity (28% Grade(G)1, 62% G2, and 8% G3), of short duration (median 1 day for G1, 2 days G2, 2.5 days G3), and resolved completely with no clinical sequalae reported. Most CRS events occured in the first week of treatment (38.3%) and gradually decreased with continuous dosing (24.8%, 7.4%, and 4.3% during weeks 2-4, respectively). Several key interventions have helped mitigate CRS severity. Sequential increment in steps of LID schedules (1 step, 2-step or multi-step LID) have successfully decreased CRS severity and incidence. For example, CRS mean grade±SEM for week 1 was 2.0±0.26 vs 1.4±0.72 vs 1.5±0.63 and for week 4, 0.67±0.42 vs 0.2 ±0.50 vs 0.1 ±0.50 (1 step, 2-step or multi-step LID, respectively). Moreover, LID improved overall tolerability. Introduction of early use of tocilizumab has helped forestall CRS development; 27 patients received tocilizumab (10 doses for G1, 27 for G2, and 2 for G3 events), only 5 pts have required steroids (4 for G2 and 1 for G3), and no pts have required vasopressor support. Blunting of CRS events did not impact antileukemic activity. CRS severity showed a relationship with baseline frequency of circulating CD4+ cells (mean 0.2 K/µL in patients with no CRS vs. 1.0 K/µL in G1 vs 1.6 K/µL in G ≥2, p < 0.000.1), and peak CRS grade in week 1. Conclusion: Like other T-cell activating therapies, flotetuzumab is associated with CRS. Several mitigating factors have helped to blunt the severity of CRS, including lead-in dosing and early tocilizumab usage. Circulating CD4+ cells at baseline continues to be associated with CRS risk, and may be a helpful marker to identify patients at increased risk for CRS. 1. Maude, SL. et al. Managing Cytokine Release Syndrome Associated With Novel T Cell-Engaging Therapies. Cancer J. 2014; 20(2): 119-122. 2. Jacobs, K, et al.Lead-in Dose Optimization to Mitigate Cytokine Release Syndrome in AML and MDS Patients Treated with Flotetuzumab, a CD123 x CD3 Dart® Molecule for T-Cell Redirected Therapy. Blood 2017 130:3856. 3. Jacobs, K, et al.Management of Cytokine Release Syndrome in AML Patients Treated with Flotetuzumab, a CD123 x CD3 Bispecific Dart® Molecule for T-Cell Redirected Therapy. Blood 2018 132:2738. Disclosures Bakkacha: Macrogenics,Inc: Employment, Equity Ownership. Uy:Astellas: Consultancy; Pfizer: Consultancy; Curis: Consultancy; GlycoMimetics: Consultancy. Aldoss:Helocyte: Consultancy, Honoraria, Other: travel/accommodation/expenses; AUTO1: Consultancy; Jazz Pharmaceuticals: Honoraria, Other: travel/accommodation/expenses, Speakers Bureau; Agios: Consultancy, Honoraria. Foster:Bellicum Pharmaceuticals, Inc: Research Funding; Daiichi Sankyo: Consultancy; MacroGenics: Research Funding; Celgene: Research Funding. Sallman:Celyad: Membership on an entity's Board of Directors or advisory committees. Sweet:Pfizer: Consultancy; Incyte: Research Funding; Agios: Membership on an entity's Board of Directors or advisory committees; Bristol Myers Squibb: Membership on an entity's Board of Directors or advisory committees; Celgene: Speakers Bureau; Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Stemline: Consultancy; Jazz: Speakers Bureau; Abbvie: Membership on an entity's Board of Directors or advisory committees; Astellas: Membership on an entity's Board of Directors or advisory committees. Rizzieri:Celgene, Gilead, Seattle Genetics, Stemline: Other: Speaker; AbbVie, Agios, AROG, Bayer, Celgene, Gilead, Jazz, Novartis, Pfizer, Sanofi, Seattle Genetics, Stemline, Teva: Other: Advisory Board; AROG, Bayer, Celgene, Celltron, Mustang, Pfizer, Seattle Genetics, Stemline: Consultancy; Stemline: Research Funding. Advani:Glycomimetics: Consultancy, Research Funding; Kite Pharmaceuticals: Consultancy; Amgen: Research Funding; Pfizer: Honoraria, Research Funding; Macrogenics: Research Funding; Abbvie: Research Funding. Emadi:Genentech: Consultancy, Honoraria; KinaRx: Membership on an entity's Board of Directors or advisory committees, Other: Co-Founder and Scientific Advisor, Patents & Royalties; NewLink Genetics: Research Funding; Jazz Pharmaceuticals: Research Funding; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees. Wieduwilt:Reata Pharmaceuticals: Equity Ownership; Daiichi Sankyo: Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees; Amgen, Leadiant, Merck, Servier: Research Funding. Vey:Novartis: Consultancy, Honoraria; Janssen: Honoraria. Arellano:Gilead: Consultancy. Löwenberg:Up-to-Date", section editor leukemia: Membership on an entity's Board of Directors or advisory committees; Abbvie: Membership on an entity's Board of Directors or advisory committees; Agios Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Astellas: Membership on an entity's Board of Directors or advisory committees; Astex: Membership on an entity's Board of Directors or advisory committees; Chairman, Leukemia Cooperative Trial Group HOVON (Netherlands: Membership on an entity's Board of Directors or advisory committees; Clear Creek Bio Ltd: Consultancy, Honoraria; Editorial Board "European Oncology & Haematology": Membership on an entity's Board of Directors or advisory committees; Elected member, Royal Academy of Sciences and Arts, The Netherlands: Membership on an entity's Board of Directors or advisory committees; Frame Pharmaceuticals: Equity Ownership; Hoffman-La Roche Ltd: Membership on an entity's Board of Directors or advisory committees; Royal Academy of Sciences and Arts, The Netherlands: Membership on an entity's Board of Directors or advisory committees; Supervisory Board, National Comprehensive Cancer Center (IKNL), Netherland: Membership on an entity's Board of Directors or advisory committees; Chairman Scientific Committee and Member Executive Committee, European School of Hematology (ESH, Paris, France): Membership on an entity's Board of Directors or advisory committees; CELYAD: Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees. Ravandi:Cyclacel LTD: Research Funding; Menarini Ricerche: Research Funding; Selvita: Research Funding; Xencor: Consultancy, Research Funding; Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Macrogenix: Consultancy, Research Funding. Tran:MacroGenics: Employment. Muth:MacroGenics, Inc.: Employment, Equity Ownership. Baughman:MacroGenics, Inc.: Employment, Equity Ownership. Timmeny:MacroGenics, Inc.: Employment, Other: Stock Ownership. Topp:Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees; Roche: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Regeneron Pharmaceuticals, Inc.: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Boehringer Ingelheim: Membership on an entity's Board of Directors or advisory committees, Research Funding; KITE: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Amgen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding. Guo:Macrogenics: Employment. Zhao:MacroGenics, Inc.: Employment. Wigginton:macrogenics: Employment, Equity Ownership; western oncolytics: Consultancy, Other: consultancy. Bonvini:MacroGenics, Inc.: Employment, Equity Ownership. Walter:Daiichi Sankyo: Consultancy; Amgen: Consultancy; Agios: Consultancy; Boston Biomedical: Consultancy; Covagen: Consultancy; Amphivena Therapeutics: Consultancy, Equity Ownership; Aptevo Therapeutics: Consultancy, Research Funding; Argenx BVBA: Consultancy; Astellas: Consultancy; BioLineRx: Consultancy; BiVictriX: Consultancy; Boehringer Ingelheim: Consultancy; Pfizer: Consultancy, Research Funding; Race Oncology: Consultancy; Seattle Genetics: Research Funding; Jazz Pharmaceuticals: Consultancy; Kite Pharma: Consultancy; New Link Genetics: Consultancy. Davidson:Macrogenics,Inc: Employment, Equity Ownership. DiPersio:Incyte: Consultancy, Research Funding; Celgene: Consultancy; Karyopharm Therapeutics: Consultancy; Bioline Rx: Research Funding, Speakers Bureau; RiverVest Venture Partners Arch Oncology: Consultancy, Membership on an entity's Board of Directors or advisory committees; Cellworks Group, Inc.: Membership on an entity's Board of Directors or advisory committees; Magenta Therapeutics: Equity Ownership; WUGEN: Equity Ownership, Patents & Royalties, Research Funding; Amphivena Therapeutics: Consultancy, Research Funding; NeoImmune Tech: Research Funding; Macrogenics: Research Funding, Speakers Bureau. Jacobs:Macrogenics,Inc: Employment, Equity Ownership.
