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3.
J Viral Hepat ; 31(7): 391-403, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38654623

RESUMO

In Vietnam and the Philippines, viral hepatitis is the leading cause of cirrhosis and liver cancer. This study aims to understand the barriers and enablers of people receiving care for hepatitis B and C to support both countries' efforts to eliminate viral hepatitis as a public health threat by 2030. Retrospective, semi-structured interviews were conducted with a purposive, quota-based sample of 63 people living with hepatitis B or C in one province of Vietnam and one region of the Philippines. A rapid deductive approach to thematic analysis produced key findings among the three phases of care: (1) pre-awareness and testing, (2) linkage and treatment initiation and (3) ongoing treatment and recovery. The research found that participants followed five typical journeys, from a variety of entry points. Barriers during the pre-awareness and testing phase included limited awareness about hepatitis and its management, stigma and psychological impacts. Enablers included being familiar with the health system and/or patients benefiting from social connections within the health systems. During the linkage and treatment initiation phase, barriers included difficult physical access, complex navigation and inadequate counselling. In this phase, family support emerged as a critical enabler. During the ongoing treatment and recovery phase, the cost of care and socially and culturally informed perceptions of the disease and medication use were both barriers and enablers. Exploring peoples' journeys with hepatitis B and C in Vietnam and the Philippines revealed many similarities despite the different cultural and health system contexts. Insights from this study may help generate a contextualized, people-centred evidence base to inform the design and improvement of primary care services for hepatitis in both research sites.


Assuntos
Acessibilidade aos Serviços de Saúde , Humanos , Vietnã/epidemiologia , Filipinas/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Estudos Retrospectivos , Idoso , Hepatite B , Entrevistas como Assunto , Adulto Jovem , Hepatite C/epidemiologia , Hepatite C/tratamento farmacológico
4.
Lancet Reg Health West Pac ; 44: 100990, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38204496

RESUMO

Chronic viral hepatitis is a significant public health concern in the Western Pacific, including in Vietnam and the Philippines. To accelerate progress toward meeting the 2030 elimination goals, the World Health Organization (WHO) encourages countries to adopt an integrated, people-centered health sector response to hepatitis, grounded in Primary Health Care (PHC). A review of the academic and grey literature, along with policy documents, was conducted to describe the national health system and PHC response to hepatitis B and C in Vietnam and the Philippines. Information was analyzed against the four strategic levers of the WHO Operational Framework for PHC to identify challenges and opportunities. The findings suggest that both countries have relatively robust policy frameworks, with some room for improvement. Vietnam may have stronger political commitment and funding than the Philippines, while the Philippines appears to be stronger in community engagement. Both countries share challenges and opportunities for learning to actualize viral hepatitis elimination utilizing a PHC approach.

5.
J Vasc Interv Radiol ; 34(7): 1200-1213, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37001638

RESUMO

Primary liver malignancy, of which hepatocellular carcinoma (HCC) is the most common type, is the second most common cause of death due to cancer worldwide. Given the historically poor prognosis of liver cancer, there has been major research on its treatment options, with significant advancements over the last decade. Transarterial radioembolization (TARE) is a locoregional treatment option for HCC that involves transarterial delivery of the ß-emitter yttrium-90 via resin or glass microspheres to arterialized tumor vasculature, delivering a tumoricidal dose to the tumor. The recent 2022 update of the Barcelona Clinic Liver Cancer (BCLC) treatment algorithm features a more prominent role for locoregional treatment, including the incorporation of radioembolization for very-early-stage (BCLC-0) and early-stage (BCLC-A) diseases. This review provides a contemporary summary of the evolving role of TARE in treatment of HCC in light of recent and upcoming trials.


