scholarly journals Aiming at the Global Elimination of Viral Hepatitis: Challenges Along the Care Continuum

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Alastair Heffernan ◽  
Ella Barber ◽  
Nicola A Cook ◽  
Asmaa I Gomaa ◽  
Yolande X Harley ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Viral Hepatitis ◽  
Point Of Care ◽  
International Workshop ◽  
Scale Up ◽  
Lessons Learned ◽  
Treatment Programs ◽  
Policy Makers ◽  
Birth Dose

Abstract A recent international workshop, organized by the authors, analyzed the obstacles facing the ambitious goal of eliminating viral hepatitis globally. We identified several policy areas critical to reaching elimination targets. These include providing hepatitis B birth-dose vaccination to all infants within 24 hours of birth, preventing the transmission of blood-borne viruses through the expansion of national hemovigilance schemes, implementing the lessons learned from the HIV epidemic regarding safe medical practices to eliminate iatrogenic infection, adopting point-of-care testing to improve coverage of diagnosis, and providing free or affordable hepatitis C treatment to all. We introduce Egypt as a case study for rapid testing and treatment scale-up: this country offers valuable insights to policy makers internationally, not only regarding how hepatitis C interventions can be expeditiously scaled-up, but also as a guide for how to tackle the problems encountered with such ambitious testing and treatment programs.

Developing Virtual Communities to Support Drug Policy Knowledge Exchange

2013 ◽  
pp. 279-302
Author(s):  
Mowafa Househ ◽  
Andre W. Kushniruk ◽  
Malcolm Maclure ◽  
Bruce Carleton ◽  
Denise Cloutier-Fisher
Keyword(s):  
Drug Policy ◽  
Policy Making ◽  
Virtual Communities ◽  
Knowledge Exchange ◽  
Lessons Learned ◽  
Policy Makers ◽  
Policy Making Process ◽  
Action Case

Within Canada, there is a growing need in the area of drug policy to develop virtual communities to facilitate knowledge exchange between academics and policy-makers. Such collaborations are regarded as a way to make research relevant by influencing the policy-making process. This chapter presents an action case study of three drug policy groups participating in various virtual knowledge exchange activities. The experiences and lessons learned by each group participating in this study are provided. Recommendations and solutions to conduct successful virtual knowledge exchange meetings based on the findings of this research are also provided.

scholarly journals A study on the timing of HIV repeat test: A case study of Mary Immaculate VCT Center, Nairobi, Kenya

2021 ◽  
Vol 12 (2) ◽  
pp. 57-62
Author(s):  
V, Otieno Okech ◽  
V. Wanjala Namulanda ◽  
D. Kimuli
Keyword(s):  
Short Interval ◽  
Late Diagnosis ◽  
Hiv Care ◽  
Treatment Programs ◽  
Time Interval ◽  
Hiv Status ◽  
Policy Makers ◽  
Repeat Test ◽  
To Receive

Population testing, especially those at risk, plays an important role in preventing and managing the HIV pandemic. It helps practitioners in identifying individuals who need to be counseled on behavior change as well as those who need to be enrolled in HIV care and treatment programs. Further still, policy makers also use outcomes of such tests in determining whether their strategies are bearing fruits or not. In this study, we sought to determine the time interval within which sexually active individuals seek HIV repeat tests in relation to their gender and marital statuses.                                                       We observed that majority of the respondents (39.8%, n=47) sought HIV repeat test within a period of 7-12 months, which we considered as short interval that leads to early diagnosis. We also observed a section of the respondents were also seeking HIV repeat test after a period that exceeded 13 months. We considered the latter as long interval that leads to late diagnosis of HIV. We further observed that, a majority of the respondents who were either married or had never been married before, sought HIV repeat tests within a short interval compared to those who were either divorced or widowed.                                                       We concluded that most widowed and divorced respondents were more likely to receive late diagnosis of HIV than those who were either married or had never been married before. Most studies have indicated that people who are unaware of their HIV status carry a higher risk of infecting others.

scholarly journals Using Complexity Assessment to Inform the Development and Deployment of a Digital Dashboard for Schizophrenia Care: Case Study (Preprint)

2019 ◽  
Author(s):  
Andreas Gremyr ◽  
Boel Andersson Gäre ◽  
Trisha Greenhalgh ◽  
Ulf Malm ◽  
Johan Thor ◽  
...  
Keyword(s):  
Health Care ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Point Of Care ◽  
Scale Up ◽  
Mental Illnesses ◽  
Complex Adaptive ◽  
Complexity Assessment ◽  
Practical Implications