29
Wale, Janney, Ken Bond, Sally Wortley, Janet Martin, Brian Godman, and Iñaki Gutiérrez-Ibarluzea. "OP105 Disinvestment Toolkit: Patients Involvement In Disinvestment Activities." International Journal of Technology Assessment in Health Care 34, S1 (2018): 39–40. http://dx.doi.org/10.1017/s0266462318001356.
Повний текст джерелаАнотація:
Introduction:Patients are the people who, with their informed consent, receive medical interventions. It is important, therefore, that patients have an understanding of interventions and their potential as a treatment for their condition. Patients are becoming more informed about their health care and the treatments that are available to them. At a population level, the potential benefits and harms of treatments need to be regularly assessed. This is part of healthcare decision making at a policy level about what treatments are publically available. As technology develops and old methods are replaced by new and evidence-based interventions and procedures, healthcare payers look to streamline their payment schedules and disinvest in old technologies and procedures. Some users of health care are reluctant to let go of outmoded methods, so disinvestment is best achieved through transparent processes. Successful engagement with key stakeholders of health care, engaging with payers, health service administrators, clinicians and patients, can facilitate implementation of disinvestment processes.Methods:To assist in this process, Health Technology Assessment International (HTAi) Interest Groups and EuroScan have come together to develop the following key points to consider in the involvement and engagement of clinicians, patients, and the public in the disinvestment of services and technologies.Results:The best time to involve clinicians and patient representatives is right at the beginning of the process. Clinicians and patients can make valuable contributions as advisory committee members. The disinvestment processes may be led by clinicians, payers, or independent organizations. This will likely influence commitment of clinicians to the process.Conclusions:Broader consultation with clinicians, patients and the public in the development and consideration of draft reports and recommendations can increase the transparency of the disinvestment process. Consultation is an important means of obtaining buy in. Feedback needs to be seen as taken seriously, and explanations given for any changes made or not made to the report and its recommendations.
30
Avulakunta, Indirapriya, Palanikumar Balasundaram, Alma Rechnitzer, Toshiba Morgan-Joseph, and Suhas Nafday. "A Improving Birth-dose Hepatitis-B Vaccination in a Tertiary Level IV Neonatal Intensive Care Unit." Pediatric Quality & Safety 8, no. 5 (September 2023): e693. http://dx.doi.org/10.1097/pq9.0000000000000693.
Повний текст джерелаАнотація:
Background: Perinatal hepatitis B is a global public health concern. To reduce perinatal hepatitis B and its complications, the Hepatitis B vaccine (HBV) is recommended by the New York State Department of Health and Advisory Committee on Immunization Practices within 24 hours of life for infants born with a birth weight ≥2000 g. Infants admitted to the neonatal intensive care unit (NICU) weighing over 2000 g missed their birth dose HBV frequently, which prompted the implementation of a quality improvement initiative to increase birth dose HBV immunization in a level IV NICU in New York. Methods: May 2019 to April 2021 baseline data showed the birth dose HBV rate of infants born ≥2000 g at 24% and 31% within 12 and 24 hours, respectively. The multidisciplinary QI team identified barriers using an Ishikawa cause-and-effect diagram. Our interventions included multidisciplinary collaboration, electronic medical record reminders, education, posters, and improved communication between staff and parents. We aimed to achieve a 25% improvement from the baseline. Results: After 19 months of QI interventions (four Plan-Do-Study-Act cycles), the rate of administering birth dose HBV within 12 hours of life increased from 24% to 56% and within 24 hours from 31% to 64%. Process measure compliance improved, exceeding the 25% target, and showed sustained improvement. Conclusion: This QI initiative improved the rate of eligible infants receiving HBV within the first 24 hours of life in the NICU. This work can serve as a model for other healthcare institutions to improve HBV immunization rates in NICUs.
31
Brintz, Carrie E., Shari Miller, Kristine Rae Olmsted, Michael Bartoszek, Joel Cartwright, Paul N. Kizakevich, Michael Butler, Nakisa Asefnia, Alex Buben, and Susan A. Gaylord. "Adapting Mindfulness Training for Military Service Members With Chronic Pain." Military Medicine 185, no. 3-4 (October 17, 2019): 385–93. http://dx.doi.org/10.1093/milmed/usz312.
Повний текст джерелаАнотація:
Abstract Introduction Rates of chronic pain in military personnel are disproportionately high. Chronic pain is often associated with mental health and substance use disorders as comorbid conditions, making treatment of chronic pain complex. Mindfulness-based interventions (MBIs) are a promising behavioral approach to managing chronic pain and psychosocial sequelae. The unique nature of the military context may require adaptations to original MBIs for successful delivery in active-duty military populations. This study adapted the mindfulness-based stress reduction (MBSR) program to create a mindfulness training program that was relevant to active-duty Army personnel experiencing chronic pain. This article delineates the adaptation process employed to modify the MBSR program to the military context and discusses the resulting training program. Materials and Methods The adaptation process consisted of three iterative stages: 1) Drafting the preliminary intervention protocol with recommendations from stakeholders, including military healthcare providers; 2) Refining the preliminary protocol after pretesting the sessions with research team members and a military Veteran advisory committee; and 3) Delivering the preliminary protocol to one cohort of active-duty Soldiers with chronic pain, collecting feedback, and further refining the intervention protocol. Results Military-related adaptations to MBSR addressed three areas: military culture, language and terminology, and practical and logistical factors relevant to implementation in the military setting. This adaptation process resulted in a live, online program with six, weekly, sessions. Feedback from a military Veteran advisory committee resulted in modifications, including increasing military-relevant examples; preliminary testing with the target population resulted in additional modifications, including shortening the sessions to 75 min and structuring discussions more efficiently. Conclusions The adaptation process was successful in generating an engaging mindfulness training program that was highly relevant to the military context. Obtaining input from stakeholders, such as military healthcare providers and active-duty soldiers, and iterative feedback and modification, were key to the process. Moreover, the program was designed to maintain the integrity and core elements of MBIs while adapting to military culture. A future randomized controlled trial design will be used to evaluate the effectiveness of the intervention in improving chronic pain in military personnel. This program is responsive to the military’s call for nonpharmacologic treatments for chronic pain that are easily accessible. If effective, the mindfulness program has the potential for widespread dissemination to complement standard care for Service Members experiencing chronic pain.
32
De Silva, Sinha, Sudharshi Seneviratne, and Dulani Samaranayake. "Development Of A Complex Public Health Intervention To Reduce Anxiety Of Children Aged 13-15 Years Attending Government Sinhala Medium Schools In Colombo District, Sri Lanka." International Journal of Progressive Sciences and Technologies 39, no. 2 (July 17, 2023): 49. http://dx.doi.org/10.52155/ijpsat.v39.2.5444.
