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2.
Nutrients ; 14(2)2022 Jan 13.
Article in English | MEDLINE | ID: covidwho-1725901

ABSTRACT

The transition from adolescence to adulthood is a critical period for the development of healthy behaviors. Yet, it is often characterized by unhealthy food choices. Considering the current pandemic scenario, it is also essential to assess the effects of coronavirus disease-19 (COVID-19) on lifestyles and diet, especially among young people. However, the assessment of dietary habits and their determinants is a complex issue that requires innovative approaches and tools, such as those based on the ecological momentary assessment (EMA). Here, we describe the first phases of the "HEALTHY-UNICT" project, which aimed to develop and validate a web-app for the EMA of dietary data among students from the University of Catania, Italy. The pilot study included 138 students (mean age 24 years, SD = 4.2; 75.4% women), who used the web-app for a week before filling out a food frequency questionnaire with validation purposes. Dietary data obtained through the two tools showed moderate correlations, with the lowest value for butter and margarine and the highest for pizza (Spearman's correlation coefficients of 0.202 and 0.699, respectively). According to the cross-classification analysis, the percentage of students classified into the same quartile ranged from 36.9% for vegetable oil to 58.1% for pizza. In line with these findings, the weighted-kappa values ranged from 0.15 for vegetable oil to 0.67 for pizza, and most food categories showed values above 0.4. This web-app showed good usability among students, assessed through a 19-item usability scale. Moreover, the web-app also had the potential to evaluate the effect of the COVID-19 pandemic on students' behaviors and emotions, showing a moderate impact on sedentary activities, level of stress, and depression. These findings, although interesting, might be confirmed by the next phases of the HEALTHY-UNICT project, which aims to characterize lifestyles, dietary habits, and their relationship with anthropometric measures and emotions in a larger sample of students.


Subject(s)
Diet/methods , Ecological Momentary Assessment/statistics & numerical data , Feeding Behavior , Health Behavior , Mobile Applications , Program Development/methods , Adult , Female , Humans , Italy , Male , Pilot Projects , Students/statistics & numerical data , Surveys and Questionnaires , Universities , Young Adult
4.
Int J Environ Res Public Health ; 19(3)2022 01 18.
Article in English | MEDLINE | ID: covidwho-1686715

ABSTRACT

Adolescents with spina bifida (SB) face challenges in their transition to adulthood due to intensive medical regimens and delayed development of independence. Despite an increasing interest in the transition of adolescents with SB to adulthood, the clinical evidence of transition care remains limited, and existing studies have focused on the effects of intervention programs. This study aims to describe the process of systematically developing an online-based transition care program for adolescents with SB using the intervention mapping (IM) protocol. IM consists of six steps: (1) logic model of the problem; (2) program objectives; (3) program design; (4) program production; (5) plan to implement the program; (6) plan for evaluation. At first, five problems faced during the transition were identified, based on which four program objectives and six program strategies were established. The online transition care program for adolescents with SB was developed as a six-week program. The main strength of this program is that it reflects the diverse perspectives of adults with SB and health care professionals and is easy to apply because it is online. We aim to further validate the feasibility of this transitional care program to evaluate its effect based on our evaluation plan.


Subject(s)
Spinal Dysraphism , Transitional Care , Adolescent , Adult , Behavior Therapy , Health Personnel , Humans , Program Development , Spinal Dysraphism/therapy
5.
Public Health Rep ; 137(2): 213-219, 2022.
Article in English | MEDLINE | ID: covidwho-1643031

ABSTRACT

From May through July 2020, Arizona was a global hotspot for new COVID-19 cases. In response to the surge of cases, local public health departments looked for innovative ways to form external partnerships to address their staffing needs. In collaboration with the Maricopa County Department of Public Health, the Arizona State University Student Outbreak Response Team (SORT) created and implemented a virtual call center to conduct public health case investigations for COVID-19. SORT officially launched a dedicated COVID-19 case investigation program after 3 weeks of program design and training. From June 29 through November 8, 2020, SORT recruited and trained 218 case investigators, completed 5000 case patient interviews, and closed 10 000 cases. Our team also developed process improvements to address disparities in case investigation timeliness. A strong infrastructure designed to accommodate remote case investigations, paired with a large workforce, enabled SORT to provide additional surge capacity for the county's high volume of cases. University-driven multidisciplinary case investigator teams working in partnership with state, tribal, and local public health staff members can be an effective tool for supporting a diverse and growing public health workforce. We discuss the essential design factors involved in building a university program to complement local COVID-19 response efforts, including workflows for case management, volunteer case investigator recruitment and training, secure technology platforms for conducting case investigations remotely, and robust data-tracking procedures for maintaining quality control and timely case reporting.