BACKGROUND Health care is becoming more complex. For an increasing number of individuals, interacting with health care means addressing more than just one illness or disorder, engaging in more than one treatment, and interacting with more than one care provider. Individuals with severe mental illnesses such as schizophrenia are disproportionately affected by this complexity. Characteristic symptoms can make it harder to establish and maintain relationships. Treatment failure is common even where there is access to effective treatments, increasing suicide risk. Knowledge of complex adaptive systems has been increasingly recognized as useful in understanding and developing health care. A complex adaptive system is a collection of interconnected agents with the freedom to act based on their own internalized rules, affecting each other. In a complex health care system, relevant feedback is crucial in enabling continuous learning and improvement on all levels. New technology has potential, but the failure rate of technology projects in health care is high, arguably due to complexity. The Nonadoption, Abandonment, and challenges to Scale-up, Spread, and Sustainability (NASSS) framework and complexity assessment tool (NASSS-CAT) have been developed specifically to help identify and manage complexity in technology-related development projects in health care. OBJECTIVE This study aimed to use a pilot version of the NASSS-CAT instrument to inform the development and deployment of a point-of-care dashboard supporting schizophrenia care in west Sweden. Specifically, we report on the complexity profile of the project, stakeholders’ experiences with using NASSS-CAT, and practical implications. METHODS We used complexity assessment to structure data collection and feedback sessions with stakeholders, thereby informing an emergent approach to the development and deployment of the point-of-care dashboard. We also performed a thematic analysis, drawing on observations and documents related to stakeholders' use of the NASSS-CAT to describe their views on its usefulness. RESULTS Application of the NASSS framework revealed different types of complexity across multiple domains, including the condition, technology, value proposition, organizational tasks and pathways, and wider system. Stakeholders perceived the NASSS-CAT tool as useful in gaining perspective and new insights, covering areas that might otherwise have been neglected. Practical implications derived from feedback sessions with managers and developers are described. CONCLUSIONS This case study shows how stakeholders can identify and plan to address complexities during the introduction of a technological solution. Our findings suggest that NASSS-CAT can bring participants a greater understanding of complexities in digitalization projects in general.

Using population-level incidence of hepatitis C virus and immigration status for data-driven screening policies: a case study in Israel

2020 ◽  
Author(s):  
Maya Leventer-Roberts ◽  
Noa Dagan ◽  
Jenna M Berent ◽  
Ilan Brufman ◽  
Moshe Hoshen ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Population Level ◽  
Risk Groups ◽  
Study Groups ◽  
Population Based ◽  
Policy Makers ◽  
New Diagnosis ◽  
Incident Cases

Abstract Background Most studies estimate hepatitis C virus (HCV) disease prevalence from convenience samples. Consequently, screening policies may not include those at the highest risk for a new diagnosis. Methods Clalit Health Services members aged 25–74 as of 31 December 2009 were included in the study. Rates of testing and new diagnoses of HCV were calculated, and potential risk groups were examined. Results Of the 2 029 501 included members, those aged 45–54 and immigrants had lower rates of testing (12.5% and 15.6%, respectively), higher rates of testing positive (0.8% and 1.1%, respectively), as well as the highest rates of testing positive among tested (6.1% and 6.9%, respectively). Discussion In this population-level study, groups more likely to test positive for HCV also had lower rates of testing. Policy makers and clinicians worldwide should consider creating screening policies using on population-based data to maximize the ability to detect and treat incident cases.

Advantages and challenges in using mobile apps for field experiments: A systematic review and a case study

2017 ◽  
Vol 6 (2) ◽  
pp. 179-196 ◽  
Author(s):  
Jingwen Zhang ◽  
Christopher Calabrese ◽  
Jieyu Ding ◽  
Mingxuan Liu ◽  
Biying Zhang
Keyword(s):  
Systematic Review ◽  
Field Experiments ◽  
Mobile Apps ◽  
Controlled Trial ◽  
Scale Up ◽  
Lessons Learned ◽  
Design Quality ◽  
Experiment Platform ◽  
Data Limitations

As smartphone’s computing power continues to grow and as mobile applications (apps) continue to dominate digital engagement, apps have become a new frontier for advancing field experiment methodology. Using apps may help researchers to scale up the reach, precisely control randomization and experiment materials, collect a variety of objective and self-reported data over time, and more conveniently replicate and adapt an experiment. We performed a systematic review on field experiments involving apps published between 2007 and 2017. Seven databases were scanned using a predefined search strategy. The database search retrieved 4,810 citations; 101 articles met the inclusion criteria. Our review suggests that scholars have only started to employ apps in field experiments in the last 4 years. Most studies only used apps as an experiment treatment instead of an experiment platform; therefore, researchers have yet to fully leverage the advantages. Almost all studies were from the health research domain and 77.2% used randomized controlled trial design. Only 7 studies utilized smartphone sensors for collecting data. Only one study reported cost and ethical concerns regarding using apps for the experiment. Given these findings, we reported a case study that targeted a minority racial group and leveraged the advantages of apps as an experiment platform and as a data collection tool to illustrate practical challenges and lessons learned regarding time, financial cost, and technical support. In conclusion, we suggest apps provide new ways to study causal mechanisms with experiment big data. Limitations of generalizability, retention, and design quality were discussed as well.

scholarly journals Using Complexity Assessment to Inform the Development and Deployment of a Digital Dashboard for Schizophrenia Care: Case Study