Повний текст джерелаАнотація:
Background: Anxiety disorders (AD) are the most prevalent psychological problem among adolescents. Both anxiety disorders and anxiety symptoms can lead to adverse outcomes. The aim of the study was to develop an evidence-based intervention package to reduce anxiety among school children aged 13-15 years.Methods: Design: UK Medical Research Council guidance for development of complex interventions were followed. Identification of evidence based was done by literature-search and expert opinions. Most suitable theory was identified based on level of evidence through consensus of Advisory committee (AC) consisting of experts. Subcomponents of the selected theory were mapped with associated factors of the AD. Eleven KII were conducted with school principals, teachers, parents, and students. Framework of the intervention package with suitable deliverables was designed with consensus of the AC by triangulating the findings. This was further fine-tuned with by using Modified-Delphi technique with participation of broader group of experts. These Delphi items were systematically derived from findings of the systematic reviews, expert opinion, and inputs from intervention recipients. The content development was done based on the proposed framework. Modeling process was done by conducting four consultative meetings with stakeholders with the aim of ensuring content and consensual validity followed by a consensus workshop. Feasibility study and pretesting of deliverables were done. Participants: Advisory committee [n=6] and stakeholder group [n=11] in Delphi component & four consultative meetings and a wider stakeholder group [n=23] in 1-day consensus workshop were involved.Results: Four RCTs and 12 RCTs/cRCTs were identified through literature review. Six types of intervention modalities were identified. CBT based intervention modality was shortlisted by AC considering the level of evidence. Five broad solutions, namely psycho education, realistic thinking, problem solving, graded exposure and relaxation techniques under CBT were mapped against the associated factors with consensus of the AC. Activities were developed under these broad solutions and most suitable options of these activities were selected by a stakeholder group using Modified Delphi technique. The intervention package was finalized by conducting a consensual workshop followed by feasibility study and pretesting of deliverables.Conclusions: A CBT-based universal intervention package was developed to reduce anxiety among children with ToT workshop for teachers with a field training, eight weekly 40 minutes sessions for children and one 40-minute session for parents. Teachers’ guide, Student’s workbook and leaflet for parents were deliverables. A process evaluation framework was used to monitor implementation.
33
Manchikanti, Laxmaiah. "Accountable Interventional Pain Management: A Collaboration Among Practitioners, Patients, Payers, and Government." Pain Physician 6;16, no. 6;11 (November 14, 2013): E635—E670. http://dx.doi.org/10.36076/ppj.2013/16/e635.
Повний текст джерелаАнотація:
The prevalence, costs, and disability associated with chronic pain continue to escalate. So too, the numerous modalities of treatments applied in managing these patients continue to increase as well. In the period from 2000 to 2011 interventional techniques increased 228%. In addition, analysis of utilization trends and expenditures for spinal interventional techniques alone from 2000 to 2008 illustrated an increase in Medicare fee-for-service expenditures of 240% in terms of dollars spent in the United States. The Office of Inspector General (OIG) of the Department of Health and Human Services showed an increase in facet joint and transforaminal epidural injections, with a significant proportion of these services did not meet the medical necessity criteria. The increasing utilization of interventional techniques is also associated with significant variations among specialty groups and regional variations among states. Overall procedures have increased by 173%, with rate of 130% per 100,000 Medicare beneficiaries for epidural injections; 383%, with a rate of 308% for facet joint interventions; and overall 410%, or a rate of 331% for sacroiliac joint interventions. Certain high volume interventions such as lumbar transforaminal epidural injections and lumbar facet joint neurolysis have actually increased a staggering 806% and 662%. Coverage policies across ambulatory settings and by multiple payers are highly variable. Apart from variability in the development of coverage policies, payments also substantially vary by site of service. In general, amongst the various ambulatory settings the highest payments are made to hospital outpatient departments (HOPDs) the lowest to in-office procedures, and payment to ambulatory surgery centers (ASCs) falling somewhere in the middle. This manuscript describes the many differences that exist between the various settings, and includes suggestions for accountable interventional pain management with coverage for techniques with evidence, addressing excessive use of specific techniques, and equalizing payments across multiple ambulatory settings. Key words: Accountable interventional pain management, Medicare, Medicare Evidence Development & Coverage Advisory Committee, epidural injections, facet joint interventions, sacroiliac joint injections, payment policies
34
Arden-Close, Emily, Sarah Thomas, Reece Bush-Evans, Ruijie Wang, Elvira Bolat, Sarah Hodge, Keith Phalp, and John McAlaney. "Social norms and goal-setting interventions to promote responsible gambling in low-to-moderate online gamblers: protocol for a four-arm randomised controlled feasibility study." BMJ Open 13, no. 3 (March 2023): e065400. http://dx.doi.org/10.1136/bmjopen-2022-065400.
Повний текст джерелаАнотація:
IntroductionGambling is increasingly recognised as an important public health issue. Problem gambling is associated with highly negative impacts on physical, psychological and social well-being, not only for those who gamble but also for those around them. There has been a rapid expansion of internet gambling and attributes such as continuous play and instant rewards, and enhanced privacy may lead to a greater likelihood of gambling-related harms. In this randomised controlled feasibility study, we are testing (1) the acceptability and feasibility of three online responsible gambling interventions targeting people with low-to-moderate risk of online problem gambling and (2) the feasibility of a future full-scale randomised controlled trial (RCT) to test their effectiveness and cost-effectiveness.Methods and analysisFour-arm randomised controlled feasibility study with qualitative substudy. One-hundred and forty UK residents with low-to-moderate risk of online gambling recruited via gambling operators and social media will be randomised (1:1:1:1) to either (1) goal setting, (2) descriptive norms messages (challenge perceptions of peer behaviours), (3) injunctive norms messages (challenge perceptions of peer attitudes) and (4) control (delayed intervention). Interventions will be delivered over 6 weeks and individually tailored. Outcomes, administered online, will be measured at baseline, 7 weeks, and 3 and 6 months post randomisation (including gambling risk behaviours and cognitions, anxiety and depression, quality of life, health use and productivity). Analyses will be descriptive, focusing on feasibility and acceptability of the interventions and study procedures. Telephone/online interviews, with a subsample of approximately 30 participants, will elicit experiences of participating in the study. Prespecified progression criteria will guide decisions around whether to progress to a definitive RCT.Ethics and disseminationEthical approval obtained from Bournemouth University Research Ethics Committee (reference number 33247). Participants will be given a participant information sheet plus a ‘Key Facts’ summary and will provide informed online consent. Findings will be published in peer-reviewed journals and presented at conferences and public engagement events.Trial registration numberISRCTN37874344.
35
Choo, Esther K., Kate Morrow Guthrie, Michael J. Mello, Terrie Fox Wetle, Megan L. Ranney, Chantal Tapé, and Caron Zlotnick. "“I Need to Hear From Women Who Have ‘Been There’”: Developing a Woman-Focused Intervention for Drug Use and Partner Violence in the Emergency Department." Partner Abuse 7, no. 2 (2016): 193–220. http://dx.doi.org/10.1891/1946-6560.7.2.193.
Повний текст джерелаАнотація:
Objective: Addressing violence and linking women to community services in parallel with drug change goals is critical for women with coexisting intimate partner violence (IPV) and substance use disorders (SUD). Our objective was to develop a Web-based intervention to address violence and drug use among women patients in the emergency department (ED). Methods: The intervention was developed in a 5-step process: (1) Initial intervention development based on selected theoretical frameworks; (2) In-depth interviews with the target population; (3) Intervention adaptation, with iterative feedback from further interviews; (4) Beta testing and review by an advisory committee of domestic violence advocates; (5) Acceptability and feasibility testing in a small open trial. Results: Themes supported the selection of motivational interviewing (MI) and empowerment models but also guided major adaptations to the intervention, including the introduction of videos and a more robust booster phone call. Participants in the open trial reported high scores for satisfaction, usability, and consistency with essential elements of MI. Conclusions: This qualitative work with our target population of women in the ED with SUD experiencing IPV underscored the importance of connection to peers and empathetic human contact. We developed an acceptable and feasible intervention distinct from prior ED-based brief interventions for substance-using populations.
36
Lea, Laura, Sarah Byford, Yve Coney, Rebecca Crane, Natalia Fagabemi, Tony Gurney, Helen Leigh-Phippard, Claire Rosten, Kate Simms, and Clara Strauss. "Reflections on my role as a mental health service user co-applicant in a randomized control trial." Research for All 4, no. 1 (February 1, 2020): 33–46. http://dx.doi.org/10.18546/rfa.04.1.04.