Subject(s)
COVID-19/epidemiology , Call Centers/organization & administration , Contact Tracing/methods , Disease Outbreaks/prevention & control , Intersectoral Collaboration , Program Development , Program Evaluation , Arizona/epidemiology , Humans , Public Health Practice , SARS-CoV-2 , Students , Universities , Volunteers , Workforce/organization & administration
6.
Public Health Rep ; 137(2): 263-271, 2022.
Article in English | MEDLINE | ID: covidwho-1643028

ABSTRACT

OBJECTIVE: Robust disease and syndromic surveillance tools are underdeveloped in the United States, as evidenced by limitations and heterogeneity in sociodemographic data collection throughout the COVID-19 pandemic. To monitor the COVID-19 pandemic in Minnesota, we developed a federated data network in March 2020 using electronic health record (EHR) data from 8 multispecialty health systems. MATERIALS AND METHODS: In this serial cross-sectional study, we examined patients of all ages who received a COVID-19 polymerase chain reaction test, had symptoms of a viral illness, or received an influenza test from January 3, 2016, through November 7, 2020. We evaluated COVID-19 testing rates among patients with symptoms of viral illness and percentage positivity among all patients tested, in aggregate and by zip code. We stratified results by patient and area-level characteristics. RESULTS: Cumulative COVID-19 positivity rates were similar for people aged 12-64 years (range, 15.1%-17.6%) but lower for adults aged ≥65 years (range, 9.3%-10.7%). We found notable racial and ethnic disparities in positivity rates early in the pandemic, whereas COVID-19 positivity was similarly elevated across most racial and ethnic groups by the end of 2020. Positivity rates remained substantially higher among Hispanic patients compared with other racial and ethnic groups throughout the study period. We found similar trends across area-level income and rurality, with disparities early in the pandemic converging over time. PRACTICE IMPLICATIONS: We rapidly developed a distributed data network across Minnesota to monitor the COVID-19 pandemic. Our findings highlight the utility of using EHR data to monitor the current pandemic as well as future public health priorities. Building partnerships with public health agencies can help ensure data streams are flexible and tailored to meet the changing needs of decision makers.


Subject(s)
COVID-19 Testing/statistics & numerical data , COVID-19/diagnosis , Data Collection/methods , Electronic Health Records/organization & administration , Program Development , Cross-Sectional Studies , Humans , Minnesota/epidemiology , Public Health Surveillance , SARS-CoV-2 , Sentinel Surveillance , Social Determinants of Health
7.
Med Sci (Paris) ; 37 Hors série n° 1: 5, 2021 Nov.
Article in French | MEDLINE | ID: covidwho-1638604
8.
Pediatrics ; 149(1)2022 01 01.
Article in English | MEDLINE | ID: covidwho-1626689

ABSTRACT

A physician workforce that reflects the patient population is associated with improved patient outcomes and promotes health equity. Notwithstanding, racial and ethnic disparities persist within US medical schools, making some individuals underrepresented in medicine (URM). We sought to increase the percentage of URM residents who matched into our pediatric residency programs from a baseline of 5% to 35% to achieve demographic parity with our patients. We developed a multifaceted approach using multiple iterative tests of change, with the primary strategy being increased visibility of URM trainees and faculty to residency applicants. Strategies included applicant interviews with URM faculty, interview dinners with URM residents, visibility at academic conferences for URM trainees, development of targeted marketing materials, and a visiting student program supported by networking with URM residents. The primary outcome measure was the percentage of matched residents in the categorical pediatrics, child neurology, and medical genetics training programs who identified as URM. The percentage of URM residents increased to 16% (6 of 37) in 2018, 26% (11 of 43) in 2019, 19% (8 of 43) in 2020, and 21% (9 of 43) in 2021 (a four-year average of 22% URM residents; P = .0002). This progress toward a more representative residency program was met by challenges, such as pipeline concerns, the minority tax, and recruitment during a pandemic. We were able to implement small, low-resource strategies that had a large cumulative impact and could be implemented in other residency programs. Specific tactics and challenges encountered are discussed in this special article.