Assuntos
Carcinoma Hepatocelular , Embolização Terapêutica , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/radioterapia , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/radioterapia , Embolização Terapêutica/efeitos adversos , Radioisótopos de Ítrio/efeitos adversos , Microesferas
6.
Ann Glob Health ; 88(1): 100, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36415327

RESUMO

Strong primary health care (PHC) systems require a robust PHC workforce. Traditionally, medical education takes place in academic medical centres that favour subspecialty care rather than PHC settings. This may undervalue primary care as a career and contribute to a shortage of PHC workers. However, designing undergraduate medical education curricula that incorporate early experiences in clinical care delivery at PHC sites remains a challenge, including in many low- and middle-income countries (LMICs). This paper describes how a collaboration between Harvard Medical School and five medical schools in Vietnam, and in-country collaborations among the Vietnamese medical schools, facilitated curricular innovation and co-creation of coursework relevant to PHC through the development of a Practice of Medicine (POM) course. The collaboration implemented a technical assistance strategy consisting of in-person workshops, focused virtual consultations, on-site 'office hours', site visits and observations to each of the five medical universities, and immersion trips to support the creation and implementation of the POM course. A pilot program was started at a single site and then scaled nationally using local customisation, experience, and expertise utilising a train-the-trainers approach. As a result, five new POM courses have been developed by five Vietnamese institutions. Fifty Vietnamese faculty received training to lead the POM course development, and 228 community-based preceptors have been trained to teach students at PHC sites. A total of 52 new PHC and community-based clinical training sites have been added, and 3,615 students have completed or are currently going through a POM course. This experience can serve as a model for future academic collaborations to support the development of a robust PHC workforce for the 21st century.


Assuntos
Educação de Graduação em Medicina , Humanos , Vietnã , Recursos Humanos , Pessoal de Saúde , Atenção Primária à Saúde
8.
Health Policy Plan ; 37(1): 55-64, 2022 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-34608933

RESUMO

The International Health Regulations-State Party Annual Reporting (IHR-SPAR) index and the Global Health Security Index (GHSI) have been developed to aid in strengthening national capacities for pandemic preparedness. We examined the relationship between country-level rankings on these two indices, along with two additional indices (the Universal Health Coverage Service Coverage Index and World Bank Worldwide Governance Indicator (n = 195)) and compared them to the country-level reported coronavirus disease (COVID-19) cases and deaths (Johns Hopkins University COVID-19 Dashboard) through 17 June 2020. Ordinary least squares regression models were used to compare weekly reported COVID-19 cases and death rates per million in the first 12 weeks of the pandemic between countries classified as low, middle and high ranking on each index while controlling for country socio-demographic information. Countries with higher GHSI and IHR-SPAR index scores experienced fewer reported COVID-19 cases and deaths but only for the first 8 weeks after the country's first case. For the GHSI, this association was further limited to countries with populations below 69.4 million. For both the GHSI and IHR-SPAR, countries with a higher sub-index score in human resources for pandemic preparedness reported fewer COVID-19 cases and deaths in the first 8 weeks after the country's first reported case. The Universal Health Coverage Service Coverage Index and Worldwide Governance Indicator country-level rankings were not associated with COVID-19 outcomes. The associations between GHSI and IHR-SPAR scores and COVID-19 outcomes observed in this study demonstrate that these two indices, although imperfect, may have value, especially in countries with a population under 69.4 million people for the GHSI. Preparedness indices may have value; however, they should continue to be evaluated as policy makers seek to better prepare for future global public health crises.


Assuntos
COVID-19 , Pandemias , Saúde Global , Humanos , Pandemias/prevenção & controle , Saúde Pública , SARS-CoV-2
9.
AEM Educ Train ; 5(3): e10547, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34099994