Повний текст джерелаАнотація:
This is not a research paper but a personal and collective reflection of patient and public involvement (PPI) for the LIGHTMind 2 randomized control trial (www. isrctn. com/ISRCTN13495752). This trial compares two guided self-help psychological interventions for depression, and is delivered in the UK NHS Improving Access to Psychological Therapy services. The paper is the result of my reviewing our PPI 18 months into the trial. The PPI includes myself as a research team member and co-applicant, with lived experience of depression, mindfulness and cognitive behaviour therapy. There is a Lived Experience Advisory Panel of six people with lived experience of depression or mindfulness, who advise the researchers. Two people with lived experience of mental health difficulties and knowledge of PPI attend the Trial Steering Committee. This paper includes comments from some of the other people with lived experience and from researchers involved in the trial, included as co-authors. I offer the Johari window (Luft, 1970) and the 4Pi National Involvement Standards (NSUN, 2018) as a way of positioning the value of PPI. Developing relationships within PPI is identified as a way of moderating the fear that some people experience as they work with researchers. I describe the importance of principles that incorporate explicit statements about the value of PPI.
37
L. Basser, Margaret. "Evaluation of Outreach Community Health Care to Insecurely Housed Sydney Men." Australian Journal of Primary Health 5, no. 3 (1999): 82. http://dx.doi.org/10.1071/py99038.
Повний текст джерелаАнотація:
A community health outreach service was piloted among older homeless Sydney men in 1997/98 from Darlinghurst Community Health Centre, responding to an observed disparity between their high health needs and low use of community health care. The project tried to improve their access to community health services, their health and quality of life by allocating a project worker who built referral networks, assisted the men and advocated for them with other agencies. From the impact evaluation, the conclusion could be drawn that the men's access to community services improved, but whether lasting benefits were delivered by the interventions remained ambiguous. Referrals of homeless men from GPs and hospitals to the health centre increased in the year following the pilot, despite the absence of a project worker for most of that time. The project was guided by an inter-sectoral advisory committee, whose deliberations altered the evaluation questions, the interpretation of findings and recommendations. Reflection on this process led to some lessons about working with committees. The pilot project has contributed to the current planning in South Eastern Sydney Area Health Service to address homeless people's health care issues by highlighting some of the issues and viable responses to them.
38
Rechis, Ruth, Haley Gardiner, Katy Oestman, Stephanie Nutt, and Michael T. Walsh. "Abstract A027: Creating partnerships to deliver community-based interventions for cancer prevention in a historically African American community." Cancer Epidemiology, Biomarkers & Prevention 32, no. 12_Supplement (December 1, 2023): A027. http://dx.doi.org/10.1158/1538-7755.disp23-a027.
Повний текст джерелаАнотація:
Abstract Be Well Communities™ is MD Anderson’s signature place-based approach for cancer prevention and control, working with communities to promote wellness and address modifiable risk factors for cancer. In this project, the planning phase of the Be Well Communities’ model was implemented in Acres Homes, a neighborhood in northwest Houston with more than 57,000 residents. While the changing demographics show increasing numbers of residents of Hispanic descent (43% of the population), Acres Homes still experiences effects of a legacy of Blacks experiencing poverty; more than half of the population of Acres Homes resides in census tracts that are considered areas of persistent poverty. Further, it is a medically underserved area with relatively high rates of unhealthy behaviors, as compared to Healthy People 2030 goals. To work toward addressing the disparities in health outcomes experienced by community residents, a community advisory group (Steering Committee) including residents, non-profit organizations, health care partners, city and county agencies, plus other stakeholders, was convened and aligned through a structured process to develop shared goals, foster multisector collaboration (as measured by a stakeholder survey administered twice), and enhance community capacity to improve health outcomes through development of a Community Action Plan. Clear, achievable goals were developed, multisector collaboration was enhanced, and more than 400 hours of capacity building support led to a Community Action Plan focused on healthy eating and active living, including 15 evidence-based interventions led by 18 organizations. The majority (93%) of the Steering Committee reports that this plan reflects community priorities and will reach the residents most in need. In the first 2 years of implementation nearly 40% of the residents of the community have been reached by programs including more than 5,000 residents participating in physical activity opportunities, classes and over 1000 individuals receiving outreach from a Community Health Worker within the safety-net hospital system to receive access to healthy food access and nutrition education programming. By listening and developing trust, the Be Well Communities team successfully worked with Acres Homes residents and organizations to enhance community capacity to address health inequities in one of Houston’s most historic communities. Citation Format: Ruth Rechis, Haley Gardiner, Katy Oestman, Stephanie Nutt, Michael T. Walsh Jr.. Creating partnerships to deliver community-based interventions for cancer prevention in a historically African American community [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A027.
39
Tremblay, Douglas, Andrew Srisuwananukorn, Lukas Ronner, Nikolai Podoltsev, Jason Gotlib, Mark L. Heaney, Andrew T. Kuykendall, et al. "European Leukemianet (ELN) Response Predicts Disease Progression but Not Thrombosis or Death in Polycythemia Vera (PV): An Analysis of a Multicenter Database." Blood 138, Supplement 1 (November 5, 2021): 240. http://dx.doi.org/10.1182/blood-2021-148020.
Повний текст джерелаАнотація:
Abstract Introduction Response criteria for judging the success of PV therapeutic interventions put forth by the ELN (Barosi Blood 2013 ) require normalization of blood counts and splenomegaly for 3 months following the administration of an agent. These criteria are frequently employed as a primary outcome in clinical trials, yet, the clinical significance of meeting these criteria have not been established. The goal of this study is to evaluate the prognostic impact of ELN response criteria in a large US retrospective database of PV patients (Ronner Blood 2020). Methods Included patients were age ≥18 years at diagnosis, met 2016 WHO diagnostic criteria for PV, and were treated with a cytoreductive agent including hydroxyurea (HU), pegylated-interferon or ruxolitinib for at least 12 weeks. Laboratory and spleen measurements were collected throughout the treatment course. Attaining an ELN response throughout the study period was defined as concurrent WBC <10 x 10^9/L, hematocrit <45%, platelet <400 x 10^9/L, and lack of palpable splenomegaly for a minimum of 12 consecutive weeks. Multivariable Cox proportional hazards methods were used to determine the associations between achieving an ELN response and events such as thrombosis, disease progression (development of myelofibrosis [MF], myelodysplastic syndrome [MDS], or myeloproliferative neoplasm in blast phase [MPN-BP] as clinically determined by treating physician) and death. Time-dependent Cox proportional hazards models were also assessed to examine the relationship between duration of response and these outcomes. All models were adjusted for age, gender, history of prior thrombosis, and the presence of cardiovascular (CV) risk factors. Results A total of 398 of the 527 patients received cytoreductive therapy for at least 12 weeks and were included in the current analysis. Baseline characteristics are shown in the Table. HU was the most common initial cytoreductive agent employed. The median maximum dose of HU was 1000mg daily (IQR 714-1500). During a median follow-up of 52.3 months, 249 (63%) patients attained an ELN response and 149 (37%) did not. The median duration of response was 37 weeks (IQR 16-74). Forty-five patients (11%) experienced a new thrombosis, including DVT (n=15), CVA/TIA (n=14), PE (n=5), MI (n=6), and splanchnic vein thrombosis (n=6). Disease progression occurred in 51 (13%) patients, including MF (n=47), MDS (n=3), and MPN-BP (n=1). Thirteen patients (3%) died during follow up. In our Cox-proportional hazards model, meeting an ELN response was not associated with a reduced