Subject(s)
Internship and Residency/organization & administration , Minority Groups/statistics & numerical data , Pediatrics/education , Program Development , COVID-19/epidemiology , Health Equity , Humans , Internship and Residency/statistics & numerical data , Pandemics , Pediatricians/supply & distribution , United States/epidemiology
11.
Interface (Botucatu, Online) ; 25(supl.1): e210123, 2021. ilus
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1538283

ABSTRACT

Considerando a escassez de espaços efetivos e afetivos de criação, reflexão e escuta que incitem o processo ensino-aprendizagem durante a pandemia de Covid-19, estruturou-se um projeto de ensino intitulado Curadorias Inventivas e Participativas. O presente trabalho constitui relato de experiência do referido projeto, cujo objetivo foi contribuir para a formação de terapeutas ocupacionais, favorecendo espaços de expressão, acolhimento e estudo. Os procedimentos foram estruturados em oito módulos sequenciais e seus resultados organizados em quatro categorias, a saber: Costurando a experiência: as curadorias vividas; Curadorias que conectaram: a formação de um coletivo; Ensinagem e as curadorias: contribuições para a formação profissional; e Outras ressonâncias. Compreende-se que o projeto contemplou seus objetivos, proporcionando uma experiência menos tradicional no âmbito do ensino acadêmico. Esteve comprometido com as relações entre as acadêmicas e seus cotidianos na pandemia (AU)


Considering the lack of effective and affective spaces for creating, reflecting and listening that promote the teaching-learning process during the Covid-19 pandemic, we developed a project entitled Inventive and Participatory Healing Spaces. This work describes the experiences of this project, whose aim was to contribute to the professional training of occupational therapists, fostering the development of spaces of expression, welcoming and study. The results are grouped into the following four categories: weaving experience: lived healing spaces; healing spaces that connected: forming a collective; teaching and healing spaces: contributions to professional training; and other resonances. The findings show that the project met its objectives, providing a less traditional experience within academic teaching. The project was committed to relations between the students and their daily lives during the pandemic (AU)


Considerando la escasez de espacios efectivos y afectivos de creación, reflexión y escucha que inciten el proceso enseñanza-aprendizaje durante la pandemia de Covid-19, se estructuró un proyecto de enseñanza titulado Curadurías Inventivas y participativas. Este trabajo se constituyó como relato de experiencia del referido proyecto, cuyo objetivo fue contribuir con la formación de terapeutas ocupacionales favoreciendo espacios de expresión, acogida y estudio. Los procedimientos se estructuraron en ocho módulos secuenciales y sus resultados se organizaron en cuatro categorías, a saber: Costura de la experiencia: las curadurías vividas; Curadurías que conectaron: la formación de un colectivo: Ensinagem y las curadurías: contribuciones para la formación profesional y otras resonancias. Se entiende que el proyecto alcanzó sus objetivos, proporcionando una experiencia menos tradicional en el ámbito de la enseñanza académica. Estuvo comprometido con las relaciones entre las academias y sus cotidianos en la pandemia (AU)


Subject(s)
Occupational Therapy/education , Program Development/methods , Data Curation , COVID-19 , Students, Health Occupations/psychology , Problem-Based Learning
12.
J Emerg Nurs ; 48(1): 22-31, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1440179