RESUMO

OBJECTIVE: To improve resident diversity, emergency medicine (EM) residencies across the United States have implemented financial scholarships to attract visiting medical students underrepresented in medicine (URiM). The impact of these scholarships on changes in residency racial and ethnic diversity is currently unknown. In this study, we describe characteristics of these visiting elective scholarships for underrepresented students and evaluate changes in residency racial and ethnic diversity after program implementation. METHODS: From 2018 to 2019, we conducted a cross-sectional survey of EM residency programs with a visiting clerkship rotation scholarship for medical students URiM. Programs were identified for study inclusion using the Society for Academic Emergency Medicine's online directory of Visiting Elective Scholarship Programs for Underrepresented Minorities. Program characteristics were analyzed descriptively. Changes in residency racial and ethnic diversity were evaluated using an interrupted time series analysis. RESULTS: Of 34 programs contacted, 20 responded. While there was some variability in funding sources, scholarship amounts, and application review, most scholarships were similar in implementation practices. Of the 20 program respondents, nine were able to provide complete data on residency race and ethnicity and were included in the time series analysis. After program implementation, the time series analysis showed a significant increase in both underrepresented minority EM residents overall and Black and Latinx EM residents in particular. CONCLUSION: Emergency medicine visiting clerkship scholarship programs for medical students URiM vary in funding type and application review but had similar implementation practices. Residency programs increased their racial and ethnic diversity after program implementation. Future investigations are needed to determine specific factors contributing to the successful implementation of scholarship programs.

10.
Emerg Med Pract ; 22(12): 1-20, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33211443

RESUMO

Rhabdomyolysis is a life-threatening pathological process that must be treated as early as possible to avoid potentially life-threatening sequelae. Much of the evidence that informs the management of rhabdomyolysis is retrospective research, often reported from mass disasters, and many practices that have been implemented as standard treatment are based on small studies published more than 30 years ago. This issue reviews the current literature on rhabdomyolysis and provides recommendations for each phase of care, from the prehospital setting through disposition. The evidence is examined regarding the variety of therapies that are used to manage rhabdomyolysis, the potential for recognizing a genetic predisposition for the condition, and therapeutic recommendations that improve patient outcomes.


Assuntos
Serviço Hospitalar de Emergência , Medicina de Emergência Baseada em Evidências , Rabdomiólise/diagnóstico , Rabdomiólise/terapia , Diagnóstico Diferencial , Humanos
11.
Ann Glob Health ; 86(1): 106, 2020 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-32874937

RESUMO

Background: The 2019 United Nations General Assembly High-Level Meeting on Universal Health Coverage and the 2018 Declaration of Astana reaffirm the highest level of political commitment by United Nations Member States to achieve access to health services and primary healthcare for all. Both documents emphasize the importance of person-centered care in both healthcare services and systems design. However, there is limited consensus on how to build a strong primary healthcare system to achieve these goals. Methods: We convened a diverse group of global stakeholders for a high-level dialogue on how to create a person-centered primary healthcare system, using the country examples of the Republic of Kenya and the Socialist Republic of Vietnam. We focused our discussion on four themes to enable the creation of person-centered primary healthcare systems in Kenya and Vietnam: (1) strengthened community, person and patient engagement in subnational and national decision making; (2) improved service delivery; (3) impactful use of innovation and technology; and (4) meaningful and timely use of measurement and data. Findings: Here, we present a summary of our convening's proceedings, with specific insights on how to enable a person-centered primary healthcare system within each of these four domains. Conclusions: Following the 2019 United Nations General Assembly High-Level Meeting on Universal Health Coverage and the 2018 Declaration of Astana, there is high-level commitment and global consensus that a person-centered approach is necessary to achieve high-quality primary healthcare and universal health coverage. We offer our recommendations to the global community to catalyze further discourse and inform policy-making and program development on the path to Universal Health Coverage by 2030.


Assuntos
Países em Desenvolvimento , Cobertura Universal do Seguro de Saúde , Ecossistema , Humanos , Participação do Paciente , Atenção Primária à Saúde
12.
Ann Glob Health ; 86(1): 9, 2020 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-32064227

RESUMO

Background: Forty years after Alma Ata, there is renewed commitment to strengthen primary health care as a foundation for achieving universal health coverage, but there is limited consensus on how to build strong primary health care systems to achieve these goals. Methods: We convened a diverse group of global stakeholders for a high-level dialogue on how to create an enabling ecosystem for disruptive primary care innovation. We focused our discussion on four themes: workforce innovation and strengthening; impactful use of data and technology; private sector engagement; and innovative financing mechanisms. Findings: Here, we present a summary of our convening's proceedings, with specific recommendations for strengthening primary health care systems within each of these four domains. Conclusions: In the wake of the Astana Declaration, there is global consensus that high-quality primary health care must be the foundation for universal health coverage. Significant disruptive innovation will be required to realize this goal. We offer our recommendations to the global community to catalyze further discourse and inform policy-making and program development on the path to Health for All by 2030.