risk of developing a thrombosis (p=0.86), but having a prior thrombosis was associated with acquiring a subsequent thrombosis (HR 3.3, 95% CI 1.80-6.05). Similarly, ELN responses were not associated with reduction in hazard of death (p=0.80). However, an ELN response was associated with a significant decrease in the hazard of progression (HR 0.47, 95% CI 0.27-0.83) (Figure). Advanced age at diagnosis was also associated with an increased hazard of progression (HR 1.03, 95% CI 1.01-1.05). Similar results were observed when examining the relationship of ELN response duration as a time-dependent covariate as it relates to thrombosis (HR 0.82, 95% CI 0.41-1.65), progression (HR 0.39, 95% CI 0.17-0.90) and death (HR 0.82, 95% CI 0.23-2.88). We also evaluated the contribution of individual ELN response components using a multivariable Cox model adjusted for age, sex, prior thrombosis, and CV risk factors. The decrease in hazard of progression was largely driven by two components: WBC <10 x 10^9/L (HR 0.28, 95% CI 0.14-0.56) and absence of splenomegaly (HR 0.25, 95% CI 0.12-0.52). Interestingly, achieving a platelet count of <400 x 10^9/L was associated with a significant increase in the hazard of progression (HR 2.70, 95% CI 1.26-5.80) while achieving a hematocrit response was not associated with progression (HR 1.91, 95% CI 0.80-4.55). Conclusions Achieving an ELN response in PV patients is not associated with a reduction of risk for thrombosis or death but may be a surrogate endpoint for delaying disease progression. When evaluating new therapeutic strategies with the primary goal of reducing thrombotic burden in PV, the present ELN response criteria are not informative. The development of new reliable surrogate endpoints for predicting thrombotic risk are required in order to rapidly evaluate interventions that can prevent thrombosis in PV patients. Figure 1 Figure 1. Disclosures Podoltsev: Incyte: Honoraria; Novartis: Honoraria; Blueprint Medicines: Honoraria; Pfizer: Honoraria; PharmaEssentia: Honoraria; CTI BioPharma: Honoraria; Bristol-Myers Squib: Honoraria; Celgene: Honoraria. Gotlib: Allakos: Consultancy; Cogent Biosciences: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Chair for the Eligibility and Central Response Review Committee, Research Funding; PharmaEssentia: Honoraria, Membership on an entity's Board of Directors or advisory committees; Kartos: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; BMS: Research Funding; Abbvie: Membership on an entity's Board of Directors or advisory committees, Research Funding; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Deciphera: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Incyte: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Blueprint Medicines: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding. Heaney: Cogent: Research Funding; CTI: Honoraria, Research Funding; BMS: Research Funding; Blueprint: Honoraria, Research Funding; Sierra Oncology: Research Funding; Kartos: Research Funding; Novartis: Honoraria. Kuykendall: Abbvie: Honoraria; Blueprint: Honoraria; Novartis: Honoraria, Speakers Bureau; Incyte: Consultancy; Protagonist: Consultancy, Research Funding; Pharmaessentia: Honoraria; Celgene/BMS: Honoraria. Shammo: Incyte: Consultancy, Honoraria, Research Funding, Speakers Bureau; CTI pharma: Research Funding; Stemline therapeutics: Research Funding; Kartos Pharma: Research Funding; Takeda: Consultancy, Current equity holder in publicly-traded company, Current holder of individual stocks in a privately-held company, Honoraria, Research Funding; Abbvie: Current holder of individual stocks in a privately-held company, Research Funding; Baxter: Current holder of stock options in a privately-held company; sanofi: Consultancy, Honoraria, Speakers Bureau; NS Pharma: Membership on an entity's Board of Directors or advisory committees; BMS: Consultancy, Honoraria, Research Funding, Speakers Bureau; Alexion: Consultancy, Honoraria, Research Funding, Speakers Bureau; Apellis: Consultancy, Membership on an entity's Board of Directors or advisory committees; Novartis: Consultancy, Honoraria, Research Funding, Speakers Bureau; Astra zeneca: Research Funding. Mesa: La Jolla Pharma: Consultancy; Incyte Corporation: Consultancy, Research Funding; CTI: Research Funding; Samus: Research Funding; Pharma: Consultancy; Sierra Oncology: Consultancy, Research Funding; Novartis: Consultancy; AOP: Consultancy; Promedior: Research Funding; Constellation Pharmaceuticals: Consultancy, Research Funding; Abbvie: Research Funding; CTI: Research Funding; Gilead: Research Funding; Celgene: Research Funding; Genentech: Research Funding. Yacoub: Incyte: Consultancy, Honoraria, Speakers Bureau; Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; CTI Biopharma: Membership on an entity's Board of Directors or advisory committees; ACCELERON PHARMA: Membership on an entity's Board of Directors or advisory committees; Agios: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Dynavex: Current equity holder in publicly-traded company; Cara: Current equity holder in publicly-traded company; Ardelyx: Current equity holder in publicly-traded company; Seattle Genetics: Honoraria, Speakers Bureau; Hylapharm: Current equity holder in publicly-traded company. Hoffman: Protagonist Therapeutics, Inc.: Consultancy; Kartos Therapeutics, Inc.: Research Funding; Novartis: Other: Data Safety Monitoring Board, Research Funding; AbbVie Inc.: Other: Data Safety Monitoring Board, Research Funding. Mascarenhas: AbbVie: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Merck: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Kartos: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Constellation: Consultancy, Membership on an entity's Board of Directors or advisory committees; Geron: Consultancy, Research Funding; Merus: Research Funding; Roche: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; PharmaEssentia: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Incyte: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Sierra Oncology: Consultancy, Membership on an entity's Board of Directors or advisory committees; Celgene/BMS: Consultancy, Membership on an entity's Board of Directors or advisory committees; Genentech/Roche: Consultancy, Membership on an entity's Board of Directors or advisory committees; Geron: Consultancy; Gilead: Consultancy, Membership on an entity's Board of Directors or advisory committees; Prelude: Consultancy; Promedior: Consultancy, Membership on an entity's Board of Directors or advisory committees; Galecto: Consultancy; CTI Biopharm: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Forbius: Research Funding.
40
Hecht, Amelie A., Megan M. Lott, Kirsten Arm, Mary T. Story, Emily Snyder, Margo G. Wootan, and Alyssa J. Moran. "Developing a National Research Agenda to Support Healthy Food Retail." International Journal of Environmental Research and Public Health 17, no. 21 (November 4, 2020): 8141. http://dx.doi.org/10.3390/ijerph17218141.
Повний текст джерелаАнотація:
The food retail environment is an important driver of dietary choices. This article presents a national agenda for research in food retail, with the goal of identifying policies and corporate practices that effectively promote healthy food and beverage purchases and decrease unhealthy purchases. The research agenda was developed through a multi-step process that included (1) convening a scientific advisory committee; (2) commissioned research; (3) in-person expert convening; (4) thematic analysis of meeting notes and refining research questions; (5) follow-up survey of convening participants; and (6) refining the final research agenda. Public health researchers, advocates, food and beverage retailers, and funders participated in the agenda setting process. A total of 37 research questions grouped into ten priority areas emerged. Five priority areas focus on understanding the current food retail environment and consumer behavior and five focus on assessing implementation and effectiveness of interventions and policies to attain healthier retail. Priority topics include how frequency, duration, and impact of retailer promotion practices differ by community characteristics and how to leverage federal nutrition assistance programs to support healthy eating. To improve feasibility, researchers should explore partnerships with retailers and advocacy groups, identify novel data sources, and use a variety of study designs. This agenda can serve as a guide for researchers, food retailers, funders, government agencies, and advocacy organizations.
41
Guthold, Regina, Laura Kann, Lubna Bhatti, Parviz Abduvahobov, Joana Ansong, Uki Atkinson, Valentina Baltag, et al. "Effectiveness of a participatory approach to develop school health interventions in four low resource cities: study protocol of the ‘empowering adolescents to lead change using health data’ cluster randomised controlled trial." BMJ Open 13, no. 7 (July 2023): e071353. http://dx.doi.org/10.1136/bmjopen-2022-071353.