10.2196/15521 ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. e15521
Author(s):  
Andreas Gremyr ◽  
Boel Andersson Gäre ◽  
Trisha Greenhalgh ◽  
Ulf Malm ◽  
Johan Thor ◽  
...  
Keyword(s):  
Health Care ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Point Of Care ◽  
Scale Up ◽  
Mental Illnesses ◽  
Complex Adaptive ◽  
Complexity Assessment ◽  
Practical Implications

Background Health care is becoming more complex. For an increasing number of individuals, interacting with health care means addressing more than just one illness or disorder, engaging in more than one treatment, and interacting with more than one care provider. Individuals with severe mental illnesses such as schizophrenia are disproportionately affected by this complexity. Characteristic symptoms can make it harder to establish and maintain relationships. Treatment failure is common even where there is access to effective treatments, increasing suicide risk. Knowledge of complex adaptive systems has been increasingly recognized as useful in understanding and developing health care. A complex adaptive system is a collection of interconnected agents with the freedom to act based on their own internalized rules, affecting each other. In a complex health care system, relevant feedback is crucial in enabling continuous learning and improvement on all levels. New technology has potential, but the failure rate of technology projects in health care is high, arguably due to complexity. The Nonadoption, Abandonment, and challenges to Scale-up, Spread, and Sustainability (NASSS) framework and complexity assessment tool (NASSS-CAT) have been developed specifically to help identify and manage complexity in technology-related development projects in health care. Objective This study aimed to use a pilot version of the NASSS-CAT instrument to inform the development and deployment of a point-of-care dashboard supporting schizophrenia care in west Sweden. Specifically, we report on the complexity profile of the project, stakeholders’ experiences with using NASSS-CAT, and practical implications. Methods We used complexity assessment to structure data collection and feedback sessions with stakeholders, thereby informing an emergent approach to the development and deployment of the point-of-care dashboard. We also performed a thematic analysis, drawing on observations and documents related to stakeholders' use of the NASSS-CAT to describe their views on its usefulness. Results Application of the NASSS framework revealed different types of complexity across multiple domains, including the condition, technology, value proposition, organizational tasks and pathways, and wider system. Stakeholders perceived the NASSS-CAT tool as useful in gaining perspective and new insights, covering areas that might otherwise have been neglected. Practical implications derived from feedback sessions with managers and developers are described. Conclusions This case study shows how stakeholders can identify and plan to address complexities during the introduction of a technological solution. Our findings suggest that NASSS-CAT can bring participants a greater understanding of complexities in digitalization projects in general.

scholarly journals Time to Scale-up Research Collaborations to Address the Global Impact of COVID-19 – A Commentary

2021 ◽  
Vol 8 (3) ◽  
pp. 277-280
Author(s):  
Annie Nguyen ◽  
Brandon Brown ◽  
Maha El Tantawi ◽  
Nicaise Ndembi ◽  
Joseph Okeibunor ◽  
...  
Keyword(s):  
Scale Up ◽  
Global Solutions ◽  
Lessons Learned ◽  
Economic Consequences ◽  
Research Collaborations ◽  
Global Problems ◽  
Science And Research ◽  
International Collaborative Research ◽  
National Borders

VID- 19 pandemic provides a compelling reason for researchers to stretch beyond usual limits and find new ways to engage in global collaborations. Methods: We point to data that have emerged on the mental health and economic consequences of the pandemic to illustrate the extent to which these common issues cross national borders. There is high likelihood that these burdens will continue to persist long after the pandemic is declared “over.” Results: We urge researchers, particularly those from countries with higher income economies, to share resources to increase international collaborative research efforts. We present a case study of an ongoing project and offer some lessons learned for individual investigators. Conclusion: Global problems require global solutions. The COVID-19 pandemic is a global crisis that should prompt researchers to engage in science and research across national borders.

Public policy and operational alignment in light of public service retrenchment – lessons learned from Canada

2015 ◽  
Vol 83 (3) ◽  
pp. 443-462 ◽  
Author(s):  
Karine Levasseur ◽  
Andrea Rounce
Keyword(s):  
Public Policy ◽  
Central Government ◽  
Lessons Learned ◽  
Policy Makers ◽  
The Public ◽  
Management Perspective ◽  
The Government ◽  
Government Of Canada ◽  
One Year

This article examines the Strategic and Operating Review (SOR) process used by the Government of Canada through a strategic management perspective. Initiated by the Harper government in the 2011 Budget as a one-year process, SOR is expected to secure savings of CDN$4 billion by 2014–15 from the CDN$80 billion operating budget of departments. Our article assesses to what degree the strategic operational cuts support the public policy priorities of the Harper government. Points for practitioners Using Canada as a case study to understand how budgetary cuts are handled, this article provides an opportunity to consider how policy makers align operational cuts with public policy priorities. While the budget cuts in this case study are operational in nature, they require direction from central government to support – not undermine – public policy priorities.

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