Assuntos
Atenção à Saúde , Países em Desenvolvimento , Mão de Obra em Saúde , Financiamento da Assistência à Saúde , Atenção Primária à Saúde , Setor Privado , Participação dos Interessados , Assistência de Saúde Universal , Governo , Pessoal de Saúde , Humanos , Inovação Organizacional
13.
Urol Case Rep ; 26: 100970, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31380221

RESUMO

Eosinophilic cystitis is a rare disease of the bladder, for which there is no clear cause or standard treatment. We report the case of a 61 year old man who presented with irritative voiding symptoms and gross hematuria. Cystoscopy showed diffuse urothelial erythema and a posterior bladder wall ulcer. Bladder biopsy revealed marked eosinophilic cystitis with ulceration. Urine culture grew Candida glabrata. After treatment with oral fluconazole, his voiding symptoms resolved and subsequent bladder biopsy revealed a complete dearth of eosinophils. This is the first case report linking eosinophilic cystitis to Candida glabrata.

14.
Int J Health Policy Manag ; 8(3): 150-157, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30980631

RESUMO

BACKGROUND: Vietnam's network of commune health centers (CHCs) have historically managed acute infectious diseases and implemented national disease-specific vertical programs. Vietnam has undergone an epidemiological transition towards non-communicable diseases (NCDs). Limited data exist on Vietnamese CHC capacity to prevent, diagnose, and treat NCDs. In this paper, we assess NCD service readiness, availability, and utilization at rural CHCs in 3 provinces in northern Vietnam. METHODS: Between January 2014 and April 2014, we conducted a cross-sectional survey of a representative sample of 89 rural CHCs from 3 provinces. Our study outcomes included service readiness, availability of equipment and medications, and utilization for five NCD conditions: hypertension, diabetes, chronic pulmonary diseases, cancer, and mental illnesses. RESULTS: NCD service availability was limited, except for mental health. Only 25% of CHCs indicated that they conducted activities focused on NCD prevention. Patient utilization of CHCs was approximately 223 visits per month or 8 visits per day. We found a statistically significant difference (P<.05) for NCD service availability, medication availability and CHC utilization among the 3 provinces studied. CONCLUSION: This is the first multi-site study on NCD service availability in Vietnam and the first study in a mountainous region consisting predominately of ethnic minorities. Despite strong government support for NCD prevention and control, Vietnam's current network of CHCs has limited NCD service capacity.


Assuntos
Serviços de Saúde Comunitária/normas , Instalações de Saúde/normas , Acessibilidade aos Serviços de Saúde , Doenças não Transmissíveis/terapia , Aceitação pelo Paciente de Cuidados de Saúde , Atenção Primária à Saúde , Serviços de Saúde Rural/normas , Estudos Transversais , Diabetes Mellitus/etnologia , Diabetes Mellitus/terapia , Etnicidade , Recursos em Saúde , Humanos , Hipertensão/etnologia , Hipertensão/terapia , Pneumopatias/etnologia , Pneumopatias/terapia , Transtornos Mentais/etnologia , Transtornos Mentais/terapia , Neoplasias/etnologia , Neoplasias/terapia , Doenças não Transmissíveis/etnologia , Preparações Farmacêuticas/provisão & distribuição , População Rural , Inquéritos e Questionários , Vietnã
15.
West J Emerg Med ; 21(1): 149-151, 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31913836