Повний текст джерелаАнотація:
IntroductionComprehensive local data on adolescent health are often lacking, particularly in lower resource settings. Furthermore, there are knowledge gaps around which interventions are effective to support healthy behaviours. This study generates health information for students from cities in four middle-income countries to plan, implement and subsequently evaluate a package of interventions to improve health outcomes.Methods and analysisWe will conduct a cluster randomised controlled trial in schools in Fez, Morocco; Jaipur, India; Saint Catherine Parish, Jamaica; and Sekondi-Takoradi, Ghana. In each city, approximately 30 schools will be randomly selected and assigned to the control or intervention arm. Baseline data collection includes three components. First, a Global School Health Policies and Practices Survey (G-SHPPS) to be completed by principals of all selected schools. Second, a Global School-based Student Health Survey (GSHS) to be administered to a target sample of n=3153 13–17 years old students of randomly selected classes of these schools, including questions on alcohol, tobacco and drug use, diet, hygiene, mental health, physical activity, protective factors, sexual behaviours, violence and injury. Third, a study validating the GSHS physical activity questions against wrist-worn accelerometry in one randomly selected class in each control school (n approximately 300 students per city). Intervention schools will develop a suite of interventions using a participatory approach driven by students and involving parents/guardians, teachers and community stakeholders. Interventions will aim to change existing structures and policies at schools to positively influence students’ behaviour, using the collected data and guided by the framework forMaking Every School a Health Promoting School. Outcomes will be assessed for differential change after a 2-year follow-up.Ethics and disseminationThe study was approved by WHO’s Research Ethics Review Committee; by the Jodhpur School of Public Health’s Institutional Review Board for Jaipur, India; by the Noguchi Memorial Institute for Medical Research Institutional Review Board for Sekondi-Takoradi, Ghana; by the Ministry of Health and Wellness’ Advisory Panel on Ethics and Medico-Legal Affairs for St Catherine Parish, Jamaica, and by the Comité d’éthique pour la recherche biomédicale of the Université Mohammed V of Rabat for Fez, Morocco. Findings will be shared through open access publications and conferences.Trial registration numberNCT04963426.
42
Van Decker, Stephanie Grana, Nicholas Bosch, and Jaime Murphy. "Catheter-associated urinary tract infection reduction in critical care units: a bundled care model." BMJ Open Quality 10, no. 4 (December 2021): e001534. http://dx.doi.org/10.1136/bmjoq-2021-001534.
Повний текст джерелаАнотація:
Catheter-associated urinary tract infections (CAUTIs) represent approximately 9% of all hospital acquired infections, and approximately 65%–70% of CAUTIs are believed to be preventable. In the spring of 2013, Boston Medical Center (BMC) began an initiative to decrease CAUTI rates within its intensive care units (ICUs). A CAUTI taskforce convened and reviewed process maps and gap analyses. Based on Centers for Disease Control and Prevention (CDC) and Institute for Healthcare Improvement (IHI) guidelines, and delineated by the Healthcare Infection Control Practices Advisory Committee 2009 guidelines, all BMC ICUs sequentially implemented plan–do–study–act cycles based on which measures were most easily adaptable and believed to have the highest impact on CAUTI rates. Implementation of five care bundles spanned 5 years and included (1) processes for insertion and maintenance of foley catheters; (2) indications for indwelling foley catheters; (3) appropriate testing for CAUTIs; (4) alternatives to indwelling devices; and (5) sterilisation techniques. Daily rounds by unit nursing supervisors and inclusion of foley catheter necessity on daily ICU checklists held staff accountable on a daily basis. With these interventions, the total number of CAUTIs at BMC decreased from 53 in 2013 to 9 in 2017 (83% reduction) with a 33.8% reduction in indwelling foley catheter utilisation during the same time period. Adapted protocols showed success in decreasing the CAUTI rate and indwelling foley catheter usage in all of the BMC ICU’s. While all interventions had favourable and additive trends towards decreasing the CAUTI rate, the CAUTI awareness education, insertion and removal protocols and implementation of PureWick female incontinence devices had clear and significant effects on decreasing CAUTI rates. Our project provides a framework for improving HAIs using rapid cycle testing and U-chart data monitoring. Targeted education efforts and standardised checklists and protocols adapted sequentially are low-cost and high yield efforts that may decrease CAUTIs in ICU settings.
43
Germana, Sarah, Govind Krishnan, Matthew McCulloch, Jane Trinh, and Sophie Shaikh. "Improving adherence to hepatitis B vaccine administration recommendations in two newborn nurseries." BMJ Open Quality 10, no. 4 (October 2021): e001282. http://dx.doi.org/10.1136/bmjoq-2020-001282.
Повний текст джерелаАнотація:
Administration of the birth dose of hepatitis B vaccine is an important step in reducing perinatally acquired hepatitis B infection, yet the USA is below the Healthy People 2020 goal for rate of administration.In response to updated Advisory Committee on Immunisation Practices recommendations to administer the dose within 24 hours of birth, we used quality improvement methodology to implement changes that would increase the vaccination rates of healthy newborns in our nurseries. The goal was to improve the proportion of infants who receive the hepatitis B vaccine within 24 hours of birth to >90% within a 2-year period, with a secondary goal of increasing vaccination rates prior to discharge from the nursery to >95%.Multiple Plan–Do–Study–Act (PDSA) cycles were performed. Initial cycles focused on increasing nurse and provider awareness of the updated timing recommendations. Later cycles targeted nursing workflow to facilitate timely administration of the vaccine. We implemented changes at our university medical centre and community hospital newborn nurseries.At the university medical centre nursery, both primary and secondary goals were met; the rate of hepatitis B vaccine administration within 24 hours increased from 81.7% to 96.2%, with vaccine administration prior to discharge increasing from 93.4% to 97.9%. In the community hospital nursery, the baseline rate of hepatitis B vaccine administration within 24 hours was 78.1%, and this increased to 85.8% with the interventions, falling short of the target of >90%. Vaccine administration prior to discharge increased from 87.2% to 92.0%, also not meeting the secondary target of 95%.Interventions that facilitated workflow had additional benefit beyond education alone to improve timing and rates of hepatitis B vaccine administration in both a university medical centre and community hospital nursery.
44
Gopinathan, Unni, and Steven J. Hoffman. "Institutionalising an evidence-informed approach to guideline development: progress and challenges at the World Health Organization." BMJ Global Health 3, no. 5 (September 2018): e000716. http://dx.doi.org/10.1136/bmjgh-2018-000716.
Повний текст джерелаАнотація:
This study explored experiences, perceptions and views among World Health Organization (WHO) staff about the changes, progress and challenges brought by the guideline development reforms initiated in 2007. Thirty-five semistructured interviews were conducted with senior WHO staff. Sixteen of the interviewees had in-depth experience with WHO’s formal guideline development process. Thematic analysis was conducted to identify key themes in the qualitative data, and these were interpreted in the context of the existing literature on WHO’s guideline development processes. First, the reforms were seen to have transformed and improved the quality of WHO’s guidelines. Second, independent evaluation and feedback by the Guidelines Review Committee (GRC) was described to have strengthened the legitimacy of WHO’s recommendations. Third, WHO guideline development processes are not yet designed to systematically make use of all types of research evidence needed to inform decisions about health systems and public health interventions. For example, several interviewees expressed dissatisfaction with the insufficient attention paid to qualitative evidence and evidence from programme experience, and how the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process evaluates the quality of evidence from non-randomised study designs, while others believed that GRADE was just not properly understood or applied. Fourth, some staff advocated for a more centralised quality assurance process covering all outputs from WHO’s departments and scientific advisory committees, especially to eliminate strategic efforts aimed at bypassing the GRC’s requirements. Overall, the ‘culture change’ senior WHO staff called for over 10 years ago appears to have gradually spread throughout the organisation. However, at least two major challenges remain: (1) ensuring that all issued advice benefits from independent evaluation, monitoring and feedback for quality and (2) designing guideline development processes to better acquire, assess, adapt and apply the full range of evidence that can inform recommendations on health systems and public health interventions.