ABSTRACT

BACKGROUND: The coronavirus disease 2019 pandemic caused an unprecedented surge of patients presenting to emergency departments and forced hospitals to adapt to provide care to patients safely and effectively. The purpose here was to disseminate a novel program developed under disaster conditions to address advance care planning communications. METHODS: A program development and initial evaluation was conducted for the Remote Goals of Care program, which was created for families to communicate patient goals of care and reduce responsibilities of those in the emergency department. RESULTS: This program facilitated 64 remote goals of care conversation, with 72% of conversations taking place remotely with families of patients who were unable to participate. These conversations included discussions of patient preferences for care, including code status, presence of caregivers or surrogates, understanding of diagnosis and prognosis, and hospice care. Initially, this program was available 24 hours per day, 7 days per week, with gradual reduction in hours as needs shifted. Seven nurses who were unable to work in corona-positive environments but were able to continue working remotely were utilized. Lessons learned include the need for speed and agility of response and the benefit of established relationships between traditionally siloed specialties. Additional considerations include available technology for patients and families and expanding the documentation abilities for remote nurses. A logic model was developed to support potential program replication at other sites. DISCUSSION: Upon initial evaluation, Remote Goals of Care Program was well received and demonstrated promise in decanting the responsibility of goals of care discussions from the emergency department to a calmer, remote setting. In future iterations, additional services and technology adjustments can be made to make this program more accessible to more patients and families. Other facilities may wish to replicate our Remote Goals of Care Program described here.


Subject(s)
Advance Care Planning , COVID-19 , Disasters , Emergency Service, Hospital , Humans , Program Development , SARS-CoV-2
16.
South Med J ; 114(8): 458-463, 2021 08.
Article in English | MEDLINE | ID: covidwho-1341958

ABSTRACT

OBJECTIVES: Health care in the United States is costly, fragmented, and often ineffective. Transitions of care (TOC), particularly from the inpatient to the outpatient setting, is an especially complicated time and one that is potentially fraught with errors that contribute to negative outcomes. The coronavirus 2019 pandemic exacerbated many of these challenges. In particular, vulnerable patient populations have experienced more barriers to successful care transitions. Effective care transitions should include interprofessional teamwork, robust patient education, and seamless communication among the various healthcare team members. Increasingly, medical schools are working toward graduating systems-ready physicians who demonstrate competency in the health system sciences and are able to operate effectively within the healthcare system, including being able to navigate complex transitions of care issues. Undergraduate medical education, however, continues to provide experiential learning in the traditional silos of inpatient versus outpatient medicine, so that learners do not have the opportunity to directly participate in transitions of care. Although transitions of care is a pivotal part of patient care, it is rarely taught at the undergraduate level, and when it is, it is typically relegated to the classroom setting. METHODS: We used the disruption of the coronavirus 2019 pandemic to develop a TOC elective. The aim was to fulfill an acute educational need and to develop competencies around care transitions for students while concurrently providing support for patient care and teamwork. The elective was offered to second-, third- and fourth-year medical students. Our educational innovation was initiated within our safety-net hospital where we care for a high percentage of uninsured patients, with a high language discordance. In addition, our city has multiple care systems without a single or connected electronic health record system, further complicating patient care transitions. The work of the TOC elective crossed inpatient and outpatient silos, with close collaboration with our local federally qualified health centers. This remotely conducted elective includes three main pillars: participation in team activities, including virtual participation in interdisciplinary rounds and care coordination; discharge planning; and communication, including goals of care and end of life communication. RESULTS: Medical students successfully integrated into team structures to directly counsel families, facilitate goals of care conversations, and engage a multidisciplinary team for discharge planning. Students found this experience valuable in their reflections. In addition, there was a value-added component from a patient care and teamwork perspective. CONCLUSIONS: Participation of students in TOC is a valuable educational experience and contributes a value-added component to patient care and interprofessional teamwork. Moreover, an appreciation of the failures of the current system is pivotal as learners start to reimagine, explore, and design improved patient-centered systems in the future.


Subject(s)
COVID-19/epidemiology , Curriculum , Education, Medical, Undergraduate , Program Development , Transitional Care , Ambulatory Care , Humans , Patient Discharge , United States
17.
Clin Obstet Gynecol ; 64(3): 422-434, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1331601

ABSTRACT

Family planning (FP) is the domain that enables people to have their desired number of children if any, and the desired spacing of births. FP initiatives are cross-cutting approaches to empower people with human and reproductive rights, lessen child morbidity and pregnancy-related morbidity and mortality, alleviate poverty, slow climate change, provide sustainable economic growth and development, advance education, and voluntarily slow overpopulation. We examine global FP programs: the history, drivers, and indicators to measure impact, policy, and strategy that surrounds human reproduction. We focus on current trends of task-sharing, self-care, digital health solutions, and the ever-changing contexts with our current pandemic of coronavirus disease 2019.