RESUMO

Interprofessional education (IPE) has been shown to improve health outcomes and patient satisfaction. IPE is now represented in the Accreditation Council for Graduate Medical Education's emergency medicine (EM) milestones given the team-based nature of EM. The Highland Allied Health Rotation Program (H-AHRP) was developed by residents to enhance and standardize IPE for EM residents in a single hospital setting. H-AHRP was incorporated into the orientation month for interns starting in the summer of 2016. EM interns were paired with emergency department preceptors in registered nursing (RN), respiratory therapy (RT), pharmacy (PH), laboratory (LAB), and social work (SW) in either a four-hour shadowing experience (RN, RT, PH) or lecture-based overview (LAB, SW). We conducted a survey before and after the program. Overall, the EM interns reported an improved understanding of the scope of practice and day-to-day logistics after working with the preceptors. They found the program helpful to their future as physicians and would recommend it to other residencies. The H-AHRP program allows for the early incorporation of IPE into EM training, enhances interns' understanding of both the scope and logistics of their colleagues, and is a well-received effort at improving team-based care.


Assuntos
Currículo , Internato e Residência , Relações Interprofissionais , Preceptoria/organização & administração , Atitude do Pessoal de Saúde , California , Medicina de Emergência/educação , Humanos
16.
JAMA Intern Med ; 178(10): 1380-1388, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30178007

RESUMO

Importance: New guidelines recommend that molecular testing replace sputum-smear microscopy to guide discontinuation of respiratory isolation in patients undergoing evaluation for active tuberculosis (TB) in health care settings. Objective: To evaluate the implementation and impact of a molecular testing strategy to guide discontinuation of isolation. Design, Setting, and Participants: Prospective cohort study with a pragmatic, before-and-after-implementation design of 621 consecutive patients hospitalized at Zuckerberg San Francisco General Hospital and Trauma Center who were undergoing sputum examination for evaluation for active pulmonary TB from January 2014 to January 2016. Interventions: Implementation of a sputum molecular testing algorithm using GeneXpert MTB/RIF (Xpert; Cepheid) to guide discontinuation of isolation. Main Outcomes and Measures: We measured the proportion of patients with molecular testing ordered and completed; the accuracy of the molecular testing algorithm in reference to mycobacterial culture; the duration of each component of the testing and isolation processes; length of stay; mean days in isolation and in hospital; and mean cost. We extracted data from hospital records and compared measures before and after implementation. Results: Clinicians ordered sputum testing for TB for 621 patients at ZSFG during the 2-year study period. Of 301 patients in the preimplementation period with at least 1 sputum microscopy and culture ordered, clinicians completed the rapid TB testing evaluation process for 233 (77%).Among 320 patients evaluated in the postimplementation period, clinicians ordered molecular testing for 234 (73%) patients and received results for 295 of 302 (98%) tests ordered. Median age was 54 years (interquartile range, 44-63 years), and 161 (26%) were women. The molecular testing algorithm accurately diagnosed all 7 patients with culture-confirmed TB and excluded TB in all 251 patients with Mycobacterium tuberculosis (MTB) culture-negative results. Compared with the preimplementation period, there were significant decreases in median times to final rapid test result (39.1 vs 22.4 hours, P < .001), discontinuation of isolation (2.9 vs 2.5 days, P = .001), and hospital discharge (6.0 vs 4.9 days, P = .003), on average saving $13 347 per isolated TB-negative patient. Conclusions and Relevance: A sputum molecular testing algorithm to guide discontinuation of respiratory isolation for patients undergoing evaluation for active TB was safe, feasible, widely and sustainably adopted, and provided substantial clinical and economic benefits. Molecular testing may facilitate more efficient, patient-centered evaluation for possible TB in US hospitals.


Assuntos
Controle de Infecções/métodos , Mycobacterium tuberculosis/isolamento & purificação , Isolamento de Pacientes , Tuberculose/diagnóstico , Adulto , Idoso , Algoritmos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade , Estados Unidos
17.
Geriatr Nurs ; 39(6): 683-688, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29859699

RESUMO

The current study describes aged care workers' interpretation of the concept of person-centred care; and identifies the barriers that exist to impede its practice, and the facilitators that encourage person-centred care practice. Data were collected from interviews with aged care workers from two residential aged care facilities providing both high and low care for residents with and without physical and psychological issues based in Australia. Data were analysed to identify and explore categories of meaning for barriers and facilitators. Analysis is grounded in Brooker's VIPS framework for person-centred dementia care which is utilised as a comparative tool for analysing participants' understanding of person-centred care. Findings revealed that aged care workers have a reasonable but incomplete understanding of person-centred care. Insufficient time and residents' dementia behaviours acted as barriers to care workers' provision of person-centred care. Teamwork was found to facilitate person-centred care by increasing instrumental and relationship resources.