45
Van Laar, Emily S., Charlotte Warren, John Maeglin, Mila Kostic, Michael Schoen, Neil Frick, and Steven Pipe. "Improving Hematologist/Oncologist Knowledge and Confidence in Managing Hemophilia through Online Educational Interventions." Blood 126, no. 23 (December 3, 2015): 5593. http://dx.doi.org/10.1182/blood.v126.23.5593.5593.
Повний текст джерелаАнотація:
Abstract The field of hemophilia has advanced tremendously over the past few decades leading to significant improvements to a patient's life expectancy. However, gaps in clinician's knowledge about appropriate tailored management of hemophilia can result in suboptimal patient outcomes. A study was conducted to determine if a series of online educational interventions on hemophilia could improve the knowledge and confidence of hematologists/oncologists in treating patients with hemophilia. The Perelman School of Medicine at the University of Pennsylvania, Office of CME, the National Hemophilia Foundation and Medscape, LLC, in partnership with an expert steering committee, developed a global, accredited educational curriculum (http://www.medscape.org/sites/advances/hemophilia-management) focused on the advances in the management of hemophilia. Six activities, including text and video formats, within the curriculum were evaluated using a pre-assessment/post-assessment study design comparing participants' responses to knowledge and case-based multiple choice questions before exposure to educational content (pre-assessment measurement) with the same participants' responses after participation in the educational activity (post-assessment measurement). Outcomes assessment questions focused on current evidence-based recommendations for the management of hemophilia. For all questions combined, paired 2-tailed t-test was used to assess whether the mean pre-assessment score was different from the mean post-assessment score. The effect size (Cohen's d) was calculated by comparing pre-assessment means and post-assessment means of linked learners to show the effect of educational intervention. Effect size of >0.8 and 0.4-0.8 are considered a large and medium effect size, respectively. A total of 256 hematologist/oncologist participants who completed all pre- and post- assessment questions for each assessment were included in the evaluation across the 6 interventions. An increase in knowledge and performance was demonstrated as a result of participation in each of the 6 interventions with effect sizes of 0.25, 0.559, 0.618, 0.721, 1.26, and 2.275. Topics that demonstrated the largest statistically significant increases in correct post-assessment compared with pre-assessment answers included: mechanism of action of Fc fusion technology (63% relative increase, p<.001), patient counseling when switching to an extended half-life factor replacement (100%, P=.008), joint health in hemophilia (340% relative increase, P<.05), and incidence of inhibitors (227% relative increase, p<.05).Confidence in when to use prophylaxis increased post-educational exposure (7.3% mean confidence shift using a 7-point Likert scale) as measured in 3 of the 6 activities. Areas where knowledge gaps remained, as evidenced by >15% incorrect answers post-education, included: adherence with prophylaxis, outcomes for children and adults with severe hemophilia A receiving prophylaxis vs episodic treatment, clinical data from recent studies with new extended half-life factor products in terms of efficacy, tolerability, and risk of inhibitor development in persons of different ages and risk settings, and the potential place of extended half-life factor products in the strategy for the care of individuals with hemophilia A and B. This study demonstrates the success of a targeted online hemophilia educational curriculum using text and video formats in improving the knowledge and confidence of hematologists/oncologists who treat patients with hemophilia, while also identifying remaining educational needs for future education. Disclosures Van Laar: Medscape LLC: Employment. Pipe:CSL Behring: Consultancy; Bayer: Consultancy; American Thrombosis and Hemostasis Network: Other: Chair of the Board of Directors; National Hemophilia Foundation: Other: member of the Medical and Scientific Advisory Committee; Novo Nordisk: Consultancy; Baxter: Consultancy; Biogen Idec Inc: Consultancy.
46
Burgess, Naomi, and Deborah Chen. "OP160 Enhancing Innovation Through HTA: Experience From South Australia." International Journal of Technology Assessment in Health Care 34, S1 (2018): 58. http://dx.doi.org/10.1017/s0266462318001666.
Повний текст джерелаАнотація:
Introduction:A statewide health technology assessment (HTA) program was implemented to increase equity of access and support robust assessment of technologies, with a focus on those that are high-cost, high-risk, or have state-wide impact.Methods:Local hospital networks and clinicians refer technologies to the South Australia Policy Advisory Committee on Technology (SAPACT) for assessment. Independently produced, comprehensive HTA reports are developed using internationally recognized evidence and critical appraisal methodologies. Clinical and economic systematic analyses are utilized, with extensive clinical consultation, to develop recommendations for new technologies and their role in models of care. Feasibility of adoption and local implementation are considered, including existing service delivery and appropriate training and credentialing. For approved technologies, SAPACT may also develop audit criteria and seek implementation reports on clinical outcomes.Results:The HTA framework has been successfully adopted across South Australia Health, increasing the incorporation of evidence-based decision making in the use of high-cost and high-risk health technologies. Over 35 evidence evaluations for high-risk and high-cost health technologies have been conducted for a broad range of treatment interventions. SAPACT develops and utilizes HTA decision-making criteria for transparency of Committee considerations. The program recommends adoption or rejection of technologies, or it may request a re-submission due to safety concerns or a lack of proven effectiveness. SAPACT has also granted temporary approval through adoption under clinical evaluation to inform investment decisions. A key component is working with clinicians to define specific treatment criteria and patient selection. SAPACT continues to strengthen relationships with all stakeholders, increase patient input through the development of public summary documents for technologies, and improve monitoring and reporting of clinical outcomes.Conclusions:The HTA program has been very productive and positively received. The success of the program is underpinned by its engagement with clinicians, hospital networks, and consumers. The completion of SAPACT HTA reviews and the publication of the SAPACT decision-making criteria have increased the credibility of decisions, supporting enhancements in patient care and cost efficiency for the state government.
47
Adams, Christy, Deborah A. Kuhls, Shelli Stephens-Stidham, Julie Alonso, Stewart Williams, and Glen H. Tinkoff. "Consensus-based Standards and Indicators to strengthen trauma center injury and violence prevention programs." Trauma Surgery & Acute Care Open 6, no. 1 (August 2021): e000762. http://dx.doi.org/10.1136/tsaco-2021-000762.
Повний текст джерелаАнотація:
For decades, the American College of Surgeons Committee on Trauma (ACSCOT) has published Resources for Optimal Care of the Injured Patient, which outlines specific criteria necessary to be verified by the college as a trauma center, including having an organized and effective approach to prevention of trauma. However, the document provides little public health-specific guidance to assist trauma centers with developing these approaches. An advisory panel was convened in 2017 with representatives from national trauma and public health organizations with the purpose of identifying strategies to support trauma centers in the development of a public health approach to injury and violence prevention and to better integrate these efforts with those of local and state public health departments. This panel developed the Standards and Indicators for Model Level I and II Trauma Center Injury and Violence Prevention Programs. The document outlines five, consensus-based core components of a model injury and violence prevention program: (1) leadership, (2) resources, (3) data, (4) effective interventions, and (5) partnerships. We think this document provides the missing public health guidance and is an essential resource to trauma centers for effectively addressing injury and violence in our communities. We recommend the Standards and Indicators be referenced in the injury prevention chapter of the upcoming revision of ACSCOT’s Resources for Optimal Care of the Injured Patient as guidance for the development, implementation and evaluation of injury prevention programs and be used as a framework for program presentation during ACSCOT verification visits.
48
Duffy, Emily W., Megan M. Lott, Emily J. Johnson, and Mary T. Story. "Developing a national research agenda to reduce consumption of sugar-sweetened beverages and increase safe water access and consumption among 0- to 5-year-olds: a mixed methods approach." Public Health Nutrition 23, no. 1 (September 5, 2019): 22–33. http://dx.doi.org/10.1017/s1368980019002106.