Subject(s)
Family Planning Services/history , Global Health/history , Developed Countries , Developing Countries , Family Planning Policy/trends , Family Planning Services/methods , Family Planning Services/organization & administration , Family Planning Services/trends , Global Health/trends , History, 20th Century , History, 21st Century , Humans , Program Development/methods , Program Evaluation/methods
18.
Ann Glob Health ; 87(1): 66, 2021.
Article in English | MEDLINE | ID: covidwho-1325925

ABSTRACT

Introduction: Partnerships are essential to creating effective global health leadership training programs. Global pandemics, including the HIV/AIDS pandemic, and more recently the COVID-19 pandemic, have tested the impact and stability of healthcare systems. Partnerships must be fostered to prepare the next generation of leaders to collaborate effectively and improve health globally. Objectives: We provide key matrices that predict success of partnerships in building global health leadership capacity. We highlight opportunities and challenges to building effective partnerships and provide recommendations to promote development of equitable and mutually beneficial partnerships. Findings: Critical elements for effective partnership when building global health leadership capacity include shared strategic vision, transparency and excellent communication, as well as intentional monitoring and evaluation of the partnership, not just the project or program. There must be recognition that partnerships can be unpredictable and unequal, especially if the end is not defined early on. Threats to equitable and effective partnerships include funding and co-funding disparities between partners from high-income and low-income countries, inequalities, unshared vision and priorities, skewed decision-making levels, and limited flexibility to minimize inequalities and make changes. Further, imbalances in power, privilege, position, income levels, and institutional resources create opportunities for exploitation of partners, particularly those in low-income countries, which widens the disparities and limits success and sustainability of partnerships. These challenges to effective partnering create the need for objective documentation of disparities at all stages, with key milestones to assess success and the environment to sustain the partnerships and their respective goals. Conclusions: Developing effective and sustainable partnerships requires a commitment to equality from the start by all partners and an understanding that there will be challenges that could derail otherwise well-intended partnerships. Guidelines and training on evaluation of partnerships exist and should be used, including generic indicators of equity, mutual benefit, and the added value of partnering. Key Takeaways: Effective partnerships in building global health leadership capacity require shared strategic vision and intentional monitoring and evaluation of goalsInequalities in partnerships may arise from disparities in infrastructure, managerial expertise, administrative and leadership capacity, as well as limited mutual benefit and mutual respectTo promote equitable and effective partnerships, it is critical to highlight and monitor key measures for success of partnerships at the beginning of each partnership and regularly through the lifetime of the partnership.We recommend that partnerships should have legal and financial laws through executed memoranda of understanding, to promote accountability and facilitate objective monitoring and evaluation of the partnership itself.More research is needed to understand better the contextual predictors of the broader influence and sustainability of partnership networks in global health leadership training.


Subject(s)
Global Health , International Cooperation , Leadership , Public-Private Sector Partnerships/organization & administration , Communication , Humans , Program Development/methods , Program Evaluation/methods , Stakeholder Participation
19.
Ann Glob Health ; 87(1): 61, 2021.
Article in English | MEDLINE | ID: covidwho-1325924