Assuntos
Demência/enfermagem , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Assistência Centrada no Paciente/métodos , Austrália , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Instituições Residenciais
18.
AEM Educ Train ; 2(Suppl Suppl 1): S31-S39, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30607377

RESUMO

Although the U.S. population continues to become more diverse, black, Hispanic, and Native American doctors remain underrepresented in emergency medicine (EM). The benefits of a diverse medical workforce have been well described, but the percentage of EM residents from underrepresented groups is small and has not significantly increased over the past 20 years. A group of experts in the field of diversity and inclusion convened a work group during the Council of Emergency Medicine Residency Program Directors (CORD) and Society for Academic Emergency Medicine (SAEM) national meetings. The objective of the discussion was to develop strategies to help EM residency programs examine and improve racial and ethnic diversity in their institutions. Specific recommendations included strategies to recruit racially and ethnically diverse residency candidates and strategies to mentor, develop, retain, and promote minority faculty.

19.
J Genet Psychol ; 178(4): 246-251, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28812974

RESUMO

The purpose of the present study was to extend the external validity of an earlier longitudinal study of school leavers by including participants from a representative sample of secondary schools. Questionnaires were administered annually to a sample of South Australian school leavers over a 10-year period. At Time 1 participants were in the last compulsory year of high school aged around 15 years and at Time 10 they were aged around 25 years. Results confirmed those from an earlier longitudinal study showing that the transition from school to satisfactory employment was associated with significant improvements in psychological well-being, whereas transition from school to unemployment or unsatisfactory employment showed no change in psychological well-being. The current findings extended the external validity of the earlier study because whereas participants in the earlier study were sampled from co-educational metropolitan public high schools, the current study included participants from every kind of high school: single sex as well as co-educational, rural as well as metropolitan, and private as well as public.


Assuntos
Emprego/psicologia , Satisfação Pessoal , Estudantes/psicologia , Desemprego/psicologia , Adolescente , Adulto , Austrália , Feminino , Humanos , Estudos Longitudinais , Masculino , Instituições Acadêmicas , Inquéritos e Questionários , Adulto Jovem
20.
Med Educ Online ; 21: 30662, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27306994

RESUMO

BACKGROUND: In 2013, the Harvard Medical School Center for Primary Care established the Abundance Agents of Change (AoC) program to promote interprofessional learning and innovation, increase partnership between 15 academic and community health centers (CHCs) in Boston's most under-served communities, and increase medical student interest in primary care careers. METHODS: The AoC is modeled in the form of a 'grants challenge', offering $20,000 to interprofessional student teams to develop an innovative solution that addresses a healthcare delivery need identified by CHCs. The program's initial two years were characterized by a four-stage process which included working with CHCs and crafting a request for proposals, forming interprofessional 20 student teams comprising students from across and outside of Harvard University, training students using a systems-based innovation curriculum, and performing program evaluation. RESULTS: Our evaluation data from cohorts 1 and 2 of the AoC program demonstrate that we succeeded in training students as innovators and members of interprofessional teams. We also learned valuable lessons regarding creating better alignment with CHC priorities, extending the program cycle from 12 to 18 months, and changing the way funding is disbursed to 25 students, which will be incorporated in later versions of the program. CONCLUSIONS: Based on our experience and evaluation data, we believe that this program is a replicable way to train students as innovators and members of interprofessional teams to address the current complex healthcare environment.


Assuntos
Centros Comunitários de Saúde/organização & administração , Educação de Graduação em Medicina/organização & administração , Pessoal de Saúde/educação , Relações Interprofissionais , Atenção Primária à Saúde/organização & administração , Faculdades de Medicina/organização & administração , Boston , Humanos , Relações Interinstitucionais , Avaliação de Programas e Projetos de Saúde
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