Повний текст джерелаАнотація:
AbstractObjective:Sugar-sweetened beverage (SSB) consumption in early childhood is a public health concern. Adequate hydration in early childhood is also important. We developed a national research agenda to improve beverage consumption patterns among 0–5-year-olds. This article focuses on the process used to develop this research agenda.Design:A mixed methods, multi-step process was used to develop the research agenda, including: (i) a scientific advisory committee; (ii) systematic reviews on strategies to reduce SSB consumption and increase water access and consumption; (iii) two stakeholder surveys to first identify and then rank strategies to reduce SSB consumption and increase water access and consumption; (iv) key informant interviews to better understand determinants of beverage consumption and strategies to improve beverage consumption patterns among high-risk groups; (v) an in-person convening with experts; and (vi) developing the final research agenda.Setting:This process included research and stakeholders from across the United States.Participants:A total of 276 participants completed survey 1 and 182 participants completed survey 2. Key informant interviews were conducted with 12 stakeholders. Thirty experts attended the convening, representing academia, government, and non-profit sectors.Results:Thirteen key issue areas and 59 research questions were developed. Priority topics were beverage consumption recommendations, fruit-flavoured drink consumption, interventions tailored to high-risk groups, and family engagement in childcare.Conclusions:This research agenda lays the groundwork for research efforts to improve beverage patterns of young children. The methods used can be a template to develop research agendas for other public health issues.
49
Boltri, John M., Howard Tracer, David Strogatz, Shannon Idzik, Pat Schumacher, Naomi Fukagawa, Ellen Leake, et al. "The National Clinical Care Commission Report to Congress: Leveraging Federal Policies and Programs to Prevent Diabetes in People With Prediabetes." Diabetes Care 46, no. 2 (January 26, 2023): e39-e50. http://dx.doi.org/10.2337/dc22-0620.
Повний текст джерелаАнотація:
Individuals with an elevated fasting glucose level, elevated glucose level after glucose challenge, or elevated hemoglobin A1c level below the diagnostic threshold for diabetes (collectively termed prediabetes) are at increased risk for type 2 diabetes. More than one-third of U.S. adults have prediabetes but fewer than one in five are aware of the diagnosis. Rigorous scientific research has demonstrated the efficacy of both intensive lifestyle interventions and metformin in delaying or preventing progression from prediabetes to type 2 diabetes. The National Clinical Care Commission (NCCC) was a federal advisory committee charged with evaluating and making recommendations to improve federal programs related to the prevention of diabetes and its complications. In this article, we describe the recommendations of an NCCC subcommittee that focused primarily on prevention of type 2 diabetes in people with prediabetes. These recommendations aim to improve current federal diabetes prevention activities by 1) increasing awareness of and diagnosis of prediabetes on a population basis; 2) increasing the availability of, referral to, and insurance coverage for the National Diabetes Prevention Program and the Medicare Diabetes Prevention Program; 3) facilitating Food and Drug Administration review and approval of metformin for diabetes prevention; and 4) supporting research to enhance the effectiveness of diabetes prevention. Cognizant of the burden of type 1 diabetes, the recommendations also highlight the importance of research to advance our understanding of the etiology of and opportunities for prevention of type 1 diabetes.
50
Shen, Zhu, Wenfei Du, Cecelia Perkins, Lenn Fechter, Vanita Natu, Holden T. Maecker, Jesse W. Rowley, Jason Gotlib, James L. Zehnder, and Anandi Krishnan. "Platelet Transcriptome Yields Progressive Markers in Chronic Myeloproliferative Neoplasms and Identifies Putative Targets of Therapy." Blood 138, Supplement 1 (November 5, 2021): 1469. http://dx.doi.org/10.1182/blood-2021-153323.
Повний текст джерелаАнотація:
Abstract Predicting disease progression remains a particularly challenging endeavor in chronic degenerative disorders and cancer, thus limiting early detection, risk stratification, and preventive interventions. Here, profiling the spectrum of chronic myeloproliferative neoplasms (MPNs), as a model, we identify the blood platelet transcriptome as a proxy strategy for highly sensitive progression biomarkers that also enables prediction of advanced disease via machine learning algorithms. Using RNA sequencing (RNA-seq), we derive disease-relevant gene expression in purified platelets from 120 peripheral blood samples constituting two time-separated cohorts of patients diagnosed with one of three MPN subtypes at sample acquisition - essential thrombocythemia, ET (n=24), polycythemia vera, PV (n=33), and primary or post ET/PV secondary myelofibrosis, MF (n=42), and healthy donors (n=21). The MPN platelet transcriptome reveals an incremental molecular reprogramming that is independent of patient driver mutation status or therapy and discriminates each clinical phenotype. Differential markers in each of ET, PV and MF also highlight candidate genes as potential mediators of the pro-thrombotic and pro-fibrotic phenotypes in MPNs. In ET and PV, a strong thromboinflammatory profile is revealed by the upregulation of several interferon inducible transmembrane genes (IFITM2, IFITM3, IFITM10, IFIT3, IFI6, IFI27L1, IFI27L2), interleukin receptor accessory kinases/proteins (IRAK1, IL15, IL1RAP, IL17RC) and several solute carrier family genes (SLC16A1, SLC25A1, SLC26A8, SLC2A9) as glucose and other metabolic transport proteins, and coagulation factor V (F5). In MF, fibrosis-specific markers were identified by an additional focused comparison of MF patients versus ET and PV, showing increased expression of several pro-fibrotic growth factors (FGFR1, FGFR3, FGFRL1), matrix metalloproteinases (MMP8, MMP14), vascular endothelial growth factor A (VEGFA), insulin growth factor binding protein (IGFBP7), and cell cycle regulators (CCND1, CCNA2, CCNB2, CCNF). Also, focusing on the JAK-inhibitor ruxolitinib/RUX-specific signatures, we not only confirm previous observations on its anti-inflammatory and immunosuppressive effects (e.g. downregulation in our RUX-treated cohort of IL1RAP, CXCR5, CPNE3, ILF3) but also identify new gene clusters responsive to RUX - e.g. inhibition of type I interferon (e.g. IFIT1, IFIT2, IFI6), chromatin regulation (HIST2H3A/C, HIST1H2BK, H2AFY, SMARCA4, SMARCC2), epigenetic methylation in mitochondrial genes (ATP6, ATP8, ND1-6 and NDUFA5), and other proliferation, and proteostasis-associated markers as putative targets for MPN-directed therapy. Mechanistic insights from our data highlight impaired protein homeostasis as a prominent driver of MPN evolution, with a persistent integrated stress response. Preliminary ex vivo data on MPN patient bone-marrow-derived CD34+ cells and cultured megakaryocytes validate a proteostasis-focused subset of our peripheral platelet RNA-seq signatures. Further leveraging this substantive dataset, and in particular a progressive expression gradient across MPN, we develop a machine learning model (Lasso-penalized regression) predictive of the advanced subtype MF at high accuracy and under two conditions of validation: i) temporal Stanford internal (AUC-ROC of 0.96) and ii) geographic external cohorts (AUC-ROC of 0.97, using independently published data of an additional n=25 MF and n=46 healthy donors). Lasso-derived signatures offer a robust core set of < 5 MPN progression markers. Together, our platelet transcriptome snapshot of chronic MPNs demonstrates a methodological avenue for disease risk stratification and progression beyond genetic data alone, with potential utility in a wide range of age-related disorders. Part of the work contributing to this abstract has been posted as a preprint at this link: https://www.biorxiv.org/content/10.1101/2021.03.12.435190v2 Figure 1 Figure 1. Disclosures Gotlib: Blueprint Medicines: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Incyte: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Deciphera: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Abbvie: Membership on an entity's Board of Directors or advisory committees, Research Funding; BMS: Research Funding; Kartos: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; PharmaEssentia: Honoraria, Membership on an entity's Board of Directors or advisory committees; Cogent Biosciences: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Chair for the Eligibility and Central Response Review Committee, Research Funding; Allakos: Consultancy.