ABSTRACT

Objectives: The changing global landscape of disease and public health crises, such as the current COVID-19 pandemic, call for a new generation of global health leaders. As global health leadership programs evolve, many have incorporated experiential learning and mentoring (ELM) components into their structure. However, there has been incomplete consideration on how ELM activities are deployed, what challenges they face and how programs adapt to meet those challenges. This paper builds on the co-authors' experiences as trainees, trainers, organizers and evaluators of six global health leadership programs to reflect on lessons learned regarding ELM. We also consider ethics, technology, gender, age and framing that influence how ELM activities are developed and implemented. Findings: Despite the diverse origins and funding of these programs, all six are focused on training participants from low- and middle-income countries drawing on a diversity of professions. Each program uses mixed didactic approaches, practice-based placements, competency and skills-driven curricula, and mentorship via various modalities. Main metrics for success include development of trainee networks, acquisition of skills and formation of relationships; programs that included research training had specific research metrics as well. Common challenges the programs face include ensuring clarity of expectations of all participants and mentors; maintaining connection among trainees; meeting the needs of trainee cohorts with different skill sets and starting points; and ensuring trainee cohorts capture age, gender and other forms of diversity. Conclusions: ELM activities for global health leadership are proving even more critical now as the importance of effective individual leaders in responding to crises becomes evident. Future efforts for ELM in global health leadership should emphasize local adaptation and sustainability. Practice-based learning and established mentoring relationships provide the building blocks for competent leaders to navigate complex dynamics with the flexibility and conscientiousness needed to improve the health of global populations. Key Takeaways: Experiential learning and mentorship activities within global health leadership programs provide the hands-on practice and support that the next generation of global health leaders need to address the health challenges of our times.Six global health leadership programs with experiential learning and mentorship components are showcased to highlight differences and similarities in their approaches and capture a broad picture of achievements that can help inform future programs.Emphasis on inter-professional training, mixed-learning approaches and mentorship modalities were common across programs. Both individual capacity building and development of trainees' professional networks were seen as critical, reflecting the value of inter-personal connections for long-term leadership success.During program design, future programs should recognize the "frame" within which the program will be incorporated and intentionally address diversity-in all its forms-during recruitment as well as consider North-South ethics, leadership roles, hierarchies and transition plans.


Subject(s)
Education, Medical, Graduate/methods , Global Health/education , Leadership , Mentoring/methods , Problem-Based Learning/methods , Clinical Competence , Developing Countries , Education, Medical, Graduate/organization & administration , Humans , International Cooperation , Mentoring/organization & administration , Problem-Based Learning/organization & administration , Program Development/methods
20.
Arch Pathol Lab Med ; 145(7): 814-820, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1314912

ABSTRACT

CONTEXT.­: In the early months of the response to the coronavirus disease 2019 (COVID-19) pandemic, the Johns Hopkins University School of Medicine (JHUSOM) (Baltimore, Maryland) leadership reached out to faculty to develop and implement virtual clinical clerkships after all in-person medical student clinical experiences were suspended. OBJECTIVE.­: To develop and implement a digital slide-based virtual surgical pathology (VSP) clinical elective to meet the demand for meaningful and robust virtual clinical electives in response to the temporary suspension of in-person clinical rotations at JHUSOM. DESIGN.­: The VSP elective was modeled after the in-person surgical pathology elective to include virtual previewing and sign-out with standardized cases supplemented by synchronous and asynchronous pathology educational content. RESULTS.­: Validation of existing Web communications technology and slide-scanning systems was performed by feasibility testing. Curriculum development included drafting of course objectives and syllabus, Blackboard course site design, electronic-lecture creation, communications with JHUSOM leadership, scheduling, and slide curation. Subjectively, the weekly schedule averaged 35 to 40 hours of asynchronous, synchronous, and independent content, approximately 10 to 11 hours of which were synchronous. As of February 2021, VSP has hosted 35 JHUSOM and 8 non-JHUSOM students, who have provided positive subjective and objective course feedback. CONCLUSIONS.­: The Johns Hopkins VSP elective provided meaningful clinical experience to 43 students in a time of immense online education need. Added benefits of implementing VSP included increased medical student exposure to pathology as a medical specialty and demonstration of how digital slides have the potential to improve standardization of the pathology clerkship curriculum.


Subject(s)
COVID-19/prevention & control , Clinical Clerkship/methods , Education, Distance/methods , Education, Medical, Undergraduate/methods , Pathology, Surgical/education , Baltimore/epidemiology , COVID-19/epidemiology , Clinical Clerkship/organization & administration , Curriculum , Education, Distance/organization & administration , Education, Medical, Undergraduate/organization & administration , Humans , Pandemics , Pathology, Surgical/methods , Program Development
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